Most approaches toward chemical and radiological/nuclear (CRN) incidents focus on the clinical skills of the first receiver. These skills are certainly important and are addressed throughout this article. Management skills are often overlooked. The following are basic competencies in information management for the emergency medicine physician to handle large-scale CRN incidents: planning information; incident management information; toxicant management; disposition/definitive care management; and recovery management. Information management and synthesis are crucial throughout the phases of the disaster cycle: planning, response, mitigation, and recovery.
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http://dx.doi.org/10.1016/j.emc.2014.09.007 | DOI Listing |
Diabetologia
January 2025
MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Aims/hypothesis: UK standard care for type 2 diabetes is structured diabetes education, with no effects on HbA, small, short-term effects on weight and low uptake. We evaluated whether remotely delivered tailored diabetes education combined with commercial behavioural weight management is cost-effective compared with current standard care in helping people with type 2 diabetes to lower their blood glucose, lose weight, achieve remission and improve cardiovascular risk factors.
Methods: We conducted a pragmatic, randomised, parallel two-group trial.
J Med Virol
January 2025
Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada.
The protective effect of naturally acquired humoral immunity against human papillomavirus (HPV) infection remains unclear. To investigate the role of infection-induced antibodies on HPV detection in heterosexual partners, we used data from 392 unvaccinated couples (females aged 18-25 years attended up to six visits over 2 years; males aged 17-37 years attended up to two visits 4 months apart) enrolled (2005-2011) in Montreal. Genital and blood samples were HPV DNA genotyped and tested for L1 antibody titers of 14 HPV genotypes.
View Article and Find Full Text PDFHepatology
January 2025
Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California San Diego School of Medicine, La Jolla, California, USA.
Background And Aims: Longitudinal outcomes in children with metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear due to the absence of a standardized monitoring approach. This study aimed to (1) define improvement and worsening in children with MASLD, (2) estimate rates of improvement or deterioration with the standard of care (SOC) over 1 and 2 years, and (3) identify baseline and longitudinal factors associated with improvement or worsening.
Approach And Results: Using data from 2 large randomized controlled trials, we derived definitions for composite improvement and worsening of MASLD based on associations between changes in ALT, GGT, and liver histology after 1 and 2 years.
Pac Symp Biocomput
December 2024
Division of Medical Informatics, Division of Pulmonary Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
We leveraged electronic health record (EHR) data from the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) Clinical Research Network (CRN) to identify social risk factor clusters, assess their association with obstructive sleep apnea (OSA), and determine relevant clinical predictors of cardiovascular (CV) outcomes among those experiencing OSA. Geographically informed social indicators were used to define social risk factor clusters via latent class analysis. EHR-wide diagnoses were used as predictors of 5-year incidence of major adverse CV events (MACE) using STREAMLINE, an end-to-end rigorous and interpretable automated machine learning pipeline.
View Article and Find Full Text PDFThorax
December 2024
School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
Background: Uncontrolled asthma is possibly caused by medication non-adherence, and financial hardship can be a major contributor to non-adherence. Since economic conditions and asthma management have changed over time, a comprehensive investigation of cost-related medication non-adherence (CRN) among adults with asthma is crucial.
Objective: To evaluate trends, prevalence and determinants of CRN, and its impact on asthma control among US adults with asthma.
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