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{ "count": 39441, "next": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=11000", "previous": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=10800", "results": [ { "pk": 1082, "title": "Pacemaker Lead Migration and Ventricular Perforation in a Patient Presenting with Chest Pain", "subtitle": null, "abstract": "Case Presentation:\n We describe a middle-age male with a past medical history of second-degree atrioventricular block type II status post permanent pacemaker placement the day prior who presented to the emergency department complaining of chest pain. Electrocardiography showed a non-paced ventricular rhythm. Chest radiograph showed the ventricular pacemaker lead located distally overlying the right ventricle apical area. On further investigation, chest computed tomography showed a perforation of the ventricular wall by the pacemaker lead prompting urgent intervention by the cardiothoracic surgery team for lead replacement and right ventricular repair.\nDiscussion:\n Our case illustrates the importance of timely recognition of a perforated pacemaker lead in a patient presenting with chest pain after device implantation. We additionally describe the risk factors for ventricular perforation, initial clinical presentation, and management approach.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "pacemaker" }, { "word": "ventricular lead" }, { "word": "perforation" }, { "word": "chest pain" } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6pm2c1x9", "frozenauthors": [ { "first_name": "Maria", "middle_name": "C.", "last_name": "Cañizares-Otero", "name_suffix": "", "institution": "Aventura Hospital & Medical Center, Department of Critical Care Medicine, Aventura, Florida", "department": "None" }, { "first_name": "Mauricio", "middle_name": "", "last_name": "Danckers", "name_suffix": "", "institution": "Aventura Hospital & Medical Center, Department of Critical Care Medicine, Aventura, Florida", "department": "None" } ], "date_submitted": "2021-09-09T19:34:07-04:00", "date_accepted": "2021-09-09T19:34:07-04:00", "date_published": "2021-09-09T19:34:49-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1082/galley/824/download/" } ] }, { "pk": 1081, "title": "Bilateral Acute Angle-Closure Glaucoma: A Case Report of an Unusual Cause of Acute Headache in a Child", "subtitle": null, "abstract": "Introduction:\n Acute angle-closure glaucoma (AACG) is typically considered a disease of adulthood. However, AACG may occasionally be seen in children. The clinical presentation is similar to adults, including headache, vomiting, and eye pain. However, the etiology of angle closure in children is different and most often associated with congenital anterior segment abnormalities. A precipitating factor of AACG in children with previous established, anterior segment abnormalities is eye dilation, which may occur during routine ophthalmological examination with topical mydriasis, or physiologic mydriasis upon entering a dark room.\nCase Report:\n We describe a 5-year-old child with a history of severe prematurity and retinopathy of prematurity (ROP) presenting with bilateral AACG following a routine outpatient, dilated ophthalmological examination. While angle-closure glaucoma has previously been reported in cases of ROP, a bilateral acute attack of AACG following pupil dilation in regressed ROP has hitherto been unreported.\nConclusion:\n Given the association of ROP and AACG, it can be expected that as the survival rate of premature infants improves, the incidence of ROP and AACG may also increase. It is therefore prudent for the emergency physician to have AACG on the differential for pediatric patients with headache and eye pain.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "pediatrics" }, { "word": "acute angle closure glaucoma" }, { "word": "retinopathy of prematurity" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/126247k7", "frozenauthors": [ { "first_name": "Breelan", "middle_name": "", "last_name": "Kear", "name_suffix": "", "institution": "Providence St. Joseph Hospital Orange, Department of Emergency Medicine, Orange, California", "department": "None" }, { "first_name": "Claudia", "middle_name": "R.", "last_name": "Gold", "name_suffix": "", "institution": "CHOC Children’s Hospital, Department of Pediatric Emergency Medicine, Orange, California", "department": "None" }, { "first_name": "Rahul", "middle_name": "", "last_name": "Bhola", "name_suffix": "", "institution": "CHOC Children’s Hospital, Department of Pediatric Emergency Medicine, Orange, California", "department": "None" } ], "date_submitted": "2021-09-09T19:21:33-04:00", "date_accepted": "2021-09-09T19:21:33-04:00", "date_published": "2021-09-09T19:22:24-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1081/galley/823/download/" } ] }, { "pk": 1080, "title": "A Case Report of Acute Prostatitis Secondary to Use of P-valve Condom Catheter During Cave Diving", "subtitle": null, "abstract": "Introduction:\n Acute bacterial prostatitis is characterized by acute inflammation of the prostate gland accompanied by the presence of pain and other urinary tract or systemic symptoms. Prostatitis is a relatively common disease of the urinary tract in men, However, this case reports a man diagnosed with acute bacterial prostatitis with an unusual presentation, as well as an unusual pathogen and a unique mechanism of colonization.\nCase Report:\n A 52-year-old male with no past medical history presented to our facility for right-sided buttock pain associated with dysuria, diarrhea, and perianal burning. The patient was diagnosed with sepsis secondary to acute bacterial prostatitis, and the pathogen identified in his urine was Aeromonas hydrophila/A. caviae. His disease process was later recognized as a complication of the use of a P-valve condom catheter while freshwater cave diving.\nConclusion: \nThis is the first documented case of prostatitis as a result of the use of a P-valve condom catheter while diving. Furthermore, the pathogen identified is of particular interest as there are very few documented cases of urosepsis secondary to Aeromonas hydrophila or A. caviae.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "case report" }, { "word": "acute bacterial prostatitis" }, { "word": "cave diving" }, { "word": "Aeromonas" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8g52d5bh", "frozenauthors": [ { "first_name": "Ashley", "middle_name": "", "last_name": "Barash", "name_suffix": "", "institution": "North Florida Regional Medical Center, Department of Graduate Medical Education, Gainesville, Florida\n\nUCF/HCA Healthcare GME Consortium of North Florida, Department of Emergency Medicine, Gainesville, Florida", "department": "None" }, { "first_name": "Evan", "middle_name": "", "last_name": "Stern", "name_suffix": "", "institution": "North Florida Regional Medical Center, Department of Graduate Medical Education, Gainesville, Florida\n\nUCF/HCA Healthcare GME Consortium of North Florida, Department of Emergency Medicine, Gainesville, Florida", "department": "None" }, { "first_name": "Robyn", "middle_name": "", "last_name": "Hoelle", "name_suffix": "", "institution": "North Florida Regional Medical Center, Department of Graduate Medical Education, Gainesville, Florida\n\nUCF/HCA Healthcare GME Consortium of North Florida, Department of Emergency Medicine, Gainesville, Florida", "department": "None" } ], "date_submitted": "2021-09-09T19:10:39-04:00", "date_accepted": "2021-09-09T19:10:39-04:00", "date_published": "2021-09-09T19:11:25-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1080/galley/822/download/" } ] }, { "pk": 1079, "title": "A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency", "subtitle": null, "abstract": "Introduction: \nChloroform, a halogenated hydrocarbon, causes central nervous depression, hepatotoxicity, nephrotoxicity, and rhabdomyolysis. Historically, chloroform had been used as a general anaesthetic and today is still used in chemical industries. Lack of proper personal protective equipment and adequate knowledge about its toxic effects can lead to serious harm.\nCase report:\n A 33-year-old gentleman presented to the emergency department (ED) with altered mental status. Given his depressed mental status, the decision was made to intubate shortly after arrival for airway protection. Further history raised suspicion of occupational chloroform exposure. Brown-colored urine further strengthened suspicion of chloroform poisoning with resultant rhabdomyolysis. Forced alkaline diuresis and N-acetylcysteine were started in the ED. His mental status and respiratory efforts improved on hospital day two, and he was ultimately extubated. Creatine phosphokinase and myoglobin levels were initially high but gradually came down by hospital day six. On hospital day 10, the patient was deemed stable and safely discharged.\nConclusion:\n A patient with chloroform inhalation who suffered resultant rhabdomyolysis and hepatotoxicity was successfully treated with early initiation of forced alkaline diuresis, N-acetylysteine, and hemodialysis.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "chloroform" }, { "word": "poisoning" }, { "word": "rhabdomyolysis" }, { "word": "N-acetylcysteine" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8kn0j1x3", "frozenauthors": [ { "first_name": "Rajadurai", "middle_name": "", "last_name": "Meenakshisundaram", "name_suffix": "", "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India", "department": "None" }, { "first_name": "Joshua", "middle_name": "Vijay", "last_name": "Joseph", "name_suffix": "", "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India", "department": "None" }, { "first_name": "Prabakaran", "middle_name": "", "last_name": "Perumal", "name_suffix": "", "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India", "department": "None" }, { "first_name": "Akmal", "middle_name": "", "last_name": "Areeb", "name_suffix": "", "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India", "department": "None" }, { "first_name": "Prathap", "middle_name": "", "last_name": "Pancheti", "name_suffix": "", "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India", "department": "None" }, { "first_name": "Dinesh", "middle_name": "Kannan", "last_name": "Sampath", "name_suffix": "", "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India", "department": "None" }, { "first_name": "Esther", "middle_name": "Monica", "last_name": "Jared", "name_suffix": "", "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India", "department": "None" } ], "date_submitted": "2021-09-09T18:57:28-04:00", "date_accepted": "2021-09-09T18:57:28-04:00", "date_published": "2021-09-09T18:59:07-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1079/galley/821/download/" } ] }, { "pk": 1078, "title": "SAPHO Syndrome: An Unusual Cause of Dysphagia", "subtitle": null, "abstract": "Case Presentation:\n This case describes a 51-year-old male who presented to the emergency department with a complaint of two weeks of progressively worsening dysphagia as well as the emergence of superficial fluid collections on the anterior chest and leg during the same period. Computed tomography showed retropharyngeal and paratracheal fluid collections with adjacent vertebral osteitis; however, biopsies were negative for any infectious or mycobacterial source, and instead showed chronic inflammatory changes.\nDiscussion:\n Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is a rare rheumatic disorder that presents with multifocal osteitis and sterile neutrophilia. SAPHO syndrome may be easily mistaken for a diffuse infectious process on initial evaluation and imaging; however, it is treated with anti-inflammatory medications, including non-steroidal anti-inflammatory drugs and corticosteroids. Although most patients achieve remission of symptoms with treatment, the location of the fluid collections and resultant bony destruction may be life-threatening if undiagnosed.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "dysphagia" }, { "word": "SAPHO syndrome" }, { "word": "emergency department" } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4tv9q218", "frozenauthors": [ { "first_name": "Megan", "middle_name": "", "last_name": "Hoffer", "name_suffix": "", "institution": "The George Washington School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, District of Columbia", "department": "None" }, { "first_name": "Michaela", "middle_name": "", "last_name": "Salvo", "name_suffix": "", "institution": "The George Washington School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, District of Columbia", "department": "None" }, { "first_name": "Sonal", "middle_name": "", "last_name": "Batra", "name_suffix": "", "institution": "The George Washington School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, District of Columbia", "department": "None" } ], "date_submitted": "2021-09-09T18:42:03-04:00", "date_accepted": "2021-09-09T18:42:03-04:00", "date_published": "2021-09-09T18:43:53-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1078/galley/820/download/" } ] }, { "pk": 63402, "title": "Unpacking the T: Understanding the Diverse Experiences Trans Students Navigating Schools", "subtitle": null, "abstract": "In this mixed methods study, we use quantitative and narrative survey data from 47 parents/guardians of trans youth to understand their experiences navigating schools. In our analytic process, we recognized that how students identified mattered to parents/guardians’ stories. We use trans theories and concepts of materiality, embodiment, and subjection to understand our initial thematic analysis. Our findings indicate the need to attend to students’ material bodies, how their embodied experiences differ based on how they are read and which “rules” they “break,” and how masculinity and femininity might be regulated differently. We aim to contribute to the growing literature in PK-12 education that calls for research to differentiate the experiences of trans students by unpacking the T.", "language": "en", "license": null, "keywords": [ { "word": "transgender youth, gender identity, gender expression, cis-heteronormativity, transgender theory" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/10v091bm", "frozenauthors": [ { "first_name": "bethy", "middle_name": "", "last_name": "leonardi", "name_suffix": "", "institution": "University of Colorado Boulder", "department": "" }, { "first_name": "Amy", "middle_name": "N.", "last_name": "Farley", "name_suffix": "", "institution": "University of Cincinnati", "department": "" }, { "first_name": "Emmett", "middle_name": "", "last_name": "Harsin Drager", "name_suffix": "", "institution": "University of Southern California", "department": "" }, { "first_name": "Jax", "middle_name": "", "last_name": "Gonzales", "name_suffix": "", "institution": "University of Colorado Boulder", "department": "" } ], "date_submitted": "2019-09-19T10:50:47-04:00", "date_accepted": "2019-09-19T10:50:47-04:00", "date_published": "2021-09-09T15:38:34-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/bre/article/63402/galley/48843/download/" } ] }, { "pk": 15896, "title": "Enroller Experience and Parental Familiarity of Disease Influence Participation in a Pediatric Trial", "subtitle": null, "abstract": "Introduction:\n Acquiring parental consent is critical to pediatric clinical research, especially in interventional trials. In this study we investigated demographic, clinical, and environmental factors associated with likelihood of parental permission for enrollment in a study of therapies for diabetic ketoacidosis (DKA) in children.\nMethods:\n We analyzed data from patients and parents who were approached for enrollment in the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) trial at one major participating center. We determined the influence of various factors on patient enrollment, including gender, age, distance from home to hospital, insurance status, known vs new onset of diabetes, glycemic control (hemoglobin A1c), DKA severity, gender of the enroller, experience of the enroller, and time of enrollment. Patients whose parents consented to participate were compared to those who declined participation using bivariable and multivariable analyses controlling for the enroller.\nResults:\n A total of 250 patient/parent dyads were approached; 177 (71%) agreed to participate, and 73 (29%) declined. Parents of patients with previous episodes of DKA agreed to enroll more frequently than those with a first DKA episode (94.3% for patients with 1-2 previous DKA episodes, 92.3% for > 2 previous episodes, vs 64.9% for new onset diabetes and 63.2% previously diagnosed but no previous DKA). Participation was also more likely with more experienced enrollers (odds ratio [95% confidence interval] of participation for an enroller with more than two years’ experience vs less than two years: 2.46 [1.53, 3.97]). After adjusting for demographic and clinical factors, significant associations between participation and both DKA history and enroller experience remained. Patient age, gender, distance of home from hospital, glycemic control, insurance status, and measures of DKA severity were not associated with likelihood of participation.\nConclusion:\n Familiarity with the disease process (previously diagnosed diabetes and previous experience with DKA) and experience of the enroller favorably influenced the likelihood of parental permission for enrollment in a study of DKA in children.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Population Health Research Design", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/12s567cx", "frozenauthors": [ { "first_name": "Jeff", "middle_name": "E.", "last_name": "Schunk", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "Kammy", "middle_name": "K.", "last_name": "Jacobsen", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "Dilon", "middle_name": "", "last_name": "Stephens", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "Amy", "middle_name": "", "last_name": "Watson", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "Cody", "middle_name": "S.", "last_name": "Olsen", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "T. Charles Casper", "middle_name": "", "last_name": "Casper", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "Nicole", "middle_name": "S.", "last_name": "Glaser", "name_suffix": "", "institution": "University of California Davis Health, Department of Pediatrics, Sacramento, California", "department": "None" }, { "first_name": "Nathan", "middle_name": "", "last_name": "Kuppermann", "name_suffix": "", "institution": "University of California Davis Health, Department of Pediatrics, Sacramento, California; University of California Davis Health, Department of Emergency Medicine, Sacramento, California", "department": "None" } ], "date_submitted": "2021-09-07T22:55:17-04:00", "date_accepted": "2021-09-07T22:55:17-04:00", "date_published": "2021-09-07T23:04:23-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15896/galley/7965/download/" } ] }, { "pk": 57231, "title": "Evidentiality in East Caucasian on the map", "subtitle": null, "abstract": "Languages spoken in contiguous areas tend to have similar systems of evidentiality marking. The Caucasus is part of a large area where systems centered on marking events as not witnessed by the speaker are widespread among genealogically unrelated languages. It is often suggested that Turkic languages could be the source of diffusion in this case, because evidentiality is an old and prominent feature of Turkic grammar. This paper explores the areal dimension of evidentiality in languages of the East Caucasian family, which are spoken on a relatively compact territory in the eastern Caucasus. It provides an overview of the most common types of marking and their geographical distribution among the East Caucasian languages and their Turkic neighbors. The spread of evidentiality as part of the tense system shows a peculiar pattern in the eastern Caucasus, which suggests that it could be a contact-induced feature. However, a number of factors prevent the reconstruction of a specific borrowing scenario. Based on the currently available data the Turkic contact hypothesis cannot be confirmed nor refuted. The paper proposes an alternative scenario for a mixed language-internal and contact-induced development that can possibly be verified with data from oral narratives.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "evidentiality, East Caucasian languages, Turkic languages, language contact, areal typology, perfect" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1zf7z1ck", "frozenauthors": [ { "first_name": "Samira", "middle_name": "", "last_name": "Verhees", "name_suffix": "", "institution": "Linguistic Convergence Lab, Higher School of Economics, Moscow", "department": "" } ], "date_submitted": "2021-09-07T18:53:18-04:00", "date_accepted": "2021-09-07T18:53:18-04:00", "date_published": "2021-09-07T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/languagesofcaucasus/article/57231/galley/43410/download/" } ] }, { "pk": 15895, "title": "WestJEM Full-Text Issue", "subtitle": null, "abstract": "n/a", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "WestJEM Full-Text Issue", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3v72j53c", "frozenauthors": [ { "first_name": "Cassandra", "middle_name": "", "last_name": "Saucedo", "name_suffix": "", "institution": "UC Irvine", "department": "None" }, { "first_name": "Nathan", "middle_name": "", "last_name": "Do", "name_suffix": "", "institution": "UC Irvine", "department": "None" } ], "date_submitted": "2021-09-07T18:07:44-04:00", "date_accepted": "2021-09-07T18:07:44-04:00", "date_published": "2021-09-07T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15895/galley/7964/download/" } ] }, { "pk": 15835, "title": "Call For Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health Wealthy nations must do much more, much faster", "subtitle": null, "abstract": "N/A", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Editorials (Limit 2000 words) (Invitation Only)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/28z0n39x", "frozenauthors": [ { "first_name": "Lukoye", "middle_name": "", "last_name": "Atwoli", "name_suffix": "", "institution": "East African Medical Journal", "department": "None" }, { "first_name": "Abdullah", "middle_name": "H.", "last_name": "Baqui", "name_suffix": "", "institution": "Journal of Health, Population and Nutrition", "department": "None" }, { "first_name": "Thomas", "middle_name": "", "last_name": "Benfield", "name_suffix": "", "institution": "Danish Medical Journal", "department": "None" }, { "first_name": "Raffaella", "middle_name": "", "last_name": "Bosurgi", "name_suffix": "", "institution": "PLOS Medicine", "department": "None" }, { "first_name": "Fiona", "middle_name": "", "last_name": "Godlee", "name_suffix": "", "institution": "The BMJ", "department": "None" }, { "first_name": "Stephen", "middle_name": "", "last_name": "Hancocks", "name_suffix": "", "institution": "British Dental Journal", "department": "None" }, { "first_name": "Richard", "middle_name": "", "last_name": "Horton", "name_suffix": "", "institution": "The Lancet", "department": "None" }, { "first_name": "Laurie", "middle_name": "", "last_name": "Laybourn-Langton", "name_suffix": "", "institution": "UK Health Alliance on Climate Change", "department": "None" }, { "first_name": "Carlos", "middle_name": "Augusto", "last_name": "Monteiro", "name_suffix": "", "institution": "Revista de Saúde Pública", "department": "None" }, { "first_name": "Ian", "middle_name": "", "last_name": "Norman", "name_suffix": "", "institution": "International Journal of Nursing Studies", "department": "None" }, { "first_name": "Kirsten", "middle_name": "", "last_name": "Patrick", "name_suffix": "", "institution": "Canadian Medical Association Journal", "department": "None" }, { "first_name": "Nigel", "middle_name": "", "last_name": "Praities", "name_suffix": "", "institution": "Pharmaceutical Journal", "department": "None" }, { "first_name": "Marcel", "middle_name": "G.M. Olde", "last_name": "Rikkert", "name_suffix": "", "institution": "Dutch Journal of Medicine", "department": "None" }, { "first_name": "Eric", "middle_name": "J.", "last_name": "Rubin", "name_suffix": "", "institution": "New England Journal of Medicine", "department": "None" }, { "first_name": "Peush", "middle_name": "", "last_name": "Sahni", "name_suffix": "", "institution": "National Medical Journal of India", "department": "None" }, { "first_name": "Richard", "middle_name": "", "last_name": "Smith", "name_suffix": "", "institution": "UK Health Alliance on Climate Change", "department": "None" }, { "first_name": "Nick", "middle_name": "", "last_name": "Talley", "name_suffix": "", "institution": "Medical Journal of Australia", "department": "None" }, { "first_name": "Sue", "middle_name": "", "last_name": "Turale", "name_suffix": "", "institution": "International Nursing Review", "department": "None" }, { "first_name": "Damián", "middle_name": "", "last_name": "Vázquez", "name_suffix": "", "institution": "Pan American Journal of Public Health", "department": "None" } ], "date_submitted": "2021-08-18T20:00:50-04:00", "date_accepted": "2021-08-18T20:00:50-04:00", "date_published": "2021-09-06T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15835/galley/7932/download/" } ] }, { "pk": 39801, "title": "People’s contribution to the knowledge of Pycnogonida: citizen science in the case of a “problematic” taxon.", "subtitle": null, "abstract": "Pycnogonida is a poorly known class of marine arthropods represented by nearly 1350 species described worldwide. We examined data about these organisms available on seven websites for photographs and information sharing among recreational naturalists. We found 384 observations, mainly with data about locality and date. Photos about 65 of them resulted correctly identified to the species level with certainty. The others refer to species whose identification requires a more in-depth analysis under a microscope. Unfortunately, this problem is common to a high percentage of pycnogonids. Therefore it seems unlikely that citizen scientists could contribute significantly to their knowledge. Nevertheless, for some species this would be possible and data on the presence of the taxon could be useful for more general studies at community level.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Geographic distribution, Observations, Pantopoda, Scuba diving, Websites" } ], "section": "Special Section: Citizen Science in Biogeography", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/12r6m7r6", "frozenauthors": [ { "first_name": "Elisa", "middle_name": "", "last_name": "Colasanto", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Loris", "middle_name": "", "last_name": "Galli", "name_suffix": "", "institution": "Genoa University", "department": "None" } ], "date_submitted": "2021-06-07T08:42:09-04:00", "date_accepted": "2021-06-07T08:42:09-04:00", "date_published": "2021-09-03T07:04:51-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/biogeographia/article/39801/galley/29976/download/" } ] }, { "pk": 1077, "title": "Early Extracorporeal Membrane Oxygenation in COVID-19 with Bullous Lung Disease on Mechanical Ventilation: A Case Report", "subtitle": null, "abstract": "Introduction:\n Extracorporeal membrane oxygenation (ECMO) has been well described as a viable option for patients in need of temporary supplemental oxygenation when ventilator capabilities have failed to augment a patient’s condition. Less described is the potential use of ECMO for lung protection in the setting of gigantic bullae despite initially adequate oxygenation.\nCase Report:\n We describe how the early incorporation of ECMO in a patient with coronavirus disease 2019 and necrotizing pneumonia complicated by multiple large and gigantic bullae led to a favorable outcome.\nConclusion:\n The decision to start ECMO early, despite room for ventilator oxygenation adjustments, may have helped to prevent potential, significant complications such as tension pneumothorax while on positive pressure, thus potentially optimizing the outcome in this patient.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "resuscitation" }, { "word": "Critical care" }, { "word": "COVID-19" }, { "word": "gigantic bullae" }, { "word": "ECMO" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7kr6z6fg", "frozenauthors": [ { "first_name": "Jason", "middle_name": "", "last_name": "Unold", "name_suffix": "", "institution": "Detroit Receiving Hospital, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "Brandon", "middle_name": "", "last_name": "Marshal", "name_suffix": "", "institution": "Detroit Receiving Hospital, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "Tolupe", "middle_name": "", "last_name": "Sonuyi", "name_suffix": "", "institution": "Detroit Receiving Hospital, Department of Emergency Medicine, Detroit, Michigan", "department": "None" } ], "date_submitted": "2021-09-02T23:40:40-04:00", "date_accepted": "2021-09-02T23:40:40-04:00", "date_published": "2021-09-02T23:41:20-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1077/galley/819/download/" } ] }, { "pk": 15155, "title": "Mobile Crisis Outreach and Emergency Department Utilization: A Propensity Score-matched Analysis", "subtitle": null, "abstract": "Introduction:\n Mental health and substance use disorder (MHSUD) patients in the emergency department (ED) have been facing increasing lengths of stay due to a shortage of inpatient beds. Previous research indicates mobile crisis outreach (MCO) reduces long ED stays for MHSUD patients. Our objective was to assess the impact of MCO contact on future ED utilization.\nMethods:\n We conducted a retrospective chart review of patients presenting to a large Midwest university ED with an MHSUD chief complaint from 2015–2018. We defined the exposure as those who had MCO contact and any MHSUD-related ED visit within 30 days of MCO contact. The MCO patients were 2:1 propensity score–matched by demographic data and comorbidities matched to patients with no MCO contact. Outcomes were all-cause and psychiatric-specific reasons for return to the ED within one year of the index ED visit. We report descriptive statistics and odds ratios (OR) to describe the difference between the two groups, and hazard ratios (HR) to estimate the risk of return ED visit. \nResults:\n The final sample included 106 MCO and 196 non-MCO patients. The MCO patients were more likely to be homeless (OR 14.8; 95% confidence interval [CI],1.87, 117), less likely to have adequate family or social support (OR 0.51; 95% CI, 0.31, 0.84), and less likely to have a hospital bed requested for them in the index visit by ED providers (OR 0.50; 95% CI, 0.29, 0.88). For those who returned to the ED, the median time for all-cause return to the ED was 28 days (interquartile range [IQR]: 6–93 days) for the MCO patients and 88 days (IQR: 20–164 days) for non-MCO patients. The risk of all-cause return to the ED was greater among MCO patients (67%) compared to non-MCO patients (49%) (adjusted HR: 1.66; 95% CI, 1.22, 2.27). \nConclusion:\n The MCO patients had less family and social support; however, they were less likely to require hospitalization for each visit, likely due to MCO involvement. Patients with MCO contact presented to the ED more frequently than non-MCO patients, which implies a strong linkage between the ED and MCO in our community. An effective referral to community service from the ED and MCO and collaboration could be the next step to improve healthcare utilization.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Crisis Intervention, Emergency Medicine, Mental Health, Suicide" } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9x25701d", "frozenauthors": [ { "first_name": "J. Priyanka", "middle_name": "", "last_name": "Vakkalanka", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa College of Public Health, Department of Epidemiology, Iowa City, Iowa", "department": "None" }, { "first_name": "Ryan", "middle_name": "A.", "last_name": "Neuhas", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Karisa", "middle_name": "K.", "last_name": "Harland", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa College of Public Health, Department of Epidemiology, Iowa City, Iowa", "department": "None" }, { "first_name": "Lance", "middle_name": "", "last_name": "Clemsen", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Elaine", "middle_name": "", "last_name": "Himadi", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Psychiatry, Iowa City, Iowa", "department": "None" }, { "first_name": "Sangil", "middle_name": "", "last_name": "Lee", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" } ], "date_submitted": "2021-02-26T14:19:19-05:00", "date_accepted": "2021-02-26T14:19:19-05:00", "date_published": "2021-09-02T21:20:27-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15155/galley/7718/download/" } ] }, { "pk": 14784, "title": "A Multivariable Model of Parent Satisfaction, Pain, and Opioid Administration in a Pediatric Emergency Department", "subtitle": null, "abstract": "Introduction:\n Children and adolescents are not impervious to the unprecedented epidemic of opioid misuse in the United States. In 2016 more than 88,000 adolescents between the ages of 12–17 reported misusing opioid medication, and evidence suggests that there has been a rise in opioid-related mortality for pediatric patients. A major source of prescribed opioids for the treatment of pain is the emergency department (ED). The current study sought to assess the complex relationship between opioid administration, pain severity, and parent satisfaction with children’s care in a pediatric ED.\nMethods:\n We examined data from a tertiary pediatric care facility. A health survey questionnaire was administered after ED discharge to capture the outcome of parental likelihood of providing a positive facility rating. We abstracted patient demographic, clinical, and top diagnostic information using electronic health records. Data were merged and multivariable models were constructed. \nResults:\n We collected data from 15,895 pediatric patients between the ages of 0–17 years (mean = 6.69; standard deviation = 5.19) and their parents. Approximately 786 (4.94%) patients were administered an opioid; 8212 (51.70%) were administered a non-opioid analgesic; and 3966 (24.95%) expressed clinically significant pain (pain score >/= 4). Results of a multivariable regression analysis from these pediatric patients revealed a three-way interaction of age, pain severity, and opioid administration (odds ratio 1.022, 95% confidence interval, 1.006, 1.038, P = 0.007). Our findings suggest that opioid administration negatively impacted parent satisfaction of older adolescent patients in milder pain who were administered an opioid analgesic, but positively influenced the satisfaction scores of parents of younger children who were administered opioids. When pain levels were severe, the relationship between age and patient experience was not statistically significant.\nConclusion:\n This investigation highlights the complexity of the relationship between opioid administration, pain severity, and satisfaction, and suggests that the impact of opioid administration on parent satisfaction is a function of the age of the child.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "parent satisfaction" }, { "word": "Opioid" }, { "word": "emergency department" }, { "word": "Pain" }, { "word": "pediatric" } ], "section": "Pediatrics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1q894734", "frozenauthors": [ { "first_name": "Candice", "middle_name": "D.", "last_name": "Donaldson", "name_suffix": "", "institution": "Chapman University, Department of Psychology, Orange, California; University of California, Irvine, Center on Stress & Health, Orange, California", "department": "None" }, { "first_name": "Theodore", "middle_name": "W.", "last_name": "Heyming", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Orange, California", "department": "None" }, { "first_name": "Louis", "middle_name": "", "last_name": "Ehwerhemuepha", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Orange, California", "department": "None" }, { "first_name": "Brooke", "middle_name": "N.", "last_name": "Jenkins", "name_suffix": "", "institution": "Chapman University, Department of Psychology, Orange, California; University of California, Irvine, Center on Stress & Health, Orange, California; University of California, Irvine, Department of Anesthesiology and Perioperative Care, Orange, California", "department": "None" }, { "first_name": "Michelle", "middle_name": "A.", "last_name": "Fortier", "name_suffix": "", "institution": "University of California, Irvine, Center on Stress & Health, Orange, California; Children’s Hospital of Orange County, Orange, California; University of California, Irvine, Department of Anesthesiology and Perioperative Care, Orange, California; University of California, Irvine, Sue & Bill Gross School of Nursing, Irvine, California", "department": "None" }, { "first_name": "William", "middle_name": "", "last_name": "Feaster", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Orange, California", "department": "None" }, { "first_name": "Zeev", "middle_name": "N.", "last_name": "Kain", "name_suffix": "", "institution": "University of California, Irvine, Center on Stress & Health, Orange, California; Children’s Hospital of Orange County, Orange, California; University of California, Irvine, Department of Anesthesiology and Perioperative Care, Orange, California; Yale Child Study Center, Yale University, New Haven, Connecticut", "department": "None" } ], "date_submitted": "2020-12-03T14:15:43-05:00", "date_accepted": "2020-12-03T14:15:43-05:00", "date_published": "2021-09-02T20:36:36-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14784/galley/7519/download/" } ] }, { "pk": 14711, "title": "Evaluation of the Initial General Ward Early Warning Score and ICU Admission, Hospital Length of Stay and Mortality", "subtitle": null, "abstract": "Introduction:\n Despite widespread implementation of the Early Warning Score (EWS) in hospitals, its effect on patient outcomes remains mostly unknown. We aimed to evaluate associations between the initial EWS and in-hospital mortality, intensive care unit (ICU) admission, and hospital length of stay (LOS). \nMethods:\n We performed a retrospective cohort study of adult patients admitted to a general hospital ward between July 1, 2014–December 31, 2017. Data were obtained from electronic health records (EHR). The primary outcome was in-hospital mortality. Secondary outcomes were ICU admission and hospital LOS. We categorized patients into three risk groups (low, medium or high risk of clinical deterioration) based on EWS. Descriptive analyses were used.\nResults:\n After applying inclusion and exclusion criteria, we included 53,180 patients for analysis. We found that the initial (low- vs high-risk) EWS was associated with an increased in-hospital mortality (1.5% vs 25.3%, P <0.001), an increased ICU admission rate (3.1% vs 17.6%, P <0.001), and an extended hospital LOS (4.0 days vs 8.0 days, P <0.001).\nConclusion:\n Our findings suggest that an initial high-risk EWS in patients admitted to a general hospital ward was associated with an increased risk of in-hospital mortality, ICU admission, and prolonged hospital LOS. Close monitoring and precise documentation of the EWS in the EHR may facilitate predicting poor outcomes in individual hospitalized patients and help to identify patients for whom timely and adequate management may improve outcomes.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Early Warning Score" }, { "word": "screening" }, { "word": "monitoring" }, { "word": "Prognosis" }, { "word": "Hospital Mortality" }, { "word": "intensive care unit" } ], "section": "Health Outcomes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/86h1f302", "frozenauthors": [ { "first_name": "Anneke", "middle_name": "", "last_name": "Gielen", "name_suffix": "", "institution": "Gelderse Vallei Hospital, Department of Intensive Care Medicine, Ede, The Netherlands", "department": "None" }, { "first_name": "Kristine", "middle_name": "", "last_name": "Koekkoek", "name_suffix": "", "institution": "Gelderse Vallei Hospital, Department of Intensive Care Medicine, Ede, The Netherlands", "department": "None" }, { "first_name": "Marijke", "middle_name": "", "last_name": "van der Steen", "name_suffix": "", "institution": "Gelderse Vallei Hospital, Department of Intensive Care Medicine, Ede, The Netherlands", "department": "None" }, { "first_name": "Martijn", "middle_name": "", "last_name": "Looijen", "name_suffix": "", "institution": "Gelderse Vallei Hospital, Department of Information Technology and Datawarehouse, Ede, Netherlands", "department": "None" }, { "first_name": "Arthur", "middle_name": "R.H.", "last_name": "Van Zanten", "name_suffix": "", "institution": "Gelderse Vallei Hospital, Department of Intensive Care Medicine, Ede, The Netherlands; Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands", "department": "None" } ], "date_submitted": "2020-11-02T17:04:56-05:00", "date_accepted": "2020-11-02T17:04:56-05:00", "date_published": "2021-09-02T20:09:15-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14711/galley/7492/download/" } ] }, { "pk": 14585, "title": "Impact of COVID-19 and Shelter in Place on Volume and Type of Traumatic Injuries", "subtitle": null, "abstract": "Introduction:\n Very little is known about the effects of the novel coronavirus (COVID-19) pandemic and its associated social distancing practices on trauma presentations to the emergency department (ED). This study aims to assess the impact of a city-wide stay at home order on the volume, type, and outcomes of traumatic injuries at urban EDs.\nMethods:\n The study was a retrospective chart review of all patients who presented to the ED of an urban Level I Trauma Center and its urban community affiliate in the time period during the 30 days before the institution of city-wide shelter-in-place (preSIP) order and 60 days after the shelter-in-place (SIP) order and the date-matched time periods in the preceding year. Volume and mechanism of traumatic injuries were compared using paired T-tests. \nResults:\n There was a significant decrease in overall ED volume. The volume of certain blunt trauma presentations (motor vehicle collisions) during the first 60 days of SIP compared to the same period from the year prior also significantly decreased. Importantly, the volume of penetrating injuries, including gunshot wounds and stab wounds, did not differ for the preSIP and SIP periods when compared to the prior year. The mortality of traumatic injuries was also unchanged during the SIP comparison period.\nConclusion:\n While there were significant decreases in visits to the ED and overall trauma volume, penetrating trauma, including gun violence, and other severe traumatic injuries remain a public health crisis that affects urban communities despite social distancing recommendations enacted during the COVID-19 pandemic.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "COVID-19" }, { "word": "Trauma" }, { "word": "emergency department" }, { "word": "gun violence" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2ck392s1", "frozenauthors": [ { "first_name": "James", "middle_name": "", "last_name": "Murrett", "name_suffix": "", "institution": "Temple University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Emily", "middle_name": "", "last_name": "Fu", "name_suffix": "", "institution": "Temple University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Zoe", "middle_name": "", "last_name": "Maher", "name_suffix": "", "institution": "Temple University Hospital, Department of Surgery, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Crystal", "middle_name": "", "last_name": "Bae", "name_suffix": "", "institution": "Temple University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Wayne", "middle_name": "A.", "last_name": "Satz", "name_suffix": "", "institution": "Temple University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Kraftin", "middle_name": "E.", "last_name": "Schreyer", "name_suffix": "", "institution": "Temple University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" } ], "date_submitted": "2020-09-21T21:37:53-04:00", "date_accepted": "2020-09-21T21:37:53-04:00", "date_published": "2021-09-02T19:53:28-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14585/galley/7447/download/" } ] }, { "pk": 15225, "title": "Mortality Variations of COVID-19 from Different Hospital Settings During Different Pandemic Phases: A Multicenter Retrospective Study", "subtitle": null, "abstract": "Introduction:\n Diverse coronavirus disease 2019 (COVID-19) mortalities have been reported but focused on identifying susceptible patients at risk of more severe disease or death. This study aims to investigate the mortality variations of COVID-19 from different hospital settings during different pandemic phases.\n \nMethods:\n We retrospectively included adult (≥18 years) patients who visited emergency departments (ED) of five hospitals in the state of Texas and who were diagnosed with COVID-19 between March–November 2020. The included hospitals were dichotomized into urban and suburban based on their geographic location. The primary outcome was mortality that occurred either during hospital admission or within 30 days after the index ED visit. We used multivariable logistic regression to investigate the associations between independent variables and outcome. Generalized additive models were employed to explore the mortality variation during different pandemic phases.\nResults:\n A total of 1,788 adult patients who tested positive for COVID-19 were included in the study. The median patient age was 54.6 years, and 897 (50%) patients were male. Urban hospitals saw approximately 59.5% of the total patients. A total of 197 patients died after the index ED visit. The analysis indicated visits to the urban hospitals (odds ratio [OR] 2.14, 95% confidence interval [CI], 1.41, 3.23), from March to April (OR 2.04, 95% CI, 1.08, 3.86), and from August to November (OR 2.15, 95% CI, 1.37, 3.38) were positively associated with mortality.\nConclusion:\n Visits to the urban hospitals were associated with a higher risk of mortality in patients with COVID-19 when compared to visits to the suburban hospitals. The mortality risk rebounded and showed significant difference between urban and suburban hospitals since August 2020. Optimal allocation of medical resources may be necessary to bridge this gap in the foreseeable future.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "COVID-19" }, { "word": "SARS-CoV-2" }, { "word": "Mortality" }, { "word": "emergency department" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4s82j8d4", "frozenauthors": [ { "first_name": "Eric", "middle_name": "H.", "last_name": "Chou", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas; John Peter Smith Hospital, Department of Emergency Medicine, Fort Worth, Texas", "department": "None" }, { "first_name": "Chih-Hung", "middle_name": "", "last_name": "Wang", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Chu-Lin", "middle_name": "", "last_name": "Tsai", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "John", "middle_name": "", "last_name": "Garrett", "name_suffix": "", "institution": "Baylor University Medical Center, Department of Emergency Medicine, Dallas, Texas", "department": "None" }, { "first_name": "Toral", "middle_name": "", "last_name": "Bhakta", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Shedd", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas", "department": "None" }, { "first_name": "Dahlia", "middle_name": "", "last_name": "Hassani", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas", "department": "None" }, { "first_name": "Robert", "middle_name": "", "last_name": "Risch", "name_suffix": "", "institution": "Baylor Scott and White Medical Center at Grapevine, Department of Emergency Medicine, Grapevine, Texas", "department": "None" }, { "first_name": "James", "middle_name": "", "last_name": "d’Etienne", "name_suffix": "", "institution": "John Peter Smith Hospital, Department of Emergency Medicine, Fort Worth, Texas", "department": "None" }, { "first_name": "Gerald", "middle_name": "O.", "last_name": "Ogola", "name_suffix": "", "institution": "Baylor Scott & White Research Institute, Dallas, Texas", "department": "None" }, { "first_name": "Matthew", "middle_name": "Huei-Ming", "last_name": "Ma", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Tsung-Chien", "middle_name": "", "last_name": "Lu", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Hao", "middle_name": "", "last_name": "Wang", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas; John Peter Smith Hospital, Department of Emergency Medicine, Fort Worth, Texas; Baylor University Medical Center, Department of Emergency Medicine, Dallas, Texas", "department": "None" } ], "date_submitted": "2021-03-25T06:10:40-04:00", "date_accepted": "2021-03-25T06:10:40-04:00", "date_published": "2021-09-02T19:25:26-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15225/galley/7735/download/" } ] }, { "pk": 15055, "title": "Balancing Efficiency and Access: Discouraging Emergency Department Boarding in a Global Budget System", "subtitle": null, "abstract": "Reducing cost without sacrificing quality of patient care is an important yet challenging goal for healthcare professionals and policymakers alike. This challenge is at the forefront in the United States, where per capita healthcare costs are much higher than in similar countries around the world. The state of Maryland is unique in the hospital financing landscape due to its “capitation” payment system (also known as “global budget”), in which revenue for hospital-based services is set at the beginning of the year. Although Maryland’s system has yielded many benefits, including reduced Medicare spending, it also has had unintentional adverse consequences. These consequences, such as increased emergency department boarding and ambulance diversion, constrain Maryland hospitals’ ability to fulfill their role as emergency care providers and act as a safety net for vulnerable patient populations. In this article, we suggest policy remedies to mitigate the unintended consequences of Maryland’s model that should also prove instructive for a variety of emerging alternative payment mechanisms.