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{ "count": 39441, "next": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=11500", "previous": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=11300", "results": [ { "pk": 14257, "title": "Utilization of Educational Videos to Improve Communication and Discharge Instructions", "subtitle": null, "abstract": "Introduction: When discharging a patient from the emergency department (ED), it is crucial to make sure that they understand their disposition and aftercare instructions. However, numerous factors make it difficult to ensure that patients understand their next steps. Our objective was to determine whether patient understanding of ED discharge and aftercare instructions could be improved through instructional videos in addition to standard written discharge instructions.Methods: This was a prospective pre- and post-intervention study conducted at a single-center, academic tertiary care ED. Patients presenting with the five selective chief complaints (closed head injury, vaginal bleeding, laceration care, splint care, and upper respiratory infection) were given questionnaires after their discharge instructions to test comprehension. Once video discharge instructions were implemented, patients received standard discharge instructions in addition to video discharge instructions and were given the same questionnaire. A total of 120 patients were enrolled in each group.Results: There were significantly better survey scores after video discharge instructions (VDI) vs standard discharge instructions (SDI) for the closed head injury (27% SDI vs 46% VDI, P = 0.003); upper respiratory infection (28% SDI vs 64% VDI; P < 0.0001); and vaginal bleeding in early pregnancy groups (20% SDI vs 60% VDI, P < 0.0001). There were no significant differences in survey scores between the splint care (53% SDI vs 66% VDI; P = 0.08) and suture care groups (29% SDI vs 31% VDI; P = 0.40).Conclusion: Video discharge instructions supplementing standard written instructions can help improve patient comprehension and information retention. This better understanding of aftercare instructions is essential to patient follow-up and has been shown to 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": "Education, Emergency Medicine, Patient Education, Video Discharge Instructions" } ], "section": "Health Outcomes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9ks6r8fm", "frozenauthors": [ { "first_name": "Alisa", "middle_name": "", "last_name": "Wray", "name_suffix": "", "institution": "University of California Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" }, { "first_name": "Ronald", "middle_name": "", "last_name": "Goubert", "name_suffix": "", "institution": "University of California Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" }, { "first_name": "Rishi", "middle_name": "", "last_name": "Gadepally", "name_suffix": "", "institution": "University of California Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" }, { "first_name": "Megan", "middle_name": "", "last_name": "Boysen-Osborn", "name_suffix": "", "institution": "University of California Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" }, { "first_name": "Warren", "middle_name": "", "last_name": "Wiechmann", "name_suffix": "", "institution": "University of California Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" }, { "first_name": "Shannon", "middle_name": "", "last_name": "Toohey", "name_suffix": "", "institution": "University of California Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" } ], "date_submitted": "2020-07-04T18:05:29Z", "date_accepted": "2020-07-04T18:05:29Z", "date_published": "2021-04-27T19:32:08Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14257/galley/7351/download/" } ] }, { "pk": 13541, "title": "Code Status Documentation Availability and Accuracy Among Emergency Patients with End-stage Disease", "subtitle": null, "abstract": "Introduction:\n Some patients with end-stage disease who may neither want nor benefit from aggressive resuscitation receive such treatment if they cannot communicate in an emergency. Timely access to patients’ current resuscitation wishes, or “code status,” should be a key metric of electronic health records (EHR). We sought to determine what percentage of a cohort of patients with end-stage disease who present to the emergency department (ED) have accessible, code status documents, and for those who do, how quickly can this documentation be retrieved.\nMethods:\n In this cross-sectional study of ED patients with end-stage disease (eg, palliative care, metastatic malignancy, home oxygen, dialysis) conducted during purposefully sampled random accrual times we performed a standardized, timed review of available health records, including accompanying transfer documents. We also interviewed consenting patients and substitute decision makers to compare available code status documents to their current wishes.\nResults:\n Code status documentation was unavailable within 15 minutes of ED arrival in most cases (54/85, or 63%). Retrieval time was under five minutes in the rest, especially when “one click deep” in the EHR. When interviewed, 20/32 (63%) expressed “do not resuscitate” wishes, 10 of whom had no supporting documentation. Patients from assisted-living (odds ratio [OR] 6.7; 95% confidence interval [CI], 1.7-26) and long-term care facilities (OR 13; 95% CI, 2.5-65) were more likely to have a documented code status available compared to those living in the community.\nConclusion:\n The majority of patients with end-stage disease, including half of those who would not wish resuscitation from cardiorespiratory arrest, did not have code status documents readily available upon arrival to our tertiary care ED. Patients living in the community with advanced disease may be at higher risk for unwanted resuscitative efforts should they present to hospital in extremis. While easily retrievable code status documentation within the EHR shows promise, its accuracy and validity remain important considerations.", "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, goals of care, code status, end-stage disease, palliative" } ], "section": "Health Outcomes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4vv609cp", "frozenauthors": [ { "first_name": "Evan", "middle_name": "", "last_name": "Russell", "name_suffix": "", "institution": "Queen’s University, Department of Emergency Medicine, Kingston, Ontario, Canada", "department": "None" }, { "first_name": "Andrew", "middle_name": "K.", "last_name": "Hall", "name_suffix": "", "institution": "Queen’s University, Department of Emergency Medicine, Kingston, Ontario, Canada", "department": "None" }, { "first_name": "Conor", "middle_name": "", "last_name": "McKaigney", "name_suffix": "", "institution": "University of Calgary, Department of Emergency Medicine, Calgary, Alberta, Canada", "department": "None" }, { "first_name": "Craig", "middle_name": "", "last_name": "Goldie", "name_suffix": "", "institution": "Queen’s University, Department of Medicine, Division of Palliative Care, Kingston, Ontario, Canada", "department": "None" }, { "first_name": "Ingrid", "middle_name": "", "last_name": "Harle", "name_suffix": "", "institution": "Queen’s University, Department of Medicine, Division of Palliative Care, Kingston, Ontario, Canada", "department": "None" }, { "first_name": "Marco", "middle_name": "L.A.", "last_name": "Sivilotti", "name_suffix": "", "institution": "Queen’s University, Department of Emergency Medicine, Kingston, Ontario, Canada; Queen’s University, Department of Biomedical & Molecular Sciences, Kingston, Ontario, Canada", "department": "None" } ], "date_submitted": "2020-07-29T17:36:44Z", "date_accepted": "2020-07-29T17:36:44Z", "date_published": "2021-04-27T19:20:08Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13541/galley/7087/download/" } ] }, { "pk": 4781, "title": "Meroe and Egypt", "subtitle": null, "abstract": "The Meroitic Period, which lasted from the third century BCE to around the mid-fourth century CE, comprises the second of two phases of Kushite empire in the territory of what is today Sudan, the first phase comprising the Napatan era (c. 655 – 300 BCE). While Meroitic culture reflects both Napatan influence and that of periods of Egyptian colonization (during Egypt’s New Kingdom, c. 1550 – 1070 BCE), it is characterized by the emergence of indigenous cultural elements. These include an indigenous script as well as ideological features such as concepts of kingship, burial customs, and the introduction of indigenous deities into the old Egypto-centric pantheon. Meroitic rulers were buried in cemeteries in the regions of (Gebel) Barkal and Meroe. The shift of burial grounds from the vicinity of Barkal to Meroe has led scholars to designate the period and culture as “Meroitic.” There was, however, no cultural break with former times, but rather a continuation and development of prevailing cultural features with the addition of new elements. Special focus is laid on the border area between Ptolemaic and, later, Roman Egypt and the Meroitic Empire, in which both power structures had interests. The politics of both states in Lower Nubia—today territory held by Egypt and Sudan—were of varied intensity during the c. 650 years of the Meroitic Period. Documentation of Meroitic history is hindered by our as yet insufficient understanding of Meroitic texts and thus relies heavily on archaeological data and the factual remains of art and architecture. In general, our knowledge is uneven: some periods are well documented, while for others we have little to no information.", "language": "en", "license": null, "keywords": [ { "word": "Arts and Humanities" } ], "section": "Time and History", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6061m848", "frozenauthors": [ { "first_name": "Josefine", "middle_name": "", "last_name": "Kuckertz", "name_suffix": "", "institution": "Research Fellow Staatliche Museen zu Berlin -\nÄgyptisches Museum und Papyrussammlung", "department": "None" } ], "date_submitted": "2009-12-12T00:07:51Z", "date_accepted": "2009-12-12T00:07:51Z", "date_published": "2021-04-27T17:02:13Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/nelc_uee/article/4781/galley/2687/download/" } ] }, { "pk": 46341, "title": "Predicting Acute Myocardial Infarction: An Unexpected Case of Wellens 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/48j7w38x", "frozenauthors": [ { "first_name": "William", "middle_name": "K.", "last_name": "Winter", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-26T16:06:25Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46341/galley/35072/download/" } ] }, { "pk": 46339, "title": "Thyroid and Bone Disease Before Pregnancy", "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/44h24110", "frozenauthors": [ { "first_name": "Jien", "middle_name": "", "last_name": "Shim", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Sheila Haji Ali", "middle_name": "", "last_name": "Ahmadi", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-26T16:05:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46339/galley/35070/download/" } ] }, { "pk": 46338, "title": "A Case of Collagenous Gastritis in a Patient with Newly Diagnosed Common Immunodeficiency Disease", "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/2cs61348", "frozenauthors": [ { "first_name": "Nidah", "middle_name": "S.", "last_name": "Khakoo", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Mona", "middle_name": "", "last_name": "Rezapour", "name_suffix": "MD, MHS", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-26T16:03:18Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46338/galley/35069/download/" } ] }, { "pk": 46337, "title": "Evaluation of Neck Mass in Primary Care", "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/46m3z1wh", "frozenauthors": [ { "first_name": "Anita", "middle_name": "", "last_name": "Srinivasa", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Darrick", "middle_name": "", "last_name": "Lee", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-26T16:01:25Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46337/galley/35068/download/" } ] }, { "pk": 46336, "title": "Recurrent Abdominal Venous Stasis Masquerading as Cellulitis", "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/9pb3x7db", "frozenauthors": [ { "first_name": "Brittney", "middle_name": "", "last_name": "Pham", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Reece", "middle_name": "", "last_name": "Doughty", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-26T15:58:47Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46336/galley/35067/download/" } ] }, { "pk": 46335, "title": "A Case of Poorly Controlled Hypothyroidism", "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/4nn605k4", "frozenauthors": [ { "first_name": "Elaine", "middle_name": "", "last_name": "Parker", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-26T15:57:02Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46335/galley/35066/download/" } ] }, { "pk": 46334, "title": "Drug-Drug Interactions in Patients Requiring Anticoagulation for Atrial Fibrillation and Atrial Flutter", "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/7cd0n51b", "frozenauthors": [ { "first_name": "Daniel", "middle_name": "P.", "last_name": "O’Brien", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Emily", "middle_name": "", "last_name": "Boychuck", "name_suffix": "", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Mehran", "middle_name": "J.", "last_name": "Kashefi", "name_suffix": "DO", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-26T15:49:39Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46334/galley/35065/download/" } ] }, { "pk": 41457, "title": "Citrus Rootstocks: Their characters and reactions (an unpublished manuscript)", "subtitle": null, "abstract": "IOCV is pleased to present “Citrus Rootstocks: Their Characters and Reactions”, an unpublished manuscript by the late Prof. W.P. Bitters, University of California, Riverside. Based upon Prof. Bitters research and many other sources, this work was compiled between the late 1960’s and 1986 (additional information in preface). It represents a comprehensive (for that era) treatment of many facets of citrus rootstock physiology, horticulture, and pathology. Rootstocks serve as both conduits for citrus disease development and potential disease management tools, as well as tools in dealing with abiotic stresses. The history of the use of rootstocks for citrus has largely been determined by these factors, and they continue to greatly influence citrus rootstock research and usage. Although many advances in knowledge regarding citrus rootstocks have been made since 1986, the basic information presented remains important for all citriculturists. We hope that this Special Topic in IOCV’s \nJournal of Citrus Pathology\n makes this valuable resource more widely available.", "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": "Citrus, Rootstocks" } ], "section": "Special Topics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1s74t1mn", "frozenauthors": [ { "first_name": "Willard", "middle_name": "P", "last_name": "Bitters", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2021-04-24T20:18:54Z", "date_accepted": "2021-04-24T20:18:54Z", "date_published": "2021-04-24T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/iocv_journalcitruspathology/article/41457/galley/31035/download/" } ] }, { "pk": 41445, "title": "Evaluating high-resolution computed tomography to study citrus tristeza virus-induced stem pitting", "subtitle": null, "abstract": "Citrus tristeza virus (CTV) is the most important viral pathogen of citrus. CTV-induced stem pitting negatively impacts grapefruit and sweet orange production. The mechanisms of stem pitting development in CTV-infected citrus remain unclear. This study evaluated the utility of high-resolution CT scanning as a tool to study stem pitting in live citrus material. CT scans were used to easily identify pits based on differences in tissue density. Stem pits were also mapped and modelled three-dimensionally along the length of the stem. Nano-CT scanning proved to be a potentially valuable, non-destructive method for stem pitting characterization in citrus.", "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": "CTV" }, { "word": "X-ray tomography" }, { "word": "3D-modelling" }, { "word": "Nano-CT" }, { "word": "Micro-CT" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4fw3c8pg", "frozenauthors": [ { "first_name": "Dirk", "middle_name": "Jacobus", "last_name": "Aldrich", "name_suffix": "", "institution": "Department of Genetics, Stellenbosch University, Private Bag X1, Matieland 7602, South Africa\n\nAgricultural Research Council, Infruitec-Nietvoorbij: Institute for Deciduous Fruit, Vines and Wine, Private Bag X5026, Stellenbosch 7599, South Africa", "department": "None" }, { "first_name": "Rachelle", "middle_name": "", "last_name": "Bester", "name_suffix": "", "institution": "Department of Genetics, Stellenbosch University, Private Bag X1, Matieland 7602, South Africa", "department": "None" }, { "first_name": "Glynnis", "middle_name": "", "last_name": "Cook", "name_suffix": "", "institution": "Citrus Research International, PO Box 28, Nelspruit 1200, Mpumalanga, South Africa", "department": "None" }, { "first_name": "Anton", "middle_name": "", "last_name": "du Plessis", "name_suffix": "", "institution": "Research group 3D Innovation, Stellenbosch University, Stellenbosch, South Africa", "department": "None" }, { "first_name": "Johan", "middle_name": "Theodorus", "last_name": "Burger", "name_suffix": "", "institution": "Department of Genetics, Stellenbosch University, Private Bag X1, Matieland 7602, South Africa", "department": "None" }, { "first_name": "Hans", "middle_name": "Jacob", "last_name": "Maree", "name_suffix": "", "institution": "Department of Genetics, Stellenbosch University, Private Bag X1, Matieland 7602, South Africa\n\nCitrus Research International, PO Box 2201, Matieland, 7602, South Africa", "department": "None" } ], "date_submitted": "2020-10-01T16:02:20Z", "date_accepted": "2020-10-01T16:02:20Z", "date_published": "2021-04-24T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/iocv_journalcitruspathology/article/41445/galley/31026/download/" } ] }, { "pk": 1019, "title": "Angioedema Secondary to tPA Use in Acute Ischemic Stroke Patient with Hypertension: A Case Report", "subtitle": null, "abstract": "Introduction:\n A well-documented complication of administering tissue plasminogen activator (tPA) in stroke patients is acute intracranial bleeding. A lesser known but still significant complication is angioedema secondary to tPA administration, which can develop in certain individuals with risk factors such as angiotensin converting enzyme (ACE) inhibitor use and location of the stroke. Knowing the potential for this life-threatening complication and being prepared for its proper management is vital for emergency physicians.\nCase Report:\n We report a 53-year-old Black female who presented to the emergency department with sudden onset of slurred speech and a facial droop. She was found to have an acute ischemic stroke and tPA was administered. She subsequently developed angioedema. Retrospectively, the patient was found to have risk factors that are thought to predispose patients to tPA-induced angioedema.