Drought as a possible contributor to the Visigothic Kingdom crisis and Islamic expansion in the Iberian Peninsula

The Muslim expansion in the Mediterranean basin was one the most relevant and rapid cultural changes in human history. This expansion reached the Iberian Peninsula with the replacement of the Visigothic Kingdom by the Muslim Umayyad Caliphate and the Muslim Emirate of Córdoba during the 8th century CE. In this study we made a compilation of western Mediterranean pollen records to gain insight about past climate conditions when this expansion took place. The pollen stack results, together with other paleohydrological records, archaeological data and historical sources, indicate that the statistically significant strongest droughts between the mid-5th and mid-10th centuries CE (450–950 CE) occurred at 545–570, 695–725, 755–770 and 900–935 CE, which could have contributed to the instability of the Visigothic and Muslim reigns in the Iberian Peninsula. Our study supports the great sensitivity of the agriculture-based economy and socio-political unrest of Early Medieval kingdoms to climatic variationsMinistry of Science and Innovation of the Government of Spain, Agencia Estatal de Investigación /10.13039/501100011033/ and Fondo Europeo de Desarrollo Regional - A way ofmaking Europe, in particular the grant numbers FJC2020-044215- IThe grant number Retos P20_00059The action Proyectos I + D + i del Programa Operativo FEDER 2018 (grant number A-RNM-336-UGR20Research group RNM-190 from the Junta de Andalucía (Regional Government of Andalusia)The project SBPLY/21/ 180501/000205Scientific Research and Technology Transfer Projects of the Junta deComunidades de Castilla-La Mancha (Regional Government of Castilla-La Mancha

Evidences of the Blake and Iceland Basin magnetic excursions in southeastern Iberia and chronological implications for the Padul sedimentary record

Acknowledgments This study was supported by the project B-RNM-144-UGR18 and ARNM- 336-UGR20 of the action “Proyectos I + D + i del Programa Operativo FEDER 2018 - Junta de Andalucía-UGR”, the projects CGL2013-47038-R and CGL2017-85415-R, of the “Ministerio de Economía y Competitividad of Spain and Fondo Europeo de Desarrollo Regional FEDER”, and the research group RNM-190 (Junta de Andalucía), and the projects P18-RT-871 and Retos P20_00059 of Junta de Andalucia. A.G.-A. was also supported by a Ram´on y Cajal Fellowship RYC-2015-18966 of the Spanish Government (Ministerio de Economía y Competividad). A.L.-A PhD is funded by BES-2018-084293 (Ministerio de Economía y Competividad). We thank the Paleomagnetic Laboratory CCiTUB-Geo3Bcn CSIC for the support on paleomagnetic analysis. LV and EB thank the Geomodels Research Institute (UB). We are very grateful to two anonymous reviewers and to the editor Christian Zeeden.The Padul-15-05 sediment core provides an exceptional perspective of the paleoenvironmental and climate change in the Western Mediterranean region for the last ca. 200 kyr. However, even though a robust chronology mainly relying on radiometric dating is available for the last 50 ka, the chronology for the older sediments is not yet fully resolved. Ages for the bottom part of the core (>21 m) were previously inferred from amino-acid racemization dating and sediment accumulation rates. In this work, we provide a more accurate chronology for the older part (>100 kyr) of the Padul-15-05 sediment core record based on the recognition of past Earth's magnetic excursions. We identify an interval prone of reversed polarity samples close to MIS-5e/5 d transition that we correlate to the Blake geomagnetic excursion (116.5 kyr–112 kyr). In addition, we identify an interval of low inclinations and two reversed samples that we interpret as the Iceland Basin geomagnetic excursion (192.7 kyr–187.7 kyr: wide scenario of VGP <40°). Our new results, which include IRM acquisition curves that contribute to understand the magnetic mineralogy, enhances the robustness of the age model for the Padul-15-05 sedimentary sequence by adding an independent age dataset with new accurate tie-points. Our refined age control together with the available paleoenvironmental and paleoclimate multiproxy data provide insightful information to unveil the response of the western Mediterranean environments to regional environmental and climate change.Project B-RNM-144-UGR18 and ARNM- 336-UGR20 of the action “Proyectos I + D + i del Programa Operativo FEDER 2018 - Junta de Andalucía-UGR”Projects CGL2013-47038-R and CGL2017-85415-R, of the “Ministerio de Economía y Competitividad of Spain and Fondo Europeo de Desarrollo Regional FEDER”Research group RNM-190 (Junta de Andalucía)Projects P18-RT-871 and Retos P20_00059 of Junta de AndaluciaRamón y Cajal Fellowship RYC-2015-18966 of the Spanish Government (Ministerio de Economía y Competividad)Funded by BES-2018-084293 (Ministerio de Economía y Competividad

Holocene summer temperature reconstruction based on a chironomid record from Sierra Nevada, southern Spain

This study was supported by projects CGL2013-47038-R, CGL2017-85415-R and PID2021-125619OB-C21/C22, funded by the Ministerio de Ciencia e Innovación of Spain, the Agencia Estatal de Investigación and the Fondo Europeo de Desarrollo Regional FEDER MCIN/AEI/10.13039/501100011033/FEDER, UE”; Junta de Andalucía I + D + i Junta de Andalucía 2020 Retos P-20-00059, UGR-FEDER B-RNM-144-UGR18, UGR-FEDER A-RNM-336-UGR20, Project cofinanced by FEDER and LifeWatch-Eric LifeWatch-2019-10-UGR-01 and the research group RNM-190 (Junta de Andalucía). RSA acknowledges several travel grants from Northern Arizona University to support this work. JC thanks the Ministerio de Ciencia e Innovación of Spain for the Juan de la Cierva Formación postdoctoral fellowship. ALA acknowledges the predoctoral fellowship BES-2018-084293 provided by the MCIN/AEI/10.13039/501100011033/. CLB acknowledges the European Union for her Marie Sklodowska-Curie grant agreement number 892487 under Horizon 2020 funds. LJ acknowledges the Ministry of Universities of Spain for her Margarita Salas grant (MS2021-204) financed by the European Union -Next Generation EU funds.Obtaining accurate temperature reconstructions from the past is crucial in understanding the consequences of changes in external climate forcings, such as orbital-scale insolation or multidecadal to centennial-scale variability on the climate system and the environment. In addition, these reconstructions help in comprehending the amplitude of natural temperature changes in the past, which can assist in evaluating the amplitude and rate of recent anthropogenic global warming. Here we present the first detailed Holocene mean July air temperature reconstruction based on chironomid assemblages from sediments retrieved from Laguna de Río Seco, an alpine lake in Sierra Nevada, southern Spain. Coldest climate conditions are recorded during the last glacial maximum and the last deglaciation. Warming occurred in the Early Holocene and warmest summer temperature conditions and the Holocene thermal maximum (HTM) occurred in the interval roughly between 9000 and 7200 cal yr BP, concurrent with summer insolation maxima. Rapid cooling of ∼1.5 °C occurred after the warmest maximum and between ∼7200 and 6500 cal yr BP, and temperatures stabilized between ∼6500 and 3000 cal yr BP. A further cooling began ∼3000 cal yr BP and culminated with coldest summer conditions during the Dark Ages (DA) and Little Ice Age (LIA) at ∼1550 cal yr BP (∼400 CE) and ∼200 cal yr BP (∼1750 CE), respectively. This cooling temperature trend was interrupted by warmer conditions during the Iberian-Roman Humid Period (IRHP) ∼2000 cal yr BP and during the Medieval Climate Anomaly (MCA) at ∼1000 cal yr BP. Our reconstruction shows a greater than two-degree cooling during the Middle and Late Holocene, agreeing with global mean surface temperature (GMST) reconstructions. Modern climate warming (MCW) during summer exceeds the two-degree Celsius forecasted for the future due to anthropogenic greenhouse gases, suggesting that recent warming is amplified at high elevations. Alpine environments and the biodiversity contained there are thus in danger if the observed temperature trend continues in the next decades.Ministerio de Ciencia e Innovación of Spain CGL2013-47038-R, CGL2017-85415-R, PID2021-125619OB-C21/C22Agencia Estatal de InvestigaciónFondo Europeo de Desarrollo Regional FEDER MCIN/AEI/10.13039/501100011033/FEDER, UEJunta de Andalucía P-20-00059, UGR-FEDER B-RNM-144-UGR18, UGR-FEDER A-RNM-336-UGR20FEDERLifeWatch-Eric LifeWatch-2019-10-UGR-01Research group RNM-190 (Junta de Andalucía)Northern Arizona UniversityMinisterio de Ciencia e Innovación of SpainMCIN/AEI/10.13039/501100011033/ BES-2018-084293Horizon 2020 European Union Marie Sklodowska-Curie 892487European Union -Next Generation EU funds MS2021-20

