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

Investigation of Electromagnetic Pulse Compaction on Conducting Graphene/PEKK Composite Powder

Polymer-composite materials have the characteristics of light weight, high load, corrosion resistance, heat resistance, and high oil resistance. In particular, graphene composite has better electrical conductivity and mechanical performance. However, the raw materials of graphene composite are processed into semi-finished products, directly affecting their performance and service life. The electromagnetic pulse compaction was initially studied to get the product Graphene/PEKK composite powder. Simultaneously, spark plasma sintering was used to get the bars to determine the electrical conductivity of Graphene/PEKK composite. On the basis of this result, conducting Graphene/PEKK composite powder can be processed by electromagnetic pulse compaction. Finite element numerical analysis was used to obtain process parameters during the electromagnetic pulse compaction. The results show that discharge voltage and discharge capacitance influence on the magnetic force, which is a main moulding factor affecting stress, strain and density distribution on the specimen during electromagnetic pulse compaction in a few microseconds

Novel Avian Influenza A(H7N9) Virus in Tree Sparrow, Shanghai, China, 2013

In spring 2013, influenza A(H7N9) virus was isolated from an apparently healthy tree sparrow in Chongming Dongping National Forest Park, Shanghai City, China. The entire gene constellation of the virus is similar to that of isolates from humans, highlighting the need to monitor influenza A(H7N9) viruses in different species

IMP3 promotes RCC cell migration and invasion.

<p>Transwell migration and invasion assays were used to detect the migration and invasion ability of RCC cells with IMP3 stable overexpression or knockdown. Migration of RCC cells with stable IMP3 overexpression or knockdown was measured. Caki-1-con and Caki-1-IMP3 cells (A), Achn-con shRNA and Achn-IMP3 shRNA cells, * <i>p</i><0.0001 (B). Invasion of RCC cells with stable IMP3 overexpression or knockdown was measured. Caki-1-con and Caki-1-IMP3 cells, * <i>p</i><0.0001 (C). Achn-con shRNA and Achn-IMP3 hRNA cells, * <i>p</i><0.05 (D). Achn cells were transfected with control siRNA or IMP3 siRNA for 48 h and then the migration (E) and invasion (F) were detected. Values shown are mean ± SEM of three independent experiments. * <i>p</i><0.05 <i>vs</i>. control group.</p

IMP3 expression in localized clear cell renal cell carcinoma and Kaplan-Meier survival analyses.

<p>A-B: Representative IMP3 immunostaining: negative (A, n = 299), positive (B, n = 48) immunoreactivity in localized CCRCC on tissue array. C-D: Kaplan-Meier survival analyses of CCRCC patients. Correlation of negative (n = 299) and positive IMP3 expression (n = 48) with recurrence free survival (C) and overall survival (D) were analyzed by univariate survival analysis (<i>p</i><0.0001).</p

IMP3 overexpression activates NF-κB signaling pathway in CCRCC cells.

<p>Genes involved in adhesion, angiogenesis, chemotactic factors and interleukins in IMP3 overexpressed Caki-1 cells were showed in heat maps (A). NF-κB pathway active signature genes were upregulated in IMP3 overexpressed Caki-1 cells by RNA sequencing (B). Relative mRNA expression of cytokines was detected by real-time PCR in IMP3 overexpressed Caki-1 cells (C). The Caki-1 cells were transfected with Flag-IMP3 vector. Forty eight hoursh after transfection, the culture medium was removed and added with serum free medium for 24 h, the medium was harvested. The secretion of IL-8 was detected by ELISA. Values are means ± SD of three independent experiments. * p<0.05 vs. empty vector (D). The Achn cells were transfected with IMP3 siRNA or control siRNA. The identical management was given to cells as shown in D. * p<0.05 vs. control (E). Western blot analyses of P50 and RelB expression in total protein (F) and nuclear extracts (G) in IMP3 overexpressed Caki-1 cells and Achn knockdown cells. Actin and YY1 were used to control the loading. The Caki-1 cells were transfected with Flag-IMP3 vector. The Achn cells were transfected with IMP3 siRNA or control siRNA. Forty eight hours after transfection cells were harvested, the expression of P65 (H) and p-IκBα (I) was detected by Western blot.</p

Enhanced IMP3 Expression Activates NF-кB Pathway and Promotes Renal Cell Carcinoma Progression

<div><p>Background</p><p>Insulin-like growth factor 2 mRNA binding protein 3 (IMP3) is expressed in metastatic and a subset of primary renal cell carcinoma (RCC). However, the role of IMP3 in RCC progression was poorly understood. We aim to uncover the mechanism of IMP3 in regulating clear cell RCC (CCRCC) progression and validate the prognostic significance of IMP3 in localized CCRCC.</p><p>Methods</p><p>Caki-1 cells stably overexpressing IMP3 and Achn cells with knockdown of IMP3 were analyzed for cell migration and invasion by Transwell assay. RNA-seq was used to profile gene expression in IMP3-expressing Caki-1 cells. A cohort of 469 localized CCRCC patients were examined for IMP3 expression by immunohistochemistry using tumor tissue array.</p><p>Results</p><p>IMP3 promoted Caki-1 cell migration and invasion, whereas knockdown of IMP3 by RNAi inhibited Achn cell migration and invasion. Enhanced IMP3 expression activated NF-кB pathway and through which, it functioned in promoting the RCC cell migration. IMP3 expression in localized CCRCC was found to be associated with higher nuclear grade, higher T stage, necrosis and sarcomatoid differentiation (<i>p</i>< 0.001). Enhanced IMP3 expression was correlated with shorter recurrence-free and overall survivals. Multivariable analysis validated IMP3 as an independent prognostic factor for localized CCRCC patients.</p><p>Conclusion</p><p>IMP3 promotes RCC cell migration and invasion by activation of NF-кB pathway. IMP3 is validated to be an independent prognostic marker for localized CCRCC.</p></div

Establishment of stable cell lines with IMP3 overexpression or knockdown.

<p>Expression of IMP3 in a panel of RCC cell lines and normal HKC cells by Western blot analysis (A). Stable overexpression of IMP3 in Caki-1 cells (left panel) transfected with FLAG-IMP3 vector and knockdown of IMP3 in Achn cells (right panel) by ShRNA (B). Real time-qPCR was performed to detect the relative mRNA expression of IMP3 in IMP3 overexpression or knockdown cells (C). Values shown are mean ± SEM of three independent experiments. * <i>p</i>< 0.05 <i>vs</i>. control group.</p