\nConclusion:\n Risk factors associated with angioedema secondary to tPA administration have been documented in patients taking ACE inhibitors, as well as patients who develop strokes in the frontal lobe. While many cases may be mild, some patients may develop life-threatening angioedema. Although this complication does not necessarily contraindicate tPA use, it is prudent for the emergency physician to be vigilant for its development, prepared for its treatment, and to be diligent in assessing the need for control of the patient’s airway.", "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": "tPa" }, { "word": "angioedema" }, { "word": "stroke" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5vw1g0x0", "frozenauthors": [ { "first_name": "Chris", "middle_name": "", "last_name": "Kim", "name_suffix": "", "institution": "Eisenhower Medical Center, Department of Emergency Medicine, Rancho Mirage, California", "department": "None" }, { "first_name": "Andrea", "middle_name": "", "last_name": "Hladik", "name_suffix": "", "institution": "Eisenhower Medical Center, Department of Emergency Medicine, Rancho Mirage, California", "department": "None" } ], "date_submitted": "2021-04-24T06:55:23Z", "date_accepted": "2021-04-24T06:55:23Z", "date_published": "2021-04-24T06:56:23Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1019/galley/766/download/" } ] }, { "pk": 1018, "title": "An Unusual ECG Artifact Caused by Faulty Cardiac Monitor Leads", "subtitle": null, "abstract": "Case Presentation:\n We present the case of a 74-year-old female patient who presented to the emergency department with lower extremity weakness found to have a fixed frequency square wave artifact in all leads of her electrocardiogram (ECG). After troubleshooting, faulty external cardiac monitor leads were identified as the cause of this unique artifact.\nDiscussion:\n The ECG is an important diagnostic tool for medical providers. Electrocardiogram artifacts are extremely common, and knowledge of artifacts is necessary to prevent inappropriate interpretation, diagnostic error, and unnecessary workup. Medical providers should have a low threshold for suspicion when ECG findings do not correlate with the patient’s chief complaint or history of present illness. They must also be familiar with the most frequent ECG artifact variants and be prepared to follow a stepwise approach to troubleshoot less frequent variants.", "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": "ECG" }, { "word": "Artifact" }, { "word": "emergency department" }, { "word": "cardiac monitor" } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0g0233gf", "frozenauthors": [ { "first_name": "Bryan", "middle_name": "", "last_name": "Imhoff", "name_suffix": "", "institution": "University of Kansas Health System, Department of Emergency Medicine, Kansas City, Kansas", "department": "None" }, { "first_name": "Wesley", "middle_name": "", "last_name": "Casey", "name_suffix": "", "institution": "University of Kansas Health System, Department of Emergency Medicine, Kansas City, Kansas", "department": "None" } ], "date_submitted": "2021-04-24T06:44:01Z", "date_accepted": "2021-04-24T06:44:01Z", "date_published": "2021-04-24T06:44:35Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1018/galley/765/download/" } ] }, { "pk": 1017, "title": "When the Red Tide Rolls In: A Red Tide Associated Angioedema Case Report", "subtitle": null, "abstract": "Introduction:\n Histamine-mediated angioedema is a potentially life-threatening reaction following exposures that incite mast cell activation. In Florida, red tides are a frequent phenomenon caused by overgrowth of the harmful algae species Karenia brevis, which contain environmentally detrimental brevetoxins. Even in low concentrations, brevetoxins can cause disease in humans through inducing histamine release. We report the first documented case of angioedema associated with red tide exposure.\nCase Report:\n A 52-year-old-male presented with severe angioedema encompassing both lips within a few hours after exposure to red tide algae. Other symptoms included voice changes and difficulty swallowing. Laboratory findings revealed complement factors that were within reference range, which ruled out a bradykinin-mediated pathology and supported the diagnosis of histaminergic angioedema. Symptoms resolved after 24 hours in the intensive care unit under management with epinephrine, diphenhydramine, methylprednisolone, and famotidine.\nConclusion:\n In coastal regions, red tide algae should be recognized as a rare cause of acute angioedema. Emergency management of histamine-mediated angioedema should focus on preventing respiratory compromise with frequent airway monitoring and treatment with steroids, antihistamines, and epinephrine.", "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": "angioedema" }, { "word": "red tide" }, { "word": "harmful algae" }, { "word": "brevetoxin" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6gr633b3", "frozenauthors": [ { "first_name": "Sarah", "middle_name": "", "last_name": "Rabinowitz", "name_suffix": "", "institution": "Charles E. Schmidt College of Medicine, Department of Emergency Medicine, Boca Raton, Florida", "department": "None" }, { "first_name": "Joshua", "middle_name": "J.", "last_name": "Solano", "name_suffix": "", "institution": "Charles E. Schmidt College of Medicine, Department of Emergency Medicine, Boca Raton, Florida", "department": "None" } ], "date_submitted": "2021-04-24T06:39:43Z", "date_accepted": "2021-04-24T06:39:43Z", "date_published": "2021-04-24T06:40:18Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1017/galley/764/download/" } ] }, { "pk": 1016, "title": "Pediatric Innominate Artery Pseudoaneurysm Rupture in Vascular Ehlers-Danlos Syndrome: A Case Report", "subtitle": null, "abstract": "Introduction:\n Ehlers-Danlos syndrome is a well classified connective tissue disorder recognized by its features of hyperextensibility of joints and hyperelasticity of the skin. However, the rare vascular type (Ehlers-Danlos type IV) is more difficult to identify in the absence, rarity, or subtlety of the classical physical features. Patients presenting to the emergency department (ED) with acute complications of vascular Ehlers-Danlos syndrome may be critically ill, requiring accurate diagnosis and tailored management.\nCase Report:\n This report details a case of spontaneous innominate artery pseudoaneurysm rupture in a pediatric patient with previously undiagnosed Ehlers-Danlos syndrome. Initial ED evaluation was followed by urgent operative intervention and subsequent genetic testing to confirm final diagnosis.\nConclusion:\n Due to its high morbidity and mortality, vascular type Ehlers-Danlos syndrome should be considered in the differential for otherwise unexplained spontaneous vascular injury.", "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": "Pseudoaneurysm" }, { "word": "pediatric vascular injury" }, { "word": "Ehlers-Danlos syndrome" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2q32s86v", "frozenauthors": [ { "first_name": "Aimee", "middle_name": "", "last_name": "Vos", "name_suffix": "", "institution": "Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois", "department": "None" }, { "first_name": "Katharine", "middle_name": "M.", "last_name": "Burns", "name_suffix": "", "institution": "Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois", "department": "None" } ], "date_submitted": "2021-04-24T06:24:09Z", "date_accepted": "2021-04-24T06:24:09Z", "date_published": "2021-04-24T06:24:44Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1016/galley/763/download/" } ] }, { "pk": 1015, "title": "48-year-old with Altered Mental Status and Respiratory Failure: A Case Report", "subtitle": null, "abstract": "Introduction:\n The differential diagnosis for altered mental status and respiratory failure is broad. Careful physical examination, appropriate use of diagnostic tools, and accurate interpretation and correlation of test results are important for piecing together the puzzle of a patient with altered mental status that emergency physicians commonly face. In certain cases, such as this one, rapid diagnosis and management is crucial for improving patient morbidity and mortality.\nCase Presentation:\n A 48-year-old male with altered mental status and respiratory failure presented to the emergency department after being found unconscious on his porch. Vital signs were notable for temperature 105.5 °F, blood pressure 202/102 millimeters of mercury, pulse 126 beats per minute, respiratory rate 30 breaths per minute, and oxygen saturation 91% on room air. Physical examination revealed an obese male lying in bed awake in severe distress with labored breathing and unable to converse. His physical examination was significant for dry mucous membranes, tachycardia, and bilateral lower extremity 1+ pitting edema. He also appeared to have Kussmaul respirations with severe tachypnea, but his breath sounds were clear to auscultation bilaterally. On further examination, the patient appeared to have intravenous (IV) injection markings along his arms suggesting the possibility of IV drug use.