Objectives: To determine the feasibility of evidence-based design and use of low-cost virtual world environments for preparation and training in multi-agency, multi-site, major incident response.
Methods: A prospective cohort feasibility study was carried out. One pre-hospital, and two in-hospital major incident scenarios, were created in an accessible virtual world environment. 23 pre-hospital and hospital-based clinicians each took part in one of three linked major incident scenarios: a pre-hospital bomb blast site, focusing on the roles of the team leader and triage person; a blast casualty in a resuscitation room, focusing on the role of the trauma team leader; a hospital command and control scenario focusing on the role of the clinical major incident co-ordinator/silver commander. Participants supplied both quantitative and qualitative feedback.
Results: Using a systematic, evidence-based approach, three scenarios were successfully developed and tested using low-cost virtual worlds (Second Life and OpenSimulator). All scenarios were run to completion. 95% of participants expressed a desire to use virtual environments for future training and preparation. Pre-hospital responders felt that the immersive virtual environment enabled training in surroundings that would be inaccessible in real-life.
Conclusions: The feasibility and face/content validity of using low-cost virtual worlds for multi-agency major incident simulation has been established. Major incident planners and trainers should explore utilising this technology as an adjunct to existing methodologies. Future work will involve development of robust assessment metrics.
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http://dx.doi.org/10.1016/j.resuscitation.2012.05.014 | DOI Listing |
N Engl J Med
January 2025
From the TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston (C.T.R., S.M.P., R.P.G., D.A.M., J.F.K., E.L.G., S.A.M., S.D.W., M.S.S.); Anthos Therapeutics, Cambridge, MA (B.H., S.P., D.B.); the Heart Rhythm Center, Taipei Veterans General Hospital and Cardiovascular Center, Taipei, Taiwan (S.-A.C.); Taichung Veterans Hospital, Taichung, Taiwan (S.-A.C.); National Yang Ming Chiao Tung University, Hsinchu, Taiwan (S.-A.C.); National Chung Hsing University, Taichung, Taiwan (S.-A.C.); St. Michael's Hospital, Unity Health Toronto, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto (S.G.G.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (S.G.G.); the Division of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (B.J.); the Department of Cardiology, Central Hospital of Northern Pest-Military Hospital, Budapest, Hungary (R.G.K.); the Heart and Vascular Center, Semmelweis University, Budapest, Hungary (R.G.K.); the Internal Cardiology Department, St. Ann University Hospital and Masaryk University, Brno, Czech Republic (J.S.); the Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (W.W.); the Departments of Medicine and of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada (J.W.); and the Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada (J.W.).
Background: Abelacimab is a fully human monoclonal antibody that binds to the inactive form of factor XI and blocks its activation. The safety of abelacimab as compared with a direct oral anticoagulant in patients with atrial fibrillation is unknown.
Methods: Patients with atrial fibrillation and a moderate-to-high risk of stroke were randomly assigned, in a 1:1:1 ratio, to receive subcutaneous injection of abelacimab (150 mg or 90 mg once monthly) administered in a blinded fashion or oral rivaroxaban (20 mg once daily) administered in an open-label fashion.
Retina
January 2025
Tennessee Retina, Nashville, TN.
Purpose: To describe the patterns of ocular inflammation following COVID-19 vaccination, assess underlying commonalities and understand outcomes.
Methods: Retrospective, multicenter cohort study, conducted between 2020 and 2021. Patients with no previous uveitis history (de novo) or a known uveitis history (recurrent) who developed ocular inflammation within 42 days of COVID-19 vaccination were identified.
J Bras Pneumol
January 2025
. Departamento de Pneumologia, Hospital das Clínicas, Programa de Pós Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia (GO), Brasil.
Objective: The aim of this study was to present epidemiological data on hospitalizations and deaths related to asthma in Brazil over the past 11 years.
Methods: An ecological study was conducted on asthma-related hospitalizations and mortality in Brazil from 2013 to 2023, using data extracted from the Department of Informatics of the Brazilian Unified Health System and the Mortality Information System.
Results: Asthma-related deaths showed an increasing trend during the analyzed period.
Mem Inst Oswaldo Cruz
January 2025
Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France.
Diphtheria, a severe respiratory infection, was a major killer of children until the early years of the 20th century. Although diphtheria is now largely controlled globally thanks to vaccination, it is still endemic in some world regions and large epidemics can occur where vaccination coverage is insufficient. The pathological effects caused by its main virulence factor, diphtheria toxin, can be diminished by passive transfer of antibodies.
View Article and Find Full Text PDFPLoS One
January 2025
Sydney Medical School, University of Sydney, Sydney, New South Wales (NSW), Australia.
Acute respiratory infections cause significant paediatric morbidity, but for pathogens other than influenza, respiratory syncytial virus (RSV), and SARS-CoV-2, systematic monitoring is not commonly performed. This retrospective analysis of six years of routinely collected respiratory pathogen multiplex PCR testing at a major paediatric hospital in New South Wales Australia, describes the epidemiology, year-round seasonality, and co-detection patterns of 15 viral respiratory pathogens. 32,599 respiratory samples from children aged under 16 years were analysed.
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