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

The Cut-size Property of Networks and Epidemics Processes

This master thesis focuses on the particular problem about the cut-size property of different networks. The scope of networks is from trivial network models (e.g., random graph) to real networks (e.g., Power grid network and Facebook network). The Susceptible-Infected-Susceptible (SIS) epidemic model can describe the spreading processes of information or diseases on networks. Within this thesis, we explore the cut-size property of networks and seek the relations between the cut-size property and the spreading behaviors. Our result deduces the cut-size property and the relevant physical meanings of the real networks. In such a way, a deeper understanding of the cut-size would help researchers to obtain insights of real networks. Our results may also contribute to the study of control of dynamic processes on networks

Differences of starch granule distribution in grains from different spikelet positions in winter wheat.

Wheat starch development is a complex process and is markedly difference by changes in spikelet spatial position. The present study deals with endosperm starch granule distribution and spatial position during filling development. The study was conducted with pure starch isolated from wheat (Triticum aestivum L.), Jimai20 and Shannong1391, at 7-35 days after anthesis (DAA). The results showed that grain number, spikelet weight and grain weight per spikelet in different spatial position showed parabolic changes. Upper spikelets had highest starch and amylose content followed by basal spikelets, then middle spikelets. The paper also suggested the volume percents of B-type and A-type granule in grain of middle spikelets were remarkably higher and lower than those of basal and upper spikelets, respectively. However, no significant difference occurred in the number percents of the two type granule. The ratio of amylase to amylopectin was positively correlated with the volume proportion of 22.8-42.8 µm, but was negatively related to the volume proportion of <9.9 µm. The results indicated that the formation and distribution of starch granules were affected significantly by spikelet position, and grains at upper and basal spikelet had the potential of increasing grain weight through increasing the volume of B-type granules

Effects of exogenous ABA application on post-anthesis dry matter redistribution and grain starch accumulation of winter wheat with different staygreen characteristics

The objective of this study was to investigate whether and how exogenous abscisic acid (ABA) is involved in mediating starch accumulation in the grain and redistribution of carbohydrates during grain filling of two wheat cultivars with different staygreen characteristics. At blooming stage, plants of Wennong 6 (a staygreen cultivar) and Jimai 20 (control) were sprayed with 10 mg L− 1 abscisic acid (ABA) for 3 days. The application of ABA significantly (P < 0.05) increased grain filling rate, starch accumulation rate and content, remobilization of dry matters to kernels, and 1000-grain weight of the two cultivars. Exogenous ABA markedly (P < 0.05) increased grain yield at maturity, and Wennong 6 and Jiami 20 showed 14.14% and 4.86% higher compared yield than the control. Dry matter accumulation after anthesis of Wennong 6 was also significantly (P < 0.05) influenced by exogenous ABA, whereas that of Jimai 20 was unchanged. Application of ABA increased endogenous zeatin riboside (ZR) content 7 days after anthesis (DAA), and spraying ABA significantly increased endogenous indole-3-acetic acid (IAA) and ABA contents from 7 to 21 DAA and decreased gibberellin (GA3) content at 14 DAA, but increased GA3 content from 21 to 35 DAA. The results suggested that increased yield of staygreen was due to greater starch assimilation owing to a higher filling rate and longer grain-filling duration

ViSTA: A Novel Network Improving Lung Adenocarcinoma Invasiveness Prediction from Follow-Up CT Series

To investigate the value of the deep learning method in predicting the invasiveness of early lung adenocarcinoma based on irregularly sampled follow-up computed tomography (CT) scans. In total, 351 nodules were enrolled in the study. A new deep learning network based on temporal attention, named Visual Simple Temporal Attention (ViSTA), was proposed to process irregularly sampled follow-up CT scans. We conducted substantial experiments to investigate the supplemental value in predicting the invasiveness using serial CTs. A test set composed of 69 lung nodules was reviewed by three radiologists. The performance of the model and radiologists were compared and analyzed. We also performed a visual investigation to explore the inherent growth pattern of the early adenocarcinomas. Among counterpart models, ViSTA showed the best performance (AUC: 86.4% vs. 60.6%, 75.9%, 66.9%, 73.9%, 76.5%, 78.3%). ViSTA also outperformed the model based on Volume Doubling Time (AUC: 60.6%). ViSTA scored higher than two junior radiologists (accuracy of 81.2% vs. 75.4% and 71.0%) and came close to the senior radiologist (85.5%). Our proposed model using irregularly sampled follow-up CT scans achieved promising accuracy in evaluating the invasiveness of the early stage lung adenocarcinoma. Its performance is comparable with senior experts and better than junior experts and traditional deep learning models. With further validation, it can potentially be applied in clinical practice

Vaclav Stefan Teplicky on the origins and analysis of 17th century Utraquist prayer books

<p>D1, 75 plants m^-2; D2, 225 plants m^-2; D3, 375 plants m^-2; D4, 525 plants m^-2.</p

Kernel numbers per spikelet (A and B), weight per spikelet (C and D), and grain weight per spikelet (E and F) in winter wheat in growing seasons 2010/2011 (left) and 2011/2012 (right).

<p>Kernel numbers per spikelet (A and B), weight per spikelet (C and D), and grain weight per spikelet (E and F) in winter wheat in growing seasons 2010/2011 (left) and 2011/2012 (right).</p