\nDiscussion:\n With limited history, the only context clues initially available to assist in the diagnosis were abnormal vital signs and physical examination. The patient was tachycardic, hyperthermic, hypertensive, hypoxic, and tachypneic with altered mental status; he eventually required endotracheal intubation for hypoxic respiratory failure. The complexity of his condition prompted a large list for the differential diagnoses. Toxidromes, endocrine abnormalities, infectious process, cardiac and/or renal etiologies, and neurological pathology such as a cerebrovascular accident were considered. In the case of this patient, urgent diagnosis and management was crucial to prevent further decompensation and improve his outcome.", "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": "Cardiorenal Syndrome, Respiratory Failure, Altered Mental Status, Sepsis, Case Report" } ], "section": "ACOEP Case Reports (Invitation Only)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2n0194qx", "frozenauthors": [ { "first_name": "Justin", "middle_name": "E.", "last_name": "Pile", "name_suffix": "", "institution": "Swedish Hospital Part of Northshore University HealthSystem, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Justina", "middle_name": "", "last_name": "Truong", "name_suffix": "", "institution": "Kingman Regional Medical Center, Department of Emergency Medicine, Kingman, Arizona", "department": "None" } ], "date_submitted": "2021-04-24T06:17:46Z", "date_accepted": "2021-04-24T06:17:46Z", "date_published": "2021-04-24T06:18:20Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1015/galley/762/download/" } ] }, { "pk": 41742, "title": "Taphonomic bias in collections of horse phalanges from the Barstow Formation (Miocene) and Rancho La Brea (Pleistocene) of California, USA", "subtitle": null, "abstract": "Isolated equid phalanges are relatively common finds in the Barstow Formation (Miocene, 19 to 13 million years ago, southern California), but anecdotal observations suggested that not all positions (proximal, middle, and distal/ungual) of the primary digit (digit III) are recovered with equal frequency. Our sample includes primarily surface-collected phalanges from the Barstow Formation, which we compare with phalanges of Pleistocene horses from Pit 3 and Pit 77 from Rancho La Brea (Los Angeles, California). The null hypothesis is that the three positions of phalanges should be equally common. Our Barstow sample includes 228 proximal, 151 middle, and 36 distal phalanges. A chi-square test (p<0.001) is consistent with preservation bias in phalangeal frequency for the full Barstow Formation sample, and this pattern generally holds within sub-samples by locality or depositional environment. Pit 3 of La Brea produced 163 proximal, 144 middle, and 103 distal phalanges. A chi-square test with correction for multiple comparisons suggests that proximal and middle phalanges are preserved with statistically equal frequency (p=0.278) whereas distal phalanges are less common (p<0.001). For Pit 77, there are 54 proximal, 55 middle, and 51 distal phalanges; the chi-square test finds that all three types are equally common (p=0.922). Overall, differences in physical properties between phalangeal positions, such as surface area, density, shape, and size, could influence preservation within each environment. The observed differences between Barstow and La Brea might be caused by variations in depositional environment that influence the surface exposure time of fossils and disarticulation pre-burial, as well as by differences in the size of the horses at each locality. We suggest that when permitted by sample size, it is desirable to distinguish unguals from other phalanges when analyzing taphonomic patterns in the fossil record.", "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": "Cenozoic, Equidae, fossil, taphonomy, ungual, tar pits" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3pg5b0ks", "frozenauthors": [ { "first_name": "Yaoran", "middle_name": "", "last_name": "Shi", "name_suffix": "", "institution": "The Webb Schools, 1175 West Baseline Road, Claremont, CA 91711.", "department": "None" }, { "first_name": "Victoria", "middle_name": "W.", "last_name": "Gu", "name_suffix": "", "institution": "The Webb Schools, 1175 West Baseline Road, Claremont, CA 91711.", "department": "None" }, { "first_name": "Andrew", "middle_name": "A.", "last_name": "Farke", "name_suffix": "", "institution": "Raymond M. Alf Museum of Paleontology at The Webb Schools, Claremont, CA 91711; Dinosaur Institute, Natural History Museum of Los Angeles County, 900 Exposition Blvd., Los Angeles, CA 90007.", "department": "None" } ], "date_submitted": "2021-04-23T01:31:17Z", "date_accepted": "2021-04-23T01:31:17Z", "date_published": "2021-04-22T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucmp_paleobios/article/41742/galley/31214/download/" } ] }, { "pk": 1014, "title": "A Traumatic Tick Bite: A Case Report", "subtitle": null, "abstract": "Introduction:\n Human granulocytic anaplasmosis is a tick-borne disease with an increasing incidence associated with morbidity and mortality. Uncertainty remains whether a prophylactic dose of doxycycline is effective in prevention.\nCase Report:\n We present a case of an 80-year-old female with syncope, resultant facial trauma, and fever two weeks after a tick bite for which she received prophylaxis. Workup revealed anaplasmosis, and treatment led to symptomatic improvement.\nConclusion:\n We review the presenting symptoms, laboratory findings, and treatment of anaplasmosis, as well as give caution about the limitations in prescribing a prophylactic dose of doxycycline following a tick bite.", "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": "Trauma" }, { "word": "anaplasmosis" }, { "word": "tick" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2km1r4bp", "frozenauthors": [ { "first_name": "Daniel", "middle_name": "", "last_name": "Finnin", "name_suffix": "", "institution": "Albany Medical Center, Department of Emergency Medicine, Albany, New York", "department": "None" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Hanowitz", "name_suffix": "", "institution": "Albany Medical Center, Department of Emergency Medicine, Albany, New York", "department": "None" } ], "date_submitted": "2021-04-19T21:17:19Z", "date_accepted": "2021-04-19T21:17:19Z", "date_published": "2021-04-19T21:18:11Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1014/galley/761/download/" } ] }, { "pk": 1013, "title": "A Pain in the Butt: A Case Series of Gluteal Compartment Syndrome", "subtitle": null, "abstract": "Introduction:\n Gluteal compartment syndrome is a rare and difficult-to-diagnose form of compartment syndrome.\nCase Series:\n We present three patients with gluteal compartment syndrome and review the clinical presentation, imaging, and laboratory findings that assist in diagnosis. Suggestions for more readily diagnosing gluteal compartment syndrome are provided.\nConclusion:\n Emergency physicians must be familiar with the diagnosis and management of gluteal compartment syndrome to prevent the significant associated morbidity and mortality.", "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": "Gluteal compartment syndrome" }, { "word": "fentanyl" } ], "section": "Case Series", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2vf4z5vk", "frozenauthors": [ { "first_name": "Jessica", "middle_name": "Ray", "last_name": "Jackson", "name_suffix": "", "institution": "Temple University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Kraftin", "middle_name": "", "last_name": "Schreyer", "name_suffix": "", "institution": "Temple University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" } ], "date_submitted": "2021-04-19T21:13:09Z", "date_accepted": "2021-04-19T21:13:09Z", "date_published": "2021-04-19T21:14:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1013/galley/760/download/" } ] }, { "pk": 1012, "title": "Point-of-care Ultrasound in Early Diagnosis of Cardiomyopathy in a Child with Viral Myocarditis: A Case Report", "subtitle": null, "abstract": "Introduction:\n Pediatric myocarditis is a commonly missed diagnosis in the pediatric emergency department (ED) with high morbidity and mortality. The presentation of cardiogenic shock secondary to myocarditis and septic shock can be difficult to differentiate during initial resuscitation, and incorrect treatment can lead to poor prognosis. Early diagnosis may provide a better prognosis for this life-threatening condition.\nCase Report:\n We report a case of a five-year-old female who presented to the ED with non-specific symptoms of myocarditis. Rapid point-of-care ultrasound led to early diagnosis, correct management, and great prognosis for the patient.\nConclusion:\n Providers must maintain a high index of suspicion for cardiogenic shock in patients with nonspecific symptoms and fluid unresponsiveness. Point-of-care ultrasound can help in the identification of cardiac disorders and guide practitioners in their management plans.", "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": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9ss8v8qm", "frozenauthors": [ { "first_name": "Ayush", "middle_name": "", "last_name": "Gupta", "name_suffix": "", "institution": "Children’s Hospital of New Orleans, Department of Pediatric Emergency Medicine, New Orleans, Louisiana", "department": "None" }, { "first_name": "Trevor", "middle_name": "", "last_name": "Eckenswiller", "name_suffix": "", "institution": "William Beaumont Hospital, Department of Emergency Medicine, Royal Oak, Michigan", "department": "None" } ], "date_submitted": "2021-04-19T21:07:55Z", "date_accepted": "2021-04-19T21:07:55Z", "date_published": "2021-04-19T21:08:32Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1012/galley/759/download/" } ] }, { "pk": 1011, "title": "Arterial-embolic Strokes and Painless Vision Loss Due to Phase II Aortitis and Giant Cell Arteritis: A Case Report", "subtitle": null, "abstract": "Introduction:\n Aortitis refers to abnormal inflammation of the aorta, most commonly caused by giant cell arteritis (GCA). Herein, we present a 57-year-old female with aortitis and arterial-embolic strokes secondary to GCA.\nCase Report:\n Our patient presented to the emergency department following an episode of transient, monocular, painless vision loss. Computed tomography angiogram head and neck demonstrated phase II aortitis, and magnetic resonance imaging revealed evidence of arterial-embolic strokes.