Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

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Bidirectional Fluid–Structure Interaction Study on Hydrofoil Hardness and Oscillation Mode Optimization

This paper investigated the optimization of the hardness and oscillation mode of flexible hydrofoils using bidirectional fluid–structure interaction (FSI) to address the issue of insufficient guidance in engineering applications. A two-dimensional flexible symmetric hydrofoil model of NACA0012 with a chord length of 1 m was constructed for this research. The hydrodynamic characteristics of low-frequency flexible hydrofoils with varying hardness and oscillation modes were analyzed through numerical simulation. The results indicated that the flexible hydrofoil with a Shore hardness of D50 exhibited the most optimal hydrodynamic performance under low-frequency conditions across the five groups of hardness tests. Among the three commonly utilized oscillation modes, the inboard oscillation mode demonstrated the most favorable performance. The hydrodynamic performance of the flexible hydrofoil surpassed that of the rigid hydrofoil in both inward and outward oscillation motions; however, it was inferior in pure pitching motions. Comparative analysis of the vortex structure and velocity distribution in the flow field revealed that the inward oscillation motion effectively enhanced the kinetic energy of the wake vortex and slowed down vortex dissipation, thereby improving the overall flow velocity. These findings provide theoretical support for the study of flexible hydrofoils and contribute to their advancement in pumping applications under actual ultra-low head conditions

Study on the Influence of Relative Chord Length and Frequency of Flapping Hydrofoil Device on Hydrodynamic Performance and Bank Slope Scour

A flapping hydrofoil device is an innovative device for enhancing the hydrodynamics of small rivers. While increasing the flow velocity of the river, it inevitably causes different degrees of scouring on the bank slope. This study aims to find an optimal combination of flapping hydrofoil parameters to maximize the pushing-water performance while minimizing the impact on bank slope scour, which is of great significance for the device’s application and environmental protection. Based on the finite volume method and overlapping dynamic grid technology, this paper selects the maximum bank slope scouring section as the research plane for numerical simulation. In order to expand the scope of application, the relative chord length c* (the ratio of chord length to river channel width) is introduced as a research parameter, and the influence of different relative chord lengths c* and frequencies f on the pushing-water performance of the device and the degree of bank slope scouring is systematically analyzed. The research results show that the near-shore current mean scouring force increases significantly with the increase in f and c*. The pushing-water efficiency will increase with c*, and will gradually increase with the increase in f and then tend to be stable. When c* = 1/2 and f = 2.5 Hz, the pushing-water efficiency reaches 51.04%, but at this time, the impact on bank slope scour is the most serious. When c* is reduced to 1/8, the bank slopes are not scoured even at the maximum frequency f = 2.5 Hz, and the pushing-water efficiency is 24.59% at this time. As c* decreases, the threshold frequency at which scour does not occur on the riverbank increases gradually. In addition, when c* is constant, decreasing f will significantly reduce the scouring force, but will have little effect on pushing-water efficiency. In order to achieve the purpose of this study, the parameters of flapping hydrofoil are recommended to be larger relative chord length and smaller motion frequency combinations

Study on the Influence of Chord Length and Frequency of Hydrofoil Device on the Discharge Characteristics of Floating Matter in Raceway Aquaculture

To investigate the influence of the chord length and frequency of an oscillating hydrofoil device on the discharge characteristics of floating particulate matter, in this study, we take raceway aquaculture as an example and systematically compare and analyze the flow field characteristics of the hydrofoil device with different chord lengths and frequencies, as well as the sewage discharge performance of the raceway based on Computational Fluid Dynamics (CFD). The results indicate that in the particulate matter discharge process of raceway aquaculture, when the chord length and motion frequency of the hydrofoil device are 0.1 W (W is the width of the raceway) and 1.0 Hz, respectively, the anti-Karman vortex streets produced by the hydrofoil device are less affected by the wall, the flow field is the most uniform, the particulate matter discharge performance is the best, and the final floating particulate matter discharge rate reaches up to 99.09%. Adjusting the chord length of the hydrofoil can effectively ameliorate flow field reflux issues, enhancing the uniformity and flow performance of the flow field. When the chord length is 0.1 W, the uniformity of the flow field is optimal. When the chord length is 0.2 W, the flow performance of the flow field is superior. Increasing the frequency enhances the flow performance of the flow field, with an average increase of 0.1 Hz in motion frequency leading to a 19.42% improvement in the average velocity at the outlet. Based on this, we recommend the use of a hydrofoil device with a chord length of 0.1 W and a motion frequency of 1.0 Hz in the raceway aquaculture system to achieve optimal particulate matter discharge performance, providing a theoretical basis and practical guidance for using hydrofoil devices to improve the efficiency of floating particulate matter treatment in raceway aquaculture environments

Investigation of the Effect of Pumping Depth and Frequency of Flapping Hydrofoil on Suspended Matter Discharge Characteristics

In order to study the effect of the pumping depth and pumping frequency of the flapping hydrofoil device on suspended solids in the waters, this paper takes raceway aquaculture as an example, and introduces a flapping hydrofoil device to improve the discharge of suspended solids in the raceway, in response to the problem of the deposition of suspended solids from fish faeces and bait residues in water. The CFD method was used to compare and analyze the discharge of suspended solids at different pumping depths, and the combined effect of the two was studied according to different combinations of pumping frequency and pumping depth. The results proved that the flapping hydrofoil motion can improve the bottom hydrodynamic insufficiency in ecological waters and thus enhance the discharge effect of suspended particles in water. In addition, the pumping depth of the flapping hydrofoil is too deep for the movement to be disturbed by the bottom surface, while the thrust generated by the flapping hydrofoil is weakened if the depth is too shallow. When the pump water depth is 1.1 H, the reversed Kármán vortex street is more stable under the balancing effect of the bottom surface and gravity, and the rate curve of the flapping hydrofoil acting on the discharge of suspended particles is better. From our comprehensive consideration of the joint effect of the pumping depth and pumping frequency, we recommend the use of a 1.1 H of pumping depth and 2.0 Hz pumping frequency in combination to achieve the best effect of discharging suspended particles. This study provides valuable insights into the actual engineering applications of flapping hydrofoil devices for improving water quality and ecological sustainability in raceway aquaculture

Numerical Study on the Influence of Installation Height and Operating Frequency of Biomimetic Pumps on the Incipient Motion of Riverbed Sediment

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pH-Responsive Nanophotosensitizer Boosting Antibacterial Photodynamic Therapy by Hydroxyl Radical Generation

In this study, a pH-responsive nanophotosensitizer (MT@Ce6) was rationally developed by strategic integration of MIL-101 (Fe)-NH2 metal–organic framework with tannic acid (TA) and chlorin e6. This nanocomposite exhibits pH-responsive degradation in acidic microenvironments, facilitating Fe3+ release and subsequent reduction to Fe2+ that catalyzes Fenton reaction-mediated hydroxyl radical (•OH) generation. This cascade reaction shifts reactive oxygen species (ROS) predominance from transient singlet oxygen (1O2) to the long-range penetrative •OH, achieving robust biofilm disruption and over 90% eradication of methicillin-resistant Staphylococcus aureus (MRSA) under 660 nm irradiation. In vivo evaluations revealed accelerated wound healing with 95% wound closure within 7 days, while species-selective antibacterial studies demonstrated a 2.3-fold enhanced potency against Gram-positive bacteria due to their unique peptidoglycan-rich cell wall architecture. These findings collectively establish a microenvironment-adaptive nanoplatform for precision antimicrobial interventions, providing a translational strategy to address drug-resistant infections