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

Maternal exposure to di-(2-ethylhexyl) phthalate impaired the social interaction via activating microglia in male pups

Di-(2-ethylhexyl) phthalate (DEHP), a common endocrine-disrupting chemical (EDC), is widely used in daily articles, early exposure to DEHP is associated with many behavioral changes in pups. This study aimed to investigate the effects and underlying mechanisms of maternal exposure to DEHP on the impaired social interaction in pups. Pregnant rats were administered 0, 30, 300, or 750 mg/kg/d DEHP daily by oral gavage. Highly aggressive proliferating immortalized (HAPI) cells were treated with mono-(2-ethylhexyl) phthalate (MEHP) and tyrosine phosphorylation inhibitor (AG490). Our results showed that DEHP exposure induced the activation of microglias (MGs) via activating the janus kinase 2 / signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway, and increased the level of pro-inflammatory factors, then impaired the social behavior in male pups, but not female pups. Moreover, MEHP exposure could also activate HAPI via activating this signaling pathway, and AG490 could inhibit the activation of this signaling pathway caused by MEHP. Therefore, we indicated that maternal exposure to DEHP could cause the gender-specific impaired social interaction in pups that might be related to the activation of MGs

Phylogenetic Diversity of Wetland Plants across China

Accelerating and severe wetland loss has made wetland restoration increasingly important. Current wetland restorations do not take into consideration the ecological adaptability of wetland plants at large scales, which likely affects their long-term restoration success. We explored the ecological adaptability, including plant life forms and phylogenetic diversity, of plants across 28 wetlands in China. We found that perennial herbs were more common than annual herbs, with the proportion of perennial herbs accounting for 40–50%, 45–65%, 45–70%, 50–60%, and 60–80% of species in coastal wetlands, human-made wetlands, lake wetlands, river wetlands, and marsh wetlands, respectively. A ranking of phylogenetic diversity indices (PDIs) showed an order of marsh < river < coastal < lake < human-made, meaning that human-made wetlands had the highest phylogenetic diversity and marsh wetlands had the lowest phylogenetic diversity. The nearest taxon index (NTI) was positive in 23 out of 28 wetlands, indicating that species were phylogenetically clustered in wetland habitats. Dominant species tended to be distantly related to non-dominant species, as were alien invasive species and native species. Our study indicated that annual herbs and perennial herbs were found in different proportions in different types of wetlands and that species were phylogenetically clustered in wetland habitats. To improve wetland restoration, we suggest screening for native annual herbs and perennial herbs in proportions that occur naturally and the consideration of the phylogenetic similarity to dominant native species

Alien, Naturalized and Invasive Plants in China

Invasive species are a subset of naturalized species, and naturalized species are a subset of alien species. Determining the relationship among these three assemblages would be helpful in predicting and preventing biological invasion. Here, we reviewed the families, lifeforms, origins, introduction pathways and phylogenetic diversity of alien, naturalized and invasive vascular plants in China. The results show that species in the Asteraceae, Fabaceae and Poaceae families had a high dominance among alien, naturalized and invasive species. Moreover, almost all alien species in the Amaranthaceae, Solanaceae, Convolvulaceae and Euphorbiaceae families became naturalized species, and about 26.7% of the naturalized species became invasive species. Perennial herbs comprised a higher proportion of alien species than did annual herbs, though annual herbs were more suited to becoming invasive than perennial herbs. A considerable proportion (57.8%) of invasive species were introduced from America. More than half (56.5%) of alien species were introduced for their ornamental value, and half of these have become naturalized in China. Moreover, about half (55.2%) of all invasive species were introduced for their economic value (including ornamental, foraging and medicinal purposes). Invasive species were phylogenetically clustered and phylogenetically distant from alien and naturalized species, which indicates that phylogenetic differences could be helpful in becoming invasive. There is no doubt that human activity plays a significant role in biological invasion. This study suggests that when introducing alien species to a region, decision-makers should certainly consider the species’ phylogeny, beyond just its fundamental characteristics

Identification of Human Enzymes Using Amino Acid Composition and the Composition of k-Spaced Amino Acid Pairs

Enzymes are proteins that can efficiently catalyze specific biochemical reactions, and they are widely present in the human body. Developing an efficient method to identify human enzymes is vital to select enzymes from the vast number of human proteins and to investigate their functions. Nevertheless, only a limited amount of research has been conducted on the classification of human enzymes and nonenzymes. In this work, we developed a support vector machine- (SVM-) based predictor to classify human enzymes using the amino acid composition (AAC), the composition of k-spaced amino acid pairs (CKSAAP), and selected informative amino acid pairs through the use of a feature selection technique. A training dataset including 1117 human enzymes and 2099 nonenzymes and a test dataset including 684 human enzymes and 1270 nonenzymes were constructed to train and test the proposed model. The results of jackknife cross-validation showed that the overall accuracy was 76.46% for the training set and 76.21% for the test set, which are higher than the 72.6% achieved in previous research. Furthermore, various feature extraction methods and mainstream classifiers were compared in this task, and informative feature parameters of k-spaced amino acid pairs were selected and compared. The results suggest that our classifier can be used in human enzyme identification effectively and efficiently and can help to understand their functions and develop new drugs

Combined Metabolome and Transcriptome Analyses Reveal the Effects of Mycorrhizal Fungus Ceratobasidium sp. AR2 on the Flavonoid Accumulation in Anoectochilus roxburghii during Different Growth Stages

Anoectochilus roxburghii is a traditional Chinese herb with high medicinal value, with main bioactive constituents which are flavonoids. It commonly associates with mycorrhizal fungi for its growth and development. Moreover, mycorrhizal fungi can induce changes in the internal metabolism of host plants. However, its role in the flavonoid accumulation in A. roxburghii at different growth stages is not well studied. In this study, combined metabolome and transcriptome analyses were performed to investigate the metabolic and transcriptional profiling in mycorrhizal A. roxburghii (M) and non-mycorrhizal A. roxburghii (NM) growth for six months. An association analysis revealed that flavonoid biosynthetic pathway presented significant differences between the M and NM. Additionally, the structural genes related to flavonoid synthesis and different flavonoid metabolites in both groups over a period of six months were validated using quantitative real-time polymerase chain reaction (qRT-PCR) and high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS). The results showed that Ceratobasidium sp. AR2 could increase the accumulation of five flavonol-glycosides (i.e., narcissin, rutin, isorhamnetin-3-O-beta-d-glucoside, quercetin-7-O-glucoside, and kaempferol-3-O-glucoside), two flavonols (i.e., quercetin and isorhamnetin), and two flavones (i.e., nobiletin and tangeretin) to some degrees. The qRT-PCR showed that the flavonoid biosynthetic genes (PAL, 4CL, CHS, GT, and RT) were significantly differentially expressed between the M and NM. Overall, our findings indicate that AR2 induces flavonoid metabolism in A. roxburghii during different growth stages, especially in the third month. This shows great potential of Ceratobasidium sp. AR2 for the quality improvement of A. roxburghii

Alien, Naturalized and Invasive Plants in China

Invasive species are a subset of naturalized species, and naturalized species are a subset of alien species. Determining the relationship among these three assemblages would be helpful in predicting and preventing biological invasion. Here, we reviewed the families, lifeforms, origins, introduction pathways and phylogenetic diversity of alien, naturalized and invasive vascular plants in China. The results show that species in the Asteraceae, Fabaceae and Poaceae families had a high dominance among alien, naturalized and invasive species. Moreover, almost all alien species in the Amaranthaceae, Solanaceae, Convolvulaceae and Euphorbiaceae families became naturalized species, and about 26.7% of the naturalized species became invasive species. Perennial herbs comprised a higher proportion of alien species than did annual herbs, though annual herbs were more suited to becoming invasive than perennial herbs. A considerable proportion (57.8%) of invasive species were introduced from America. More than half (56.5%) of alien species were introduced for their ornamental value, and half of these have become naturalized in China. Moreover, about half (55.2%) of all invasive species were introduced for their economic value (including ornamental, foraging and medicinal purposes). Invasive species were phylogenetically clustered and phylogenetically distant from alien and naturalized species, which indicates that phylogenetic differences could be helpful in becoming invasive. There is no doubt that human activity plays a significant role in biological invasion. This study suggests that when introducing alien species to a region, decision-makers should certainly consider the species’ phylogeny, beyond just its fundamental characteristics