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

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

Development of a novel ribosomal RNA based method for fingerprinting bacterial consortia

The last two decades have seen a revolution in the development of molecular based methods to investigate microbial diversity and function, such as stable isotope probing (SIP) methods and fluorescence in situ hybridisation-based technology. Unprecedented advancements in our knowledge have been achieved largely thanks to the advent of the polymerase chain reaction (PCR), which is the basis for many current microbial fingerprinting techniques and clone libraries. A major drawback of PCR is that accurate information of species abundance cannot be gained, because of procedural biases which substantially modify abundance information. Additionally, in SIP studies the isotopic signal is erased after DNA amplification. Consequently, the option of quantifying isotopic enrichment directly from specific taxa is lost.This work describes the development of a novel method that eliminates the need of PCR in microbial community fingerprinting. It is based on the separation of small rRNA fragments by polyacrylamide gel electrophoresis on the basis of sequence-dependant conformational differences. The rRNA fragments are created by a targeted cleavage of the ribosomal small subunit using Ribonuclease H. The development and optimisation of the protocol to achieve this is presented here. The method was tested with several environmental samples and showed that it had greatest utility when applied to samples harbouring low microbial diversity. This was confirmed through profiling of several artificial communities. Taxonomic identification of bacterial species represented by bands in profiles was determined, as well as their relative abundance. The method was applied to follow changes in community diversity and abundance in three different types of enrichment cultures. Experiments were also carried out to determine the isotopic content of [13]C-labelled rRNA retrieved from acrylamide gels and the detection of [14]C-labelled RNA from profile bands. It was shown that removal of contaminating [12]C from [13]C-RNA was essential for detection of isotopic signatures and that radioactive rRNA bands can be detected by phosphor imaging technology. Overall, the method termed here ‘Direct rRNA Fingerprinting’ is a PCR-free alternative that offers detection of microbial abundance and activity using radioactive or stable isotope labelling. Further methodological developments that address its limitations will enhance its sensitivity and utility in diversity and functional studies

Ti - Introducción Al Diseño Arquitectónico-AR149-201302

Este es el primer curso de los Talleres de Diseño que constituyen la columna vertebral de la carrera de Arquitectura. En el Taller de Diseño el estudiante adquiere los fundamentos para el ejercicio de proyectar.El estudiante realiza sus primeros trabajos de composición (relacionada con la arquitectura). Conoce y experimenta los conceptos de armonía contraste simetría y asimetría. Se familiariza con los elementos que intervienen en la composición de formas: punto línea plano y volumen. También con intersecciones destajos primeras estructuraciones que incluyen pórticos escaleras volados

Rhamnus liukiuensis Koidz.

原著和名: リウキウクロウメモドキ科名: クロウメモドキ科 = Rhamnaceae採集地: 鹿児島県 沖永良部島 大山 (大隅 沖永良部島 大山)採集日: 1973/4/2採集者: 萩庭丈壽整理番号: JH023326国立科学博物館整理番号: TNS-VS-97332