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Health Care Cost, Health Policy, Capitation, Health Care Financing, Emergency Department, Ambulance Diversion, Access to Health Care" } ], "section": "Health Policy Perspectives", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/94z252kn", "frozenauthors": [ { "first_name": "Benoit", "middle_name": "", "last_name": "Stryckman", "name_suffix": "", "institution": "University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" }, { "first_name": "Diane", "middle_name": "", "last_name": "Kuhn", "name_suffix": "", "institution": "University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" }, { "first_name": "Daniel", "middle_name": "B.", "last_name": "Gingold", "name_suffix": "", "institution": "University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" }, { "first_name": "Kyle", "middle_name": "R.", "last_name": "Fischer", "name_suffix": "", "institution": "University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" }, { "first_name": "J. David", "middle_name": "", "last_name": "Gatz", "name_suffix": "", "institution": "University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" }, { "first_name": "Stephen", "middle_name": "M.", "last_name": "Schenkel", "name_suffix": "", "institution": "University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" }, { "first_name": "Brian", "middle_name": "J.", "last_name": "Brown", "name_suffix": "", "institution": "University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" } ], "date_submitted": "2021-01-26T10:06:09-05:00", "date_accepted": "2021-01-26T10:06:09-05:00", "date_published": "2021-09-02T19:12:22-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15055/galley/7688/download/" } ] }, { "pk": 15083, "title": "Enroller Experience and Parental Familiarity of Disease Influence Participation in a Pediatric Trial", "subtitle": null, "abstract": "Introduction:\n Acquiring parental consent is critical to pediatric clinical research, especially in interventional trials. In this study we investigated demographic, clinical, and environmental factors associated with likelihood of parental permission for enrollment in a study of therapies for diabetic ketoacidosis (DKA) in children.\n \nMethods:\n We analyzed data from patients and parents who were approached for enrollment in the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) trial at one major participating center. We determined the influence of various factors on patient enrollment, including gender, age, distance from home to hospital, insurance status, known vs new onset of diabetes, glycemic control (hemoglobin A1c), DKA severity, gender of the enroller, experience of the enroller, and time of enrollment. Patients whose parents consented to participate were compared to those who declined participation using bivariable and multivariable analyses controlling for the enroller.\nResults:\n A total of 250 patient/parent dyads were approached; 177 (71%) agreed to participate, and 73 (29%) declined. Parents of patients with previous episodes of DKA agreed to enroll more frequently than those with a first DKA episode (94.3% for patients with 1-2 previous DKA episodes, 92.3% for > 2 previous episodes, vs 64.9% for new onset diabetes and 63.2% previously diagnosed but no previous DKA). Participation was also more likely with more experienced enrollers (odds ratio [95% confidence interval] of participation for an enroller with more than two years’ experience vs less than two years: 2.46 [1.53, 3.97]). After adjusting for demographic and clinical factors, significant associations between participation and both DKA history and enroller experience remained. Patient age, gender, distance of home from hospital, glycemic control, insurance status, and measures of DKA severity were not associated with likelihood of participation.\nConclusion:\n Familiarity with the disease process (previously diagnosed diabetes and previous experience with DKA) and experience of the enroller favorably influenced the likelihood of parental permission for enrollment in a study of DKA in children.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "informed consent" }, { "word": "research" }, { "word": "Diabetic ketoacidosis" }, { "word": "Diabetes" } ], "section": "Brief Research Report (Limit 1500 words)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8pn3k9mv", "frozenauthors": [ { "first_name": "Jeff", "middle_name": "E.", "last_name": "Schunk", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "Kammy", "middle_name": "K.", "last_name": "Jacobsen", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "Dilon", "middle_name": "", "last_name": "Stephens", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "Amy", "middle_name": "", "last_name": "Watson", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "Cody", "middle_name": "S.", "last_name": "Olsen", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "T. Charles", "middle_name": "", "last_name": "Casper", "name_suffix": "", "institution": "University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah", "department": "None" }, { "first_name": "Nicole", "middle_name": "S.", "last_name": "Glaser", "name_suffix": "", "institution": "University of California Davis Health, Department of Pediatrics, Sacramento, California", "department": "None" }, { "first_name": "Nathan", "middle_name": "", "last_name": "Kuppermann", "name_suffix": "", "institution": "University of California Davis Health, Department of Pediatrics, Sacramento, California; University of California Davis Health, Department of Emergency Medicine, Sacramento, California", "department": "None" } ], "date_submitted": "2021-02-02T13:24:49-05:00", "date_accepted": "2021-02-02T13:24:49-05:00", "date_published": "2021-09-02T18:15:11-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15083/galley/7699/download/" } ] }, { "pk": 14308, "title": "Cannabis in Homes with Children: A Survey on Use, Storage, and Attitudes", "subtitle": null, "abstract": "Introduction:\n The recent legalization of cannabis in California has the potential to affect cannabis prevalence in households with children. This eventuality, combined with suboptimal cannabis storage practices, could lead to adverse effects such as unintentional pediatric ingestion, which occurred in Colorado after legalization. Our objective was to assess prevalence and storage practices of cannabis in households with children, and attitudes on use and storage education in a state that has legalized cannabis.\nMethods:\n We administered electronic surveys to 401 adults in a pediatric emergency department in California. Participants were excluded if they were not English- or Spanish-speaking or did not live in a household with children <18 years old. They answered questions regarding cannabis use, storage, and attitudes on cannabis storage education. We used convenience sampling and analyzed data using descriptive statistics. \nResults: \nResearch assistants approached 558 participants of whom 401 completed the survey. Three participants did not respond regarding past or current cannabis use, and 14.5% (58/401) reported cannabis use in their home in the prior six months. Both users and non-users rated safe storage of high importance in homes with children. Only 44.8% of home users (26/58) reported that their cannabis was both locked and hidden. Among home users, the most common source of storage advice was friends and family (21/58, 36.2%), and 45% of home users (26/58) received no storage information whatsoever. Most cannabis users (53/67, 79.1%) and non-users (241/330, 73%) reported that they would feel comfortable receiving cannabis education from their primary care provider. \nConclusion:\n Cannabis is used and stored in homes with children; however, safe storage is not clearly defined in California, and storage education is lacking. Healthcare providers in primary care and the emergency department may play an important role in educating the public about cannabis use and safe storage.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "cannabis" }, { "word": "marijuana" }, { "word": "Storage" } ], "section": "Toxicology", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/99b6999d", "frozenauthors": [ { "first_name": "Alex", "middle_name": "", "last_name": "Gimelli", "name_suffix": "", "institution": "UC Davis Medical Center, Department of Emergency Medicine, Sacramento, California", "department": "None" }, { "first_name": "Anusha", "middle_name": "", "last_name": "Deshpande", "name_suffix": "", "institution": "Scripps Mercy Hospital, Department of Internal Medicine, San Diego, California", "department": "None" }, { "first_name": "Julia", "middle_name": "N.", "last_name": "Magana", "name_suffix": "", "institution": "UC Davis Medical Center, Department of Emergency Medicine, Sacramento, California", "department": "None" }, { "first_name": "Aimee", "middle_name": "", "last_name": "Moulin", "name_suffix": "", "institution": "UC Davis Medical Center, Department of Emergency Medicine, Sacramento, California", "department": "None" } ], "date_submitted": "2020-07-13T19:57:04-04:00", "date_accepted": "2020-07-13T19:57:04-04:00", "date_published": "2021-09-02T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14308/galley/7364/download/" } ] }, { "pk": 15043, "title": "Cervical Spine Injuries in Older Patients with Falls Found on Magnetic Resonance Imaging After Computed Tomography", "subtitle": null, "abstract": "Introduction:\n In this study we aimed to determine the rate of traumatic abnormalities on cervical spine magnetic resonance imaging (MRI) after a normal cervical spine computed tomography (CT) in older patients with ground-level falls. We hypothesized that MRI is low yield following a normal physical examination and normal CT after a ground-level fall. \n \nMethods:\n This was a retrospective cohort study of patients 65 years and older evaluated with a cervical spine MRI following a ground-level fall. Inclusion criteria included age 65 years and older, ground-level fall, normal cervical spine CT followed by a cervical spine MRI. We abstracted data following accepted methodologic guidelines. Patients with any focal neurological finding were considered to have an abnormal neurological examination. Imaging studies were considered to be abnormal if there was a report of an acute traumatic injury. The primary outcome was a traumatic abnormality identified on MRI. We described data with simple descriptive statistics. \nResults:\n Eighty-seven patients with a median age of 74 (interquartile range [IQR] 69, 83]) years had an MRI following a normal cervical spine CT. Median emergency department length of stay was 8.2 hours (IQR 5.3, 13.5). Sixty-four (73.6%) patients had a normal neurological examination on arrival; eight of these patients (12.5% (95% confidenced interval [CI], 5.6-23.2%) had an abnormal cervical spine MRI. Twenty-three patients (26.4%) had an abnormal neurological examination on arrival; two of these patients (8.7%, 95% CI, 1.1-28%) had an abnormal cervical spine MRI. Overall, 10 patients (11.5%) had an abnormal cervical spine MRI. One patient underwent operative intervention due to an unstable injury. Of the remaining nine patients with acute findings on cervical spine MRI, there were no other unstable injuries; two patients were managed with cervical orthosis, and seven patients had no additional management. \nConclusion:\n In this study of older patients with ground-level falls and normal, atraumatic, cervical spine CT, a small portion had traumatic abnormalities on MRI, with few requiring further intervention. Further study is required to identify criteria to determine when MRI should be performed in older patients after a ground-level fall.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "geriatrics, trauma, falls, MRI" } ], "section": "Geriatrics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3m3690c5", "frozenauthors": [ { "first_name": "Corinne", "middle_name": "H.", "last_name": "Cushing", "name_suffix": "", "institution": "University of California, Davis School of Medicine, Department of Emergency Medicine, Sacramento, California", "department": "None" }, { "first_name": "James", "middle_name": "F.", "last_name": "Holmes", "name_suffix": "", "institution": "University of California, Davis School of Medicine, Department of Emergency Medicine, Sacramento, California", "department": "None" }, { "first_name": "Katren", "middle_name": "R.", "last_name": "Tyler", "name_suffix": "", "institution": "University of California, Davis School of Medicine, Department of Emergency Medicine, Sacramento, California", "department": "None" } ], "date_submitted": "2021-01-22T13:37:46-05:00", "date_accepted": "2021-01-22T13:37:46-05:00", "date_published": "2021-09-02T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15043/galley/7684/download/" } ] }, { "pk": 15200, "title": "Radiology Education Among Emergency Medicine Residencies: A National Needs Assessment", "subtitle": null, "abstract": "Introduction:\n Radiology training is an important component of emergency medicine (EM) education, but its delivery has been variable. Program directors have reported a lack of radiology skills in incoming interns. A needs assessment is a crucial first step toward improving radiology education among EM residencies. Our objective was to explore the current state of radiology education in EM residency programs.\nMethods:\n This was a cross-sectional survey study of all Accreditation Council for Graduate Medical Education-accredited EM programs in the United States. Program leadership completed an online survey consisting of multiple choice, Likert scale, and free-response items. We calculated and reported descriptive statistics.\nResults:\n Of eligible EM programs, 142/252 (56%) completed the survey including 105 postgraduate year (PGY) 1-3 and 36 PGY 1-4 programs. One respondent opted out of answering demographic questions. 23/141 (16%) were from the Western region, 29/141 (21%) were from the North Central region, 14/141 (10%) were from the South-Central region, 28/141 (20%) were from the Southeast region, and 47/141 (33%) were from the Northeast region. A total of 88/142 (62%) of responding programs did not have formal radiology instruction. Of the education that is provided, 127/142 (89%) provide it via didactics/lectures and 115/142 (81%) rely on instruction during clinical shifts. Only 51/142 (36%) provide asynchronous opportunities, and 23/142 (16%) have a dedicated radiology rotation. The majority of respondents reported spending 0-2 hours per month on radiology instruction (108/142; 76%); 95/141 (67%) reported that EM faculty “often” or “always” provide radiology instruction; 134/142 (95%), felt that it was “extremely” or “very important” for ED providers to be able to independently interpret radiograph results; and 129/142 (90.84%) either “sometimes” or “always” rely on their independent radiograph interpretations to make clinical decisions. The radiology studies identified as most important to be able to independently interpret were radiographs obtained for lines/tubes, chest radiographs, and radiographs obtained for musculoskeletal-related complaints.\nConclusion:\n A minority of EM residency programs have formal instruction in radiology despite the majority of responding program leadership believing that these are important skills. The most important curricular areas were identified. These results may inform the development of formal radiology curricula in EM graduate medical education.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Radiology, Needs Assessment, Emergency Medicine" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4d69j0sw", "frozenauthors": [ { "first_name": "Stephen", "middle_name": "E.", "last_name": "Villa", "name_suffix": "", "institution": "University of California, Los Angeles, David Geffen School of Medicine, Department of Emergency Medicine, Los Angeles, California", "department": "None" }, { "first_name": "Natasha", "middle_name": "", "last_name": "Wheaton", "name_suffix": "", "institution": "University of California, Los Angeles, David Geffen School of Medicine, Department of Emergency Medicine, Los Angeles, California", "department": "None" }, { "first_name": "Steven", "middle_name": "", "last_name": "Lai", "name_suffix": "", "institution": "University of California, Los Angeles, David Geffen School of Medicine, Department of Emergency Medicine, Los Angeles, California", "department": "None" }, { "first_name": "Jaime", "middle_name": "", "last_name": "Jordan", "name_suffix": "", "institution": "University of California, Los Angeles, David Geffen School of Medicine, Department of Emergency Medicine, Los Angeles, California", "department": "None" } ], "date_submitted": "2021-03-24T14:16:32-04:00", "date_accepted": "2021-03-24T14:16:32-04:00", "date_published": "2021-09-02T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15200/galley/7727/download/" } ] }, { "pk": 15878, "title": "This Article Corrects:”Assessment of Physician Well-being, Part One: Burnout and Other Negative States”", "subtitle": null, "abstract": "n/a", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Erratum", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0qt2214v", "frozenauthors": [ { "first_name": "Michelle", "middle_name": "D.", "last_name": "Lall", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Theodore", "middle_name": "J.", "last_name": "Gaeta", "name_suffix": "", "institution": "New York-Presbyterian Brooklyn Methodist Hospital, Department of Emergency Medicine, New York, New York", "department": "None" }, { "first_name": "Arlene", "middle_name": "S.", "last_name": "Chung", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "Erin", "middle_name": "", "last_name": "Dehon", "name_suffix": "", "institution": "University of Mississippi Medical Center, Department of Emergency Medicine, Jackson, Mississippi", "department": "None" }, { "first_name": "William", "middle_name": "", "last_name": "Malcolm", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Adam", "middle_name": "", "last_name": "Ross", "name_suffix": "", "institution": "University of Louisville School of Medicine, Department of Emergency Medicine, Louisville, Kentucky", "department": "None" }, { "first_name": "David", "middle_name": "P.", "last_name": "Way", "name_suffix": "", "institution": "The Ohio State University College of Medicine, Department of Emergency Medicine, Columbus, Ohio", "department": "None" }, { "first_name": "Lori", "middle_name": "", "last_name": "Weichenthal", "name_suffix": "", "institution": "University of San Francisco-Fresno, Department of Emergency Medicine, Fresno, California", "department": "None" }, { "first_name": "Nadine", "middle_name": "T.", "last_name": "Himelfarb", "name_suffix": "", "institution": "Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island", "department": "None" } ], "date_submitted": "2021-09-02T21:29:10-04:00", "date_accepted": "2021-09-02T21:29:10-04:00", "date_published": "2021-09-02T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15878/galley/7957/download/" } ] }, { "pk": 1076, "title": "The Use of Point-of-care Ultrasound in the Diagnosis of Pott’s Puffy Tumor: A Case Report", "subtitle": null, "abstract": "Introduction:\n Pott’s puffy tumor (PPT) is a rare clinical disease characterized by forehead swelling from a subperiosteal abscess coupled with frontal bone osteomyelitis. It is often associated with severe complications and poor outcomes if left undiagnosed; thus, rapid recognition is crucial. Point-of-care ultrasound (POCUS) may provide an alternative pathway to diagnosis. It can be performed rapidly at the bedside and assist in early screening of patients, identifying those with high suspicion for PPT and prioritizing imaging and consultation.\nCase Report: \nA 59-yghb ar-old-male presented to the emergency department for evaluation of a “lump” on his forehead. He recently had a bifrontal craniotomy to de-bulk a polyp burden in an effort to manage his recurrent sinusitis. To further characterize the mass, a POCUS examination was performed by the treating emergency physician. The examination found a subcutaneous, hypoechoic fluid collection extending superficially along the frontal bone. A discontinuity in the surface of the frontal bone was visualized through which the collection appeared to extend. Given the heightened concern for PPT based on the POCUS examination findings, otolaryngology service was consulted and the patient was admitted for further imaging and treatment.\nConclusion:\n Pott’s puffy tumor is a rare diagnosis that has the potential for life-threatening complications. Timely diagnosis is imperative. Point-of-care ultrasound can easily be used to help identify patients with suspicion for PPT in the acute care setting and influence patient management with regard to obtaining further imaging and plans for early consultation.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "ultrasound" }, { "word": "point-of-care" }, { "word": "Emergency Medicine" }, { "word": "radiology" }, { "word": "case report." } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4n80r84c", "frozenauthors": [ { "first_name": "Josie", "middle_name": "", "last_name": "Acuña", "name_suffix": "", "institution": "The University of Arizona Tucson, Department of Emergency Medicine, Tucson, Arizona", "department": "None" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Shockey", "name_suffix": "", "institution": "The University of Arizona Tucson, Department of Emergency Medicine, Tucson, Arizona", "department": "None" }, { "first_name": "Srikar", "middle_name": "", "last_name": "Adhikari", "name_suffix": "", "institution": "The University of Arizona Tucson, Department of Emergency Medicine, Tucson, Arizona", "department": "None" } ], "date_submitted": "2021-09-01T23:59:15-04:00", "date_accepted": "2021-09-01T23:59:15-04:00", "date_published": "2021-09-02T00:00:14-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1076/galley/818/download/" } ] }, { "pk": 15836, "title": "WestJEM Will No Longer Use the Term “Provider” to Refer to Physicians", "subtitle": null, "abstract": "N/A", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Editorials (Limit 2000 words) (Invitation Only)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4dw2g8w4", "frozenauthors": [ { "first_name": "Andrew", "middle_name": "", "last_name": "Phillips", "name_suffix": "", "institution": "DHR Health, Departments of Emergency Medicine and Critical Care, Edinburg, Texas", "department": "None" }, { "first_name": "Shahram", "middle_name": "", "last_name": "Lotfipour", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, California; Eisenhower Health, Department of Emergency Medicine, Rancho Mirage, California", "department": "None" }, { "first_name": "Mark", "middle_name": "I.", "last_name": "Langdorf", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" } ], "date_submitted": "2021-08-18T20:50:46-04:00", "date_accepted": "2021-08-18T20:50:46-04:00", "date_published": "2021-09-01T18:59:03-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15836/galley/7933/download/" } ] }, { "pk": 1075, "title": "Atypical Presentation of Aseptic Meningitis Due to Varicella Zoster: A Case Report", "subtitle": null, "abstract": "Introduction: \nVaricella zoster virus (VZV) meningitis is primarily an infection of the immuno-compromised. However, it can also affect immunocompetent individuals. Reactivation of VZV typically presents with a distinct dermatomal rash suggestive of varicella zoster, but there have also been reports of VZV meningitis presenting without a rash.\nCase Report:\n We describe a case of VZV meningitis in a healthy, 30-year-old male presenting to the emergency department shortly after receiving his first coronavirus disease 2019 vaccination. He was treated with intravenous acyclovir and then discharged home on oral valacyclovir.\nConclusion:\n Emergency physicians should consider aseptic meningitis in immunocompetent patients presenting with atypical headaches in this population.