Three-year multicenter surveillance of community-acquired listeria monocytogenes meningitis in adults

Background: Listeria monocytogenes is the third most frequent cause of bacterial meningitis. The aim of this study is to know the incidence and risk factors associated with development of acute community-acquired Lm meningitis in adult patients and to evaluate the clinical features, management, and outcome in this prospective case series. Methods: A descriptive, prospective, and multicentric study carried out in 9 hospitals in the Spanish Network for Research in Infectious Diseases (REIPI) over a 39-month period. All adults patients admitted to the participating hospitals with the diagnosis of acute community-acquired bacterial meningitis (Ac-ABM) were included in this study. All these cases were diagnosed on the basis of a compatible clinical picture and a positive cerebrospinal fluid (CSF) culture or blood culture. The patients were followed up until death or discharge from hospital. Results: Two hundred and seventy-eight patients with Ac-ABM were included. Forty-six episodes of Lm meningitis were identified in 46 adult patients. In the multivariate analysis only age (OR 1.026; 95% CI 1.00-1.05; p = 0.042), immunosupression (OR 2.520; 95% CI 1.05-6.00; p = 0.037), and CSF/blood glucose ratio (OR 39.42; 95% CI 4.01-387.50; p = 0.002) were independently associated with a Lm meningitis. The classic triad of fever, neck stiffness and altered mental status was present in 21 (49%) patients, 32% had focal neurological findings at presentation, 12% presented cerebellum dysfunction, and 9% had seizures. Twenty-nine (68%) patients were immunocompromised. Empirical antimicrobial therapy was intravenous ampicillin for 34 (79%) of 43 patients, in 11 (32%) of them associated to aminoglycosides. Definitive ampicillin plus gentamicin therapy was significantly associated with unfavourable outcome (67% vs 28%; p = 0.024) and a higher mortality (67% vs 32%; p = 0.040). The mortality rate was 28% (12 of 43 patients) and 5 of 31 (16.1%) surviving patients developed adverse clinical outcome. Conclusions: Elderly or immunocompromised patients, and a higher CSF/blood glucose ratio in patients with Ac-ABM must alert clinicians about Lm aetiology. Furthermore, we observed a high incidence of acute community-acquired Lm meningitis in adults and the addition of aminoglycosides to treatment should be avoid in order to improve the patients' outcome. Nevertheless, despite developments in intensive care and antimicrobial therapy, this entity is still a serious disease that carries high morbidity and mortality rates

Orbital-scale environmental and climatic changes recorded in a new ∼200,000-year-long multiproxy sedimentary record from Padul, southern Iberian Peninsula

