Cirrhosis is a major cause of morbidity and mortality. Patients with decompensated cirrhosis, or end-stage liver disease (ESLD), have a high symptom burden and an increased mortality risk. Yet, the uptake of palliative care in patients with ESLD remains low and variable. Despite robust evidence of the value of home palliative care in other advanced diseases, this has not been well studied in patients with ESLD. Hence, the primary aim of this study is to explore the implementation, feasibility and acceptability of home palliative care in patients with ESLD and healthcare professionals. We also aim to describe its impact on the quality of life (QoL), mood, symptom burden, caregiver burden and healthcare utilisation of patients with ESLD.

The study is a single-centre, mixed-methods feasibility study. Eligible patients include those with decompensated liver cirrhosis who are admitted under the gastroenterology and hepatology service and fulfil the Supportive and Palliative Care Indicator Tools (SPICT) criteria. Recruited patients will be followed up by a multi-disciplinary homecare team led by a palliative care physician for 6 months. Both qualitative and quantitative measures will be used to evaluate the primary aim and include the uptake of the service by both eligible patients and physicians. Semistructured interviews with key stakeholder groups will be conducted to determine their perspectives and experiences. Secondary outcome measures include changes in health-related QoL using the Chronic Liver Disease Questionnaire, depression severity, goals of care discussions, patient symptom burden, caregiver burden and healthcare utilisation.

This study will adhere to the Declaration of Helsinki and has been approved by the research ethics committee of the National Healthcare Group (DSRB (Domain Specific Review Board) reference: 2023/00852). Results will be submitted for publication in international peer-reviewed journals.

Despite global efforts, gender disparities in oncology may persist. Understanding these disparities within the context of major conferences can inform strategies to promote gender inclusiveness in the field. This study evaluates the participation of women and men at the American Society of Clinical Oncology (ASCO) 2024 congress, focusing on chairs, speakers and audience questioners.

Observational study.

152 recorded sessions of the ASCO 2024 annual meeting, one of the largest conferences in the field of oncology, available on the ASCO website.

Individuals serving as chairs, speakers and audience members who asked questions.

In this observational study, gender for chairs, speakers and audience questioners across 152 sessions of the ASCO 2024 congress was assessed by two independent reviewers using audio and video recordings. Speaking times for questions and responses were also evaluated. Statistical analyses, including ² and unpaired t-tests, were conducted to analyse the data.

Women were well represented as chairs (n=124) and speakers (n=402) in 66% and 95% of sessions, respectively. However, only 21% of questions from the audience were posed by women, while 37% of questions were asked by men and 42% online or by chairs/speakers. Women were more likely to pose questions when the sessions were chaired by women (71% vs 53%; p=0.047). There were no statistically significant gender disparities concerning speaking time (questions: p=0.30; responses: 0.53). The response dynamics indicated a pattern of gender homogeneity, with individuals more frequently responding to questions from their own gender.

While the balanced representation of women in leadership roles at the ASCO 2024 congress reflects positive development in gender equality, disparities in active participation persist. These findings underscore the need for strategies that not only promote women in visible roles but also foster an environment that supports their active engagement in scientific discussions.

Sepsis is a major cause of death both globally and in the United States. Early identification and treatment of sepsis are crucial for improving patient outcomes. International guidelines recommend hospital sepsis screening programmes, which are commonly implemented in the electronic health record (EHR) as an interruptive sepsis screening alert based on systemic inflammatory response syndrome (SIRS) criteria. Despite widespread use, it is unknown whether these sepsis screening and alert tools improve the delivery of high-quality sepsis care.

The Sepsis Electronic Prompting for Timely Intervention and Care (SEPTIC) master protocol will study two distinct populations in separate trials: emergency department (ED) patients (SEPTIC-ED) and inpatients (SEPTIC-IP). The SEPTIC trials are pragmatic, multicentre, blinded, randomised controlled trials, with equal allocation to compare four SIRS-based sepsis screening alert groups: no alerts (control), nurse alerts only, prescribing clinician alerts only, or nurse and prescribing clinician alerts. Randomisation will be at the patient level. SEPTIC will be performed at eight acute-care hospitals in the greater New York City area and enrol patients at least 18 years old. The primary outcome is the percentage of patients with completion of a modified Surviving Sepsis Campaign (SSC) hour-1 bundle within 3 hours of the first SIRS alert. Secondary outcomes include time from first alert to completion of a modified SSC hour-1 bundle, time from first alert to individual bundle component order and completion, intensive care unit (ICU) transfer, hospital discharge disposition, inpatient mortality at 90 days, positive blood cultures (bacteraemia), adverse antibiotic events, sepsis diagnoses and septic shock diagnoses.

Ethics approval was obtained from the Columbia University Institutional Review Board (IRB) serving as a single IRB. Results will be disseminated in peer-reviewed journal(s), scientific meeting(s) and via social media.

ClinicalTrials.gov: NCT06117605 and NCT06117618.