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

Une nouvelle approche pour l'étude de l'expression du génome mitochondrial de Triticum oestivum

Les mécanismes d'expression génique de la mitochondrie de plante sont complexes (présence de promoteurs multiples, la maturation de transcrits par de cis- ou trans-épissage et l'édition de l'ARN). J'ai étudié l'expression de l'orf mat-r situé dans un trans-intron associé à deux exons, nad1e et nadIII, dans le même locus. Cet orf contient deux domaines, RT et X, homologue aux maturases. Il semble impliqué dans l'épissage des intronsvoire dans le transfert de gènes entre organelles. Deux transcrits de mat-r ont été mis en évidence : l'un de 2,8kb comprenany le domaine X lié à nad1e et nad5III. Le promoteur de l'ARm de 2,4kb se trouve dans la région codante de mat-r et contient la séquence canonique CRTA. Le promoteur du transcrit de 2,8kb ne présente pas de motif connu. L'étude de l'édition du transcrit mat-r chez le blé et la pomme de terre, a montré que des changements C->U ont lieiu à l'intérieur des domaines RT et maturase. Deux événements d'édition ont lieu dans le domaine VI des trans-introns de nad1e et nad5III. L'édition permet d'organiser le domaine VI dans une conformation mieux adaptée à l'épissage. La conservation du cadre de lecture mat-r dans la plupart des plantes indique que cet orf est fonctionnel.J'ai mis au point une procédure de transformation des mitochondries me permettant d'étudier in organello les processus d'épissage et d'édition des ARNmt. Deux plasmides ont été construits, l'un contenant un gène exogène(luciférase) et l'autre un gène mitochondrial (coxII) contrôlés par le promoteur de coxII. Les transgènes sont transcrits après électrotransformation. Le gène coxII a été muté dans des régions nécessaires à l'épissage, c'est à dire les séquences d'interaction entre l'exon 1 et l'intron (EBS1-IBS1 et EBS2-IBS2), dans le domaine VI. J'ai confirmé le rôle fonctionnel de ces régions et la participation d'un site alternatif EBS2' ce qui montre que des interactions multiples interviennent au cours de l'épissage. J'ai montré que la structure canonique tige-boucle du domaine VI est indispensable à l'épissage. Le site C259 de coxII est une cible pertinente pour étudier les éléments de la reconnaissance en cis du site d'édition. Des mutations par délétion autour du site ont permis de situer le domaine reconnu entre 15 nt en amont et 6 nt en aval du C et de constater que le résidu voisin en 3' est important pour l'édition du site. La région 3' est nécessaire à la détermination du C à éditer. La région 5' peut être interchangée entre deux sites d'édition, par contre, la région 3' n'est pas interchangeable. La possibilité de "transformer" des mitochondries isolées avec des plasmides recombinants, m'a permis d'analyser les mécanismes d'épissage et de proposer un modèle de reconnaissance du site d'édition chez la mitochondrie de plante.The mechanism of gene expression in plant mitochondria is extremely complex given the involvement of multiple promotors, transcript maturation by cis- and trans-splicing and RNA editing This work describes the expression of the mat-r orf which is found in a trans-intron associated with two exons, nad1e and nad5III in the same locus. This orf has two motifs, reverse transcriptase (RT) and maturase (X domain) homologous to maturases. This orf has been described as being involved in the splicing as well as in gene transfer between organelles. Two mat-r transcription products have been described, a minor form of 2.8 kb and a more abondant product of 2.4 kb carrying the X domain linked to nad1e and nad5III. The promoter corresponding to the 2.4 kb mRNA, found in the mat-r coding region, carries the canonical sequence CRTA. The 2.8 promoter does not contain this consensus motif. RNA editing studies of mat-r in wheat and potato show that C-to-U changes are found in the RT and maturase domains. Two additional editing events take place in the domain VI of the nad1e and nad5III trans-introns. RNA editing of the VI domain led to a conformation favouring the splicing step. The conservation of the mat-r reading frame in most plants and the presence of RNA editing observed in this orf suggest strongly that mat-r is functional in plant mitochondrial gene expression. In the second part of my thesis project I have described the transformation of isolated mitochondria, thus allowing the study in organello of two post-transcriptional processes : splicing and RNA editing. Two plasmids were made, one contained the exogenous luciferase gene and the other a paradigmatic mitochondrial gene, coxII, both genes were under the control of the coxII promotor. Our results showed unambiguosly that ...BORDEAUX2-BU Santé (330632101) / SudocSudocFranceF

Convergent and divergent mechanisms of peroxisomal and mitochondrial division.

