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

Non-promoted Ru/sepiolite catalyst for ammonia synthesis

154-158Sepiolite was used as support for ruthenium catalyst. Non-promoted Ru/Sep is proved to be effective for ammonia synthesis. The catalyst was characterized by XRD, XPS and nitrogen adsorption isotherms. Ru is reduced completely and is present in few oxidation states on the support. Using non-aqueous solvent instead of water in the impregnation process on basic support, the Ru dispersion could be increased. Chlorine-free Ruthenium catalyst was prepared using RuCl3 by washing with ammonia solution

Introduction: the scholarship of environmental governance

The chapters in this book show the many ways in which legal scholarship is pivotal to good governance in all these respects, and the extent of innovation that is being generated by the ecological, economic and social challenges that are arising. The content and scope of these chapters demonstrate clearly the increasing breadth and depth of environmental law scholarship. The chapters show the many ways in which community and political leadership towards sustainability is being translated into institutional arrangements in the international and national spheres. The book also demonstrates the many conflicts and potential conflicts inherent in a radical transformation of society and economy. Legal scholars are, as a result, being called to take a leadership role in some of the fundamental contests of ideas and of interests that are taking place across the planet, as societies try to find a way of living with the reality of our finite and declining resources. The chapters in this book suggest that this requires significant legal and institutional innovations that are interlinked with scientific discovery and the march of community power (enabled in no small degree by technology). The chapters reflect a willingness on the part of legal scholars to question the received wisdom of economics, and to contest the entrenched power structures within societies in the interests of sustainability, social justice and future citizens

Optimal selective floor cleaning using deep learning algorithms and reconfigurable robot hTetro

Floor cleaning robots are widely used in public places like food courts, hospitals, and malls to perform frequent cleaning tasks. However, frequent cleaning tasks adversely impact the robot's performance and utilize more cleaning accessories (such as brush, scrubber, and mopping pad). This work proposes a novel selective area cleaning/spot cleaning framework for indoor floor cleaning robots using RGB-D vision sensor-based Closed Circuit Television (CCTV) network, deep learning algorithms, and an optimal complete waypoints path planning method. In this scheme, the robot will clean only dirty areas instead of the whole region. The selective area cleaning/spot cleaning region is identified based on the combination of two strategies: tracing the human traffic patterns and detecting stains and trash on the floor. Here, a deep Simple Online and Real-time Tracking (SORT) human tracking algorithm was used to trace the high human traffic region and Single Shot Detector (SSD) MobileNet object detection framework for detecting the dirty region. Further, optimal shortest waypoint coverage path planning using evolutionary-based optimization was incorporated to traverse the robot efficiently to the designated selective area cleaning/spot cleaning regions. The experimental results show that the SSD MobileNet algorithm scored 90% accuracy for stain and trash detection on the floor. Further, compared to conventional methods, the evolutionary-based optimization path planning scheme reduces 15% percent of navigation time and 10% percent of energy consumption.Agency for Science, Technology and Research (A*STAR)Published versionThis research is supported by the National Robotics Programme under its Robotics Enabling Capabilities and Technologies (Funding Agency Project No. 192 25 00051), National Robotics Programme under its Robot Domain Specifc (Funding Agency Project No. 192 22 00058), National Robotics Programme under its Robotics Domain Specifc (Funding Agency Project No. 192 22 00108), and administered by the Agency for Science, Technology and Research

Significantly High Modulation Efficiency of Compact Graphene Modulator Based on Silicon Waveguide

Abstract We theoretically and experimentally demonstrate a significantly large modulation efficiency of a compact graphene modulator based on a silicon waveguide using the electro refractive effect of graphene. The modulation modes of electro-absorption and electro-refractive can be switched with different applied voltages. A high extinction ratio of 25 dB is achieved in the electro-absorption modulation mode with a driving voltage range of 0 V to 1 V. For electro-refractive modulation, the driving voltage ranges from 1 V to 3 V with a 185-pm spectrum shift. The modulation efficiency of 1.29 V · mm with a 40-μm interaction length is two orders of magnitude higher than that of the first reported graphene phase modulator. The realisation of phase and intensity modulation with graphene based on a silicon waveguide heralds its potential application in optical communication and optical interconnection systems