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

Circular polarization modulation for digital communication systems

Conventional approaches of digital modulation schemes make use of amplitude, frequency and/or phase as modulation characteristic to transmit data. In this paper, we exploit circular polarization (CP) of the propagating electromagnetic carrier as modulation attribute which is a novel concept in digital communications. The requirement of antenna alignment to maximize received power is eliminated for CP signals and these are not affected by linearly polarized jamming signals. The work presents the concept of Circular Polarization Modulation for 2, 4 and 8 states of carrier and refers them as binary circular polarization modulation (BCPM), quaternary circular polarization modulation (QCPM) and 8-state circular polarization modulation (8CPM) respectively. Issues of modulation, demodulation, 3D symbol constellations and 3D propagating waveforms for the proposed modulation schemes are presented and analyzed in the presence of channel effects, and they are shown to have the same bit error performance in the presence of AWGN compared with conventional schemes while provide 3dB gain in the flat Rayleigh fading channel. © 2012 IEEE

Facile preparation of reduced graphene oxide, polypyrrole, carbon black, and polyvinyl alcohol nanocomposite by electrospinning: a low-cost and sustainable approach for supercapacitor application

The design and synthesis of nanostructures have played an essential role in the supercapacitor field. In this paper, nanofiber composites including graphene oxide (GO), polypyrrole (PPy), carbon black (CB), and polyvinyl alcohol (PVA) as GO/PPy/PVA, rGO/PPy/PVA, GO/PPy/CB/PVA, and rGO/PPy/CB/PVA were synthesized using an easy, low cost, and sustainable approach, which is the electrospinning technique. Nanofiber composites were characterized by Fourier transform infrared spectroscopy–attenuated total reflectance (FTIR–ATR), X-ray powder diffraction (XRD), scanning electron microscopy–energy dispersive X-ray (SEM-EDX), thermogravimetric and differential thermal analysis (TGA-DTA), and solid-state conductivity analysis. Device performances were tested by cyclic voltammetry (CV), galvanostatic charge/discharge (GCD), and electrochemical impedance spectroscopy (EIS) analysis. The Randles circuit model of Rs(CdlRct)) was adopted to understand the dynamic parameters such as: the solution resistance (Rs), the double layer capacitance (Cdl), and the charge transfer resistance (Rct). The highest specific capacitances were obtained as Csp= 951 F/g by the CV method, Csp= 272 F/g by the GCD method, and Csp= 140.3 F/g by the EIS method for rGO/PPy/CB/PVA nanofiber composites. It is supported by other results such as phase angle (?= 66°) and solid conductivity (625 S/cm). Therefore, the encouraging results of rGO/PPy/CB/PVA nanofiber show the potential of this nanocomposite as a promote electrodes for flexible supercapacitors due to the considerable specific capacitance, the excellent cycling retention and the important power and energy densities. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.This work is a part of the research project NKUBAP.01.?NAP.19.213 approved by the Scientific and Research Project Unit (Tekirdag Namik Kemal University). This research grant is gratefully acknowledged

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine