This 2025 supplemental issue of Disaster Medicine and Public Health Preparedness (DMPHP) honors Dr. C. Norman (Norm) Coleman who dedicated his life to applying his expert knowledge of radiation to develop elegant, science-based solutions to incredibly complex problems such as the public health and medical response to radiological disasters and creating a corps of experts to provide quality cancer care for people in developing countries.

Sepsis-related deaths remain prevalent in intensive care settings, with metabolic dysregulation as a key contributor. Although amino acid supplementation has shown promise, its clinical effectiveness in sepsis is unclear. This study evaluated the impact of intravenous amino acid administration on 28-day mortality in intensive care unit (ICU) sepsis patients using retrospective cohort analysis and Mendelian randomization (MR). We analyzed data from the MIMIC-IV database, matching 726 patients (363 per group) using propensity scores. The association between amino acid supplementation and mortality was assessed using Logistic regression, Cox regression, and targeted maximum likelihood estimation (TMLE). Two-sample MR was used to explore causal links between 20 common amino acids and sepsis mortality. In the cohort analysis, amino acid supplementation was consistently associated with significantly reduced 28-day mortality across all analytical methods (logistic regression: OR = 0.48, p < 0.01; Cox regression: HR = 0.48, p < 0.01; TMLE: ATE = -0.102, p < 0.01). In contrast, the MR analysis did not find a significant causal association for any single amino acid after correction for multiple comparisons; although glycine showed a nominal protective signal, it did not remain significant after FDR correction. This dual-method study demonstrates a strong association between compound amino acid infusions and reduced mortality in sepsis but did not identify any single amino acid as a robust causal mediator. These findings suggest the benefit may arise from a synergistic effect, highlighting the need for randomized controlled trials to validate these observational results and optimize nutritional strategies.

17p13.3 microdeletions involving deletion of the gene YWHAE are a newly recognised cause of neurodevelopmental disorder. There are now emerging case reports of this genetic disorder associated with CHDs, and this case report outlines the first instance of this specific 17p13.3 microdeletion with pulmonary atresia with ventricular septal defect.

The convergence of nuclear and radiological preparedness with epidemic and pandemic response, reveals valuable opportunities for cross-disciplinary learning and capability development. Insights from the extensive career of Dr. C. Norman Coleman illustrate how methodologies from radiation medical countermeasures can inform strategies for managing emerging infectious diseases. While nuclear incidents are infrequent, infectious disease outbreaks occur regularly, underscoring the need for sustained, adaptable capabilities to detect and respond to such threats. To draw on some examples, case studies on the development and deployment of vaccines against filoviruses highlight measurable advances in response speed and efficacy, while persistent challenges related to equitable access to medical countermeasures during public health emergencies can be addressed drawing lessons from the COVID-19 pandemic. Iterative improvement, strategic planning and performance optimization is very important, as is, the value of understanding the structure of a problem to find its solution.

This study is a prospective observational study to systematically compare the effects of intermittent tube feeding and thickened feeding on dehydration status, thirst degree and quality of life in patients with dysphagia after stroke. A total of forty-eight patients with dysphagia after stroke were selected and divided into intermittent tube feeding group (twenty-four cases) and thickened feeding group (twenty-four cases). The grouping was based on the nutritional intake mode after clinical decision-making. Participants were selected from the Affiliated Brain Hospital of Nanjing Medical University and the First Affiliated Hospital of Nanjing Medical University. All enrolled patients received conventional treatment and nursing measures and were treated for 2 weeks. The dehydration status was evaluated by plasma osmotic pressure. The degree of thirst is evaluated by the Numerical Rate Scale. Total protein and Hb are used to assess nutritional status; The Functional Oral Intake Scale (FOIS) assesses swallowing function. The Swallowing Quality of Life Scale (SWAL-QOL) was used to assess the quality of life. After 2 weeks of treatment, the improvement in dehydration and thirst in intermittent tube feeding group was better than that in thickened feeding group (P < 0·05). The FOIS and SWAL-QOL scores of both groups of patients improved compared with those before treatment (P < 0·05). Intermittent tube feeding can improve the dehydration status of patients with dysphagia after stroke, relieve thirst and enhance swallowing function and quality of life. The study may provide a more comprehensive basis for the selection of clinical nutritional support plans.

Crisis Resolution Teams (CRTs) are being piloted in Ireland as community-based, intensive, short-term services providing rapid intervention for individuals experiencing acute mental health crises. This perspective highlights a group over-represented in emergency care pathways: autistic adults without intellectual disability. For many autistic adults, crises can emerge from burnout, transition pressures and sensory or communication overload, often presenting with heightened distress or suicidality. In systems with limited onward pathways, brief-episode crisis care can become part of a cycle of repeated contacts, with limited scope to address enduring neurodevelopmental needs. We outline pragmatic adaptations: autism-informed workforce education; proactive crisis and safety planning; clear crisis service boundaries with connected pathways for ongoing support; and cross-sector coordination across health and social services. Embedding lived-experience and data capture in learning-sites can drive improvement. Aligned with the Crisis Resolution Service Model of Care and autism policy, these steps can improve safety, equity and continuity of care.