\nConclusion:\n Cerebrovascular accident is a rare complication of large-vessel vasculitis and can occur due to multiple underlying etiologies including intracranial vasculitis, aortic branch proximal occlusion, or arterial-embolic stroke.", "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": "aortitis" }, { "word": "giant cell arteritis" }, { "word": "arterial-embolic stroke" }, { "word": "painless vision loss" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8mm5n23g", "frozenauthors": [ { "first_name": "Kaitlin", "middle_name": "", "last_name": "Endres", "name_suffix": "", "institution": "University of Ottawa, Department of Medicine, Ottawa, Ontario, Canada", "department": "None" }, { "first_name": "Omar", "middle_name": "", "last_name": "Anjum", "name_suffix": "", "institution": "University of Ottawa, Department of Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital, Department of Emergency Medicine, Ottawa, Ontario, Canada", "department": "None" }, { "first_name": "Nicholas", "middle_name": "", "last_name": "Costain", "name_suffix": "", "institution": "University of Ottawa, Department of Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital, Department of Emergency Medicine, Ottawa, Ontario, Canada", "department": "None" } ], "date_submitted": "2021-04-19T21:00:14Z", "date_accepted": "2021-04-19T21:00:14Z", "date_published": "2021-04-19T21:02:27Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1011/galley/758/download/" } ] }, { "pk": 14584, "title": "Failure Rates During Reuse of Disposable N95 Masks in Clinical Practice in the Emergency Department", "subtitle": null, "abstract": "Introduction:\n The coronavirus 2019 pandemic caused a shortage of disposable N95 respirators, prompting healthcare entities to extend the use of these masks beyond their intended single-use manufacturer recommendation with a paucity of supporting research.\nMethods:\n We performed a prospective cohort study of ED healthcare workers (HCW) (“subjects”) required to use respirators at an academic, Level I trauma center. Subjects had been previously fit tested and assigned an appropriately sized N95 mask per hospital protocol. Per study protocol, subjects were fit tested periodically throughout their shifts and on multiple shifts over the eight-week study period. Data points collected included the age of the mask, subjective assessment of mask seal quality, and fit test results. We analyzed the data using Fisher’s exact test, and calculated odds ratios (OR) to determine the failure rate of disposable N95 masks following reuse.\nResults:\n A total of 130 HCWs underwent fit testing and 127 were included for analysis. Mask failure rate climbed after day 2 of use, with 33.3% of masks failing at day 3, 42.9% at day 4, and 50% at ≥ day 5. Categorizing the masks into those being used for two or fewer days vs those in use for three or more, failure was more common on day 3 of use or older compared to those in the first two days of use (41.8% vs 8.3%, P < 0.0001) with an OR of failure with an older mask of 7.9 (confidence interval [CI], 2.8-22.3). The healthcare workers’ assessment of poor seal was 33.3% sensitive (CI, 18.6-51.9) and 95.7% specific (CI, 88.8-98.6) for fit test failure.\nConclusion:\n Disposable N95 masks have significant failure rates following reuse in clinical practice. Healthcare personnel also performed poorly in assessing the integrity of the seal of their disposable respirators.", "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": "Personal Protective Equipment" }, { "word": "N95 Respirator" }, { "word": "coronavirus" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3vt2p9zc", "frozenauthors": [ { "first_name": "Ronald", "middle_name": "", "last_name": "Check", "name_suffix": "", "institution": "St. Luke’s University Health Network, Department of Emergency Medicine, Bethlehem, Pennsylvania", "department": "None" }, { "first_name": "Brian", "middle_name": "", "last_name": "Kelly", "name_suffix": "", "institution": "St. Luke’s University Health Network, Department of Emergency Medicine, Bethlehem, Pennsylvania", "department": "None" }, { "first_name": "Kathleen", "middle_name": "", "last_name": "McMahon", "name_suffix": "", "institution": "St. Luke’s University Health Network, Department of Emergency Medicine, Bethlehem, Pennsylvania", "department": "None" }, { "first_name": "Vamsi", "middle_name": "", "last_name": "Balakrishnan", "name_suffix": "", "institution": "St. Luke’s University Health Network, Department of Emergency Medicine, Bethlehem, Pennsylvania", "department": "None" }, { "first_name": "Leah", "middle_name": "", "last_name": "Rivard", "name_suffix": "", "institution": "St. Luke’s University Health Network, Department of Emergency Medicine, Bethlehem, Pennsylvania", "department": "None" }, { "first_name": "Jonathan", "middle_name": "", "last_name": "Pester", "name_suffix": "", "institution": "St. Luke’s University Health Network, Department of Emergency Medicine, Bethlehem, Pennsylvania", "department": "None" }, { "first_name": "Donald", "middle_name": "", "last_name": "Jeanmonod", "name_suffix": "", "institution": "St. Luke’s University Health Network, Department of Emergency Medicine, Bethlehem, Pennsylvania", "department": "None" }, { "first_name": "Rebecca", "middle_name": "K.", "last_name": "Jeanmonod", "name_suffix": "", "institution": "St. Luke’s University Health Network, Department of Emergency Medicine, Bethlehem, Pennsylvania", "department": "None" } ], "date_submitted": "2020-09-21T18:50:31Z", "date_accepted": "2020-09-21T18:50:31Z", "date_published": "2021-04-19T17:09:46Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14584/galley/7446/download/" } ] }, { "pk": 14521, "title": "Effect of the Prescription Drug Monitoring Program on Emergency Department Opioid Prescribing", "subtitle": null, "abstract": "Introduction: \nOur goal was to determine whether implementation of a prescription drug monitoring program (PDMP) altered emergency department (ED) opioid prescription rates overall and in patients of different pain severities.\nMethods:\n We conducted this single-center, retrospective review at an academic ED. The study examined patients discharged from the ED who received opioid prescriptions, before and after the state’s implementation of a PDMP (August 25, 2016). The monthly rate was a ratio of the patients given ≥ 1 opioid prescription to the ED patients with a numeric pain rating scale (NPRS) > 0. We performed an interrupted time series analysis on each demographic.\nResults: \nThe overall ED opioid prescription rate decreased from 51.3% (95% confidence interval [Cl], 50.4%-52.2%) to 47.9% (95% Cl, 47.0%- 48.7%). For males, this decreased from 51.1% to 46.7% (P < 0.0001), while in females it did not significantly change (51.6% to 49.7% [P = 0.0529]). For those with mild pain, the rate increased from 27.5% to 34.3% (P < 0.0001), while for those with moderate pain, it did not significantly change (42.8% to 43.5% [P = 0.5924]). For those with severe pain, the rate decreased from 66.1% to 59.6% (P < 0.0001).\nConclusion:\n We found that PDMP implementation was associated with an overall decrease in opioid prescription rates, and that patients with mild pain were prescribed opioids more often while severe pain patients were prescribed opioids less often.", "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": "Prescription Drug Monitoring Programs, opioids, emergency department, prescriptions, analgesics, pain management" } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7wz7z6k3", "frozenauthors": [ { "first_name": "Rahul", "middle_name": "", "last_name": "Gupta", "name_suffix": "", "institution": "Penn State College of Medicine, Hershey, Pennsylvania", "department": "None" }, { "first_name": "Sue", "middle_name": "", "last_name": "Boehmer", "name_suffix": "", "institution": "Penn State Hershey Medical Center, Department of Public Health Services, Division of Biostatistics, Hershey, Pennsylvania", "department": "None" }, { "first_name": "David", "middle_name": "", "last_name": "Giampetro", "name_suffix": "", "institution": "Penn State Hershey Medical Center, Department of Anesthesiology and Perioperative Medicine", "department": "None" }, { "first_name": "Anuj", "middle_name": "", "last_name": "Gupta", "name_suffix": "", "institution": "University of Texas at Dallas, Richardson, Texas", "department": "None" }, { "first_name": "Christopher", "middle_name": "J.", "last_name": "DeFlitch", "name_suffix": "", "institution": "Penn State Hershey Medical Center, Department of Emergency Medicine, Hershey, Pennsylvania", "department": "None" } ], "date_submitted": "2020-08-31T20:52:52Z", "date_accepted": "2020-08-31T20:52:52Z", "date_published": "2021-04-19T17:03:18Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14521/galley/7425/download/" } ] }, { "pk": 1010, "title": "Point-of-care Ultrasound to Distinguish Subgaleal and Cephalohematoma: Case Report", "subtitle": null, "abstract": "Introduction:\n Cephalohematomas generally do not pose a significant risk to the patient and resolve spontaneously. Conversely, a subgaleal hematoma is a rare but more serious condition. While it may be challenging to make this diagnostic distinction based on a physical examination alone, the findings that differentiate these two conditions can be appreciated on point-of-care ultrasound (POCUS). We describe two pediatric patient cases where POCUS was used to distinguish between a subgaleal hematoma and a cephalohematoma.\nCase Reports:\n We describe one case of a 14-month-old male brought to the pediatric emergency department (PED) with concern for head injury. A POCUS examination revealed a large fluid collection that did not cross the sagittal suture. Thus, the hematoma was more consistent with a cephalohematoma and less compatible with a subgaleal hematoma. Given these findings, further emergent imaging was deferred in the PED and the patient was kept for observation. In the second case an 8-week-old male presented with suspected swelling over the right parietal region. A POCUS examination was performed, which demonstrated an extensive, simple fluid collection that extended across the suture line, making it more concerning for a subgaleal hematoma. Given the heightened suspicion for a subgaleal hematoma, the patient was admitted for further imaging and evaluation.