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

A report of the complete mitochondrial genome of Bisetocreagris titanium (Arachnida: Pseudoscorpiones: Neobisiidae) from Yunnan Province, China

A complete mitogenome of a cave dwelling pseudoscorpion Bisetocreagris titanium is reported here. The mitogenome is a circular DNA molecule with a length of 14,756 base pairs (bp), and it contains 13 protein coding genes (PCGs), 22 transfer RNAs (tRNAs), 2 ribosomal RNAs (rRNAs), and 1 putative control region. Phylogenetic analysis of 30 Arachnida species was performed based on the amino acid datasets of 13 PCGs, and the result indicated Pseudoscorpiones is the sister lineage of Acariformes. This result is congruent with the former phylogenetic results of mitogenomes, but incongruent with the results of morphological characters and/or ribosomal DNA data that indicated Pseudoscorpiones are positioned in a clade with the Solifugae

Electro- or Turbo-Driven?—Analysis of Different Blast Processes of Blast Furnace

There has always been a dispute about the energy efficiency and energy cost of electro-driven and turbo-driven blast furnace (BF) blast processes. In order to find where the problem lies, energy efficiency analysis models and energy cost analysis models of electro-driven and turbo-driven blast processes were established, and the differences between the two driving processes in terms of theoretical minimum steam consumption, energy efficiency and energy cost were studied. The results showed that the theoretical minimum steam consumption of a blast process depends on steam thermodynamic properties and is unrelated to drive mode and drive process. A certain overlapped interval between electro-driven and turbo-driven blast processes in terms of energy efficiency exists. The equation for calculating the standard coal coefficient of steam was proposed, and the relationship to judge strengths and weaknesses of the two driving modes in terms of energy efficiency and energy cost was established. Finally, two companies were selected for case study research. The results led to different conclusions because of the differences between energy media in terms of standard coal coefficient and unit price. To select the best driving mode, plant-running conditions and energy prices of the region of operation in addition to other relevant factors should all be taken into account

Sustained delivery of 17β-estradiol by human amniotic extracellular matrix (HAECM) scaffold integrated with PLGA microspheres for endometrium regeneration

The endometrial injury usually results in intrauterine adhesions (IUAs). However, there is no effective treatment to promote the regeneration of the endometrium currently. The decellularized amnion membrane (AM) is a promising material in human tissue repair and regeneration due to its biocompatibility, biodegradability, as well as the preservation of abundant bioactive components. Here, an innovative drug-delivering system based on human amniotic extracellular matrix (HAECM) scaffolds were developed to facilitate endometrium regeneration. The 17β-estradiol (E2) loaded PLGA microspheres (E2-MS) were well dispersed in the scaffolds without altering their high porosity. E2 released from E2-MS-HAECM scaffolds in vitro showed a decreased initial burst release followed with a sustained release for 21 days, which coincided with the female menstrual cycle. Results of cell proliferation suggested E2-MS-HAECM scaffolds had good biocompatibility and provided more biologic guidance of endometrial cell proliferation except for mechanical supports. Additionally, the mRNA expression of growth factors in endometrial cells indicated that HAECM scaffolds could upregulate the expression of EGF and IGF-1 to achieve endometrium regeneration. Therefore, these advantages provide the drug-loaded bioactive scaffolds with new choices for the treatments of IUAs

Synovial Macrophages Expression of OX40L Is Required for Follicular Helper T Cells Differentiation in the Joint Microenvironment

Signaling via the OX40/OX40L axis plays a key role in CD4+ T cell development, and OX40L expression is primarily restricted to antigen-presenting cells (APCs). This study was designed to assess the role of APC-mediated OX40L expression in the context of the development of rheumatoid arthritis (RA)-associated CD4+ T cell subsets. For these analyses, clinical samples were harvested from patients with osteoarthritis and RA, with additional analyses performed using OX40−/− mice and mice harboring monocyte/macrophage-specific deletions of OX40L. Together, these analyses revealed tissue-specific roles for OX40/OX40L signaling in RA. Specifically, higher levels of synovial macrophage OX40L expression were associated with the enhanced development of T follicular helper cells in the joint microenvironment, thereby contributing to the pathogenesis of RA. This Tfh differentiation was found to be OX40/OX40L-dependent in this synovial setting. Overall, these results indicate that the expression of OX40L by synovia macrophages is necessary to support Tfh differentiation in the joint tissues, thus offering new insight regarding the etiological basis for RA progression

Comprehensive study on the removal of chromate from aqueous solution by synthesized kaolin supported nanoscale zero-valent iron

A removal mechanism of chromate (Cr) by synthesized kaolin supported nanoscale zero-valent iron (K-nZVI) from aqueous solution is demonstrated. Parameters which potentially influenced the functioning of K-nZVI have been investigated as well. Based on the scanning electron microscopy, Fourier transform infrared spectroscopes, X-ray crystal powder diffraction and X-ray photoelectron spectroscopy identifications, we confirm that amorphous Fe-0 core/FexOy shell nZVI can be successfully loaded into the pores and cracks, and onto the surface of kaolin. Removal efficiency of Cr by K-nZVI decreased with increasing initial pH and Cr(VI) concentration, but increased while K-nZVI dosage increased. Humic acid and phosphate had similar dual impacts on chromium removal by K-nZVI, and the inhibitory effect was obvious at high concentrations in spite of their different reaction mechanisms. In contrast, high concentrations of sulfate and nitrate could advance the chromium removal. Adsorption isotherms indicate that the removal processes are endothermic. The data obtained can be better explained with Langmuir than Freundlich model. At the conditions of 318K and optimized pH 4.0, the maximum adsorption capacity was 33.39mgg(-1) illustrating that K-nZVI was effective for the removal of total Cr. The removal mechanism is proposed to divide into four phases, including: (1) aqueous Cr(VI) ions are captured on the surface of K-nZVI; (2) the captured Cr(VI) are partly reduced to Cr(III) accompanied by Fe-0 oxidizing to Fe2+; (3) part of oxidized Fe2+ continues to reduce Cr(VI); and (4) produced Cr(III), Fe2+, and Fe3+ are formed passivation layers on the K-nZVI surface which prevent further removal of chromium and result in redundant Fe-0