Semi-arid zone caves:Evaporation and hydrological controls on δ¹⁸O drip water composition and implications for speleothem paleoclimate reconstructions

Oxygen isotope ratios in speleothems may be affected by external processes that are independent of climate, such as karst hydrology and kinetic fractionation. Consequently, there has been a shift towards characterising and understanding these processes through cave monitoring studies, particularly focussing on temperate zones where precipitation exceeds evapotranspiration. Here, we investigate oxygen isotope systematics at Wellington Caves in semi-arid, SE Australia, where evapotranspiration exceeds precipitation. We use a novel D2O isotopic tracer in a series of artificial irrigations, supplemented by pre-irrigation data comprised four years of drip monitoring and three years of stable isotope analysis of both drip waters and rainfall. This study reveals that: (1) evaporative processes in the unsaturated zone dominate the isotopic composition of drip waters; (2) significant soil zone ‘wetting up’ is required to overcome soil moisture deficits in order to achieve infiltration, which is highly dependent on antecedent hydro-climatic conditions; (3) lateral flow, preferential flow and sorption in the soil zone are important in redistributing subsurface zone water; (4) isotopic breakthrough curves suggest clear evidence of piston-flow at some drip sites where an older front of water discharged prior to artificial irrigation water; and (5) water residence times in a shallow vadose zone (<2 m) are highly variable and can exceed six months. Oxygen isotope speleothem records from semi-arid regions are therefore more likely to contain archives of alternating paleo-aridity and paleo-recharge, rather than paleo-rainfall e.g. the amount effect or mean annual. Speleothem-forming drip waters will be dominated by evaporative enrichment, up to ∼3‰ in the context of this study, relative to precipitation-weighted mean annual rainfall. The oxygen isotope variability of such coeval records may further be influenced by flow path and storage in the unsaturated zone that is not only drip specific but also influenced by internal cave climatic conditions, which may vary spatially in the cave

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

The original version of this article unfortunately contained a mistake

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

Spatially dense drip hydrological monitoring and infiltration behaviour at the Wellington Caves, South East Australia

Despite the fact that karst regions are recognised as significant groundwater resources, the nature of groundwater flow paths in the unsaturated zone of such fractured rock is at present poorly understood. Many traditional methods for constraining groundwater flow regimes in karst aquifers are focussed on the faster drainage components and are unable to inform on the smaller fracture or matrix-flow components of the system. Caves however, offer a natural inception point to observe both the long term storage and the preferential movement of water through the unsaturated zone of such fractured carbonate rock by monitoring of drip rates of stalactites, soda straws and seepage from fractures/micro fissures that emerge in the cave ceiling. Here we present the largest spatial survey of automated cave drip rate monitoring published to date with the aim of better understanding both karst drip water hydrogeology and the relationship between drip hydrology and surface climate. By the application of cross correlation functions and multi-dimensional scaling, clustered by k-means technique, we demonstrate the nature of the relationships between drip behaviour and initial surface infiltration and similarity amongst the drip rate time series themselves that may be interpreted in terms of flow regimes and cave chamber morphology and lithology

‘No evidence of harm’ implies no evidence of safety: Framing the lack of causal evidence in gambling advertising research

From Crossref journal articles via Jisc Publications RouterHistory: received 2023-09-20, accepted 2023-09-22, epub 2023-11-12, issued 2023-11-12, published 2023-11-12Article version: VoRPublication status: Publishe