\nConclusion:\n Point-of-care ultrasound can be used to help differentiate between a subgaleal hematoma and a cephalohematoma to risk-stratify patients and determine the need for further imaging.", "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": "Emergency Medicine" }, { "word": "pediatrics" }, { "word": "point-of-care" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3br8879p", "frozenauthors": [ { "first_name": "Josie", "middle_name": "", "last_name": "Acuña", "name_suffix": "", "institution": "University of Arizona, Department of Emergency Medicine, Tucson, Arizona", "department": "None" }, { "first_name": "Srikar", "middle_name": "", "last_name": "Adhikari", "name_suffix": "", "institution": "University of Arizona, Department of Emergency Medicine, Tucson, Arizona", "department": "None" } ], "date_submitted": "2021-04-19T16:22:38Z", "date_accepted": "2021-04-19T16:22:38Z", "date_published": "2021-04-19T16:23:30Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1010/galley/757/download/" } ] }, { "pk": 1009, "title": "Young Woman with Leg Lesions", "subtitle": null, "abstract": "Case Presentation:\n The patient was a 33-year-old woman with inflammatory bowel disease presenting for worsening lower leg lesions with significant pain recalcitrant to oral doxycycline.\nDiscussion:\n Pyoderma gangrenosum is a rare ulcerative skin condition with significant pain that is often associated with other systemic diseases typically treated with immunosuppressive medications aimed at the underlying cause.", "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": "Pyoderma gangrenosum" }, { "word": "case report" }, { "word": "ulcerative colitis" } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6r09366g", "frozenauthors": [ { "first_name": "Daniel", "middle_name": "", "last_name": "Finnin", "name_suffix": "", "institution": "Albany Medical Center, Department of Emergency Medicine, Albany, New York", "department": "None" } ], "date_submitted": "2021-04-17T04:14:05Z", "date_accepted": "2021-04-17T04:14:05Z", "date_published": "2021-04-17T04:14:53Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1009/galley/756/download/" } ] }, { "pk": 1008, "title": "55-year-old Male with Fatigue", "subtitle": null, "abstract": "This clinicopathological case presentation from the University of Maryland details the initial assessment and management of a 55-year-old, dialysis-dependent man with fatigue. We present how one of our emergency medicine faculty develops her differential when faced with this complaint. She describes how she arrives at the suspected diagnosis and the test she believes is needed to prove her hypothesis. The final surprising diagnosis is then revealed.", "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": "CPC" }, { "word": "dialysis" }, { "word": "shock" } ], "section": "Clinicopathological Cases from the University of Maryland", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/62v0f4t6", "frozenauthors": [ { "first_name": "Jennifer", "middle_name": "", "last_name": "Nichols", "name_suffix": "", "institution": "University of Maryland Medical Center, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" }, { "first_name": "Jennifer", "middle_name": "", "last_name": "Guyther", "name_suffix": "", "institution": "University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" }, { "first_name": "Laura", "middle_name": "J.", "last_name": "Bontempo", "name_suffix": "", "institution": "University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" }, { "first_name": "Zachary", "middle_name": "D.W.", "last_name": "Dezman", "name_suffix": "", "institution": "University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland; University of Maryland, Baltimore, Department of Epidemiology and Public Health, Baltimore, Maryland", "department": "None" } ], "date_submitted": "2021-04-17T04:09:05Z", "date_accepted": "2021-04-17T04:09:05Z", "date_published": "2021-04-17T04:09:49Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1008/galley/755/download/" } ] }, { "pk": 46333, "title": "The “Start-Up Syndrome” of HIV Pre-Exposure Prophylaxis", "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/1zk4x1rm", "frozenauthors": [ { "first_name": "Sheila", "middle_name": "", "last_name": "Naghshineh", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Puneky", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-16T18:50:26Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46333/galley/35064/download/" } ] }, { "pk": 46332, "title": "IgG Lambda Myeloma in a Young Man Presenting with Acute Renal Failure", "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/9x67t4jv", "frozenauthors": [ { "first_name": "Rietta", "middle_name": "", "last_name": "Goodglick", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Michael", "middle_name": "", "last_name": "Lazarus", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-16T18:48:45Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46332/galley/35063/download/" } ] }, { "pk": 46331, "title": "Retro-Orbital Infantile Hemangioma: A Rare Cause of Proptosis", "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/0t81d8rg", "frozenauthors": [ { "first_name": "Kimberly", "middle_name": "", "last_name": "Dang", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Kelsi", "middle_name": "", "last_name": "McCoy-Wilson", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Indu", "middle_name": "", "last_name": "Kannan", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-16T18:47:07Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46331/galley/35062/download/" } ] }, { "pk": 46330, "title": "Peeing Within, A Rare Cause of Pseudo-renal-failure", "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/9dp4c5gw", "frozenauthors": [ { "first_name": "Jonathan", "middle_name": "Kwong-Shing", "last_name": "Lin", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Kahn", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-16T18:45:17Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46330/galley/35061/download/" } ] }, { "pk": 46329, "title": "Medical Students’ Perceptions of Dermatology Education", "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/6pg177zq", "frozenauthors": [ { "first_name": "Regina", "middle_name": "", "last_name": "Liu", "name_suffix": "BA", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Nicholas", "middle_name": "", "last_name": "Jackson", "name_suffix": "PhD, MPH", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Marcia", "middle_name": "", "last_name": "Hogeling", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-16T18:42:32Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46329/galley/35060/download/" } ] }, { "pk": 46328, "title": "Assessing the Risks of Emergency Transfusion in the Operating Room", "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/7ft4t8ww", "frozenauthors": [ { "first_name": "David", "middle_name": "", "last_name": "Khandabi", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Kenneth", "middle_name": "", "last_name": "Liu", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-16T18:40:22Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46328/galley/35059/download/" } ] }, { "pk": 46327, "title": "Serotonin Syndrome Caused by Mirtazapine and Quetiapine in a Patient with 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/07h3q22f", "frozenauthors": [ { "first_name": "Matthew", "middle_name": "", "last_name": "Mulroy", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Jonathan", "middle_name": "", "last_name": "Wanagat", "name_suffix": "MD, PhD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-16T18:38:40Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46327/galley/35058/download/" } ] }, { "pk": 46326, "title": "A Serious Case of Muscle Cramps", "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/8gp4s99n", "frozenauthors": [ { "first_name": "Ramandeep", "middle_name": "", "last_name": "Bains", "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": "2021-04-16T18:36:48Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46326/galley/35057/download/" } ] }, { "pk": 46325, "title": "Dynamic ST-Segment Elevation Mimicking Acute Myocardial Infarction in a Patient with Chest Pain and Acute 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/64r1k3p8", "frozenauthors": [ { "first_name": "James", "middle_name": "S.", "last_name": "Lee", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-16T18:31:46Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46325/galley/35056/download/" } ] }, { "pk": 40256, "title": "Teaching Consent: Medieval Pastourelles in the Undergraduate Classroom", "subtitle": null, "abstract": "Students’ familiarity with the #MeToo movement, with its emphasis on multiple narratives of different kinds of violations, creates a valuable opportunity for educators to use medieval pastourelles to teach about long histories of power and sexual consent. Focusing specifically on the undergraduate medieval literature classroom, this essay argues for the importance of teaching pastourelles—a genre frequently overlooked by instructors—and outlines concrete strategies for doing so with knowledge, sensitivity, and care. It discusses multiple frameworks for teaching pastourelles, including connecting them to street harassment, intersectionality, or contemporary survivor narratives. It closes by discussing larger-scale strategies for cultivating a supportive classroom atmosphere and providing students with resources to