Epidemiology of birth defects based on a birth defects surveillance system in southwestern China and the associated risk factors

BackgroundBirth defects (BDs) are associated with many potential risk factors, and its causes are complex.ObjectivesThis study aimed to explore the epidemiological characteristics of BDs in Guangxi of China and the associated risk factors of BDs.MethodsBDs data of perinatal infants (PIs) were obtained from the Guangxi birth defects monitoring network between 2016 and 2020. Univariate Poisson regression was used to calculate the prevalence-rate ratios (PRR) to explore the changing trends of BDs prevalence by year and the correlation between the regarding of characteristics of BDs (including infant gender, maternal age, and quarter) and BDs. Clinical characteristics of PIs with BDs and general characteristics of their mothers were documented, and Spearman correlation analysis was used to explore the potential associated risk factors of BDs.ResultsBetween 2016 and 2020, 44,146 PIs with BDs were monitored, with an overall BDs prevalence of 121.71 (95% CI: 120.58–122.84) per 10,000 PIs, showing a significant increase trend (PRR = 1.116, 95% CI: 1.108–1.123), especially the prevalence of congenital heart defects (CHDs) that most significantly increased (PRR = 1.300, 95% CI: 1.283–1.318). The 10 most common BDs were CHDs, polydactyly, congenital talipes equinovarus, other malformation of external ear, syndactyly, hypospadias, cleft lip with cleft palate, cleft lip, hemoglobin Bart's hydrops fetalis syndrome (BHFS), and congenital atresia of the rectum and anus. BDs were positively correlated with pregnant women's age (R = 0.732, P < 0.01) and education level (R = 0.586, P < 0.05) and having pre-gestational diabetes mellitus (PGDM)/gestational diabetes mellitus (GDM) (R = 0.711, P < 0.01), while when the pregnant women had a family history of a dead fetus (R = −0.536, P < 0.05) and a birth of a fetus with BDs (R = −0.528, P < 0.05) were negatively correlated with BDs.ConclusionA significant increase in the prevalence of BDs was detected between 2016 and 2020 in Guangxi, especially the prevalence of CHDs that most significantly increased. Older maternal age, higher maternal education level, and having PGDM before pregnancy or GDM in early pregnancy were the risk factors for BDs

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

Bagged Tree Model to Retrieve Planetary Boundary Layer Heights by Integrating Lidar Backscatter Profiles and Meteorological Parameters

The planetary boundary layer (PBL) is the part of the troposphere in which the soil’s influence is noticeable. It plays an important role in the fields of air pollution, meteorology, weather forecasting, and climate. Continuous observation of lidar makes obtaining the day–night PBL height (PBLH) with a high temporal resolution possible. A high-precision PBLH retrieval method is the key to achieving this goal. In this study, we propose a new method based on a bagged tree model to retrieve the PBLH from micro-lidar backscatter profiles. With the radiosonde measurements taken as the true reference, lidar features (the ten maximum slopes identified by the maximum gradient method) and four meteorological parameters (atmospheric pressure, temperature, relative humidity, and wind speed) serve as characteristic variables. The PBLH retrieval model is evaluated using a 10-fold cross-validation (CV) method and then compared with the four traditional methods (i.e., maximum gradient, maximum standard deviation, wavelet covariance, and the ideal profile method). The correlation coefficient (R) between the retrieved PBLHs and the radiosonde measurements is 0.89, which is much bigger than the R (0.2–0.48) from the four traditional methods. Moreover, the root mean square error and mean absolute error for the retrieved PBLH are 0.3 km and 0.2 km, respectively, which are lower than those of the four traditional methods (0.5~0.6 km for RMSE and 0.4–0.5 for MAE). Cases with different conditions show that this new method is almost undisturbed by cloud and suspended/thick aerosol layers. It can also be used to retrieve shallow PBL in cases in which using traditional methods would be difficult. Long-term analysis of averaged PBLHs retrieved by the proposed model from 2013 to 2016 shows that the hourly PBLH rises at sunrise and sets at sunset, and that the monthly PBLH in summer is higher than that in winter. The results suggest that the proposed method is better than the four traditional methods and available for use in conditions such as existing cloud layers and multiple-layers

Bagged Tree Model to Retrieve Planetary Boundary Layer Heights by Integrating Lidar Backscatter Profiles and Meteorological Parameters

The planetary boundary layer (PBL) is the part of the troposphere in which the soil’s influence is noticeable. It plays an important role in the fields of air pollution, meteorology, weather forecasting, and climate. Continuous observation of lidar makes obtaining the day–night PBL height (PBLH) with a high temporal resolution possible. A high-precision PBLH retrieval method is the key to achieving this goal. In this study, we propose a new method based on a bagged tree model to retrieve the PBLH from micro-lidar backscatter profiles. With the radiosonde measurements taken as the true reference, lidar features (the ten maximum slopes identified by the maximum gradient method) and four meteorological parameters (atmospheric pressure, temperature, relative humidity, and wind speed) serve as characteristic variables. The PBLH retrieval model is evaluated using a 10-fold cross-validation (CV) method and then compared with the four traditional methods (i.e., maximum gradient, maximum standard deviation, wavelet covariance, and the ideal profile method). The correlation coefficient (R) between the retrieved PBLHs and the radiosonde measurements is 0.89, which is much bigger than the R (0.2–0.48) from the four traditional methods. Moreover, the root mean square error and mean absolute error for the retrieved PBLH are 0.3 km and 0.2 km, respectively, which are lower than those of the four traditional methods (0.5~0.6 km for RMSE and 0.4–0.5 for MAE). Cases with different conditions show that this new method is almost undisturbed by cloud and suspended/thick aerosol layers. It can also be used to retrieve shallow PBL in cases in which using traditional methods would be difficult. Long-term analysis of averaged PBLHs retrieved by the proposed model from 2013 to 2016 shows that the hourly PBLH rises at sunrise and sets at sunset, and that the monthly PBLH in summer is higher than that in winter. The results suggest that the proposed method is better than the four traditional methods and available for use in conditions such as existing cloud layers and multiple-layers

IL-17 signaling induces iNOS+ microglia activation in retinal vascular diseases

Activation of microglia and inflammation-mediated vascular damages are suggested to play a decisive role in the pathogenesis of various retinopathies. The inducible nitric oxide synthase (iNOS) was required for activated microglia-mediated injuries. However, the induction mechanism of microglia activation during retinal vascular diseases is still elusive. Here we showed that IL-17 induced microglia activation with high expression of iNOS and promoted the development of retinal vascular diseases. IL-17-dependent activation of the STAT3-iNOS pathway was essentially required for microglia activation, which promoted endothelial cell growth and accelerated vascular leakage and leukostasis via IL-6 in vitro and in vivo. Taken together, our data provide novel mechanistic insights on microglia activation-mediated retinopathy, unveil the specific role of IL-17 on microglia, and define novel therapeutic targets for treating retinal vascular diseases

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