Organelle division and segregation are important in cellular homeostasis. Peroxisomes (POs) and mitochondria share a core division machinery and mechanism of membrane scission. The division of each organelle is interdependent not only on the other but also on other organelles, reflecting the dynamic communication between subcellular compartments, even as they coordinate the exchange of metabolites and signals. We highlight common and unique mechanisms involved in the fission of these organelles under the premise that much can be gleaned regarding the division of one organelle based on information available for the other

OXPHOS deficiencies affect peroxisome proliferation by downregulating genes controlled by the SNF1 signaling pathway.

How environmental cues influence peroxisome proliferation, particularly through organelles, remains largely unknown. Yeast peroxisomes metabolize fatty acids (FA), and methylotrophic yeasts also metabolize methanol. NADH and acetyl-CoA, produced by these pathways enter mitochondria for ATP production and for anabolic reactions. During the metabolism of FA and/or methanol, the mitochondrial oxidative phosphorylation (OXPHOS) pathway accepts NADH for ATP production and maintains cellular redox balance. Remarkably, peroxisome proliferation in Pichia pastoris was abolished in NADH-shuttling- and OXPHOS mutants affecting complex I or III, or by the mitochondrial uncoupler, 2,4-dinitrophenol (DNP), indicating ATP depletion causes the phenotype. We show that mitochondrial OXPHOS deficiency inhibits expression of several peroxisomal proteins implicated in FA and methanol metabolism, as well as in peroxisome division and proliferation. These genes are regulated by the Snf1 complex (SNF1), a pathway generally activated by a high AMP/ATP ratio. In OXPHOS mutants, Snf1 is activated by phosphorylation, but Gal83, its interacting subunit, fails to translocate to the nucleus. Phenotypic defects in peroxisome proliferation observed in the OXPHOS mutants, and phenocopied by the Δgal83 mutant, were rescued by deletion of three transcriptional repressor genes (MIG1, MIG2, and NRG1) controlled by SNF1 signaling. Our results are interpreted in terms of a mechanism by which peroxisomal and mitochondrial proteins and/or metabolites influence redox and energy metabolism, while also influencing peroxisome biogenesis and proliferation, thereby exemplifying interorganellar communication and interplay involving peroxisomes, mitochondria, cytosol, and the nucleus. We discuss the physiological relevance of this work in the context of human OXPHOS deficiencies

Information and Communication Technologies Within Human Resource Development : E-Learning in HRD : A Case Study on the Swedish Banking Industry

In the last years, new and quick advancements in information and communication technologies (ICT) have entered the field of Human Resource Development (HRD). Many new technological and electronic tools, such as e-learning were developed paving the way to several kinds of learning and training programs. In the Swedish banking industry most of the banks have adopted ICT (e-learning) within their human resource development practices. The purpose of this study is to analyze the impact of ICT integration on HRD functions that aim at empowering individual employees to meet organizational goals. The study also focuses on business key drivers of e-learning implementation. The results and findings of this research indicate that the respondent banks’ e-learning strategies are directly influenced by their organization strategy, and that HRD objectives flow from the analysis of the internal and external factors influencing e-learning implementation. The study shows that the respondent bank organizations, in general, have successfully employed the technological changes in the delivery of their training and learning activities using an effective e-learning development process that achieves the desired strategic objectives. However, HRD functions require more improvements in integrating the different systems and applications, and need more involvement by the employees and managers, within the context of e-learning, so as to maximize the effectiveness of HRD strategies and e-learning approach.Validerat; 20111201 (anonymous

Unveiling a new era with liquid chromatography coupled with mass spectrometry to enhance parathyroid hormone measurement in patients with chronic kidney disease.

peer reviewedPrecise determination of circulating parathyroid hormone (PTH) concentration is crucial to diagnose and manage various disease conditions, including the chronic kidney disease-mineral and bone disorder. However, the lack of standardization in PTH assays is challenging for clinicians, potentially leading to medical errors because the different assays do not provide equivalent results and use different reference ranges. Here, we aimed to evaluate the impact of recalibrating PTH immunoassays by means of a recently developed LC-MS/MS method as the reference. Utilizing a large panel of pooled plasma samples with PTH concentrations determined by the LC-MS/MS method calibrated with the World Health Organization (WHO) 95/646 International Standard, five PTH immunoassays were recalibrated. The robustness of this standardization was evaluated over time using different sets of samples. The recalibration successfully reduced inter-assay variability with harmonization of PTH measurements across different assays. By recalibrating the assays based on the WHO 95/646 International Standard, we demonstrated the feasibility for standardizing PTH measurement results and adopting common reference ranges for PTH assays, facilitating a more consistent interpretation of PTH values. The recalibration process aligns PTH results obtained from various immunoassays with the LC-MS/MS method, providing more consistent and reliable measurements. Thus, establishing true standardization across all PTH assays is crucial to ensure consistent interpretation and clinical decision-making

Quantification of 1-84 Parathyroid Hormone: from immunoassays to LC-MS/MS candidate reference measurement

peer reviewe