navigate these difficult but important texts.", "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": "Consent" }, { "word": "Medieval Pastourelles" }, { "word": "pedagogy" }, { "word": "intersectionality" }, { "word": "#MeToo" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7m19739z", "frozenauthors": [ { "first_name": "Carissa", "middle_name": "M.", "last_name": "Harris", "name_suffix": "", "institution": "Temple University", "department": "None" } ], "date_submitted": "2021-04-15T12:50:24Z", "date_accepted": "2021-04-15T12:50:24Z", "date_published": "2021-04-16T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ncs_pedagogyandprofession/article/40256/galley/30274/download/" } ] }, { "pk": 41741, "title": "Califrapana\n: a new genus of California and Bája California late Oligocene to early Miocene muricids previously attributed to the genus \nRapana\n (Mollusca: Gastropoda: Muricidae)", "subtitle": null, "abstract": "Califrapana\n n. gen., is proposed for California late Oligocene to early Miocene muricids attributed previously to the possibly Paleocene to modern western Pacific and Indian oceans genus\n Rapana\n. Four fossil species have been assigned to \nRapana\n in the eastern Pacific. One of these species, \nR. perrini\n Clark and Arnold (1923), should be placed in another genus, the other species \nPurpura vaquerosensis\n Arnold (1907), \nR. imperialis\n Hertlein and Jordan (1927), and \nR. serrai\n Wiedey (1928) are synonymized here with the morphologically variable species \nCalifrapana vaquerosensis\n n. comb. We confirm \nC. vaquerosensis\n is an index fossil for the lower and middle “Vaqueros” California provincial molluscan stage of late Oligocene to early Miocene age in southern California and Bája California, México, although the lack of numerical dating and the misuse of lithostratigraphic and biostratigraphic names had made that difficult to determine. \nCalifrapana\n is distinguishable from similar genera by 1) its heavier shell, 2) an aperture that is pointed at its anterior and posterior ends, 3) more numerous fine to coarse spiral cords on the ultimate whorl, 4) less numerous nodes at the top of the ultimate whorl, which are commonly larger and more pronounced, and 5) the siphonal fasciole, which is large and broad, with a large, open channel.", "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": "Califrapana vaquerosensis, new combination, fossil gastropod, shallow-marine, \"Vaqueros\" molluscan stage, eastern Pacific, western Pacific" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3wr5675z", "frozenauthors": [ { "first_name": "Charles", "middle_name": "L.", "last_name": "Powell, II", "name_suffix": "", "institution": "United States Geological Survey, Menlo Park, CA 94025", "department": "None" }, { "first_name": "Roland", "middle_name": "", "last_name": "Houart", "name_suffix": "", "institution": "Research Associate: Royal Belgian Institute of Natural Sciences, Brussels, Belgium and Institute of Systematics, Evolution, Biodiversity (ISYEB); National Museum of Natural History (MNHN), CNRS, SU, EPHE, UA CP 51, 57 rue Cuvier, 75005 Paris, France.", "department": "None" } ], "date_submitted": "2021-04-15T18:45:21Z", "date_accepted": "2021-04-15T18:45:21Z", "date_published": "2021-04-15T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucmp_paleobios/article/41741/galley/31213/download/" } ] }, { "pk": 46324, "title": "PARP Inhibitor Maintenance in Newly Diagnosed Advanced Ovarian Cancer", "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/1rp5r7zj", "frozenauthors": [ { "first_name": "Kari", "middle_name": "", "last_name": "Kubalanza", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-12T17:21:13Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46324/galley/35055/download/" } ] }, { "pk": 46323, "title": "An Atypical Presentation of the Most Common Bacterial Diarrheal Infection: Shigellosis in a 27-Year-Old Daycare Goer", "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/2vc424q2", "frozenauthors": [ { "first_name": "Sarah", "middle_name": "", "last_name": "Jensen", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Linda", "middle_name": "", "last_name": "Czypinski", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-12T17:19:40Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46323/galley/35054/download/" } ] }, { "pk": 46322, "title": "A Rare Case of Acquired Hemophilia Presenting as an “Unusual GI Bleed”", "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/3886j63h", "frozenauthors": [ { "first_name": "Craig", "middle_name": "", "last_name": "Gluckman", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Rimma", "middle_name": "", "last_name": "Shaposhnikov", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-12T17:17:38Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46322/galley/35053/download/" } ] }, { "pk": 46321, "title": "Acute and Chronic Kidney Injury Associated with Vitamin D Toxicity", "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/5t26t1xb", "frozenauthors": [ { "first_name": "Hamid", "middle_name": "", "last_name": "Hajmomenian", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-12T17:15:48Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46321/galley/35052/download/" } ] }, { "pk": 46320, "title": "Bilateral Hand Arthritis in a Patient with Hemochromatosis and Persistent Ferritinemia", "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/8wf7t09g", "frozenauthors": [ { "first_name": "Maryann", "middle_name": "", "last_name": "Kimoto", "name_suffix": "DO", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-12T17:13:12Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46320/galley/35051/download/" } ] }, { "pk": 46319, "title": "Acute Kidney Injury and Hyperkalemia as the First Presentation of Addison Disease", "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/5tz8406s", "frozenauthors": [ { "first_name": "Hamid", "middle_name": "", "last_name": "Hajmomenian", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-12T17:11:10Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46319/galley/35050/download/" } ] }, { "pk": 5568, "title": "Decreased Key Pecking in Response to Reward Uncertainty Followed by Surprising Delay Extension in Pigeons", "subtitle": null, "abstract": "The Pavlovian autoshaping paradigm has often been used to assess the behavioral effects of reward omission on behavior. We trained pigeons to receive a food reward (unconditioned stimulus or UCS) following illumination of a response key (conditioned stimulus or CS). In Experiment 1, one group of pigeons was trained with two 100% predictive CS-UCS associations (reward certainty) and another group with two 25% predictive CS-UCS associations (reward uncertainty) for 12 sessions. In both groups, the two CS durations were 8 s. Then, in each group, the duration of one CS remained unchanged and that of the other CS was suddenly extended from 8 to 24 s for 6 sessions. In Experiment 2, some experienced individuals (from Experiment 1) and naïve individuals formed two groups trained with a 24-s CS throughout for 18 sessions. Our results show that pigeons (a) pecked less at the uncertain than the certain CS, (b) decreased and then increased CS-pecking after extending CS duration, especially in the certainty condition, (c) were unresponsive to the 24-s CS in the absence of previous experience, and (d) decreased their response rate close to the end of a trial irrespective of the reinforcement condition, CS duration, and amount of training. These results are discussed in relation to several theoretical frameworks.", "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": "autoshaping" }, { "word": "rewards" }, { "word": "uncertainty" }, { "word": "delay discounting" }, { "word": "Frustration" }, { "word": "Pigeons" } ], "section": "Research Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7zr588q0", "frozenauthors": [ { "first_name": "Neslihan", "middle_name": "", "last_name": "Wittek", "name_suffix": "", "institution": "Ruhr-University Bochum", "department": "None" }, { "first_name": "Kevin", "middle_name": "", "last_name": "Wittek", "name_suffix": "", "institution": "Westphalian University of Applied Sciences", "department": "None" }, { "first_name": "Onur", "middle_name": "", "last_name": "Güntürkün", "name_suffix": "", "institution": "Ruhr-University Bochum", "department": "None" }, { "first_name": "Patrick", "middle_name": "", "last_name": "Anselme", "name_suffix": "", "institution": "Ruhr-University Bochum", "department": "None" } ], "date_submitted": "2020-07-17T13:20:13Z", "date_accepted": "2020-07-17T13:20:13Z", "date_published": "2021-04-12T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uclapsych_ijcp/article/5568/galley/3370/download/" } ] }, { "pk": 14604, "title": "Provider Antibody Serology Study of Virus in the Emergency Room (PASSOVER) Study: Special Population COVID-19 Seroprevalence", "subtitle": null, "abstract": "Introduction:\n Limited data on the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCW) are publicly available. In this study we sought to determine the seroprevalence of SARS-CoV-2 in a population of HCWs in a pediatric emergency department (ED).\nMethods: \nWe conducted this observational cohort study from April 14–May 13, 2020 in a pediatric ED in Orange County, CA. Asymptomatic HCW ≥18 years of age were included in the study. Blood samples were obtained by fingerstick at the start of each shift. The inter-sampling interval was ≤96 hours. The primary outcome was positive seroprevalence of SARS-CoV-2 as determined with an antibody fast detection kit (Colloidal Gold, Superbio, Timisoara, Romania) for the SARS-CoV-2 immunoglobulin M/immunoglobulin G (IgM/IgG) antibody.