Padul is one of the few wetland sites in southern Europe and the Mediterranean region that exhibits an unusually large temporal span (&gt;100 kyr) and continuous Quaternary sedimentary record. Previous core-based studies from Padul yielded paleoecological datasets (i.e., pollen and organic geochemistry), but with a poor age control that resulted in rather arbitrary climate inferences. Therefore, precise age control and a multidisciplinary approach is necessary to understand long-term regional environmental and climate change and the associated local response of the Padul wetland environment. Here we present a new long sediment record (Padul-15-05) from this wetland in the southern Iberian Peninsula with the aim of improving the age control of the sedimentary sequence and carrying out up-to-date high-resolution multiproxy analyses. In this study the age control is based on 61 AMS radiocarbon dates for the last ca. 50 kyr BP and on the extent of amino acid racemization (AAR) in mollusc shells extending back ∼118 kyr BP. No numerical ages are available for the bottom part of the core but the sediment accumulation rates (SAR) and the cyclostratigraphic analysis of the multiproxy data suggest that the core preserves a continuous record of the last ∼197 kyr (from late MIS 7 to present) with millennial-scale time resolution. Sedimentological (lithology, magnetic susceptibility, XRD, color), geochemical (XRF, TOC, C/N, % carbonate content) and paleontological (pollen, charophytes, gastropods) data show co-varying cyclical paleoenvironmental changes linked to orbital-scale climatic variability. Silicon, magnetic susceptibility (MS) and total organic carbon (TOC) data show periodicities between ∼26.2–19.6 kyr linked to insolation, which is strongly dominated by precession cycles at this latitude. High values of Si and MS data have been related to high siliciclastic/detrital input from Sierra Nevada range during minima in insolation due to enhanced soil weathering/erosion during regional aridity and lower forest cover recorded by the arboreal pollen, which could also be favored by a minor biogenic productivity. In addition, warm climate conditions during maxima in insolation mostly resulted in negative precipitation/evapotranspiration balance and low lake levels, while cold glacial and stadial periods were mainly characterized by positive precipitation/evapotranspiration balance, and therefore, high lake levels. The improved chronology of the Padul sedimentary sequence along with a multiproxy study permitted us to better relate environmental and vegetation changes to climatic events and to demonstrate how both local (i.e., lake level, sedimentation) and regional (i.e., vegetation) environments responded to orbital-scale climate changes

NLRP3 inflammasome activation and symptom burden in KRAS-mutated CMML patients is reverted by IL-1 blocking therapy

Chronic myelomonocytic leukemia (CMML) is frequently associated with mutations in the rat sarcoma gene (RAS), leading to worse prognosis. RAS mutations result in active RAS-GTP proteins, favoring myeloid cell proliferation and survival and inducing the NLRP3 inflammasome together with the apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), which promote caspase-1 activation and interleukin (IL)-1(3 release. Here, we report, in a cohort of CMML patients with mutations in KRAS, a constitutive activation of the NLRP3 inflammasome in monocytes, evidenced by ASC oligomerization and IL-1(3 release, as well as a specific inflammatory cytokine signature. Treatment of a CMML patient with a KRASG12D mutation using the IL-1 receptor blocker anakinra inhibits NLRP3 inflammasome activation, reduces monocyte count, and improves the patient's clinical status, enabling a stem cell transplant. This reveals a basal inflammasome activation in RAS-mutated CMML patients and suggests potential therapeutic applications of NLRP3 and IL-1 blockers

El conflicto entre cristianos y musulmanes en las relaciones de sucesos : la liberación de Buda

Este trabajo propone el análisis de una selección de textos escritos en romance sobre la derrota turca y la toma de la ciudad de Buda en 1686, que denuncian la exultante acogida popular de la noticia de las gestas cristianas en Centroeuropa, la percepción del eterno conflicto entre Oriente y Occidente y la proyección del imaginario colectivo del siglo xvii acerca de la lucha contra los infieles.This paper offers the analysis of a selection of texts, written in Romance languages, about the Turkish defeat and the conquest of the city of Buda in 1686, which provide evidence of the popular exultation at the news of the Christian achievements in Central Europe, the perception of the eternal conflict between East and West, and the projection of the seventeenth-century collective imagination regarding the struggle against the infidel

Taking the pulse of Earth's tropical forests using networks of highly distributed plots

Tropical forests are the most diverse and productive ecosystems on Earth. While better understanding of these forests is critical for our collective future, until quite recently efforts to measure and monitor them have been largely disconnected. Networking is essential to discover the answers to questions that transcend borders and the horizons of funding agencies. Here we show how a global community is responding to the challenges of tropical ecosystem research with diverse teams measuring forests tree-by-tree in thousands of long-term plots. We review the major scientific discoveries of this work and show how this process is changing tropical forest science. Our core approach involves linking long-term grassroots initiatives with standardized protocols and data management to generate robust scaled-up results. By connecting tropical researchers and elevating their status, our Social Research Network model recognises the key role of the data originator in scientific discovery. Conceived in 1999 with RAINFOR (South America), our permanent plot networks have been adapted to Africa (AfriTRON) and Southeast Asia (T-FORCES) and widely emulated worldwide. Now these multiple initiatives are integrated via ForestPlots.net cyber-infrastructure, linking colleagues from 54 countries across 24 plot networks. Collectively these are transforming understanding of tropical forests and their biospheric role. Together we have discovered how, where and why forest carbon and biodiversity are responding to climate change, and how they feedback on it. This long-term pan-tropical collaboration has revealed a large long-term carbon sink and its trends, as well as making clear which drivers are most important, which forest processes are affected, where they are changing, what the lags are, and the likely future responses of tropical forests as the climate continues to change. By leveraging a remarkably old technology, plot networks are sparking a very modern revolution in tropical forest science. In the future, humanity can benefit greatly by nurturing the grassroots communities now collectively capable of generating unique, long-term understanding of Earth's most precious forests.Additional co-authors: Susan Laurance, William Laurance, Francoise Yoko Ishida, Andrew Marshall, Catherine Waite, Hannsjoerg Woell, Jean-Francois Bastin, Marijn Bauters, Hans Beeckman, Pfascal Boeckx, Jan Bogaert, Charles De Canniere, Thales de Haulleville, Jean-Louis Doucet, Olivier Hardy, Wannes Hubau, Elizabeth Kearsley, Hans Verbeeck, Jason Vleminckx, Steven W. Brewer, Alfredo Alarcón, Alejandro Araujo-Murakami, Eric Arets, Luzmila Arroyo, Ezequiel Chavez, Todd Fredericksen, René Guillén Villaroel, Gloria Gutierrez Sibauty, Timothy Killeen, Juan Carlos Licona, John Lleigue, Casimiro Mendoza, Samaria Murakami, Alexander Parada Gutierrez, Guido Pardo, Marielos Peña-Claros, Lourens Poorter, Marisol Toledo, Jeanneth Villalobos Cayo, Laura Jessica Viscarra, Vincent Vos, Jorge Ahumada, Everton Almeida, Jarcilene Almeida, Edmar Almeida