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "case report" }, { "word": "varicella" }, { "word": "meningitis" }, { "word": "COVID" }, { "word": "headache" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/34p7q609", "frozenauthors": [ { "first_name": "Sharon", "middle_name": "", "last_name": "Jia", "name_suffix": "", "institution": "WellSpan York Hospital, Department of Emergency Medicine, York, Pennsylvania", "department": "None" }, { "first_name": "Thuyvi", "middle_name": "", "last_name": "Luong", "name_suffix": "", "institution": "WellSpan York Hospital, Department of Emergency Medicine, York, Pennsylvania", "department": "None" } ], "date_submitted": "2021-09-01T00:58:50-04:00", "date_accepted": "2021-09-01T00:58:50-04:00", "date_published": "2021-09-01T01:01:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1075/galley/817/download/" } ] }, { "pk": 1074, "title": "Pheochromocytoma Leading to Multiorgan Failure in a Pregnant Patient: A Case Report", "subtitle": null, "abstract": "Introduction:\n Pheochromocytoma, a neuroendocrine tumor that secretes catecholamines, can present with episodic sweating, diaphoresis, headaches, and hypertension, as well as cardiac and pulmonary involvement. In a pregnant patient, it must be differentiated from preeclampsia, a leading cause of maternal mortality in the developed world, which can similarly present with hypertension and multiorgan involvement. Both conditions require early diagnosis and treatment to reduce maternal and fetal morbidity and mortality.\nCase Report: \nWe discuss the case of a pregnant patient at approximately 24 weeks’ gestation presenting with chest pain and shortness of breath who was found to have a left adrenal mass and hypertensive urgency. The patient acutely decompensated during the course of evaluation. She ultimately suffered pregnancy loss and multiorgan failure requiring percutaneous heart pump placement and extracorporeal membrane oxygenation therapy for support before fully recovering. The adrenal mass was confirmed to be a pheochromocytoma after excision and contributed to the development of hypertensive emergency with multiorgan failure.\nConclusion:\n Pheochromocytoma during pregnancy is a rare condition but must remain on the differential until ruled out to improve patient outcomes as much as possible. Obtaining blood pressure control is imperative to reducing maternal and fetal mortality. Preeclampsia is similarly serious, and early diagnosis is essential for adequate management of the condition until delivery can occur.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Medicine" }, { "word": "pheochromocytoma" }, { "word": "pregnancy" }, { "word": "case report." } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5bs0c90s", "frozenauthors": [ { "first_name": "Toby", "middle_name": "", "last_name": "Myatt", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" }, { "first_name": "Margot", "middle_name": "", "last_name": "Barker", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" } ], "date_submitted": "2021-09-01T00:38:30-04:00", "date_accepted": "2021-09-01T00:38:30-04:00", "date_published": "2021-09-01T00:39:40-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1074/galley/816/download/" } ] }, { "pk": 1073, "title": "Traumatic Anterior Dislocation of Ocular Cataract Lens", "subtitle": null, "abstract": "Case presentation:\n A 33-year-old male presented to the emergency department following a motor vehicle collision with complaints of right eye pain after hitting his head on the steering wheel. Point-of-care ultrasound (POCUS) revealed retinal detachment and an anterior lens dislocation.\nDiscussion:\n Lens dislocations following blunt head trauma can often be diagnosed using POCUS. Anterior ocular lens dislocation is a rare but vision-threatening result of head trauma. This case highlights how POCUS can facilitate early detection of ocular pathology, such as lens dislocation, and improves patient outcomes.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "traumatic lens dislocation" }, { "word": "anterior lens dislocation" }, { "word": "lens dislocation" }, { "word": "retinal detachment" }, { "word": "point-of-care ultrasound" }, { "word": "POCUS." } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1jp6m7kn", "frozenauthors": [ { "first_name": "Tanvi", "middle_name": "", "last_name": "Shirke", "name_suffix": "", "institution": "Wellspan York Hospital, Department of Emergency Medicine, York, Pennsylvania", "department": "None" }, { "first_name": "Kyle", "middle_name": "", "last_name": "Wilcox", "name_suffix": "", "institution": "Wellspan York Hospital, Department of Emergency Medicine, York, Pennsylvania", "department": "None" }, { "first_name": "Thuyvi", "middle_name": "", "last_name": "Luong", "name_suffix": "", "institution": "Wellspan York Hospital, Department of Emergency Medicine, York, Pennsylvania", "department": "None" } ], "date_submitted": "2021-08-31T19:35:05-04:00", "date_accepted": "2021-08-31T19:35:05-04:00", "date_published": "2021-08-31T19:35:52-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1073/galley/815/download/" } ] }, { "pk": 15141, "title": "Inpatient Outcomes Following a Return Visit to the Emergency Department: A Nationwide Cohort Study", "subtitle": null, "abstract": "Introduction:\n Emergency department (ED) revisits are traditionally used to measure potential lapses in emergency care. However, recent studies on in-hospital outcomes following ED revisits have begun to challenge this notion. We aimed to examine inpatient outcomes and resource use among patients who were hospitalized following a return visit to the ED using a national database.\nMethods:\n This was a retrospective cohort study using the National Health Insurance Research Database in Taiwan. One-third of ED visits from 2012–2013 were randomly selected and their subsequent hospitalizations included. We analyzed the inpatient outcomes (mortality and intensive care unit [ICU] admission) and resource use (length of stay [LOS] and costs). Comparisons were made between patients who were hospitalized after a return visit to the ED and those who were hospitalized during the index ED visit. \nResults:\n Of the 3,019,416 index ED visits, 477,326 patients (16%) were directly admitted to the hospital. Among the 2,504,972 patients who were discharged during the index ED visit, 229,059 (9.1%) returned to the ED within three days. Of them, 37,118 (16%) were hospitalized. In multivariable analyses, the inpatient mortality rates and hospital LOS were similar between the two groups. Compared with the direct-admission group, the return-admission group had a lower ICU admission rate (adjusted odds ratio, 0.78; 95% confidence interval [CI], 0.72-0.84), and lower costs (adjusted difference, -5,198 New Taiwan dollars, 95% CI, -6,224 to -4,172). \nConclusion:\n Patients who were hospitalized after a return visit to the ED had a lower ICU admission rate and lower costs, compared to those who were directly admitted. Our findings suggest that ED revisits do not necessarily translate to poor initial care and that subsequent inpatient outcomes should also be considered for better assessment.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Health Outcomes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3fc9j752", "frozenauthors": [ { "first_name": "Chu-Lin", "middle_name": "", "last_name": "Tsai", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University Hospital, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Dean-An", "middle_name": "", "last_name": "Ling", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Tsung-Chien", "middle_name": "", "last_name": "Lu", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University Hospital, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Jasper Chia-Cheng", "middle_name": "", "last_name": "Lin", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University Hospital, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Chien-Hua", "middle_name": "", "last_name": "Huang", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University Hospital, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Cheng-Chung", "middle_name": "", "last_name": "Fang", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University Hospital, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" } ], "date_submitted": "2021-02-21T02:56:04-05:00", "date_accepted": "2021-02-21T02:56:04-05:00", "date_published": "2021-08-30T23:41:24-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15141/galley/7713/download/" } ] }, { "pk": 15082, "title": "A Clinical Prediction Tool for MRI in Emergency Department Patients with Spinal Infection", "subtitle": null, "abstract": "Introduction:\n Patients with pyogenic spinal Infection (PSI) are often not diagnosed at their initial presentation, and diagnostic delay is associated with increased morbidity and medical-legal risk. We derived a decision tool to estimate the risk of spinal infection and inform magnetic resonance imaging (MRI) decisions.\nMethods:\n We conducted a two-part prospective observational cohort study that collected variables from spine pain patients over a six-year derivation phase. We fit a multivariable regression model with logistic coefficients rounded to the nearest integer and used them for variable weighting in the final risk score. This score, SIRCH (spine infection risk calculation heuristic), uses four clinical variables to predict PSI. We calculated the statistical performance, MRI utilization, and model fit in the derivation phase. In the second phase we used the same protocol but enrolled only confirmed cases of spinal infection to assess the sensitivity of our prediction tool.\nResults:\n In the derivation phase, we evaluated 134 non-PSI and 40 PSI patients; median age in years was 55.5 (interquartile range [IQR] 38-70 and 51.5 (42-59), respectively. We identified four predictors for our risk score: historical risk factors; fever; progressive neurological deficit; and C-reactive protein (CRP) ≥ 50 milligrams per liter (mg/L). At a threshold SIRCH score of ≥ 3, the predictive model’s sensitivity, specificity, and positive predictive value were, respectively, as follows: 100% (95% confidence interval [CI], 100-100%); 56% (95% CI, 48-64%), and 40% (95% CI, 36-46%). The area under the receiver operator curve was 0.877 (95% CI, 0.829-0.925). The SIRCH score at a threshold of ≥ 3 would prompt significantly fewer MRIs compared to using an elevated CRP (only 99/174 MRIs compared to 144/174 MRIs, P <0.001). In the second phase (49 patient disease-only cohort), the sensitivities of the SIRCH score and CRP use (laboratory standard cut-off 3.5 mg/L) were 92% (95% CI, 84-98%), and 98% (95% CI, 94-100%), respectively.\nConclusion:\n The SIRCH score provides a sensitive estimate of spinal infection risk and prompts fewer MRIs than elevated CRP (cut-off 3.5 mg/L) or clinician suspicion.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "spinal epidural abscess, discitis, vertebral osteomyelitis, septic facet, back pain, prediction tool" } ], "section": "Clinical Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/64p8t49m", "frozenauthors": [ { "first_name": "Steven", "middle_name": "R.", "last_name": "Shroyer", "name_suffix": "", "institution": "Methodist Hospital System, Greater San Antonio Emergency Physicians, San Antonio, Texas", "department": "None" }, { "first_name": "William", "middle_name": "T.", "last_name": "Davis", "name_suffix": "", "institution": "Uniformed Services University of the Health Sciences, Department of Military and Emergency Medicine, Bethesda, Maryland", "department": "None" }, { "first_name": "Michael", "middle_name": "D.", "last_name": "April", "name_suffix": "", "institution": "Uniformed Services University of the Health Sciences, Department of Military and Emergency Medicine, Bethesda, Maryland; Massachusetts General Hospital, Department of Radiology, Boston, Massachusetts", "department": "None" }, { "first_name": "Brit", "middle_name": "", "last_name": "Long", "name_suffix": "", "institution": "Uniformed Services University of the Health Sciences, Department of Military and Emergency Medicine, Bethesda, Maryland", "department": "None" }, { "first_name": "Gregory", "middle_name": "", "last_name": "Boys", "name_suffix": "", "institution": "Methodist Hospital System, Department of Radiology, San Antonio, Texas", "department": "None" }, { "first_name": "Sumeru", "middle_name": "G.", "last_name": "Mehta", "name_suffix": "", "institution": "Methodist Hospital System, Greater San Antonio Emergency Physicians, San Antonio, Texas", "department": "None" }, { "first_name": "Sarah", "middle_name": "F.", "last_name": "Mercaldo", "name_suffix": "", "institution": "Massachusetts General Hospital, Department of Radiology, Boston, Massachusetts", "department": "None" } ], "date_submitted": "2021-02-02T11:48:58-05:00", "date_accepted": "2021-02-02T11:48:58-05:00", "date_published": "2021-08-30T22:35:19-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15082/galley/7698/download/" } ] }, { "pk": 14738, "title": "Outcomes Associated with Lower Doses of Ketamine by Emergency Medical Services for Profound Agitation", "subtitle": null, "abstract": "Introduction:\n Ketamine is commonly used to treat profound agitation in the prehospital setting. Early in ketamine’s prehospital use, intubation after arrival in the emergency department (ED) was frequent. We sought to measure the frequency of ED intubation at a Midwest academic medical center after prehospital ketamine use for profound agitation, hypothesizing that intubation has become less frequent as prehospital ketamine has become more common and prehospital dosing has improved.\nMethods:\n We conducted a retrospective cohort study of adult patients receiving ketamine in the prehospital setting for profound agitation and transported to a midwestern, 60,000-visit, Level 1 trauma center between January 1, 2017–- March 1, 2021. We report descriptive analyses of patient-level prehospital clinical data and ED outcomes. The primary outcome was proportion of patients intubated in the ED. \nResults:\n A total of 78 patients received ketamine in the prehospital setting (69% male, mean age 36 years). Of the 42 (54%) admitted patients, 15 (36% of admissions) were admissions to the intensive care unit. Overall, 12% (95% confidence interval [CI]), 4.5-18.6%)] of patients were intubated, and indications included agitation (n = 4), airway protection not otherwise specified (n = 4), and respiratory failure (n = 1). \nConclusion:\n Endotracheal intubation in the ED after prehospital ketamine use for profound agitation in our study sample was found to be less than previously reported.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "ketamine, excited delirium, intubation, pre-hospital, EMS" } ], "section": "Emergency Medical Services", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8586430f", "frozenauthors": [ { "first_name": "Shaila", "middle_name": "K.", "last_name": "Coffey", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "J.", "middle_name": "Priyanka", "last_name": "Vakkalanka", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa Carver College of Public Health, Department of Epidemiology, Iowa City, Iowa", "department": "None" }, { "first_name": "Haley", "middle_name": "", "last_name": "Egan", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Kelli", "middle_name": "", "last_name": "Wallace", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Karisa", "middle_name": "K.", "last_name": "Harland", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa Carver College of Public Health, Department of Epidemiology, Iowa City, Iowa", "department": "None" }, { "first_name": "Nicholas", "middle_name": "M.", "last_name": "Mohr", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa Carver College of Public Health, Department of Epidemiology, Iowa City, Iowa; University of Iowa Carver College of Medicine, Department of Anesthesia, Iowa City, Iowa", "department": "None" }, { "first_name": "Azeemuddin", "middle_name": "", "last_name": "Ahmed", "name_suffix": "", "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa Tippie College of Business, Iowa City, Iowa", "department": "None" } ], "date_submitted": "2020-11-10T17:46:32-05:00", "date_accepted": "2020-11-10T17:46:32-05:00", "date_published": "2021-08-30T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14738/galley/7503/download/" } ] }, { "pk": 15183, "title": "Positive Toxicology Results Are Not Associated with Emergency Physician’s Opioid Prescribing Behavior", "subtitle": null, "abstract": "Introduction:\n Given the general lack of literature on opioid and naloxone prescribing guidelines for patients with substance use disorder, we aimed to explore how a physician’s behavior and prescribing habits are altered by knowledge of the patient’s concomitant use of psychotropic compounds as evident on urine and serum toxicology screens.\nMethods:\n We conducted a retrospective chart review study at a tertiary, academic, Level I trauma center between November 2017–October 2018 that included 358 patients who were discharged from the emergency department (ED) with a diagnosis of fracture, dislocation, or amputation and received an opioid prescription upon discharge. We extracted urine and serum toxicology results, number and amount of prescription opioids upon discharge, and the presence of a naloxone script.\nResults:\n The study population was divided into five subgroups that included the following: negative urine and serum toxicology screen; depressants; stimulants; mixed; and no toxicology screens. When comparing the 103 patients in which toxicology screens were obtained to the 255 patients without toxicology screens, we found no statistically significant differences in the total prescribed morphine milligram equivalent (75.0 and 75.0, respectively) or in the number of pills prescribed (15.0 and 13.5, respectively). Notably, none of the 103 patients who had toxicology screens were prescribed naloxone upon discharge.\nConclusion:\n Our study found no association between positive urine toxicology results for psychotropically active substances and the rates of opioid prescribing within a single-center, academic ED. Notably, none of the 103 patients who had toxicology screens were prescribed naloxone upon discharge. More research on the associations between illicit drug use, opioids, and naloxone prescriptions is necessary to help establish guidelines for high-risk patients.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "opioids, naloxone, pain medicine, illicit drugs" } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5c24s4n0", "frozenauthors": [ { "first_name": "Jonathan", "middle_name": "B.", "last_name": "Lee", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Orange, California", "department": "None" }, { "first_name": "Ghadi", "middle_name": "", "last_name": "Ghanem", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Orange, California", "department": "None" }, { "first_name": "Soheil", "middle_name": "", "last_name": "Saadat", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Orange, California", "department": "None" }, { "first_name": "Justin", "middle_name": "", "last_name": "Yanuck", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Orange, California", "department": "None" }, { "first_name": "Brent", "middle_name": "", "last_name": "Yeung", "name_suffix": "", "institution": "University of California, Irvine, Department of Anesthesiology & Perioperative Care, Orange, California", "department": "None" }, { "first_name": "Bharath", "middle_name": "", "last_name": "Chakravarthy", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Orange, California", "department": "None" }, { "first_name": "Ariana", "middle_name": "", "last_name": "Nelson", "name_suffix": "", "institution": "University of California, Irvine, Department of Anesthesiology & Perioperative Care, Orange, California", "department": "None" }, { "first_name": "Shalini", "middle_name": "", "last_name": "Shah", "name_suffix": "", "institution": "University of California, Irvine, Department of Anesthesiology & Perioperative Care, Orange, California", "department": "None" } ], "date_submitted": "2021-03-08T15:30:47-05:00", "date_accepted": "2021-03-08T15:30:47-05:00", "date_published": "2021-08-30T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15183/galley/7725/download/" } ] }, { "pk": 1072, "title": "Nutcracker Syndrome Masquerading as Renal Colic in an Adolescent Athlete: A Case Report", "subtitle": null, "abstract": "Introduction:\n Abdominal pain and flank pain cause a significant proportion of emergencydepartment (ED) visits. The diagnosis often remains unclear and is frequently associated withrepeat visits to the ED for the same complaint. A rare cause of left upper abdominal and flank painis compression of the left renal vein between the aorta and the superior mesenteric artery known asnutcracker syndrome. Diagnostic findings on ultrasound include increased left renal vein diameterproximal and peak blood flow velocity increase distal to the superior mesenteric artery. We describesuch a patient presenting to an ED repeatedly with severe pain mimicking renal colic before the finaldiagnosis and intervention occurred.\nCase Report: \nA 16-year-old female, long-distance runner presented four times complaining ofintractable left upper quadrant abdominal pain radiating to the left flank after exercise. On each visiturinalysis revealed proteinuria and hematuria, and on two visits abdominal computed tomographyrevealed no kidney stone or dilatation of the collecting system. Ultimately, she was referred tovascular surgery where Doppler ultrasonography was used to diagnose left renal vein compression. Transposition of the left renal vein improved Doppler diameter and flow measurements andeliminated symptoms.\nConclusion:\n Emergency physicians must maintain a large list of possible diagnoses during theevaluation of abdominal and flank pain with a repetitive and uncertain etiology. Nutcracker syndromemay mimic other causes of abdominal and flank pain such as renal colic and requires appropriatereferral.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "renal vein" }, { "word": "abdominal pain" }, { "word": "flank pain" }, { "word": "nutcracker syndrome" }, { "word": "hematuria" }, { "word": "proteinuria" }, { "word": "case report." } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1dt718r8", "frozenauthors": [ { "first_name": "Ron", "middle_name": "D.", "last_name": "Waldrop", "name_suffix": "", "institution": "USA Health Systems, Department of Pediatric Emergency Medicine, Mobile, Alabama", "department": "None" }, { "first_name": "Paul", "middle_name": "", "last_name": "Henning", "name_suffix": "", "institution": "USA Health Systems, Department of Emergency Medicine, Mobile, Alabama", "department": "None" } ], "date_submitted": "2021-08-28T01:12:07-04:00", "date_accepted": "2021-08-28T01:12:07-04:00", "date_published": "2021-08-28T01:12:58-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1072/galley/814/download/" } ] }, { "pk": 1071, "title": "COVID-19 Associated Thyroid Storm: A Case Report", "subtitle": null, "abstract": "Introduction:\n The distinction between coronavirus disease 2019 (COVID-19) and thyroid storm can be extremely difficult to determine on clinical grounds alone as there is significant overlap between the signs and symptoms of each.\nCase report:\n We present a case of a patient with thyroid storm triggered by underlying COVID-19 infection.\nConclusion:\n Infection with severe acute respiratory syndrome coronavirus 2 is linked to dysregulation of the thyroid gland through numerous mechanisms, although thyroid storm triggered by COVID-19 appears rare, with only a single case previously identified in the literature.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "COVID-19" }, { "word": "Thyroid storm" }, { "word": "thyroiditis" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/872047db", "frozenauthors": [ { "first_name": "Kevin", "middle_name": "", "last_name": "Sullivan", "name_suffix": "", "institution": "Naval Medical Center San Diego, Department of Emergency Medicine, San Diego, California", "department": "None" }, { "first_name": "Jana", "middle_name": "", "last_name": "Helgeson", "name_suffix": "", "institution": "Naval Medical Center San Diego, Department of Emergency Medicine, San Diego, California", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "McGowan", "name_suffix": "", "institution": "Naval Medical Center San Diego, Department of Emergency Medicine, San Diego, California", "department": "None" } ], "date_submitted": "2021-08-28T00:57:44-04:00", "date_accepted": "2021-08-28T00:57:44-04:00", "date_published": "2021-08-28T00:59:28-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1071/galley/813/download/" } ] }, { "pk": 1070, "title": "Point-of-care Ultrasound Diagnosis of Pulmonary Hydatid Cyst Disease Causing Shock: A Case Report", "subtitle": null, "abstract": "Introduction:\n Point-of-care ultrasound (POCUS) is accepted as an important tool for evaluatingpatients presenting to the emergency department (ED) with dyspnea1 and undifferentiated shock.2Identifying the etiology and type of shock is time-critical since treatments vary based on thisinformation. Clinicians typically rely on the history, exam, and diagnostics tests to identify theetiology of shock. In resource-limited settings where there is reduced access to timely laboratory anddiagnostic studies. The use of POCUS enables rapid classification and directed treatment of shock.Additionally, POCUS can aid in the diagnosis of rarer tropical diseases that can be important causesof shock in resource-limited settings.