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

Efectividad de especies naturales como ayudantes de Coagulación, para la clarificación de aguas turbias en épocas de avenidas en caseríos y centros poblados de Huaraz y Callejón de Huaylas

The populations that consume water from water sources must guarantee a good qualityfor their consumption, for that reason the objective was to evaluate the effectivenessof natural species as coagulation aids for the clarification of turbid waters that aregenerated in times of floods in the LLullan rivers, Paria and Chucchun. The appliedmethodology: Collection of coagulants, jar test and determination of optimal dosesand pH. Natural coagulants such as mashua, potato, tara, penca and wheat were used,which were added to the sample in the jar test, obtaining a dose of 45 mg/l at awater pH of 7,5 with concentrations of 5,3%, obtaining important removal values forturbidity parameters and total dissolved solids. When evaluating the efficiency, it wasverified that there is removal of turbidity below the norm, with efficiency values of89,9% for mashua, potato, tara, penca and wheat coagulants, the coagulants reachedthe removal of dissolved solids up to 89% in the tare and a minimum of 13,5% in thewheat value required by the standard. Therefore, it is possible to use natural inputsas coagulants for the clarification of surface waters during rainy seasons and to makethem drinkable and suitable for human consumptionLas poblaciones que consumen agua de fuentes hídricas deben garantizar una buena calidad para su consumo, por ello se tuvo por objetivo evaluar la efectividad de especies naturales como ayudantes de coagulación para la clarificación de aguas turbias que se generan en épocas de avenidas en los ríos LLullan, Paria y Chucchun. La metodología aplicada: Recolección de los coagulantes, Test de jarras y determinación de dosis optimas y pH. Se utilizó coagulantes naturales como la mashua, papa, tara, penca y trigo, que se añadieron a la muestra en el ensayo de test de jarras, obteniéndose una dosis de 45 mg/l a un pH de agua de 7,5 con concentraciones de 5,3% obteniéndose valores de remoción importantes para los parámetros de turbiedad y solidos disueltos totales.Al evaluar la eficiencia se comprobó que existe remoción de turbiedad por debajo de la norma, con valores de eficiencia de 89,9% para los coagulantes de mashua, papa, tara, penca y trigo, los coagulantes alcanzaron la remoción de solidos disueltos de hasta el 89% en la tara y un mínimo de 13,5% en el trigo valor exigido por la norma. Por tanto, es posible utilizar insumos naturales como coagulantes para la clarificación de aguas superficiales en épocas de lluvias y pode potabilizarlas y ser aptas para consumo human

Eficiencia de la Unidad Básica de Saneamiento empleando humedales artificiales con especies nativas para la depuración de aguas residuales en el centro experimental Tuyu Ruri – Marcara, para su reúso como agua de riego

El trabajo de investigación tuvo por objetivo evaluar la eficiencia de la Unidad Básica de Saneamiento (UBS) empleando humedales artificiales con especies nativas de la zona, se implementó un Biodigestor y se construyó dos humedales: uno con Cola de Caballo y otro con Cartucho, así mismo evaluarlas para su reúso como agua de riego.Las muestras se obtuvieron de la caja de recepción, de las salidas del: Biodigestor, humedal con Cartucho y humedal con Cola de caballo. La eficiencia de remoción de la Demanda Bioquímica de Oxígeno (DBO) fue 82% y la Demanda Química de Oxígeno (DQO) fue 81%, ambos en la salida del Biodigestor. La remoción en la Demanda Bioquímica de Oxígeno (DBO) en la salida del humedal con Cartucho fue 68% y del humedal con Cola de caballo fue 58%; de la Demanda Química de Oxígeno (DQO) en el humedal con Cartucho fue 68% y del humedal con Cola de caballo fue 58%. Los resultados obtenidos de las diversas salidas evaluadas se compararon con los Estándares de Calidad Ambiental (ECA), como: la Demanda Bioquímica de Oxígeno (DBO), De manda Química de Oxígeno (DQO), los coliformes totales y fecales, el Fosfato (PO4) y Nitrato (NO3) mientras que los Sólidos Suspendidos Totales (SST) fueron comparados con la Norma Chilena de DIGESA.Palabras clave: contaminación; aguas residuales; humedales artificiales; calidad del agua</p

