Effects of Semaglutide on Heart Failure Outcomes in Diabetes and Chronic Kidney Disease in the FLOW Trial.

Background: People with type 2 diabetes (T2D) and chronic kidney disease (CKD) are at high risk for heart failure (HF) and premature death from cardiovascular (CV) causes. The FLOW (Research Study To See How Semaglutide Works Compared to Placebo in People With Type 2 Diabetes and Chronic Kidney Disease), which enrolled participants with T2D and CKD, demonstrated that semaglutide, a glucagon-like peptide-1 receptor agonist, reduced the incidence of the primary composite outcome (persistent ≥50% decline in estimated glomerular filtration rate, persistent estimated glomerular filtration rate <15 mL/min/1.73 m, kidney replacement therapy, and kidney or CV death) by 24%.

Hand hygiene compliance in nursing home wards: The effects of feedback with lights on alcohol-based hand rub dispensers.

Background: Hand hygiene (HH) among health care workers (HCWs) is crucial in preventing infections in nursing homes. However, HH compliance (HHC) among HCWs remains low. This study aimed to investigate the effect of feedback lights on HCWs' HHC.

Effects of data-driven feedback on nurses' and physicians' hand hygiene in hospitals - a non-resource-intensive intervention in real-life clinical practice.

Background: Hand hygiene (HH) by healthcare workers (HCWs) is one of the most important measures to prevent hospital-acquired infections. However, HCWs struggle to adhere to HH guidelines. We aimed to investigate the effect of a non-resource intensive intervention with group and individual feedback on HCWs HH in a real-life clinical practice during the COVID-19 pandemic.

Empowering health care workers with personalized data-driven feedback to boost hand hygiene compliance.

Background: Achieving high hand hygiene compliance among health care workers is a challenge, requiring effective interventions. This study investigated the impact of individualized feedback on hand hygiene compliance using an electronic monitoring system.

Methods: A quasi-experimental intervention design with pretest-post-test was conducted in an orthopedic surgical ward.

Effects of light-guided nudges on health care workers' hand hygiene behavior.

Background: Hospital-acquired infections are the most frequent adverse events in health care and can be reduced by improving the hand hygiene compliance (HHC) of health care workers (HCWs). We aimed to investigate the effect of nudging with sensor lights on HCWs' HHC.

Methods: An 11-month intervention study was conducted in 2 inpatient departments at a university hospital.

Clinical evaluation of an electronic hand hygiene monitoring system.

Background: We aimed to test the accuracy of an electronic hand hygiene monitoring system (EHHMS) during daily clinical activities in different wards and with varying health care professions.

Methods: The accuracy of an EHHMS (Sani Nudge) was assessed during real clinical conditions by comparing events registered by two observers in parallel with events registered by the EHHMS. The events were categorized as true-positive, false-positive, and false-negative registrations.

Associations between YKL-40 and markers of disease severity and death in patients with necrotizing soft-tissue infection.

Background: Necrotizing soft-tissue infection (NSTI) is a severe and fast-progressing bacterial infection. Prognostic biomarkers may provide valuable information in treatment guidance and decision-making, but none have provided sufficient robustness to have a clinical impact. YKL-40 may reflect the ongoing pathological inflammatory processes more accurately than traditional biomarkers as it is secreted by the activated immune cells, but its prognostic yields in NSTI remains unknown.

Discriminatory plasma biomarkers predict specific clinical phenotypes of necrotizing soft-tissue infections.

BACKGROUNDNecrotizing soft-tissue infections (NSTIs) are rapidly progressing infections frequently complicated by septic shock and associated with high mortality. Early diagnosis is critical for patient outcome, but challenging due to vague initial symptoms. Here, we identified predictive biomarkers for NSTI clinical phenotypes and outcomes using a prospective multicenter NSTI patient cohort.

Hand hygiene compliance of healthcare workers before and during the COVID-19 pandemic: A long-term follow-up study.

Background: Information about the long-term effects of hand hygiene (HH) interventions is needed. We aimed to investigate the change in HH compliance (HHC) of healthcare workers (HCWs) once a data-driven feedback intervention was stopped, and to assess if the COVID-19 pandemic influenced the HH behavior.

Methods: We conducted an observational, extension trial in a surgical department between January 2019-December 2020.

Assessing the clinical accuracy of a hand hygiene system: Learnings from a validation study.

There is a need to establish validation standards that allow for comparison of automated hand hygiene systems. To assess the accuracy of an innovative monitoring tool (Sani nudge), 2 test nurses performed clinical standard tasks while being observed by 2 infection preventionists. Data from the direct observations were compared with data obtained from the hand hygiene system (Sani nudge) using an independent-event approach.

Risk factors for kidney disorders in patients with type 2 diabetes at high cardiovascular risk: An exploratory analysis (DEVOTE 12).

Aim: To investigate risk factors associated with kidney disorders in patients with type 2 diabetes (T2D) at high cardiovascular (CV) risk.

Methods: In DEVOTE, a cardiovascular outcomes trial, 7637 patients were randomised to insulin degludec (degludec) or insulin glargine 100 units/mL (glargine U100), with standard of care. In these exploratory post hoc analyses, serious adverse event reports were searched using Standardised MedDRA Queries related to chronic kidney disease (CKD) or acute kidney injury (AKI).

Light-guided nudging and data-driven performance feedback improve hand hygiene compliance among nurses and doctors.

Background: Evidence-based practices to increase hand hygiene compliance (HHC) among health care workers are warranted. We aimed to investigate the effect of a multimodal strategy on HHC.