de Oliveira, Wesley Alves da Cruz, Atila Alves de Oliveira, Fabrício Alvim Carvalho, Flávio Amorim Obermuller, Ana Andrade, Fernanda Antunes Carvalho, Simone Aparecida Vieira, Ana Carla Aquino, Luiz Aragão, Ana Claudia Araújo, Marco Antonio Assis, Jose Ataliba Mantelli Aboin Gomes, Fabrício Baccaro, Plínio Barbosa de Camargo, Paulo Barni, Jorcely Barroso, Luis Carlos Bernacci, Kauane Bordin, Marcelo Brilhante de Medeiros, Igor Broggio, José Luís Camargo, Domingos Cardoso, Maria Antonia Carniello, Andre Luis Casarin Rochelle, Carolina Castilho, Antonio Alberto Jorge Farias Castro, Wendeson Castro, Sabina Cerruto Ribeiro, Flávia Costa, Rodrigo Costa de Oliveira, Italo Coutinho, John Cunha, Lola da Costa, Lucia da Costa Ferreira, Richarlly da Costa Silva, Marta da Graça Zacarias Simbine, Vitor de Andrade Kamimura, Haroldo Cavalcante de Lima, Lia de Oliveira Melo, Luciano de Queiroz, José Romualdo de Sousa Lima, Mário do Espírito Santo, Tomas Domingues, Nayane Cristina dos Santos Prestes, Steffan Eduardo Silva Carneiro, Fernando Elias, Gabriel Eliseu, Thaise Emilio, Camila Laís Farrapo, Letícia Fernandes, Gustavo Ferreira, Joice Ferreira, Leandro Ferreira, Socorro Ferreira, Marcelo Fragomeni Simon, Maria Aparecida Freitas, Queila S. García, Angelo Gilberto Manzatto, Paulo Graça, Frederico Guilherme, Eduardo Hase, Niro Higuchi, Mariana Iguatemy, Reinaldo Imbrozio Barbosa, Margarita Jaramillo, Carlos Joly, Joice Klipel, Iêda Leão do Amaral, Carolina Levis, Antonio S. Lima, Maurício Lima Dan, Aline Lopes, Herison Madeiros, William E. Magnusson, Rubens Manoel dos Santos, Beatriz Marimon, Ben Hur Marimon Junior, Roberta Marotti Martelletti Grillo, Luiz Martinelli, Simone Matias Reis, Salomão Medeiros, Milton Meira-Junior, Thiago Metzker, Paulo Morandi, Natanael Moreira do Nascimento, Magna Moura, Sandra Cristina Müller, Laszlo Nagy, Henrique Nascimento, Marcelo Nascimento, Adriano Nogueira Lima, Raimunda Oliveira de Araújo, Jhonathan Oliveira Silva, Marcelo Pansonato, Gabriel Pavan Sabino, Karla Maria Pedra de Abreu, Pablo José Francisco Pena Rodrigues, Maria Piedade, Domingos Rodrigues, José Roberto Rodrigues Pinto, Carlos Quesada, Eliana Ramos, Rafael Ramos, Priscyla Rodrigues, Thaiane Rodrigues de Sousa, Rafael Salomão, Flávia Santana, Marcos Scaranello, Rodrigo Scarton Bergamin, Juliana Schietti, Jochen Schöngart, Gustavo Schwartz, Natalino Silva, Marcos Silveira, Cristiana Simão Seixas, Marta Simbine, Ana Claudia Souza, Priscila Souza, Rodolfo Souza, Tereza Sposito, Edson Stefani Junior, Julio Daniel do Vale, Ima Célia Guimarães Vieira, Dora Villela, Marcos Vital, Haron Xaud, Katia Zanini, Charles Eugene Zartman, Nur Khalish Hafizhah Ideris, Faizah binti Hj Metali, Kamariah Abu Salim, Muhd Shahruney Saparudin, Rafizah Mat Serudin, Rahayu Sukmaria Sukri, Serge Begne, George Chuyong, Marie Noel Djuikouo, Christelle Gonmadje, Murielle Simo-Droissart, Bonaventure Sonké, Hermann Taedoumg, Lise Zemagho, Sean Thomas, Fidèle Baya, Gustavo Saiz, Javier Silva Espejo, Dexiang Chen, Alan Hamilton, Yide Li, Tushou Luo, Shukui Niu, Han Xu, Zhang Zhou, Esteban Álvarez-Dávila, Juan Carlos Andrés Escobar, Henry Arellano-Peña, Jaime Cabezas Duarte, Jhon Calderón, Lina Maria Corrales Bravo, Borish Cuadrado, Hermes Cuadros, Alvaro Duque, Luisa Fernanda Duque, Sandra Milena Espinosa, Rebeca Franke-Ante, Hernando García, Alejandro Gómez, Roy González-M., Álvaro Idárraga-Piedrahíta, Eliana Jimenez, Rubén Jurado, Wilmar López Oviedo, René López-Camacho, Omar Aurelio Melo Cruz, Irina Mendoza Polo, Edwin Paky, Karen Pérez, Angel Pijachi, Camila Pizano, Adriana Prieto, Laura Ramos, Zorayda Restrepo Correa, James Richardson, Elkin Rodríguez, Gina M. Rodriguez M., Agustín Rudas, Pablo Stevenson, Markéta Chudomelová, Martin Dancak, Radim Hédl, Stanislav Lhota, Martin Svatek, Jacques Mukinzi, Corneille Ewango, Terese Hart, Emmanuel Kasongo Yakusu, Janvier Lisingo, Jean-Remy Makana, Faustin Mbayu, Benjamin Toirambe, John Tshibamba Mukendi, Lars Kvist, Gustav Nebel, Selene Báez, Carlos Céron, Daniel M. Griffith, Juan Ernesto Guevara Andino, David Neill, Walter Palacios, Maria Cristina Peñuela-Mora, Gonzalo Rivas-Torres, Gorky Villa, Sheleme Demissie, Tadesse Gole, Techane Gonfa, Kalle Ruokolainen, Michel Baisie, Fabrice Bénédet, Wemo Betian, Vincent Bezard, Damien Bonal, Jerôme Chave, Vincent Droissart, Sylvie Gourlet-Fleury, Annette Hladik, Nicolas Labrière, Pétrus Naisso, Maxime Réjou-Méchain, Plinio Sist, Lilian Blanc, Benoit Burban, Géraldine Derroire, Aurélie Dourdain, Clement Stahl, Natacha Nssi Bengone, Eric Chezeaux, Fidèle Evouna Ondo, Vincent Medjibe, Vianet Mihindou, Lee White, Heike Culmsee, Cristabel Durán Rangel, Viviana Horna, Florian Wittmann, Stephen Adu-Bredu, Kofi Affum-Baffoe, Ernest Foli, Michael Balinga, Anand Roopsind, James Singh, Raquel Thomas, Roderick Zagt, Indu K. Murthy, Kuswata Kartawinata, Edi Mirmanto, Hari Priyadi, Ismayadi Samsoedin, Terry Sunderland, Ishak Yassir, Francesco Rovero, Barbara Vinceti, Bruno Hérault, Shin-Ichiro Aiba, Kanehiro Kitayama, Armandu Daniels, Darlington Tuagben, John T. Woods, Muhammad Fitriadi, Alexander Karolus, Kho Lip Khoon, Noreen Majalap, Colin Maycock, Reuben Nilus, Sylvester Tan, Almeida Sitoe, Indiana Coronado G., Lucas Ojo, Rafael de Assis, Axel Dalberg Poulsen, Douglas Sheil, Karen Arévalo Pezo, Hans Buttgenbach Verde, Victor Chama Moscoso, Jimmy Cesar Cordova Oroche, Fernando Cornejo Valverde, Massiel Corrales Medina, Nallaret Davila Cardozo, Jano de Rutte Corzo, Jhon del Aguila Pasquel, Gerardo Flores Llampazo, Luis Freitas, Darcy Galiano Cabrera, Roosevelt García Villacorta, Karina Garcia Cabrera, Diego García Soria, Leticia Gatica Saboya, Julio Miguel Grandez Rios, Gabriel Hidalgo Pizango, Eurídice Honorio Coronado, Isau Huamantupa-Chuquimaco, Walter Huaraca Huasco, Yuri Tomas Huillca Aedo, Jose Luis Marcelo Peña, Abel Monteagudo Mendoza, Vanesa Moreano Rodriguez, Percy Núñez Vargas, Sonia Cesarina Palacios Ramos, Nadir Pallqui Camacho, Antonio Peña Cruz, Freddy Ramirez Arevalo, José Reyna Huaymacari, Carlos Reynel Rodriguez, Marcos