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

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Diosmetin ameliorates glucose metabolism in KK-Ay diabetic mice through regulation of Corynebacterium glutamicum via IRS/PI3K/ AKT signaling pathway

Background and Purpose: Diosmetin (Dios), a flavonoid compound with multiple pharmacological activities. However, fewer studies have reported its effects on diabetes. Here, we address the effect of Dios on glucose metabolism and gut microbiota in KK-Ay diabetic mice. Experimental Approach: Wild type C57BL/6J mice or diabetic KK-Ay mice were treated with vehicle or Dios for one month. The liver RNA-Seq was used to reveal the key signaling pathway interfered with Dios. The liver 16S rRNA gene sequencing was used to reveal the effects of Dios on gut microbiota. The experiment of C. glu transplantation was used to reveal the relationship between Dios and C. glu on glucose metabolism. Key Results: Dios treatment significantly decreased blood glucose and increased serum insulin concentrations. Transcriptome sequencing analysis found that the underlining mechanism of diosmetin on T2DM by regulating signal pathways of glucose metabolism, which was proved by up-regulating IRS/PI3K/AKT signaling pathway to promote glycogen synthesis and GLUT4 translocation. Besides, Dios treatment reshaped the unbalanced gut microbiota by suppressing the ratio of Firmicutes/Bacteroidetes and markedly increasing the richness of C. glu. Moreover, Treatment with C. glu and Dios together can markedly ameliorate glucose metabolism by up-regulating IRS/PI3K/AKT signaling pathway to promoting glycogen synthesis and GLUT4 translocation. Conclusions and Implications: Dios treatment remarkably ameliorated glucose metabolism in KK-Ay diabetic mice by the regulation of C. glu on IRS/PI3K/AKT signaling pathway and reshaped the unbalanced gut microbiota. Our study provided evidence for the application of Dios to the treatment of T2DM.</jats:p

Construction of 3d Model of Complex Geological Structure Deposits under Big Data

Abstract The traditional mining hand-drawn graphics were slow, inefficient, and the use of two-dimensional CAD graphics to display three-dimensional space was obviously not strong, and it was easy to misunderstand. To this end, a three-dimensional model of complex geological structure deposits under big data was constructed, and a complex geological structure deposit database was established to provide diversified information; CD-TIN technology was used to generate one-time constraint TIN, for saving time in fabricting; Extracting the structure of the deposit and standardizing the original geological map to construct a three-dimensional model of the complex geological structure deposit under the big data; Through experimental research and analysis, the proposed three-dimensional model of complex geological structure deposits under the big data realized the establishment and visualization of the deposit model, which was highly feasible, improved the speed and efficiency of the deposit space model, and had high definition with an increase of 38% over traditional methods.</jats:p

Bifunctional PtCu electrocatalysts for the N₂ reduction reaction under ambient conditions and methanol oxidation

PtCu nanoalloys were employed as bifunctional electrocatalysts in both the N2 reduction and methanol oxidation, in which the electrocatalytic activity and stability is composition dependent and highly improved compared to their counterpart.</p

Hospital hyperglycemia: Status Investigation and Effect of a Real-time Glycemic Alert System

BACKGROUND Hospital hyperglycemia is common and associated with potential adverse outcomes. A Hospital-wide Mobile Phone Alert (HMA) system was built to achieve real time glucose monitoring with warnings for glucose excursions. This study investigated the status of glucose control and evaluated the impact of HMA system on inpatient glycemia management. METHODS Inpatients with hyperglycemia hospitalized between 1 January, 2017 and 31 December, 2018 were identified excluding those &lt; 18 years of age. The HMA system was activated on 1 October, 2017. It sent real time cellphone warning messages to the patient’s designated team physician whenever glucose levels &gt; 10 mmol/L or &lt; 3 mmol/L were detected. A serum glucose &gt; 7.8 mmol/L was defined as hospital hyperglycemia (HH), and &gt; 10 mmol/L was defined as significant HH (SHH). Glucose excursions before and after the HMA system was instituted were compared. RESULTS The incidence of HH, SHH and hypoglycemia was 26.1%, 12.8% and 2.5%, respectively. With the HMA system, the monthly glucose related consultation rate for all inpatients increased 65.9%. The rate of HH glucose amount/ total glucose amount improved with the HMA system, being lower than pre HMA system activation for the surgical wards (15.8 ± 4.7% vs 21.1 ± 6.1%，p&lt;0.05). CONCLUSIONS In this study, one third of inpatients were noted to experience hyperglycemia. Real time cellphone warning messages to the patient’s designated team physician can improve consultation utilization for blood glucose excursions. The alert system was found to reduce the incidence of hyperglycemia on surgical wards.</jats:p