Efectividad de especies naturales como ayudantes de Coagulación, para la clarificación de aguas turbias en épocas de avenidas en caseríos y centros poblados de Huaraz y Callejón de Huaylas

Las poblaciones que consumen agua de fuentes hídricas deben garantizar una buena calidad para su consumo, por ello se tuvo por objetivo evaluar la efectividad de especies naturales como ayudantes de coagulación para la clarificación de aguas turbias que se generan en épocas de avenidas en los ríos LLullan, Paria y Chucchun. La metodología aplicada: Recolección de los coagulantes, Test de jarras y determinación de dosis optimas y pH. Se utilizó coagulantes naturales como la mashua, papa, tara, penca y trigo, que se añadieron a la muestra en el ensayo de test de jarras, obteniéndose una dosis de 45 mg/l a un pH de agua de 7,5 con concentraciones de 5,3% obteniéndose valores de remoción importantes para los parámetros de turbiedad y solidos disueltos totales.Al evaluar la eficiencia se comprobó que existe remoción de turbiedad por debajo de la norma, con valores de eficiencia de 89,9% para los coagulantes de mashua, papa, tara, penca y trigo, los coagulantes alcanzaron la remoción de solidos disueltos de hasta el 89% en la tara y un mínimo de 13,5% en el trigo valor exigido por la norma. Por tanto, es posible utilizar insumos naturales como coagulantes para la clarificación de aguas superficiales en épocas de lluvias y pode potabilizarlas y ser aptas para consumo humano</p

Eficiencia de la Unidad Básica de Saneamiento empleando humedales artificiales con especies nativas para la depuración de aguas residuales en el centro experimental Tuyu Ruri – Marcara, para su reúso como agua de riego

The objective of the research work was to evaluate the efficiency of the Basic SanitationUnit (UBS) using artificial wetlands with native species from the area, a Biodigestorwas implemented and two wetlands were built: one with Horsetail and another withCartridge, as well as same evaluate them for their reuse as irrigation water. The sampleswere obtained from the reception box, from the outputs of: Biodigestor, wetland withCartridge and wetland with Horsetail. The removal efficiency of the Biochemical Oxygen Demand (BOD) was 82% and the Chemical Oxygen Demand (COD) was 81%, both at the output of the Biodigestor. The removal in the Biochemical Oxygen Demand (BOD) at the exit of the wetland with Cartridge was 68% and the wetland with Horsetail was 58%; of the Chemical Oxygen Demand (COD) in the wetland with Cartridge was 68% and of the wetland with Horsetail was 58%. The results obtained from the various outputs evaluated were compared with the Environmental Quality Standards (ECA), such as: Biochemical Oxygen Demand (BOD), Chemical Oxygen Demand (COD), total and fecal coliforms, Phosphate (PO4) and Nitrate (NO3) while the Total Suspended Solids (SST) were compared with the Chilean Standard of DIGESAEl trabajo de investigación tuvo por objetivo evaluar la eficiencia de la Unidad Básica de Saneamiento (UBS) empleando humedales artificiales con especies nativas de la zona, se implementó un Biodigestor y se construyó dos humedales: uno con Cola de Caballo y otro con Cartucho, así mismo evaluarlas para su reúso como agua de riego.Las muestras se obtuvieron de la caja de recepción, de las salidas del: Biodigestor, humedal con Cartucho y humedal con Cola de caballo. La eficiencia de remoción de la Demanda Bioquímica de Oxígeno (DBO) fue 82% y la Demanda Química de Oxígeno (DQO) fue 81%, ambos en la salida del Biodigestor. La remoción en la Demanda Bioquímica de Oxígeno (DBO) en la salida del humedal con Cartucho fue 68% y del humedal con Cola de caballo fue 58%; de la Demanda Química de Oxígeno (DQO) en el humedal con Cartucho fue 68% y del humedal con Cola de caballo fue 58%. Los resultados obtenidos de las diversas salidas evaluadas se compararon con los Estándares de Calidad Ambiental (ECA), como: la Demanda Bioquímica de Oxígeno (DBO), De manda Química de Oxígeno (DQO), los coliformes totales y fecales, el Fosfato (PO4) y Nitrato (NO3) mientras que los Sólidos Suspendidos Totales (SST) fueron comparados con la Norma Chilena de DIGESA.Palabras clave: contaminación; aguas residuales; humedales artificiales; calidad del agu

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts

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