Internal medicine journal
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The environmental impact of large language models (LLMs) in medicine spans carbon emission, water consumption and rare mineral usage. Prior-generation LLMs, such as GPT-3, already have concerning environmental impacts. Next-generation LLMs, such as GPT-4, are more energy intensive and used frequently, posing potentially significant environmental harms. We propose a five-step pathway for clinical researchers to minimise the environmental impact of the natural language algorithms they create.
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Internal medicine journal · Dec 2024
Rule-based clinician-developed programmes can facilitate haemodialysis clinical workflows.
There are routine hospital workflows that are not addressed by certain institutional electronic medical records, including the detection of patients requiring haemodialysis who are admitted under non-nephrology services. In this study, the feasibility and performance of a clinician-developed automated haemodialysis patient finder was evaluated. The programme ran with zero downtime for 6 months and had zero false negatives or false positives. This work demonstrates the potential benefits that may be gained when clinicians can meaningfully alter electronic clinical workflows.
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Internal medicine journal · Dec 2024
Putting skin in the game: a descriptive study of lower extremity ulcers in general medical inpatients.
Lower extremity ulcers contribute a significant burden to patient care. Targeted investigation and management are pertinent to improving patient outcomes. ⋯ There was evidence of under-ordering of appropriate investigations, and over-treatment for infection. We proposed a quality improvement initiative to optimise lower extremity ulcer care.
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Internal medicine journal · Dec 2024
Historical ArticleBlack-and-white pepper: unravelling Cruella De Vil's medical diagnoses.
Cruella De Vil, the iconic character from Dodie Smith's novel The Hundred and One Dalmatians, was traditionally viewed through a psychodynamic lens as a figure embodying narcissistic personality disorder, psychosis and mania. In this article, we propose an alternative hypothesis that her erratic behaviour and distinctive physical appearance may be attributed to a chronic systemic condition.