\nCase Report:\n We discuss a case of a pediatric patient who presented to an ED in Cusco, Peru, withacute dyspnea and shock. Point-of-care ultrasound was used to expedite the diagnosis of a rupturedpulmonary hydatid cyst, guide proper management of septic and anaphylactic shock, and expeditedefinitive surgical intervention.\nConclusion:\n In resource-limited settings where there is reduced access to timely laboratory anddiagnostic studies, the use of POCUS enables rapid classification and directed treatment of shock.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "point-of-care ultrasound" }, { "word": "POCUS" }, { "word": "shock" }, { "word": "Dyspnea" }, { "word": "hydatid cyst" }, { "word": "case report." } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6z52x3m5", "frozenauthors": [ { "first_name": "Alexandra", "middle_name": "", "last_name": "Hill", "name_suffix": "", "institution": "Highland Hospital - Alameda Health System, Department of Emergency Medicine, Oakland, California", "department": "None" }, { "first_name": "Marco", "middle_name": "", "last_name": "Guillén", "name_suffix": "", "institution": "Hospital Nacional Adolfo Guevara Velasco, Department of Emergency Medicine, Cusco, Peru", "department": "None" }, { "first_name": "David", "middle_name": "", "last_name": "Martin", "name_suffix": "", "institution": "Highland Hospital - Alameda Health System, Department of Emergency Medicine, Oakland, California", "department": "None" }, { "first_name": "Andrea", "middle_name": "", "last_name": "Dreyfuss", "name_suffix": "", "institution": "Highland Hospital - Alameda Health System, Department of Emergency Medicine, Oakland, California", "department": "None" } ], "date_submitted": "2021-08-28T00:42:26-04:00", "date_accepted": "2021-08-28T00:42:26-04:00", "date_published": "2021-08-28T00:45:21-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1070/galley/812/download/" } ] }, { "pk": 1069, "title": "Gastric Pneumatosis: An Atypical Presentation of Desmoid Tumor", "subtitle": null, "abstract": "Case presentation:\n A middle-aged woman presented to the emergency department with a chiefcomplaint of abdominal pain, fever, vomiting, and diarrhea. Abdominal computed tomographyrevealed gastric pneumatosis and air in the portal system. The patient had an unfavorable clinicalcourse with pneumoperitoneum and septic shock due to secondary peritonitis. She underwentemergency laparotomy where neoformation of the mesentery root was found with infiltration of thesmall intestine and jejunal perforation. The anatomopathological study of the tumor revealed that itwas a desmoid tumor.\nDiscussion:\n To our knowledge this is the first report in the literature of gastric pneumatosis as theinitial presentation of a mesenteric desmoid tumor. Although it usually has a benign clinical course,its locally invasive characteristics can lead to critical illness. Physicians shouldn’t overlook thesetypes of complications, as early identification and surgical intervention can modify the prognosis andshorten hospital stay.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Gastric pneumatosis" }, { "word": "desmoid tumor" }, { "word": "septic shock." } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9jz0t7b0", "frozenauthors": [ { "first_name": "Catarina", "middle_name": "", "last_name": "Jorge", "name_suffix": "", "institution": "University Hospital Centre of Algarve - Faro Unit, Department of Internal Medicine, Faro, Portugal", "department": "None" }, { "first_name": "Miguel", "middle_name": "", "last_name": "Varela", "name_suffix": "", "institution": "University Hospital Centre of Algarve - Faro Unit, Department of Emergency and Intensive Care, Faro, Portugal", "department": "None" }, { "first_name": "Júlio", "middle_name": "Ricardo", "last_name": "Soares", "name_suffix": "", "institution": "University Hospital Centre of Algarve - Faro Unit, Department of Anesthesiology, Faro, Portugal", "department": "None" }, { "first_name": "Hugo", "middle_name": "", "last_name": "Uribe", "name_suffix": "", "institution": "University Hospital Centre of Algarve - Faro Unit, Department of Emergency and Intensive Care, Faro, Portugal", "department": "None" }, { "first_name": "Luis", "middle_name": "", "last_name": "Flores", "name_suffix": "", "institution": "University Hospital Centre of Algarve - Faro Unit, Department of Emergency and Intensive Care, Faro, Portugal", "department": "None" }, { "first_name": "Javier", "middle_name": "", "last_name": "Moreno", "name_suffix": "", "institution": "University Hospital Centre of Algarve - Faro Unit, Department of Emergency and Intensive Care, Faro, Portugal", "department": "None" } ], "date_submitted": "2021-08-28T00:19:07-04:00", "date_accepted": "2021-08-28T00:19:07-04:00", "date_published": "2021-08-28T00:20:56-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1069/galley/811/download/" } ] }, { "pk": 14758, "title": "The Use of Dexmedetomidine in the Emergency Department: A Cohort Study", "subtitle": null, "abstract": "Introduction:\n Management of sedation, analgesia, and anxiolysis are cornerstone therapies in the emergency department (ED). Dexmedetomidine (DEX), a central alpha-2 agonist, is increasingly being used, and intensive care unit (ICU) data demonstrate improved outcomes in patients with respiratory failure. However, there is a lack of ED-based data. We therefore sought to: 1) characterize ED DEX use; 2) describe the incidence of adverse events; and 3) explore factors associated with adverse events among patients receiving DEX in the ED.\nMethods:\n This was a single-center, retrospective, cohort study of consecutive ED patients administered DEX (January 1, 2017–July 1, 2019) at an academic, tertiary care ED with an annual census of ~90,000 patient visits. All included patients (n= 103) were analyzed for characterization of DEX use in the ED. The primary outcome was a composite of adverse events, bradycardia and hypotension. Secondary clinical outcomes included ventilator-, ICU-, and hospital-free days, and hospital mortality. To examine for variables associated with adverse events, we used a multivariable logistic regression model.\nResults:\n We report on 103 patients. Dexmedetomidine was most commonly given for acute respiratory failure, including sedation for mechanical ventilation (28.9%) and facilitation of non-invasive ventilation (17.4%). Fifty-four (52.4%) patients experienced the composite adverse event, with hypotension occurring in 41 patients (39.8%) and bradycardia occurring in 18 patients (17.5%). Dexmedetomidine was stopped secondary to an adverse event in eight patients (7.8%). Duration of DEX use in the ED was associated with an increase adverse event risk (adjusted odds ratio, 1.004; 95% confidence interval, 1.001, 1.008).\nConclusion:\n Dexmedetomidine is most commonly administered in the ED for patients with acute respiratory failure. Adverse events are relatively common, yet DEX is discontinued comparatively infrequently due to adverse events. Our results suggest that DEX could be a viable option for analgesia, anxiolysis, and sedation in ED patients.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "emergency medicine, dexmedetomidine, sedation" } ], "section": "Critical Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1v0402j7", "frozenauthors": [ { "first_name": "Joseph", "middle_name": "", "last_name": "Sinnott", "name_suffix": "", "institution": "Washington University School of Medicine in St. Louis, Department of Emergency Medicine, St. Louis, Missouri", "department": "None" }, { "first_name": "Christopher", "middle_name": "V.", "last_name": "Holthaus", "name_suffix": "", "institution": "Washington University School of Medicine in St. Louis, Department of Emergency Medicine, St. Louis, Missouri", "department": "None" }, { "first_name": "Enyo", "middle_name": "", "last_name": "Ablordeppey", "name_suffix": "", "institution": "Washington University School of Medicine in St. Louis, Department of Emergency Medicine, St. Louis, Missouri; Washington University School of Medicine in St. Louis, Department of Anesthesiology, St. Louis, Missouri", "department": "None" }, { "first_name": "Brian", "middle_name": "T.", "last_name": "Wessman", "name_suffix": "", "institution": "Washington University School of Medicine in St. Louis, Department of Emergency Medicine, St. Louis, Missouri; Washington University School of Medicine in St. Louis, Department of Anesthesiology, St. Louis, Missouri", "department": "None" }, { "first_name": "Brian", "middle_name": "W.", "last_name": "Roberts", "name_suffix": "", "institution": "Cooper University Hospital, Department of Emergency Medicine, Camden, New Jersey", "department": "None" }, { "first_name": "Brian", "middle_name": "M.", "last_name": "Fuller", "name_suffix": "", "institution": "Washington University School of Medicine in St. Louis, Department of Emergency Medicine, St. Louis, Missouri; Washington University School of Medicine in St. Louis, Department of Anesthesiology, St. Louis, Missouri", "department": "None" } ], "date_submitted": "2020-11-19T16:15:53-05:00", "date_accepted": "2020-11-19T16:15:53-05:00", "date_published": "2021-08-22T18:48:36-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14758/galley/7509/download/" } ] }, { "pk": 14688, "title": "Toxicologic Exposures in California Emergency Departments in 2011 and Its Risk Factors", "subtitle": null, "abstract": "Introduction:\n Toxicologic exposures (TE) are a major preventable public health issue, with most cases due to unintentional causes. Although these cases are well documented and reported via the National Poison Data System, there is little information regarding toxicologic exposure cases in the emergency department (ED). The aim of this study was to identify demographic groups at risk for potential poisoning.\n \nMethods:\n This was a cross-sectional study. We used data from the California State Emergency Department Database (SEDD) 2011 for statistical analysis.\nResults:\n The study included 10,124,598 ED visits in California in 2011. The prevalence of TE was 383.4 (379.6-387.3) per 100,000 visits. Toxicologic exposures were most common among patients aged <10 years (555.4, 95% confidence interval [CI], 544.5-566.5 per 100,000 visits). Overall, TE was more common among males. White patients showed the highest prevalence of TE compared to other racial groups (P <0.001). Subpopulation analysis showed Native American female patients ages 10-19 had a noticeably higher prevalence of TE (1,464.4, 95% CI, 802.9-2444.9 per 100,000). The prevalence of TE was higher in households of higher median income (P <0.001). Prevalence of TE among those with a history of substance use was also elevated. \nConclusion:\n Toxicologic exposure cases in the ED are elevated in particular age and race/ethnicity groups, as well as among those with a diagnosis of substance use disorder. The strength of association between these factors and TE in the general population may be different because we examined ED visits only. Further preventive and education strategies are necessary and should target the demographic groups identified in this epidemiological study.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "poisoning" }, { "word": "emergency department" }, { "word": "Substance Abuse" } ], "section": "Toxicology", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1fk8w5dx", "frozenauthors": [ { "first_name": "Shahram", "middle_name": "", "last_name": "Lotfipour", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, California; Eisenhower Health, Department of Emergency Medicine, Rancho Mirage, California", "department": "None" }, { "first_name": "Connie", "middle_name": "", "last_name": "Au", "name_suffix": "", "institution": "University of California, Irvine, School of Medicine, Irvine, California", "department": "None" }, { "first_name": "Soheil", "middle_name": "", "last_name": "Saadat", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" }, { "first_name": "Tim", "middle_name": "", "last_name": "Bruckner", "name_suffix": "", "institution": "University of California, Irvine, Program in Public Health, Irvine, California", "department": "None" }, { "first_name": "Parvati", "middle_name": "", "last_name": "Singh", "name_suffix": "", "institution": "University of California, Irvine, Program in Public Health, Irvine, California", "department": "None" }, { "first_name": "Bharath", "middle_name": "", "last_name": "Chakravarthy", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" } ], "date_submitted": "2020-10-26T23:05:41-04:00", "date_accepted": "2020-10-26T23:05:41-04:00", "date_published": "2021-08-22T18:00:18-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14688/galley/7483/download/" } ] }, { "pk": 41917, "title": "The Tale of the Fat, Beautiful, Black Butterfly: My COVID-19 Chrysalis and the Disruptive Potential of Cultivating Yoga Practices Emerging from Black Feminist Thought", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [ { "word": "Self-Love" }, { "word": "Yoga" }, { "word": "COVID-19" }, { "word": "sustainability" }, { "word": "poses" }, { "word": "posture" }, { "word": "Fat" }, { "word": "Black women" }, { "word": "intellectuals" } ], "section": "Personal Narratives", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/481837x5", "frozenauthors": [ { "first_name": "Teigha", "middle_name": "Mae", "last_name": "VanHester", "name_suffix": "", "institution": "Illinois State University", "department": "None" } ], "date_submitted": "2021-03-19T18:20:16-04:00", "date_accepted": "2021-03-19T18:20:16-04:00", "date_published": "2021-08-22T11:37:27-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/41917/galley/31307/download/" } ] }, { "pk": 41909, "title": "Desis on the Mat: Building BIPOC Community During Two Pandemics", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [ { "word": "Yoga, Black Lives Matter, Decolonizing, South Asian" } ], "section": "Personal Narratives", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8br0w83r", "frozenauthors": [ { "first_name": "Farha", "middle_name": "", "last_name": "Ternikar", "name_suffix": "", "institution": "Le Moyne College", "department": "None" } ], "date_submitted": "2021-01-15T10:27:21-05:00", "date_accepted": "2021-01-15T10:27:21-05:00", "date_published": "2021-08-22T10:29:14-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/41909/galley/31306/download/" } ] }, { "pk": 15181, "title": "Does the Medical Student Performance Evaluation Change the Decision to Invite Residency Applicants?", "subtitle": null, "abstract": "Introduction:\n Although emergency medicine (EM) residency program directors (PD) have multiple sources to evaluate each applicant, some programs await the release of the medical student performance evaluation (MSPE) to extend interview offers. While prior studies have demonstrated that MSPE content is variable and selectively positive, no prior work has evaluated the impact of the MSPE on the likelihood to invite (LTI) applicants for a residency interview. This study aimed to evaluate how information in the MSPE impacted LTI, with the hypothesis that changes in LTI would be relatively rare based on MSPE review alone. \nMethods:\n We conducted a prospective, observational study analyzing applications to three EM residency programs during the 2019-2020 match cycle. Reviewers assessed applications and rated the LTI on a five-point Likert scale where LTI was defined as follows: 1 = definitely no; 2 = probably no; 3 = unsure; 4 = probably yes; and 5 = definitely yes. The LTI was recorded before and after MSPE review. A change in LTI was considered meaningful when it changed the overall trajectory of the applicant’s likelihood to receive an invitation to interview. \nResults:\n We reviewed a total of 877 applications with the LTI changing ≥1 point on the Likert scale 160 (18.2%) times. The LTI was meaningfully impacted in a minority of applications – 48 total (5.5 %, p< 0.01) – with only 1 (0.11%) application changing from 1 or 2 (definitely/probably no) to 4 or 5 (probably/definitely yes) and 34 (3.8%) changing from 3 (unsure) to 4 or 5 (probably/definitely yes). Thirteen (1.5%) applications changed from 4 or 5 (probably/definitely yes) to 3 (unsure or probably/definitely no).\nConclusion:\n Review of the MSPE resulted in a meaningful change in LTI in only 5.5% of applications. Given the time required for program leadership to review all parts of the variably formatted MSPEs, this finding supports a more efficient application review, where the PD’s focus is on succinct and objective aspects of the application, such as the Standardized Letter of Evaluation.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "resident selection, medical education, medical student performance evaluation" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3sv6w2jf", "frozenauthors": [ { "first_name": "Terra", "middle_name": "N.", "last_name": "Thimm", "name_suffix": "", "institution": "West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia", "department": "None" }, { "first_name": "Christopher", "middle_name": "S.", "last_name": "Kiefer", "name_suffix": "", "institution": "West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia", "department": "None" }, { "first_name": "Mara", "middle_name": "S.", "last_name": "Aloi", "name_suffix": "", "institution": "Allegheny General Hospital, Department of Emergency Medicine, Pittsburgh, Pennsylvania", "department": "None" }, { "first_name": "Moira", "middle_name": "", "last_name": "Davenport", "name_suffix": "", "institution": "Allegheny General Hospital, Department of Emergency Medicine, Pittsburgh, Pennsylvania", "department": "None" }, { "first_name": "Jared", "middle_name": "", "last_name": "Kilpatrick", "name_suffix": "", "institution": "Allegheny General Hospital, Department of Emergency Medicine, Pittsburgh, Pennsylvania", "department": "None" }, { "first_name": "Jeffrey", "middle_name": "S.", "last_name": "Bush", "name_suffix": "", "institution": "Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina", "department": "None" }, { "first_name": "Lindsey", "middle_name": "", "last_name": "Jennings", "name_suffix": "", "institution": "Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina", "department": "None" }, { "first_name": "Stephen", "middle_name": "M.", "last_name": "Davis", "name_suffix": "", "institution": "West Virginia University School of Public Health, Department of Health Policy, Management, and Leadership, Morgantown, West Virginia", "department": "None" }, { "first_name": "Kimberly", "middle_name": "D.", "last_name": "Quedado", "name_suffix": "", "institution": "West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia", "department": "None" }, { "first_name": "Erica", "middle_name": "B.", "last_name": "Shaver", "name_suffix": "", "institution": "West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia", "department": "None" } ], "date_submitted": "2021-03-08T13:05:44-05:00", "date_accepted": "2021-03-08T13:05:44-05:00", "date_published": "2021-08-21T23:23:26-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15181/galley/7724/download/" } ] }, { "pk": 14660, "title": "A Global Survey of Emergency Department Responses to the COVID-19 Pandemic", "subtitle": null, "abstract": "Introduction:\n Emergency departments (ED) globally are addressing the coronavirus disease 2019 (COVID-19) pandemic with varying degrees of success. We leveraged the 17-country, Emergency Medicine Education & Research by Global Experts (EMERGE) network and non-EMERGE ED contacts to understand ED emergency preparedness and practices globally when combating the COVID-19 pandemic.\nMethods:\n We electronically surveyed EMERGE and non-EMERGE EDs from April 3–June 1, 2020 on ED capacity, pandemic preparedness plans, triage methods, staffing, supplies, and communication practices. The survey was available in English, Mandarin Chinese, and Spanish to optimize participation. We analyzed survey responses using descriptive statistics.\nResults:\n 74/129 (57%) EDs from 28 countries in all six World Health Organization global regions responded. Most EDs were in Asia (49%), followed by North America (28%), and Europe (14%). Nearly all EDs (97%) developed and implemented protocols for screening, testing, and treating patients with suspected COVID-19 infections. Sixty percent responded that provider staffing/back-up plans were ineffective. Many sites (47/74, 64%) reported staff missing work due to possible illness with the highest provider proportion of COVID-19 exposures and infections among nurses.\nConclusion:\n Despite having disaster plans in place, ED pandemic preparedness and response continue to be a challenge. Global emergency research networks are vital for generating and disseminating large-scale event data, which is particularly important during a pandemic.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Emergency Medicine" }, { "word": "COVID 19" }, { "word": "Pandemic" }, { "word": "Global Pandemic Preparedness" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4sx5893n", "frozenauthors": [ { "first_name": "Prashant", "middle_name": "", "last_name": "Mahajan", "name_suffix": "", "institution": "University of Michigan, Departments of Emergency Medicine and Pediatrics, Ann Arbor, Michigan", "department": "None" }, { "first_name": "Chong", "middle_name": "", "last_name": "Shu-Ling", "name_suffix": "", "institution": "KK Women’s and Children’s Hospital, Department of Emergency Medicine, Singapore", "department": "None" }, { "first_name": "Camilo", "middle_name": "", "last_name": "Gutierrez", "name_suffix": "", "institution": "George Washington University School of Medicine and Health Sciences, Departments of Emergency Medicine and Pediatrics, Washington, District of Columbia", "department": "None" }, { "first_name": "Emily", "middle_name": "", "last_name": "White", "name_suffix": "", "institution": "University of Michigan, SABER, Ann Arbor, Michigan", "department": "None" }, { "first_name": "Benjamin", "middle_name": "A.Y.", "last_name": "Cher", "name_suffix": "", "institution": "University of Michigan Medical School, Ann Arbor, Michigan", "department": "None" }, { "first_name": "Elizabeth", "middle_name": "", "last_name": "Freiheit", "name_suffix": "", "institution": "University of Michigan, SABER, Ann Arbor, Michigan", "department": "None" }, { "first_name": "Apoorva", "middle_name": "", "last_name": "Belle", "name_suffix": "", "institution": "University of Michigan EMERGE, Department of Emergency Medicine, Ann Arbor, Michigan", "department": "None" }, { "first_name": "Johanna", "middle_name": "", "last_name": "Kaartinen", "name_suffix": "", "institution": "University of Helsinki/Helsinki University Hospital, Department of Emergency Medicine and Services, Helsinki, Finland", "department": "None" }, { "first_name": "Vijaya Arun", "middle_name": "", "last_name": "Kumar", "name_suffix": "", "institution": "Wayne State University, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "Paul", "middle_name": "M.", "last_name": "Middleton", "name_suffix": "", "institution": "South Western Emergency Research Institute, Department of Emergency Medicine, Liverpool, England", "department": "None" }, { "first_name": "Chip Jin", "middle_name": "", "last_name": "Ng", "name_suffix": "", "institution": "Chang Gung Memorial Hospital, Department of Emergency Medicine, Taoyuan City, Taiwan", "department": "None" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Osei-Kwame", "name_suffix": "", "institution": "Komfo Anokye Teaching Hospital, Department of Emergency Medicine, Kumasi, Ghana", "department": "None" }, { "first_name": "Dominik", "middle_name": "", "last_name": "Roth", "name_suffix": "", "institution": "Medical University of Vienna, Department of Emergency Medicine, Vienna, Austria", "department": "None" }, { "first_name": "Tej Prakash", "middle_name": "", "last_name": "Sinha", "name_suffix": "", "institution": "All India Institute of Medical Sciences, Department of Emergency Medicine, New Delhi, India", "department": "None" }, { "first_name": "Sagar", "middle_name": "", "last_name": "Galwankar", "name_suffix": "", "institution": "Sarasota Memorial Hospital, Department of Emergency Medicine, Sarasota, Florida", "department": "None" }, { "first_name": "Michele", "middle_name": "", "last_name": "Nypaver", "name_suffix": "", "institution": "University of Michigan, Department of Emergency Medicine, Ann Arbor, Michigan", "department": "None" }, { "first_name": "Nathan", "middle_name": "", "last_name": "Kuppermann", "name_suffix": "", "institution": "University of California, Davis School of Medicine, Departments of Emergency Medicine and Pediatrics, Davis, California", "department": "None" }, { "first_name": "Ulf", "middle_name": "", "last_name": "Ekelund", "name_suffix": "", "institution": "Skane University at Lund, Department of Emergency Medicine, Lund, Sweden", "department": "None" } ], "date_submitted": "2020-10-20T09:53:59-04:00", "date_accepted": "2020-10-20T09:53:59-04:00", "date_published": "2021-08-21T22:34:47-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14660/galley/7476/download/" } ] }, { "pk": 15115, "title": "National Survey of Point-of-Care Ultrasound Scholarly Tracks in Emergency Medicine Residency Programs", "subtitle": null, "abstract": "Introduction:\n Residency scholarly tracks are educational programs, designed to help trainees develop an area of expertise. Although the breadth of residency point-of-care ultrasound (POCUS) education has developed considerably in recent years, there is no literature to date describing scholarly tracks specifically in POCUS. In this study we sought to determine the prevalence, characteristics, and outcomes of POCUS scholarly tracks in emergency medicine (EM).