Antonio Ríos Paredes, Lily Rodriguez Bayona, Rocio del Pilar Rojas Gonzales, Maria Elena Rojas Peña, Norma Salinas Revilla, Yahn Carlos Soto Shareva, Raul Tupayachi Trujillo, Luis Valenzuela Gamarra, Rodolfo Vasquez Martinez, Jim Vega Arenas, Christian Amani, Suspense Averti Ifo, Yannick Bocko, Patrick Boundja, Romeo Ekoungoulou, Mireille Hockemba, Donatien Nzala, Alusine Fofanah, David Taylor, Guillermo Bañares-de Dios, Luis Cayuela, Íñigo Granzow-de la Cerda, Manuel Macía, Juliana Stropp, Maureen Playfair, Verginia Wortel, Toby Gardner, Robert Muscarella, Hari Priyadi, Ervan Rutishauser, Kuo-Jung Chao, Pantaleo Munishi, Olaf Bánki, Frans Bongers, Rene Boot, Gabriella Fredriksson, Jan Reitsma, Hans ter Steege, Tinde van Andel, Peter van de Meer, Peter van der Hout, Mark van Nieuwstadt, Bert van Ulft, Elmar Veenendaal, Ronald Vernimmen, Pieter Zuidema, Joeri Zwerts, Perpetra Akite, Robert Bitariho, Colin Chapman, Eilu Gerald, Miguel Leal, Patrick Mucunguzi, Miguel Alexiades, Timothy R. Baker, Karina Banda, Lindsay Banin, Jos Barlow, Amy Bennett, Erika Berenguer, Nicholas Berry, Neil M. Bird, George A. Blackburn, Francis Brearley, Roel Brienen, David Burslem, Lidiany Carvalho, Percival Cho, Fernanda Coelho, Murray Collins, David Coomes, Aida Cuni-Sanchez, Greta Dargie, Kyle Dexter, Mat Disney, Freddie Draper, Muying Duan, Adriane Esquivel-Muelbert, Robert Ewers, Belen Fadrique, Sophie Fauset, Ted R. Feldpausch, Filipe França, David Galbraith, Martin Gilpin, Emanuel Gloor, John Grace, Keith Hamer, David Harris, Tommaso Jucker, Michelle Kalamandeen, Bente Klitgaard, Aurora Levesley, Simon L. Lewis, Jeremy Lindsell, Gabriela Lopez-Gonzalez, Jon Lovett, Yadvinder Malhi, Toby Marthews, Emma McIntosh, Karina Melgaço, William Milliken, Edward Mitchard, Peter Moonlight, Sam Moore, Alexandra Morel, Julie Peacock, Kelvin Peh, Colin Pendry, R. Toby Pennington, Luciana de Oliveira Pereira, Carlos Peres, Oliver L. Phillips, Georgia Pickavance, Thomas Pugh, Lan Qie, Terhi Riutta, Katherine Roucoux, Casey Ryan, Tiina Sarkinen, Camila Silva Valeria, Dominick Spracklen, Suzanne Stas, Martin Sullivan, Michael Swaine, Joey Talbot, James Taplin, Geertje van der Heijden, Laura Vedovato, Simon Willcock, Mathew Williams, Luciana Alves, Patricia Alvarez Loayza, Gabriel Arellano, Cheryl Asa, Peter Ashton, Gregory Asner, Terry Brncic, Foster Brown, Robyn Burnham, Connie Clark, James Comiskey, Gabriel Damasco, Stuart Davies, Tony Di Fiore, Terry Erwin, William Farfan-Rios, Jefferson Hall, David Kenfack, Thomas Lovejoy, Roberta Martin, Olga Martha Montiel, John Pipoly, Nigel Pitman, John Poulsen, Richard Primack, Miles Silman, Marc Steininger, Varun Swamy, John Terborgh, Duncan Thomas, Peter Umunay, Maria Uriarte, Emilio Vilanova Torre, Ophelia Wang, Kenneth Young, Gerardo A. Aymard C., Lionel Hernández, Rafael Herrera Fernández, Hirma Ramírez-Angulo, Pedro Salcedo, Elio Sanoja, Julio Serrano, Armando Torres-Lezama, Tinh Cong Le, Trai Trong Le, Hieu Dang Tra

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