Background The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. Methods We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient’s age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. Results The median age in the sample of 7487 consecutive patients was 84 years (IQR 81–87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). Conclusion Knowledge about a patient’s frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)

Antimicrobial photodynamic therapy (aPDT) may be useful as a supportive antimicrobial measure for caries-active subjects. In this study, the antimicrobial efficacy of aPDT with a phenalen-1-one photosensitizer was evaluated in a novel in vitro biofilm model comprising Actinomyces naeslundii, Actinomyces odontolyticus, and Streptococcus mutans and was compared to chlorhexidine. The proposed biofilm model allows high-throughput screening for antimicrobial efficacy while exhibiting a differentiated response to different antimicrobial approaches. While chlorhexidine 0.2% showed a reduction of ≈4 log₁₀ for all species, aPDT led to a more pronounced reduction of S. mutans (2.8 log₁₀) than of Actinomyces spp. (1.2 or 1.3 log₁₀). A similar effect was also observed in monospecies biofilms. Therefore, aPDT may be more effective against S. mutans than against Actinomyces spp. when in biofilms, and this antimicrobial approach merits further investigations.

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The article is aimed at verifying the state of a real workplace using virtual reality. In analyzing the readiness of virtual reality applications, augmented reality was selected for the following work. The most significant advantage of augmented reality is the implementation of a virtual model and the ability to deal with the analysis in a real environment, which is particularly beneficial in the case of production plants. In the first phase of the work, an analysis of the current state of the workplace was carried out, where the requirements for the design of the new workplace were specified. This was followed by the phase of design preparation in 3D modeller. At this very stage it appeared to be advantageous to use virtual reality applications; in the design process, regular approval procedures are required as for an expert team (management, design, quality, ...), which puts high qualification requirements on the readiness of this team. In this phase, the 3D design of the new workplace was inserted into the application supported by augmented reality and some options were indicated to deal with the ergonomic and risk analysis. The result of this work is, in particular, an extension of options in designing and analyzing production workplaces and machinery in multidisciplinary teams.