\nMethods:\n This was a cross-sectional survey of EM residency programs accredited by the Accreditation Council for Graduate Medical Education. Surveys were distributed between March-August 2020 using a listserv followed by targeted emails to residency and ultrasound leadership. We summarized data using descriptive statistics, and performed logistic regression to identify factors associated with a POCUS scholarly track.\nResults:\n Of 267 residency programs 199 (74.5%) completed the survey. Fifty-seven (28.6%) had a POCUS scholarly track as of the 2019-2020 academic year. Scholarly tracks in POCUS were more common in university-based/academic sites and larger residency programs. Of the 57 programs with POCUS scholarly tracks, 48 (84.2%) required residents to present at least one POCUS lecture, 45 (78.9%) required residents to serve as instructor at a hands-on workshop, and 42 (73.7%) required residents to participate in quality assurance of departmental POCUS scans. Only 28 (49.1%) tracks had a structured curriculum, and 26 (45.6%) required POCUS research. In total, 300 EM residents completed a POCUS scholarly track over the past three academic years, with a median of 4 (2-9) per program. Seventy-five (25.0%) proceeded to a clinical ultrasound fellowship after residency graduation, with a median of 1 (interquartile range 0-2) per program. A total of 139 POCUS-specific abstracts (median 2 [0-3]) and 80 peer-reviewed manuscripts (median 1 [0-2]) were published by scholarly track residents over the past three years.\nConclusion:\n This survey study describes the current prevalence, characteristics, and outcomes of POCUS scholarly tracks across EM residency programs. The results may inform the decisions of residency programs to create these tracks.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "point-of-care ultrasound" }, { "word": "ultrasound" }, { "word": "Emergency Medicine" }, { "word": "scholarly track" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1ns8v17k", "frozenauthors": [ { "first_name": "Stephen", "middle_name": "", "last_name": "Alerhand", "name_suffix": "", "institution": "Rutgers New Jersey Medical School, Department of Emergency Medicine, Newark, New Jersey", "department": "None" }, { "first_name": "Elaine", "middle_name": "", "last_name": "Situ-Lacasse", "name_suffix": "", "institution": "University of Arizona College of Medicine, Department of Emergency Medicine, Phoenix, Arizona", "department": "None" }, { "first_name": "Christine", "middle_name": "", "last_name": "Ramdin", "name_suffix": "", "institution": "Rutgers New Jersey Medical School, Department of Emergency Medicine, Newark, New Jersey", "department": "None" }, { "first_name": "Michael", "middle_name": "", "last_name": "Gottlieb", "name_suffix": "", "institution": "Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois", "department": "None" } ], "date_submitted": "2021-02-11T10:36:21-05:00", "date_accepted": "2021-02-11T10:36:21-05:00", "date_published": "2021-08-21T20:29:18-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15115/galley/7706/download/" } ] }, { "pk": 15075, "title": "Comparing Physician Assistant and Nurse Practitioner Practice in U.S. Emergency Departments, 2010–2017", "subtitle": null, "abstract": "Introduction:\n We sought to compare physician assistant (PA) and nurse practitioner (NP) practice in United States emergency departments (ED) based on ED visits as reported by the National Hospital Ambulatory Medical Care Survey (NHAMCS). \nMethods:\n We performed a retrospective, secondary analysis of the 2010 to 2017 NHAMCS with analysis of ED visits, patient demographics, and hospital characteristics. \nResults:\n Between 2010 to 2017, 21.0% (95% confidence interval, [CI] +/-3.1%) of ED visits were seen by either a PA/NP (with and without physician involvement) and 8.6% (+/-2.9%) were seen by PA/NP alone. We identified an increase for NP visits between 2014–2016 and found that PA/NP visits share many of the same characteristics. \nConclusion:\n While emergency medicine has predominately been a specialty for PAs, the number of ED visits with NPs has been increasing over the past several years. While there are some differences, PAs/NPs share many similar practice characteristics in the ED.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "physician assistant" }, { "word": "Nurse practitioner" }, { "word": "Emergency Medicine" }, { "word": "Workforce" }, { "word": "midlevel" }, { "word": "advanced practice provider" }, { "word": "emergency department" } ], "section": "Emergency Medicine Workforce", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1m208048", "frozenauthors": [ { "first_name": "Fred", "middle_name": "", "last_name": "Wu", "name_suffix": "", "institution": "University of California, San Francisco, Department of Emergency Medicine, Fresno, California", "department": "None" }, { "first_name": "Michael", "middle_name": "A.", "last_name": "Darracq", "name_suffix": "", "institution": "University of California, San Francisco, Department of Emergency Medicine, Fresno, California", "department": "None" } ], "date_submitted": "2021-01-30T16:19:52-05:00", "date_accepted": "2021-01-30T16:19:52-05:00", "date_published": "2021-08-21T20:16:35-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15075/galley/7695/download/" } ] }, { "pk": 14799, "title": "Cancer-related Emergency Department Visits: Comparing Characteristics and Outcomes", "subtitle": null, "abstract": "Introduction:\n There is increasing appreciation of the challenges of providing safe and appropriate care to cancer patients in the emergency department (ED). Our goal here was to assess which patient characteristics are associated with more frequent ED revisits.\nMethods:\n This was a retrospective cohort study of all ED visits in California during the 2016 calendar year using data from the California Office of Statewide Health Planning and Development. We defined revisits as a return visit to an ED within seven days of the index visit. For both index and return visits, we assessed various patient characteristics, including age, cancer type, medical comorbidities, and ED disposition.\nResults:\n Among 12.9 million ED visits, we identified 73,465 adult cancer patients comprising 103,523 visits that met our inclusion criteria. Cancer patients had a 7-day revisit rate of 17.9% vs 13.2% for non-cancer patients. Cancer patients had a higher rate of admission upon 7-day revisit (36.7% vs 15.6%). Patients with cancers of the small intestine, stomach, and pancreas had the highest rate of 7-day revisits (22-24%). Cancer patients younger than 65 had a higher 7-day revisit rate than the elderly (20.0% vs 16.2%).\nConclusion:\n In a review of all cancer-related ED visits in the state of California, we found a variety of characteristics associated with a higher rate of 7-day ED revisits. Our goal in this study was to inform future research to identify interventions on the index visit that may improve patient outcomes.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "oncologic emergencies, cancer, revisits" } ], "section": "Health Outcomes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7009d51p", "frozenauthors": [ { "first_name": "Rahul", "middle_name": "V.", "last_name": "Nene", "name_suffix": "", "institution": "University of California, San Diego, Department of Emergency Medicine, San Diego, California", "department": "None" }, { "first_name": "Jesse", "middle_name": "J.", "last_name": "Brennan", "name_suffix": "", "institution": "University of California, San Diego, Department of Emergency Medicine, San Diego, California", "department": "None" }, { "first_name": "Edward", "middle_name": "M.", "last_name": "Castillo", "name_suffix": "", "institution": "University of California, San Diego, Department of Emergency Medicine, San Diego, California", "department": "None" }, { "first_name": "Peter", "middle_name": "", "last_name": "Tran", "name_suffix": "", "institution": "University of California, San Diego, Department of Emergency Medicine, San Diego, California", "department": "None" }, { "first_name": "Renee", "middle_name": "Y.", "last_name": "Hsia", "name_suffix": "", "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California; University of California, San Francisco, Institute for Health Policy Studies, San Francisco, California", "department": "None" }, { "first_name": "Christopher", "middle_name": "J.", "last_name": "Coyne", "name_suffix": "", "institution": "University of California, San Diego, Department of Emergency Medicine, San Diego, California", "department": "None" } ], "date_submitted": "2020-12-08T18:02:55-05:00", "date_accepted": "2020-12-08T18:02:55-05:00", "date_published": "2021-08-21T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14799/galley/7525/download/" } ] }, { "pk": 41753, "title": "Reconstructing oyster paleocommunity structure over the last 3.6 million years: A southern California case study", "subtitle": null, "abstract": "We culled abundance record data from the NSF-funded TCN, Eastern Pacific Invertebrate Communities of the Cenozoic (EPICC), including all southern California localities that recorded the presence of oysters from the last 3.6 million years to document how oyster communities change through time. In total, over 120,000 specimens from 78 localities throughout southern California (i.e., Los Angeles, Orange, and San Diego counties) were examined. The data were broken down into four-time bins: late Pliocene, middle Pleistocene, late Pleistocene, and Holocene. Using multivariate statistics, several statistically coherent groups based on occurrences and abundances through time were indentified. Results indicate that the late Pliocene coherent groups possessed a loose, facultative, individualistic community structure that allowed taxa to shift their latitudinal gradients as they tracked shifting environments. The dominant oyster—\nDendrostrea vespertina\n—as well as other taxa, became extinct at the Plio-Pleistocene boundary. Afterwards, community structure changed, as did the dominant oyster. We suspect that the onset of northern hemisphere glaciation at the Plio-Pleistocene boundary changed both the magnitude and rate of sea surface temperatures such that local extinction occurred causing changes in dominance within marine communities. During the middle Pleistocene, \nOstrea conchaphila\n (\nlurida\n) appeared and remained dominant throughout the Holocene. In addition, distinct spatial groups existed causing reduced migration along the coast of southern California. Perhaps southern California marine communities responded to the water-mass differences associated with the mid-Pleistocene transition from a mild, 41 ka glacial-interglacial cycle to the more variable ~100 ka glacial-interglacial cycle reducing migration along the coast of southern California. The loose, individualistic community structure seen in the late Pliocene returned during the late Pleistocene and continued through the Holocene allowing marine communities the flexibility to track shifting environments.", "language": "en", "license": { "name": "Creative Commons Attribution-NonCommercial-ShareAlike 4.0", "short_name": "CC BY-NC-SA 4.0", "text": "<p><!-- x-tinymce/html --></p>\n<p>Readers are free to:</p>\n<ul>\n<li><strong>Share</strong> — copy and redistribute the material in any medium or format</li>\n<li><strong>Adapt</strong> — remix, transform, and build upon the material<br><br>The licensor cannot revoke these freedoms as long as you follow the license terms.</li>\n</ul>\n<p>Under the following terms:</p>\n<ul>\n<li><strong>Attribution</strong> — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.</li>\n<li><strong>NonCommercial</strong> — You may not use the material for commercial purposes .</li>\n<li><strong>ShareAlike</strong> — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br><br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</li>\n</ul>\n<p>Notices:</p>\n<p>You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.</p>\n<p>No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.</p>", "url": "https://creativecommons.org/licenses/by-nc-sa/4.0" }, "keywords": [ { "word": "Late Pliocene, Pleistocene, Ostrea, Dendrostrea, Los Angeles Basin, San Diego Embayment" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6p42x1st", "frozenauthors": [ { "first_name": "Nicole", "middle_name": "", "last_name": "Bonuso", "name_suffix": "", "institution": "Department of Geological Sciences, California State University, 800 N. State College Blvd., Fullerton, CA, USA 92834.", "department": "None" }, { "first_name": "Danielle", "middle_name": "C.", "last_name": "Zacherl", "name_suffix": "", "institution": "Department of Biological Sciences, California State University, 800 N. State College Blvd., Fullerton, CA, USA 92834.", "department": "None" }, { "first_name": "Kelly", "middle_name": "", "last_name": "Vreeland", "name_suffix": "", "institution": "Cogstone Resource Management, Inc., 1518 W. Taft Avenue, CA, USA 92865.", "department": "None" }, { "first_name": "Jolene", "middle_name": "", "last_name": "Ditmar", "name_suffix": "", "institution": "Metropolitan Water District of Southern California, 700 North Alameda St., Los Angeles, CA, USA 90012.", "department": "None" } ], "date_submitted": "2021-08-21T16:02:57-04:00", "date_accepted": "2021-08-21T16:02:57-04:00", "date_published": "2021-08-21T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucmp_paleobios/article/41753/galley/31221/download/" } ] }, { "pk": 14852, "title": "Use of Telemedicine to Expedite and Expand Care During COVID-19", "subtitle": null, "abstract": "Introduction:\n The novel coronavirus disease 2019 (COVID-19) created challenges with access to care including increased burden on healthcare systems and potential exposure risks for vulnerable patients. To address these needs, Rush University Medical Center created a virtual, urgent care program specifically designed to address these challenges during the COVID-19 pandemic.\nMethods:\n This was a retrospective study analyzing adult patients with COVID-19-related telemedicine visits performed between March 1–June 30, 2020. COVID-19-related telemedicine visits refer to those who used the “Concern for Coronavirus” module. We assessed the total number of telemedicine visits using this module, percentage with a subsequent emergency department (ED) visit within seven days, and outcomes (ie, hospitalization status, intubation, and death) of patients who presented to the ED for evaluation. Data are presented using descriptive statistics.\nResults:\n A total of 2,974 adult patients accessed the program via the COVID-19 module over the four-month period. Of those, 142 patients (4.8%) had an ED visit within seven days. Only 14 patients (0.5%) required admission. One patient was intubated, and there were no deaths among the telemedicine population.\nConclusion:\n The data suggests that telemedicine may be a safe and effective way to screen and treat patients with possible COVID-19, while reducing potential burdens on EDs.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Telehealth" }, { "word": "COVID-19" }, { "word": "virtual care" }, { "word": "informatics" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4dk4v4j0", "frozenauthors": [ { "first_name": "Meeta", "middle_name": "", "last_name": "Shah", "name_suffix": "", "institution": "Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Keya", "middle_name": "", "last_name": "Patel", "name_suffix": "", "institution": "Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Popa", "name_suffix": "", "institution": "Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Anthony", "middle_name": "", "last_name": "Perry", "name_suffix": "", "institution": "Rush University Medical Center, Department of Internal Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Shayna", "middle_name": "", "last_name": "Adams", "name_suffix": "", "institution": "Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Braden", "middle_name": "", "last_name": "Hexom", "name_suffix": "", "institution": "Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Carter", "middle_name": "", "last_name": "Neugarten", "name_suffix": "", "institution": "Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois; Rush University Medical Center, Department of Internal Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Michael", "middle_name": "", "last_name": "Gottlieb", "name_suffix": "", "institution": "Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois", "department": "None" } ], "date_submitted": "2020-12-23T23:04:39-05:00", "date_accepted": "2020-12-23T23:04:39-05:00", "date_published": "2021-08-19T18:27:53-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14852/galley/7544/download/" } ] }, { "pk": 14735, "title": "Emergency Department Visits by Patients with Substance Use Disorder in the United States", "subtitle": null, "abstract": "Introduction:\n We aimed to characterize emergency department (ED) utilization and clinical characteristics of patients with substance use disorder (SUD) seeking emergency care for all reasons.\nMethods:\n Using 2016–2017 ED data from the National Hospital Ambulatory Medical Care Survey, we investigated demographics, ED resource utilization, and clinical characteristics of patients with SUD vs those without SUD. \nResults:\n Of all adult ED visits (N = 27,609) in the US in 2016–2017, 11.1% of patients had SUD. Among ED patients with SUD, they were mostly non-Hispanic White (62.5%) and were more likely to be male (adjusted odds ratio [aOR] 1.80 confidence interval [CI], 1.66-1.95). Emergency department patients with SUD were also more likely to return to the ED within 72 hours (aOR 1.32, CI, 1.09-1.61) and more likely to be admitted to the hospital (aOR 1.28, CI, 1.14-1.43) and intensive care unit (aOR 1.40, CI, 1.05-1.85).\nConclusion:\n Patients with SUD have specific demographic, socioeconomic, and clinical characteristics associated with their ED visits. These findings highlight the importance of recognizing co-existing SUD as risk factors for increasing morbidity in acutely ill and injured patients, and the potential role of the ED as a site for interventions aimed at reducing harm from SUD.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5z5303j4", "frozenauthors": [ { "first_name": "Xingyu", "middle_name": "", "last_name": "Zhang", "name_suffix": "", "institution": "University of Michigan School of Nursing, Department of Systems, Populations, and Leadership, Ann Arbor, Michigan, United States of America; University of Pittsburgh Medical Center, Thomas E. Starzl Transplantation Institute, Pittsburgh, Pennsylvania, United States of America", "department": "None" }, { "first_name": "Ningyuan", "middle_name": "", "last_name": "Wang", "name_suffix": "", "institution": "University of Michigan, College of Literature, Science, and the Arts; Ann Arbor, Michigan, United States of America", "department": "None" }, { "first_name": "Fengsu", "middle_name": "", "last_name": "Hou", "name_suffix": "", "institution": "Shenzhen Kangning Hospital, Department of Public Health, Shenzhen, Guangdong Province, China", "department": "None" }, { "first_name": "Yaseen", "middle_name": "", "last_name": "Ali", "name_suffix": "", "institution": "University of Michigan, College of Literature, Science, and the Arts; Ann Arbor, Michigan, United States of America", "department": "None" }, { "first_name": "Aaron", "middle_name": "", "last_name": "Dora-Laskey", "name_suffix": "", "institution": "Michigan State University College of Human Medicine, Department of Emergency Medicine, East Lansing, Michigan, United States of America", "department": "None" }, { "first_name": "Chin", "middle_name": "Hwa", "last_name": "Dahlem", "name_suffix": "", "institution": "University of Michigan School of Nursing, Department of Health Behavior and Biological Sciences, Ann Arbor, Michigan, United States of America", "department": "None" }, { "first_name": "Sean", "middle_name": "Esteban", "last_name": "McCabe", "name_suffix": "", "institution": "University of Michigan School of Nursing, Department of Health Behavior and Biological Sciences, Ann Arbor, Michigan, United States of America; University of Michigan, Institute for Social Research, Ann Arbor, Michigan", "department": "None" } ], "date_submitted": "2020-11-09T15:01:34-05:00", "date_accepted": "2020-11-09T15:01:34-05:00", "date_published": "2021-08-19T18:08:29-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14735/galley/7502/download/" } ] }, { "pk": 1858, "title": "Not just normal: Exploring power with Shiny apps", "subtitle": null, "abstract": "Statistical power is an important topic taught in most graduate-level and undergraduate-level mathematical statistics courses, but it is often difficult to understand conceptually. Visualizing the power curve, sampling distributions, and how they interact can help students more easily conceptualize power, but the creation of such visuals can be difficult and time-consuming. Interactive web applications provide a way for students to dynamically visualize power, and many web applications for understanding power exist. However, most of these applications assume samples are drawn from a Normal population, concern only the sample mean, and/or were created for introductory classes. In this paper, we describe a web application suitable for undergraduate-level and graduate-level mathematical statistics courses that was created to allow users to visualize the complex relationships underlying power for multiple different statistics and population distributions (available at https://powerapp.shinyapps.io/powerapp/) source code is provided for instructors who wish to modify the application. Our experience implementing this application across two different semesters is also discussed, and example activities are provided in the appendix.", "language": "en", "license": null, "keywords": [ { "word": "mathematical statistics, statistics education, statistical power, shiny applications" } ], "section": "Technology Innovations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8qz638ng", "frozenauthors": [ { "first_name": "Christian", "middle_name": "", "last_name": "Stratton", "name_suffix": "", "institution": "Montana State University", "department": "None" }, { "first_name": "Jennifer", "middle_name": "L", "last_name": "Green", "name_suffix": "", "institution": "Montana State University", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Hoegh", "name_suffix": "", "institution": "Montana State University", "department": "None" } ], "date_submitted": "2020-01-13T16:16:25-05:00", "date_accepted": "2020-01-13T16:16:25-05:00", "date_published": "2021-08-19T17:35:43-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/tise/article/1858/galley/1262/download/" } ] }, { "pk": 41752, "title": "The first \nin situ\n collection of a mosasaurine from the marine Breien Member of the Hell Creek Formation in south-central North Dakota, USA", "subtitle": null, "abstract": "The upper Maastrichtian Breien Member situated within the lower portion of the Hell Creek Formation in south-central North Dakota records one of the last transgressions of the Western Interior Seaway (WIS) during the terminal Cretaceous. A fragmentary articular-prearticular complex and isolated vertebra belonging to a mosasauroid were recovered in 2016 from sandstones and mudstones deposited in a nearshore marine paleoenvironment within the southern arm of the bisected WIS. The medially-rotated retroarticular process on the articular-prearticular complex, the shape of the glenoid fossa, along with the morphology of the isolated vertebra, facilitate a conservative referral to a large-bodied mosasaurine such as \nMosasaurus\n or \nPrognathodon\n. The rocks of the Breien Member provide paleontologists a unique glimpse of intracontinental marine ecosystems immediately prior to the end of the Cretaceous Period. This discovery provides additional evidence that the latest Maastrichtian marine fauna is a continuation of the fauna preserved in the underlying Fox Hills Formation and that the marine faunal turnover that gave rise to the subsequent Cannonball Sea fauna recorded in Paleocene rocks in North Dakota occurred at the Cretaceous-Paleogene boundary.", "language": "en", "license": { "name": "Creative Commons Attribution-NonCommercial-ShareAlike 4.0", "short_name": "CC BY-NC-SA 4.0", "text": "<p><!