Methods: During this 14-month prospective, observational study, an automated monitoring system was implemented in a 29-bed surgical ward.

Integrated Univariate, Multivariate, and Correlation-Based Network Analyses Reveal Metabolite-Specific Effects on Bacterial Growth and Biofilm Formation in Necrotizing Soft Tissue Infections.

Necrotizing soft-tissue infections (NSTIs) have multiple causes, risk factors, anatomical locations, and pathogenic mechanisms. In patients with NSTI, circulating metabolites may serve as a substrate having impact on bacterial adaptation at the site of infection. Metabolic signatures associated with NSTI may reveal the potential to be useful as diagnostic and prognostic markers and novel targets for therapy.

Glomerular Filtration Rate and Associated Risks of Cardiovascular Events, Mortality, and Severe Hypoglycemia in Patients with Type 2 Diabetes: Secondary Analysis (DEVOTE 11).

Introduction: The associations of chronic kidney disease (CKD) severity, cardiovascular disease (CVD), and insulin with the risks of major adverse cardiovascular events (MACE), mortality, and severe hypoglycemia in patients with type 2 diabetes (T2D) at high cardiovascular (CV) risk are not known. This secondary, pooled analysis of data from the DEVOTE trial examined whether baseline glomerular filtration rate (GFR) categories were associated with a higher risk of these outcomes.

Methods: DEVOTE was a treat-to-target, double-blind trial involving 7637 patients with T2D at high CV risk who were randomized to once-daily treatment with either insulin degludec (degludec) or insulin glargine 100 units/mL (glargine U100).

Clinical experiences with a new system for automated hand hygiene monitoring: A prospective observational study.

Background: Hand hygiene compliance (HHC) among health care workers remains suboptimal, and good monitoring systems are lacking. We aimed to evaluate HHC using an automated monitoring system.

Methods: A prospective, observational study was conducted at 2 Danish university hospitals employing a new monitoring system (Sani nudge).

Patient's characteristics and outcomes in necrotising soft-tissue infections: results from a Scandinavian, multicentre, prospective cohort study.

Purpose: Necrotising soft-tissue infections (NSTI) are characterised by necrosis, fast progression, and high rates of morbidity and mortality, but our knowledge is primarily derived from small prospective studies and retrospective studies.

Methods: We performed an international, multicentre, prospective cohort study of adults with NSTI describing patient's characteristics and associations between baseline variables and microbiological findings, amputation, and 90-day mortality.

Results: We included 409 patients with NSTI; 402 were admitted to the ICU.

Mortality in critical illness: The impact of asymmetric dimethylarginine on survival-A systematic review and meta-analysis.

Introduction: Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of the nitric oxide system, may be associated with an adverse outcome in critically ill patients. The aim of the present review was to clarify if plasma ADMA and the arginine-to-ADMA ratio (arginine/ADMA) are associated with mortality in critically ill patients.

Methods: We searched PubMed, EMBASE and Web of Science/BIOSIS Previews on 31 July 2017 for studies published after 2000 including critically ill paediatric or adult patients and evaluating any association between all-cause mortality and admission ADMA and/or arginine/ADMA ratio.

Treatment with 24 h-delayed normo- and hyperbaric oxygenation in severe sepsis induced by cecal ligation and puncture in rats.

Background: Septic shock remains a leading cause of death worldwide. Hyperbaric oxygen treatment (HBO) has been shown to alter the inflammatory response during sepsis and to reduce mortality. A therapeutic window of HBO treatment has been demonstrated experimentally, but optimal timing remains uncertain.

Associations of Plasma Nitrite, L-Arginine and Asymmetric Dimethylarginine With Morbidity and Mortality in Patients With Necrotizing Soft Tissue Infections.

Background: The nitric oxide system could play an important role in the pathophysiology related to necrotizing soft tissue infection (NSTI). Accordingly, we investigated the association between plasma nitrite level at admission and the presence of septic shock in patients with NSTI. We also evaluated the association between nitrite, asymmetric dimethylarginine (ADMA), L-arginine, L-arginine/ADMA ratio, and outcome.

Hyperbaric oxygen therapy may overcome nitric oxide blockage during cyanide intoxication.

Purpose: To determine the effects of a blockade of nitric oxide (NO) synthesis on hyperbaric oxygen (HBO₂) therapy during cyanide (CN) intoxication.

Methods: 39 anesthetized female Sprague-Dawley rats were exposed to CN intoxication (5.4 mg/kg intra-arterially) with or without previous nitric oxide synthase (NOS) inhibition by L-NG-nitroarginine methyl ester (L-NAME) injection (40 mg/kg intraperitoneally).

Biomarkers of Necrotising Soft Tissue Infections Aspects of the Innate Immune Response.

Necrotising soft tissue infection (NSTI) is a life-threatening and rapidly progressing bacterial infection involving one or more layers of the soft tissue compartments causing necrosis. The amputation and mortality rates remain high despite increased focus on the patients. Timely treatment, including surgical intervention, reduces the risk of severe disability and death.

Immunoglobulin G for patients with necrotising soft tissue infection (INSTINCT): a randomised, blinded, placebo-controlled trial.

Purpose: The aim of the INSTINCT trial was to assess the effect of intravenous polyspecific immunoglobulin G (IVIG) compared with placebo on self-reported physical function in intensive care unit (ICU) patients with necrotising soft tissue infection (NSTI).

Methods: We randomised 100 patients with NSTI 1:1 to masked infusion of 25 g of IVIG (Privigen, CSL Behring) or an equal volume of 0.9% saline once daily for the first 3 days of ICU admission.