The updated Surviving Sepsis Campaign care bundles are associated with improved outcomes in patients with sepsis, yet adherence to the bundles remains inconsistent. The Centers for Medicare & Medicaid Services has adopted similar care bundles as a core measure that went into effect with October 1, 2015 discharges. The aim of this study was to assess bundle compliance, length of stay (LOS), and in-hospital mortality before and after introduction of the new sepsis core measure. A retrospective cohort study was conducted in 158 patients with a diagnosis of severe sepsis or septic shock from April 2015 to February 2016. The before group ( = 48) consisted of sequential patients discharged from April 1, 2015 to September 30, 2015 (prior to core measure implementation), and the after group ( = 110) consisted of sequential patients discharged from October 1, 2015 to February 29, 2016 (after core measure implementation). Significant improvement was seen in the after group compared to the before group for bundle compliance with the 3-hour (66.4% vs 31.3%; < 0.01) and 6-hour (75.5% vs 41.7%; < 0.01) components and the overall core measure (51.8% vs 16.7%; < 0.01). In-hospital mortality was lower in the after group compared to the before group (14.5% vs 27.1%; = 0.05), but this difference was not statistically significant. There was no significant difference in LOS. The study found a significant increase in compliance with the sepsis care bundles since the implementation of this core measure. Increased adherence to the care bundles may improve in-hospital survival.
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http://dx.doi.org/10.1310/hpj5203-177 | DOI Listing |
Front Psychol
December 2024
Université Claude Bernard Lyon 1, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Centre de Recherche en Neurosciences de Lyon U1028 UMR5292, PSYR2, Bron, France.
Background: Anhedonia, including social, physical, and less-known, olfactory, stands as a core symptom of major depressive disorder (MDD). At the neurobiological level, anhedonia has been associated with abnormal activity within the reward system, suggesting a key role for dopamine. Repetitive Transcranial Magnetic Stimulation (rTMS) has emerged as an innovative treatment for alleviating depressive symptoms.
View Article and Find Full Text PDFNature
January 2025
Institute of Arctic and Alpine Research, University of Colorado, Boulder, CO, USA.
Understanding the causes of past atmospheric methane (CH) variability is important for characterizing the relationship between CH, global climate and terrestrial biogeochemical cycling. Ice core records of atmospheric CH contain rapid variations linked to abrupt climate changes of the last glacial period known as Dansgaard-Oeschger (DO) events and Heinrich events (HE). The drivers of these CH variations remain unknown but can be constrained with ice core measurements of the stable isotopic composition of atmospheric CH, which is sensitive to the strength of different isotopically distinguishable emission categories (microbial, pyrogenic and geologic).
View Article and Find Full Text PDFClin Teach
February 2025
Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Background: Most postgraduate medical education tracks are faculty-led and emphasise teaching skills. A peer-to-peer medical education track focused on curriculum development and scholarship is notably underrepresented in the literature, especially within graduate medical education. To address these gaps, a 2-year Distinction in Medical Education (DIME) track was developed.
View Article and Find Full Text PDFEpilepsy Behav
December 2024
University of Michigan, Department of Neurology, Ann Arbor, MI, USA. Electronic address:
Objective: While guidelines encourage individualized discussions of the risks and benefits of antiseizure medication (ASM) withdrawal after a period of seizure-freedom, no formal methods exist for assessing patient preferences. We report the initial development of a rapid patient preferences screener.
Methods: We conducted a mixed-methods study of adults who were ≥1 year seizure-free and seen for epilepsy across three institutions.
Top Stroke Rehabil
January 2025
Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.
Background: The core is important in providing local strength and balance and is central to almost all kinetic chains of daily activities.
Objective: This study aimed to assess the effectiveness of additional Core Stability Exercises (CSE) to conventional physiotherapy (CP) versus CP alone to improve dynamic sitting balance, coordination, trunk function, and stepping (gait) as a primary outcome and functional sitting balance, postural control, standing balance and fall risk, lower limb spasticity, activities of daily living, degree of disability, and quality of life for early subacute stroke recovery.
Methods: A multicentre parallel, randomized, controlled, assessor-blinded trial was conducted.
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