-- x-tinymce/html --></p>\n<p>Readers are free to:</p>\n<ul>\n<li><strong>Share</strong> — copy and redistribute the material in any medium or format</li>\n<li><strong>Adapt</strong> — remix, transform, and build upon the material<br><br>The licensor cannot revoke these freedoms as long as you follow the license terms.</li>\n</ul>\n<p>Under the following terms:</p>\n<ul>\n<li><strong>Attribution</strong> — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.</li>\n<li><strong>NonCommercial</strong> — You may not use the material for commercial purposes .</li>\n<li><strong>ShareAlike</strong> — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br><br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</li>\n</ul>\n<p>Notices:</p>\n<p>You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.</p>\n<p>No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.</p>", "url": "https://creativecommons.org/licenses/by-nc-sa/4.0" }, "keywords": [ { "word": "Biogeography, Youngest Occurrence, Morphology, Squamate, Marine" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8v08w2d6", "frozenauthors": [ { "first_name": "Nathan", "middle_name": "E.", "last_name": "Van Vranken", "name_suffix": "", "institution": "STEM Division, Potomac State College, Keyser, West Virginia, USA", "department": "None" }, { "first_name": "Clint", "middle_name": "A.", "last_name": "Boyd", "name_suffix": "", "institution": "North Dakota Geological Survey, Bismarck, North Dakota, USA", "department": "None" } ], "date_submitted": "2021-08-19T18:48:16-04:00", "date_accepted": "2021-08-19T18:48:16-04:00", "date_published": "2021-08-19T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucmp_paleobios/article/41752/galley/31220/download/" } ] }, { "pk": 5574, "title": "Human and rat behavioral variability in the Dashiell maze: a comparative analysis", "subtitle": null, "abstract": "To assess their orientation in mazes, Dashiell (1930) developed a procedure allowing rats to reach the goal by utilizing paths of equal distance from the starting point. The main finding was the variety of new pathways the subjects took to reach the goal. Given the need for a task that might evaluate behavioral variability in humans, a simulation of the Dashiell procedure was developed: a virtual maze for human participants. With the goal of validating an animal model task for assessing human behavior variability, this study presents an experiment comparing rat and human performance when traversing a Dashiell maze. Results showed that rats in their maze and humans in the virtual version had similar path variability for reaching the goal; though humans showed higher dispersion from the mean. We conclude that the adaptive function of route variability in rats is similar to that in humans; thus the virtual Dashiell maze could become a reliable and straightforward task for assessing human behavior variability. Our study encourages the use of virtual mazes to compare behavioral variability between humans and other species.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Dashiell maze, variability, route, spatial, humans, rats" } ], "section": "SI: ISCP bienniel meeting (2018)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7r64k2g7", "frozenauthors": [ { "first_name": "Idania", "middle_name": "", "last_name": "Zepeda", "name_suffix": "", "institution": "Universidad de Guadalajara", "department": "None" }, { "first_name": "Felipe", "middle_name": "", "last_name": "Cabrera", "name_suffix": "", "institution": "Universidad de Guadalajara", "department": "None" } ], "date_submitted": "2020-08-10T21:49:40-04:00", "date_accepted": "2020-08-10T21:49:40-04:00", "date_published": "2021-08-18T17:23:47-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uclapsych_ijcp/article/5574/galley/3375/download/" } ] }, { "pk": 14703, "title": "Efficacy of Various Facial Protective Equipment for Infection Control in a Healthcare Setting", "subtitle": null, "abstract": "Introduction:\n The coronavirus 2019 (COVID-19) pandemic has reinforced the importance of facial protection against droplet transmission of diseases. Healthcare workers wear personal protection equipment (PPE), including face shields and masks. Plastic face shields may have advantages over regular medical masks. Although many designs of face shields exist, there is a paucity of evidence regarding the efficacy of shield designs against droplet transmissions. There is even less published evidence comparing various face shields. Due to the urgency of the pandemic and the health and safety of healthcare workers, we aimed to study the efficacy of various face shields against droplet transmission.\n \nMethods:\n We simulated droplet transmission via coughing using a heavy-duty chemical spray bottle filled with fluorescein. A standard-adult sized mannequin head was used. The mannequin head wore various face shields and was positioned to face the spray bottle at either a 0°, 45°, or 90° angle. The spray bottle was positioned at and sprayed from 30 centimeters (cm), 60 cm, or 90 cm away from the head. These steps were repeated for all face shields used. Control was a mannequin that wore no PPE. A basic mask was also tested. We collected data for particle count, total area of particle distribution, average particle size, and percentage area covered by particles. We analyzed percent covered by particles using a repeated measures mixed-model regression with Tukey-Kramer pairwise comparison.\nResults:\n We used least square means to estimate the percentage area covered by particles. Wearing PPE regardless of the design reduced particle transmission to the mannequin compared to the control. The LCG mask had the lowest square means of 0.06 of all face-shield designs analyzed. Tukey-Kramer pairwise comparison showed that all PPEs had a decrease in particle contamination compared to the control. LCG shield was found to have the least contamination compared to all other masks (P < 0.05).\nConclusion:\n Results suggest the importance of wearing a protective covering against droplet transmission. The LCG shield was found to decrease facial contamination by droplets the most of any tested protective equipment.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "COVID-19" }, { "word": "Public health" }, { "word": "Personal Protective Equipment" }, { "word": "Face Shield" }, { "word": "Droplet Transmission" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8gb0w7bf", "frozenauthors": [ { "first_name": "Jessica", "middle_name": "", "last_name": "Dinsmore", "name_suffix": "", "institution": "Medical College of Georgia at Augusta University, Department of Emergency Medicine, Augusta, Georgia", "department": "None" }, { "first_name": "Susan", "middle_name": "", "last_name": "Brands", "name_suffix": "", "institution": "Medical College of Georgia at Augusta University, Department of Emergency Medicine, Augusta, Georgia", "department": "None" }, { "first_name": "Steven", "middle_name": "", "last_name": "Perry", "name_suffix": "", "institution": "Medical College of Georgia at Augusta University, Department of Emergency Medicine, Augusta, Georgia", "department": "None" }, { "first_name": "Michael", "middle_name": "", "last_name": "Lopez", "name_suffix": "", "institution": "Medical College of Georgia at Augusta University, Department of Emergency Medicine, Augusta, Georgia", "department": "None" }, { "first_name": "Yutong", "middle_name": "", "last_name": "Dong", "name_suffix": "", "institution": "Medical College of Georgia at Augusta University, Department of Emergency Medicine, Augusta, Georgia", "department": "None" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Palasz", "name_suffix": "", "institution": "Medical College of Georgia at Augusta University, Department of Emergency Medicine, Augusta, Georgia", "department": "None" }, { "first_name": "Jennifer", "middle_name": "", "last_name": "Tucker", "name_suffix": "", "institution": "Medical College of Georgia at Augusta University, Department of Emergency Medicine, Augusta, Georgia", "department": "None" } ], "date_submitted": "2020-10-30T20:30:36-04:00", "date_accepted": "2020-10-30T20:30:36-04:00", "date_published": "2021-08-17T22:20:34-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14703/galley/7487/download/" } ] }, { "pk": 14853, "title": "Patient Perceptions of Drive-through Medical Treatment Facilities During the COVID-19 Pandemic", "subtitle": null, "abstract": "Introduction:\n The cumulative burden of coronavirus disease 2019 (COVID-19) on the United States’ healthcare system is substantial. To help mitigate this burden, novel solutions including telehealth and dedicated screening facilities have been used. However, there is limited data on the efficacy of such models and none assessing patient comfort levels with these changes in healthcare delivery. The aim of our study was to evaluate patients’ perceptions of a drive-through medical treatment system in the setting of the COVID-19 pandemic. \nMethod:\n Patients presenting to a drive-through COVID-19 medical treatment facility were surveyed about their experience following their visit. An anonymous questionnaire consisting of five questions, using a five-point Likert scale was distributed via electronic tablet. \nResults:\n We obtained 827 responses over two months. Three quarters of respondents believed care received was similar to that in a traditional emergency department (ED). Overall positive impression of the drive-through was 86.6%, and 95% believed that it was more convenient. \nConclusion:\n Overall, the drive-through medical system was perceived as more convenient than the ED and was viewed as a positive experience. While representing a dramatic change in the delivery model of medical care, if such systems can provide comparable levels of care, they may be a viable option for sustained and surge healthcare delivery.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "healthcare delivery systems, drive-through, SARS-CoV-2, COVID-19, pandemic" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4nr3c5vq", "frozenauthors": [ { "first_name": "Sean", "middle_name": "", "last_name": "Stuart", "name_suffix": "", "institution": "Naval Medical Center Portsmouth, Department of Emergency Medicine, Portsmouth, Virginia;\nUniformed Services University of the Health Sciences, Department of Military and Emergency Medicine, Bethesda, Maryland", "department": "None" }, { "first_name": "Sally", "middle_name": "", "last_name": "Mandichak", "name_suffix": "", "institution": "Naval Medical Center Portsmouth, Department of Emergency Medicine, Portsmouth, Virginia", "department": "None" }, { "first_name": "Julianne", "middle_name": "", "last_name": "Davison", "name_suffix": "", "institution": "Naval Medical Center Portsmouth, Department of Emergency Medicine, Portsmouth, Virginia", "department": "None" }, { "first_name": "Shai", "middle_name": "", "last_name": "Ansell", "name_suffix": "", "institution": "Naval Medical Center Portsmouth, Department of Internal Medicine, Portsmouth, Virginia", "department": "None" }, { "first_name": "Timothy", "middle_name": "", "last_name": "Parker", "name_suffix": "", "institution": "Naval Medical Center Portsmouth, Department of Emergency Medicine, Portsmouth, Virginia", "department": "None" } ], "date_submitted": "2020-12-24T13:12:17-05:00", "date_accepted": "2020-12-24T13:12:17-05:00", "date_published": "2021-08-17T21:59:31-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14853/galley/7545/download/" } ] }, { "pk": 3893, "title": "Tower Houses", "subtitle": null, "abstract": "Egyptian tower houses are a type of dwelling developed in the Third Intermediate Period in Egypt. They were extensively used in the time from the Late Period (26th Dynasty) until Roman times and were still in use through Late Antiquity, Medieval times until modern times. Many of these houses used the so called casemate foundations, a foundation type that was also used for other types of buildings. This article discusses typical elements, functions and chronological development of casemate structures and tower houses as well as known sources and possible reasons for their development.", "language": "en", "license": null, "keywords": [ { "word": "unfired brick" }, { "word": "casemate" }, { "word": "domestic architecture" } ], "section": "Material Culture, Art and Architecture", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6c57f675", "frozenauthors": [ { "first_name": "Manuela", "middle_name": "", "last_name": "Lehmann", "name_suffix": "", "institution": "British Museum, London", "department": "None" } ], "date_submitted": "2017-09-12T20:44:32-04:00", "date_accepted": "2017-09-12T20:44:32-04:00", "date_published": "2021-08-15T03:00:00-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/nelc_uee/article/3893/galley/2504/download/" } ] }, { "pk": 46383, "title": "Recurrent Head and Neck Pain due to Unsuspected Carotid Artery Dissection", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/27q089s8", "frozenauthors": [ { "first_name": "Lara", "middle_name": "", "last_name": "Kose", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-09T12:56:43-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46383/galley/35114/download/" } ] }, { "pk": 1068, "title": "CPC-EM Full-Text Issue", "subtitle": null, "abstract": "n/a", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "CPC-EM Full-Text Issue", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/05j417tb", "frozenauthors": [ { "first_name": "Cassandra", "middle_name": "", "last_name": "Saucedo", "name_suffix": "", "institution": "UC Irvine", "department": "None" }, { "first_name": "Trina", "middle_name": "", "last_name": "Nguyen", "name_suffix": "", "institution": "UC Irvine", "department": "None" } ], "date_submitted": "2021-08-06T16:22:31-04:00", "date_accepted": "2021-08-06T16:22:31-04:00", "date_published": "2021-08-06T16:26:02-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1068/galley/810/download/" } ] }, { "pk": 40276, "title": "The Shock of Tradition: The Case of the Humanities Lab", "subtitle": null, "abstract": "This essay assesses recent claims for the special innovations and collaborations of the Humanities Lab in the context of a century long tradition of 'laboratory' work in Chaucer Studies.", "language": "en", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [ { "word": "Humanities Lab, collaboration, innovation, Chaucer Studies" } ], "section": "Conversations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8zb562qb", "frozenauthors": [ { "first_name": "Patricia", "middle_name": "Clare", "last_name": "Ingham", "name_suffix": "", "institution": "Indiana University, Bloomington", "department": "None" } ], "date_submitted": "2021-08-05T12:00:55-04:00", "date_accepted": "2021-08-05T12:00:55-04:00", "date_published": "2021-08-06T07:40:18-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ncs_pedagogyandprofession/article/40276/galley/30290/download/" } ] }, { "pk": 15802, "title": "Special Issue on Firearm Violence Injury and Prevention", "subtitle": null, "abstract": "n/a", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Special Issue on Firearm Violence Injury and Prevention", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5vv5r9zm", "frozenauthors": [ { "first_name": "Cassandra", "middle_name": "", "last_name": "Saucedo", "name_suffix": "", "institution": "UC Irvine", "department": "None" } ], "date_submitted": "2021-08-05T22:10:06-04:00", "date_accepted": "2021-08-05T22:10:06-04:00", "date_published": "2021-08-05T22:13:25-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/15802/galley/7917/download/" } ] }, { "pk": 1067, "title": "Serotonin Syndrome Triggered by Increasing the Dose of Quetiapine", "subtitle": null, "abstract": "Case presentation:\n An 85-year-old woman with a history of depression treated with polypharmacy including selective serotonin reuptake inhibitor presented to the emergency department with head, and upper and lower limb tremors four hours after increasing the dose of quetiapine from 12.5 milligrams (mg) per day to 25 mg/day. She was diagnosed with serotonin syndrome (SS), and all medications except clotiazepam were discontinued. The symptoms subsided within 48 hours.\nDiscussion:\n The use of atypical antipsychotics alone seldom increases the risk of SS. However, combining atypical antipsychotics with serotonergic agents increases the risk of SS because the activity of serotonin receptor subtype 1A is relatively enhanced. This report suggests that physicians should be aware that even a small increase in quetiapine could pose a risk of developing SS.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "serotonin syndrome" }, { "word": "quetiapine" }, { "word": "tremor" }, { "word": "neuroleptic malignant syndrome" } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0m32v39j", "frozenauthors": [ { "first_name": "Yayoi", "middle_name": "", "last_name": "Miyamatsu", "name_suffix": "", "institution": "Nabari City Hospital, Department of Internal Medicine, Nabari, Japan", "department": "None" }, { "first_name": "Ryutaro", "middle_name": "", "last_name": "Tanizaki", "name_suffix": "", "institution": "Mie University School of Medicine, Department of Community Medicine, Nabari, Japan", "department": "None" } ], "date_submitted": "2021-08-05T20:52:44-04:00", "date_accepted": "2021-08-05T20:52:44-04:00", "date_published": "2021-08-05T20:55:35-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1067/galley/809/download/" } ] }, { "pk": 40275, "title": "Response to “#MeToo, Medieval Literature, and Trauma-Informed Pedagogy”", "subtitle": null, "abstract": "This response to “#MeToo, Medieval Literature, and Trauma-Informed Pedagogy” takes up the themes of identification, consciousness raising, and calling out.", "language": "en", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [ { "word": "Medieval studies, Chaucer, Feminism" } ], "section": "Conversations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4r92j31v", "frozenauthors": [ { "first_name": "Emma", "middle_name": "Margaret", "last_name": "Solberg", "name_suffix": "", "institution": "Bowdoin College, Brunswick, U.S.", "department": "None" } ], "date_submitted": "2021-08-02T11:14:03-04:00", "date_accepted": "2021-08-02T11:14:03-04:00", "date_published": "2021-08-05T07:22:07-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ncs_pedagogyandprofession/article/40275/galley/30289/download/" } ] }, { "pk": 1066, "title": "Three Cases of Emergency Department Medical Malpractice Involving “Consultations”: How Is Liability Legally Determined?", "subtitle": null, "abstract": "This article presents three successfully litigated medical malpractice cases involving emergency physicians and consultants. We discuss the respective case medical diagnoses, as well as established legal principles that determine in a court proceeding which provider will be liable. Specifically, we explain the legal principles of “patient physician relationship” and “affirmative act.”", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Medical Legal Case Report", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3zc769rq", "frozenauthors": [ { "first_name": "Alaa", "middle_name": "", "last_name": "Aldalati", "name_suffix": "", "institution": "Mayo Clinic College of Medicine and Science, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota", "department": "None" }, { "first_name": "Venkatesh", "middle_name": "", "last_name": "Bellamkonda", "name_suffix": "", "institution": "Mayo Clinic College of Medicine and Science, Department of Emergency Medicine, Rochester, Minnesota", "department": "None" }, { "first_name": "Gregory", "middle_name": "", "last_name": "Moore", "name_suffix": "", "institution": "Mayo Clinic College of Medicine and Science, Department of Emergency Medicine, Rochester, Minnesota", "department": "None" }, { "first_name": "Alexander", "middle_name": "", "last_name": "Finch", "name_suffix": "", "institution": "Mayo Clinic College of Medicine and Science, Department of Emergency Medicine, Rochester, Minnesota", "department": "None" } ], "date_submitted": "2021-08-05T02:23:19-04:00", "date_accepted": "2021-08-05T02:23:19-04:00", "date_published": "2021-08-05T02:24:48-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1066/galley/808/download/" } ] }, { "pk": 1065, "title": "Cryptococcus gattii Meningitis in a Previously Healthy Young Woman: A Case Report", "subtitle": null, "abstract": "Introduction: \nCryptococcus gattii (C. gatti) is a rare cause of meningitis in the United States. Outbreaks in new geographic distributions in the past few decades raise concern that climate change may be contributing to a broader distribution of this pathogen. We review a case of C. gattii in a 23-year-old woman in Northern California who was diagnosed via lumbar puncture after six weeks of headache, blurred vision, and tinnitus.\nCase Report:\n A 23-year-old previously healthy young woman presented to the emergency department (ED) after multiple visits to primary care, other EDs, and neurologists, for several weeks of headache, nausea, tinnitus, and blurred vision. On examination the patient was found to have a cranial nerve VI palsy (impaired abduction of the left eye) and bilateral papilledema on exam. Lumbar puncture had a significantly elevated opening pressure. Cerebrospinal fluid studies were positive for C. gattii. The patient was treated with serial lumbar punctures, followed by lumbar drain, as well as amphotericin and flucytosine. The patient had improvement in headache and neurologic symptoms and was discharged to another facility that specializes in management of this disease to undergo further treatment with immunomodulators and steroids.\nConclusion:\n Fungal meningitis is uncommon in the US, particularly among immunocompetent patients. Due to climate change, C. gattii may be a new pathogen to consider. This finding raises important questions to the medical community about the way global climate change affects day to day medical care now, and how it may change in the future.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "climate change" }, { "word": "meningitis" }, { "word": "Cryptococcus gattii" }, { "word": "headache" }, { "word": "emergency medicine." } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3151j5w8", "frozenauthors": [ { "first_name": "Sarabeth", "middle_name": "", "last_name": "Maciey", "name_suffix": "", "institution": "Stanford School of Medicine, Stanford Health Care, Department of Emergency Medicine, Palo Alto, California", "department": "None" }, { "first_name": "Chloe", "middle_name": "Santa", "last_name": "Maria", "name_suffix": "", "institution": "Stanford School of Medicine, Stanford Comprehensive Otolaryngology Clinic, Department of Otolaryngology, Stanford School of Medicine, Palo Alto, California", "department": "None" }, { "first_name": "Sachie", "middle_name": "", "last_name": "Oshima", "name_suffix": "", "institution": "Stanford School of Medicine, Stanford Health Care, Department of Emergency Medicine, Palo Alto, California", "department": "None" }, { "first_name": "Jennifer", "middle_name": "", "last_name": "Newberry", "name_suffix": "", "institution": "Stanford School of Medicine, Stanford Health Care, Department of Emergency Medicine, Palo Alto, California", "department": "None" } ], "date_submitted": "2021-08-05T01:54:42-04:00", "date_accepted": "2021-08-05T01:54:42-04:00", "date_published": "2021-08-05T01:58:26-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1065/galley/807/download/" } ] }, { "pk": 1064, "title": "Case Report: An Intracranial Complication of COVID-19 Nasopharyngeal Swab", "subtitle": null, "abstract": "Introduction:\n Cerebrospinal fluid (CSF) leaks are often the result of trauma or recent surgical procedures; however, a subset can develop from non-traumatic etiologies. Cerebrospinal fluid leaks from congenital and spontaneous encephaloceles can be clinically occult and have devastating consequences if undetected for prolonged periods of time. This report highlights a unique case of meningitis after CSF leak caused by ruptured congenital meningocele during a routine nasopharyngeal swab.\nCase Report:\n A 54-year-old female with diagnosed CSF leak presented to the emergency department (ED) with acute onset of severe headache, and neck and back pain. Prior to this presentation, the patient had experienced two months of persistent headache and rhinorrhea since her coronavirus disease 2019 (COVID-19) nasopharyngeal swab. As part of her outpatient workup, an otolaryngology consultation with subsequent beta-2 transferrin testing and magnetic resonance imaging was performed and she was diagnosed with a CSF leak from ruptured congenital meningocele. On ED presentation, she was afebrile, but with mild tachycardia, leukocytosis, and meningismus. Lumbar puncture revealed acute streptococcal meningitis. This patient’s meningitis developed due to prolonged occult CSF leak after her COVID-19 nasopharyngeal swab ruptured a pre-existing congenital meningocele.\nConclusion:\n Nasopharyngeal swabs are being performed much more frequently due to the COVID-19 pandemic. All front-line providers should be aware of the potential presence and rupture of congenital meningoceles in patients who have undergone recent nasopharyngeal swab when risk-stratifying for potential CSF leak and meningitis.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "nasopharyngeal swab" }, { "word": "meningitis" }, { "word": "cerebrospinal fluid leak" }, { "word": "meningocele" }, { "word": "encephalocele." } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5vw2q86v", "frozenauthors": [ { "first_name": "Alexandria", "middle_name": "", "last_name": "Holmes", "name_suffix": "", "institution": "Carolinas Medical Center, Department of Emergency Medicine, Charlotte, North Carolina", "department": "None" }, { "first_name": "Bryant", "middle_name": "", "last_name": "Allen", "name_suffix": "", "institution": "Carolinas Medical Center, Department of Emergency Medicine, Charlotte, North Carolina", "department": "None" } ], "date_submitted": "2021-08-05T01:32:34-04:00", "date_accepted": "2021-08-05T01:32:34-04:00", "date_published": "2021-08-05T01:38:23-04:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1064/galley/806/download/" } ] }, { "pk": 46382, "title": "Suspected Asymptomatic COVID-19 Infection and Pulmonary Embolism", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3h71r6xv", "frozenauthors": [ { "first_name": "Amy", "middle_name": "S.", "last_name": "Wang", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T13:26:50-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46382/galley/35113/download/" } ] }, { "pk": 46381, "title": "A Mysterious Case of Erythema Nodosum", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6qn6q0rg", "frozenauthors": [ { "first_name": "Mindy", "middle_name": "", "last_name": "Goh", "name_suffix": "DO", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Chris", "middle_name": "", "last_name": "Gornes", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T13:24:55-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46381/galley/35112/download/" } ] }, { "pk": 46380, "title": "Head Scratcher or Cat Scratcher?", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2kn1s614", "frozenauthors": [ { "first_name": "Ryan", "middle_name": "", "last_name": "Clagg", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Rosemarie", "middle_name": "", "last_name": "DiPentino", "name_suffix": "", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T13:22:52-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46380/galley/35111/download/" } ] }, { "pk": 46379, "title": "A Classic Case of Pituitary Apoplexy", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/97n203w1", "frozenauthors": [ { "first_name": "Michael J. Ahlers", "middle_name": "J.", "last_name": "Ahlers", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Julianna", "middle_name": "", "last_name": "Gardner", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Julie", "middle_name": "E.", "last_name": "Magorien", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T13:20:17-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46379/galley/35110/download/" } ] }, { "pk": 46378, "title": "Regional Anesthesia in a Patient with Familial Mediterranean Fever", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9s89s8q7", "frozenauthors": [ { "first_name": "Calvin", "middle_name": "W.", "last_name": "Wong", "name_suffix": "", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Elizabeth", "middle_name": "", "last_name": "Tsai", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Fei", "middle_name": "", "last_name": "Zheng-Ward", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T13:14:55-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46378/galley/35109/download/" } ] }, { "pk": 46377, "title": "Smoldering Multiple Myeloma in a Young Newly Diagnosed Diabetic with Microalbuminuria", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9pj0j4wn", "frozenauthors": [ { "first_name": "Raghu Konanur", "middle_name": "", "last_name": "Venkataram", "name_suffix": "MBBS", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "David", "middle_name": "D.", "last_name": "Kim", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Jeff", "middle_name": "", "last_name": "Borenstein", "name_suffix": "MD, MPH", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T13:12:26-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46377/galley/35108/download/" } ] }, { "pk": 46376, "title": "Coexisting Hashimoto’s Hypothyroidism and Graves’ Hyperthyroidism", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/04v1b0ts", "frozenauthors": [ { "first_name": "Shira", "middle_name": "", "last_name": "Grock", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Vanessa", "middle_name": "", "last_name": "Schmidt", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T13:10:07-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46376/galley/35107/download/" } ] }, { "pk": 46375, "title": "Fibrillary Glomerulonephritis", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/78s183r6", "frozenauthors": [ { "first_name": "Reza", "middle_name": "", "last_name": "Khorsan", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Qiao Nan", "middle_name": "", "last_name": "Ruan", "name_suffix": "", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T13:06:22-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46375/galley/35106/download/" } ] }, { "pk": 46374, "title": "Syrinx Formation Associated with Chiropractic Cervical Spinal Manipulation", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/31z235rg", "frozenauthors": [ { "first_name": "Jason", "middle_name": "", "last_name": "Bahk", "name_suffix": "MA, MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Patrick", "middle_name": "", "last_name": "Poquiz", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T13:00:17-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46374/galley/35105/download/" } ] }, { "pk": 46373, "title": "“Ouch, My Belly Hurts!” A Case of a Large Non-Infectious Splenic Cyst", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6fm262ff", "frozenauthors": [ { "first_name": "Olivia", "middle_name": "", "last_name": "Arreola-Owen", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Chaivat", "middle_name": "", "last_name": "Phuvadakorn", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:58:02-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46373/galley/35104/download/" } ] }, { "pk": 46372, "title": "Back Pain due to Retroperitoneal Liposarcoma", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6c66g6rj", "frozenauthors": [ { "first_name": "Olivia", "middle_name": "", "last_name": "Arreola-Owen", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Chaivat", "middle_name": "", "last_name": "Phuvadakorn", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:56:13-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46372/galley/35103/download/" } ] }, { "pk": 46371, "title": "Sjogren’s Ganglionapathy", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/865285v4", "frozenauthors": [ { "first_name": "Geraldine", "middle_name": "", "last_name": "Navarro", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Ricardo", "middle_name": "", "last_name": "Salas", "name_suffix": "MD, MPH", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:53:52-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46371/galley/35102/download/" } ] }, { "pk": 46370, "title": "POTS Secondary to COVID-19", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4vm4w03c", "frozenauthors": [ { "first_name": "Sarah", "middle_name": "", "last_name": "Goldgar", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:51:20-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46370/galley/35101/download/" } ] }, { "pk": 46369, "title": "Diabetic Amyotrophy Presenting as Weight Loss, Foot Drop and Truncal Pruritus", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/90r1t1nw", "frozenauthors": [ { "first_name": "Rachel", "middle_name": "T", "last_name": "Oxman", "name_suffix": "MD, MPH", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Gregory", "middle_name": "J", "last_name": "Lam", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:45:17-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46369/galley/35100/download/" } ] }, { "pk": 46368, "title": "A Perfect Storm: A Case of Thyrotoxicosis in the Setting of COVID-19 Infection and Methamphetamine Use", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/33d8b58d", "frozenauthors": [ { "first_name": "Alexandra", "middle_name": "R", "last_name": "Ly", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Bradley", "middle_name": "", "last_name": "Neutel", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": "Elizabeth", "middle_name": "L", "last_name": "Goodman", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:42:57-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46368/galley/35099/download/" } ] }, { "pk": 46367, "title": "A Rare Case of Disseminated Kaposi Sarcoma after Glucocorticoid Use", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6g98m48k", "frozenauthors": [ { "first_name": "Lin", "middle_name": "", "last_name": "Deng", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Jason", "middle_name": "", "last_name": "Ng", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:40:44-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46367/galley/35098/download/" } ] }, { "pk": 46366, "title": "Severe Hyponatremia due to Microadenoma", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0q21g0xd", "frozenauthors": [ { "first_name": "Lin", "middle_name": "", "last_name": "Deng", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Jason", "middle_name": "", "last_name": "Ng", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:38:43-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46366/galley/35097/download/" } ] }, { "pk": 46365, "title": "“Whodunit”: Urinary Tract Infection by Pasteurella canis", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7107j3nz", "frozenauthors": [ { "first_name": "Khushboo", "middle_name": "", "last_name": "Kaushal", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Wossen", "middle_name": "", "last_name": "Belachew", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:35:36-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46365/galley/35096/download/" } ] }, { "pk": 46364, "title": "An Irritating Presentation of Primary CNS Lymphoma", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6mc9w8hv", "frozenauthors": [ { "first_name": "Jessica", "middle_name": "", "last_name": "Liao", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Benjamin", "middle_name": "", "last_name": "Waterman", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:30:32-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46364/galley/35095/download/" } ] }, { "pk": 46363, "title": "The Heart-Mind Connection", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Review" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7q2136w5", "frozenauthors": [ { "first_name": "Tamara", "middle_name": "", "last_name": "Horwich", "name_suffix": "MS, MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Marcella", "middle_name": "", "last_name": "Calfon-Press", "name_suffix": "MD, PhD", "institution": "", "department": "" }, { "first_name": "Karol", "middle_name": "E", "last_name": "Watson", "name_suffix": "MD, PhD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:27:58-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46363/galley/35094/download/" } ] }, { "pk": 46362, "title": "Development of Scleroderma in a Young Child Following Resolution of Hypereosinophilic Syndrome", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/23x3z0rk", "frozenauthors": [ { "first_name": "Ami", "middle_name": "", "last_name": "Philipp", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Bob", "middle_name": "", "last_name": "Geng", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:24:59-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46362/galley/35093/download/" } ] }, { "pk": 46361, "title": "Avoid Those Flea Bites: A Local Case of Murine Typhus", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3t98x7k3", "frozenauthors": [ { "first_name": "Eric", "middle_name": "J", "last_name": "Kwoh", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Jonathan", "middle_name": "M", "last_name": "Helali", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:23:01-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46361/galley/35092/download/" } ] }, { "pk": 46360, "title": "Moving the Line: A Hospitalist-Run Procedure Service Expedites Outpatient Oncology Care Safely", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Original Research" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3zq8j4gz", "frozenauthors": [ { "first_name": "Catherine", "middle_name": "", "last_name": "Durant", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Gary", "middle_name": "", "last_name": "Feigenbaum", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": "Alexandra", "middle_name": "M", "last_name": "Glaeser", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:20:35-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46360/galley/35091/download/" } ] }, { "pk": 46359, "title": "SARS-CoV-2 Infection and Challenges of Diffuse Large B-Cell Lymphoma", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3rc5h7gh", "frozenauthors": [ { "first_name": "Balbir", "middle_name": "", "last_name": "Brar", "name_suffix": "MD, MPH", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Michael", "middle_name": "E", "last_name": "Lazarus", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:18:01-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46359/galley/35090/download/" } ] }, { "pk": 46358, "title": "Androgenic-Anabolic Steroid Drug-Induced Liver Injury", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6610b71r", "frozenauthors": [ { "first_name": "Jonathan", "middle_name": "", "last_name": "Balakumar", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Derrick", "middle_name": "", "last_name": "Darnsteadt", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:15:02-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46358/galley/35089/download/" } ] }, { "pk": 46357, "title": "Penile Incarceration in Metallic Ring", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8610g6dk", "frozenauthors": [ { "first_name": "Stephanie", "middle_name": "", "last_name": "Wang", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Derrick", "middle_name": "", "last_name": "Darnsteadt", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:12:23-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46357/galley/35088/download/" } ] }, { "pk": 46356, "title": "Acute Kidney Injury Related to Repeated Oxaliplatin Use", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2rg5h0rh", "frozenauthors": [ { "first_name": "Ramya", "middle_name": "", "last_name": "Malchira", "name_suffix": "", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Mufaddal", "middle_name": "", "last_name": "Dahodwala", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:10:02-04:00", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46356/galley/35087/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46356/galley/35087/download/" } ] }, { "pk": 46355, "title": "Contemporary Issues on Lyme Borreliosis Management", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Review" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0171q5g1", "frozenauthors": [ { "first_name": "Maurice", "middle_name": "J", "last_name": "Berkowitz", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Alexander", "middle_name": "P", "last_name": "Arzoo", "name_suffix": "BS", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:06:58-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46355/galley/35086/download/" } ] }, { "pk": 46354, "title": "Epiploic Appendagitis: An Uncommon Cause of Recurrent Abdominal Pain", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0m42k0ct", "frozenauthors": [ { "first_name": "Ahmad", "middle_name": "", "last_name": "Jabaiah", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T12:04:09-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46354/galley/35085/download/" } ] }, { "pk": 46353, "title": "54-Year-Old Male with Chronic Headache and Worsening Dysphagia and Odynophagia", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/70k4s4wx", "frozenauthors": [ { "first_name": "Ana", "middle_name": "", "last_name": "Rivera", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Geraldine", "middle_name": "", "last_name": "Navarro", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T11:59:40-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46353/galley/35084/download/" } ] }, { "pk": 46352, "title": "Hashimoto Thyroiditis Following COVID-19 Infection", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7pk5v6nz", "frozenauthors": [ { "first_name": "Qays", "middle_name": "", "last_name": "Albustani", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Mustafa", "middle_name": "", "last_name": "Albustani", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Ahmed", "middle_name": "", "last_name": "Alsarray", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-08-04T11:54:16-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46352/galley/35083/download/" } ] }, { "pk": 31596, "title": "Beyond Borders: How Principles of Prison Abolition Can Shape the Future of Immigration Reform", "subtitle": null, "abstract": "<p>This Note presents prison abolition theory and discusses how principles of abolition can be applied in the context of immigration enforcement and reform. In doing so, this Note argues for an “open borders” approach to immigration, presents several viewpoints on what such a regime may look like, and discusses how this vision can shape immigration reform efforts. In applying abolition theory to the immigration legal system, this Note uses a framework of three tenets of prison abolition. First, the assumptions upon which our current system of immigration enforcement is based, such as public safety and economic justifications, are open to questioning, and an alternate approach to migration is possible. Second, the immigration system exacts a human cost and infringes upon human dignity in ways that cannot be justified. Third, reform efforts are most effective when they envision a world beyond the current system of enforcement, rather than expanding the machinery of current enforcement efforts or merely shifting who is the target of immigration enforcement. Though it seems difficult to envision life without it, immigration enforcement as we know it is a recent invention and in many ways has proven ineffective at achieving its own purported goals. Further, the system results in significant human suffering in a myriad of ways, from the exploitation of those without status, to detention, to deportation, and beyond. As such, reform efforts that focus on who should be subject to immigration enforcement or how such enforcement should be carried out miss the opportunity to ask whether such enforcement should have a place in our society at all.</p>", "language": null, "license": { "name": "All rights reserved", "short_name": "Copyright", "text": "© the author(s). All rights reserved.", "url": "https://creativecommons.org/licenses/authors" }, "keywords": [], "section": "Note", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/70h963hv", "frozenauthors": [ { "first_name": "Anna", "middle_name": "", "last_name": "Hales", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-07-31T20:00:00-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucilr/article/31596/galley/22665/download/" } ] }, { "pk": 31597, "title": "Cover", "subtitle": null, "abstract": "", "language": null, "license": { "name": "All rights reserved", "short_name": "Copyright", "text": "© the author(s). All rights reserved.", "url": "https://creativecommons.org/licenses/authors" }, "keywords": [], "section": "Prefatory", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7tg7n8j6", "frozenauthors": [], "date_submitted": null, "date_accepted": null, "date_published": "2021-07-31T20:00:00-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucilr/article/31597/galley/22666/download/" } ] }, { "pk": 31598, "title": "Investing in Alternatives: Three Logics of Criminal System Replacement", "subtitle": null, "abstract": "<p>What logics underlie the call to “defund the police,” and how do those logics matter in policy debate? In the wake of widespread protests after the deaths of George Floyd, Breonna Taylor, and other victims of police violence during the summer of 2020, the Black Lives Matter movement’s call to “defund the police” captured the national imagination. Several municipal governments promised to cut funding and contracts for their respective police departments, with mixed results. Because we expect police defunding and reinvestment to remain a central movement demand, this Article explores the demand’s discursive and normative terrain. It does so by describing and critically engaging three logics of criminal system alternatives that we have observed in activists’ demands and organizing efforts. Specifically, we theorize investments in social welfare, safety production, and racial reparation as deeply connected but distinct logics that might guide decisions about where and how money should be spent as part of defund initiatives, and we discuss some implications of each for transformational change within and beyond policing.</p>", "language": null, "license": { "name": "All rights reserved", "short_name": "Copyright", "text": "© the author(s). All rights reserved.", "url": "https://creativecommons.org/licenses/authors" }, "keywords": [], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/27v5s94f", "frozenauthors": [ { "first_name": "Monica", "middle_name": "C.", "last_name": "Bell", "name_suffix": "", "institution": "", "department": "" }, { "first_name": "Katherine", "middle_name": "", "last_name": "Beckett", "name_suffix": "", "institution": "", "department": "" }, { "first_name": "Forrest", "middle_name": "", "last_name": "Stuart", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-07-31T20:00:00-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucilr/article/31598/galley/22667/download/" } ] }, { "pk": 31599, "title": "Masthead", "subtitle": null, "abstract": "", "language": null, "license": { "name": "All rights reserved", "short_name": "Copyright", "text": "© the author(s). All rights reserved.", "url": "https://creativecommons.org/licenses/authors" }, "keywords": [], "section": "Prefatory", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4hx9975n", "frozenauthors": [], "date_submitted": null, "date_accepted": null, "date_published": "2021-07-31T20:00:00-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucilr/article/31599/galley/22668/download/" } ] }, { "pk": 31600, "title": "Mission Statement", "subtitle": null, "abstract": "", "language": null, "license": { "name": "All rights reserved", "short_name": "Copyright", "text": "© the author(s). All rights reserved.", "url": "https://creativecommons.org/licenses/authors" }, "keywords": [], "section": "Prefatory", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1zq7n58z", "frozenauthors": [], "date_submitted": null, "date_accepted": null, "date_published": "2021-07-31T20:00:00-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucilr/article/31600/galley/22669/download/" } ] }, { "pk": 31601, "title": "Olmstead as a Tool for Decarceration", "subtitle": null, "abstract": "<p><em>Olmstead v. L.C. ex rel. Zimring</em> established that the Americans with Disabilities Act of 1990’s integrated-care mandate requires the government to make reasonable accommodations to protect the right of people with disabilities to live in the most integrated setting possible. In response, counties began releasing people from restrictive mental-health institutions but did not provide the necessary resources, such as supportive housing and outpatient care, to allow people to live successfully in their communities. As many people contending with disabilities were left homeless and the United States increased its reliance on incarceration, shuttered mental-health institutions gave way to jails and prisons. <em>Olmstead</em> litigation focused on decarceration could establish counties’ legal obligation to release eligible people from jails and prisons and to provide them with mental-health care in their communities.</p>", "language": null, "license": { "name": "All rights reserved", "short_name": "Copyright", "text": "© the author(s). All rights reserved.", "url": "https://creativecommons.org/licenses/authors" }, "keywords": [], "section": "Note", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1k64h4mt", "frozenauthors": [ { "first_name": "Sarah", "middle_name": "", "last_name": "Kahn", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-07-31T20:00:00-04:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucilr/article/31601/galley/22670/download/" } ] } ] }