\nResults:\n A total of 143 HCWs participated in the study. Overall SARS-CoV-2 seroprevalence was 10.5% (n = 15). Positive seroprevalence was classified as IgG only (4.9%), IgM+IgG (3.5%), or IgM only (2.1%). SARS-CoV-2 was detected by reverse transcription polymerase chain reaction RT-PCR in 0.7% of the overall study population (n = 1). Samples obtained on Day 1 indicated seropositivity in 4.2% of the study population (n = 6). Subsequent seroconversion occurred in 6.3% of participants (n = 9). The rate of seroconversion was linear with a rate of approximately one new case every two days, starting at Day 9 of the study.\nConclusion:\n We observed a linear rate of seroconversion to SARS-CoV-2–positive status among asymptomatic HCWs who underwent daily symptom surveys and temperature screens in an environment with universal source control. Rapid antibody testing may be useful for screening for SARS-CoV-2 seropositivity in high-risk populations, such as HCWs 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": "COVID-19, seroprevalence, emergency medicine" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4rv6721f", "frozenauthors": [ { "first_name": "Theodore", "middle_name": "W.", "last_name": "Heyming", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Department of Emergency Medicine, Orange, California\nUniversity of California, Irvine, Department of Emergency Medicine, Irvine, California", "department": "None" }, { "first_name": "Terence", "middle_name": "", "last_name": "Sanger", "name_suffix": "", "institution": "University of California, Irvine, Department of Electrical Engineering and Computer Science, Irvine, California\nChildren’s Hospital of Orange County, Research Institute, Orange, California", "department": "None" }, { "first_name": "Aprille", "middle_name": "", "last_name": "Tongol", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Research Institute, Orange, California", "department": "None" }, { "first_name": "John", "middle_name": "", "last_name": "Schomberg", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Department of Nursing, Orange, California", "department": "None" }, { "first_name": "Kellie", "middle_name": "", "last_name": "Bacon", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Research Institute, Orange, California", "department": "None" }, { "first_name": "Bryan", "middle_name": "", "last_name": "Lara", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Research Institute, Orange, California", "department": "None" } ], "date_submitted": "2020-09-28T17:13:49Z", "date_accepted": "2020-09-28T17:13:49Z", "date_published": "2021-04-09T23:58:41Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14604/galley/7453/download/" } ] }, { "pk": 14478, "title": "Financial Implications of Boarding: A Call for Research", "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": [ { "word": "Hospital operations, healthcare finances, emergency department, boarding" } ], "section": "Emergency Department Operations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/22d6f437", "frozenauthors": [ { "first_name": "Maureen", "middle_name": "M.", "last_name": "Canellas", "name_suffix": "", "institution": "University of Massachusetts Medical School, Department of Emergency Medicine, Worcester, Massachusetts", "department": "None" }, { "first_name": "Kevin", "middle_name": "A.", "last_name": "Kotkowski", "name_suffix": "", "institution": "University of Massachusetts Medical School, Department of Emergency Medicine, Worcester, Massachusetts", "department": "None" }, { "first_name": "Sean", "middle_name": "S.", "last_name": "Michael", "name_suffix": "", "institution": "University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado", "department": "None" }, { "first_name": "Martin", "middle_name": "A.", "last_name": "Reznek", "name_suffix": "", "institution": "University of Massachusetts Medical School, Department of Emergency Medicine, Worcester, Massachusetts", "department": "None" } ], "date_submitted": "2020-08-26T00:20:42Z", "date_accepted": "2020-08-26T00:20:42Z", "date_published": "2021-04-09T23:45:51Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14478/galley/7411/download/" } ] }, { "pk": 14412, "title": "Increased Emergency Department Hallway Length of Stay is Associated with Development of Delirium", "subtitle": null, "abstract": "Introduction:\n Our study aimed to determine 1) the association between time spent in the emergency department (ED) hallway and the development of delirium and 2) the hospital location of delirium development.\nMethods:\n This single-center, retrospective chart review included patients 18+ years old admitted to the hospital after presenting, without baseline cognitive impairment, to the ED in 2018. We identified the Delirium group by the following: key words describing delirium; orders for psychotropics, special observation, and restraints; or documented positive Confusion Assessment Method (CAM) screen. The Control group included patients not meeting delirium criteria. We used a multivariable logistic regression model, while adjusting for confounders, to assess the odds of delirium development associated with percentage of ED LOS spent in the hallway.\nResults:\n A total of 25,156 patients met inclusion criteria with 1920 (7.6%) meeting delirium criteria. Delirium group vs. Control group patients spent a greater percentage of time in the ED hallway (median 50.5% vs 10.8%, P<0.001); had longer ED LOS (median 11.94 vs 8.12 hours, P<0.001); had more ED room transfers (median 5 vs 4, P<0.001); and had longer hospital LOS (median 5.0 vs 4.6 days, P<0.001). Patients more frequently developed delirium in the ED (77.5%) than on inpatient units (22.5%). The relative odds of a patient developing delirium increased by 3.31 times for each percent increase in ED hallway time (95% confidence interval, 2.85, 3.83).\nConclusion: \nPatients with delirium had more ED hallway exposure, longer ED LOS, and more ED room transfers. Understanding delirium in the ED has substantial implications for improving patient safety.", "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": "Delirium, Hallway, Length of Stay" } ], "section": "Emergency Department Operations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9jq9q26v", "frozenauthors": [ { "first_name": "Kate", "middle_name": "", "last_name": "van Loveren", "name_suffix": "", "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Arnav", "middle_name": "", "last_name": "Singla", "name_suffix": "", "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Liron", "middle_name": "", "last_name": "Sinvani", "name_suffix": "", "institution": "Center for Health Innovations and Outcomes Research, Feinstein Institutes of Medical Research, Northwell Health, Manhasset, New York\nDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Medicine, Division of Hospital Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Calandrella", "name_suffix": "", "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York \nDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Emergency Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Thomas", "middle_name": "", "last_name": "Perera", "name_suffix": "", "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York \nDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Emergency Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Martina", "middle_name": "", "last_name": "Brave", "name_suffix": "", "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Lance", "middle_name": "", "last_name": "Becker", "name_suffix": "", "institution": "North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York \nDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Emergency Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Timmy", "middle_name": "", "last_name": "Li", "name_suffix": "", "institution": "Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Emergency Medicine, Manhasset, New York", "department": "None" } ], "date_submitted": "2020-07-30T21:53:09Z", "date_accepted": "2020-07-30T21:53:09Z", "date_published": "2021-04-09T23:24:23Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14412/galley/7397/download/" } ] }, { "pk": 14371, "title": "Help Us Help You: Engaging Emergency Physicians to Identify Organizational Strategies to Reduce Burnout", "subtitle": null, "abstract": "Introduction\n:\n Burnout is a major threat to patient care quality and physician career longevity in emergency medicine. We sought to develop and implement a quality improvement process to engage emergency department (ED) faculty in identifying sources of burnout and generating interventions targeted at improving the work environment.\nMethods:\n In this prospective interventional study conducted at a large, urban, academic medical center, we surveyed a 60-person faculty group using the Professional Fulfilment Index (PFI), as well as burnout-relevant questions from the American Medical Association’s Mini-Z survey and the Maslach-Leiter framework for organizational burnout, in order to identify organizational sources of burnout. We assessed the relationship between burnout scores and responses to the Maslach-Leiter framework using univariate regression analysis. In a two-hour facilitated session, we shared survey results and led the group in a process using the six Maslach-Leiter domains to develop a rank-ordered list of interventions to reduce burnout in each domain.\nResults\n: In total, 47 of 60 faculty (78.3%) completed the survey and 45 faculty (75%) attended the discussion session. Of the 47 survey respondents, 14 (30%) met criteria for moderate to severe burnout. The respondents’ answers to the Maslach-Leiter organizational burnout domain questions were significantly correlated with their burnout scores (P <0.001). Session attendees generated 31 potential interventions for process improvement, which were analyzed and thematically organized. Common intervention themes included reducing documentation burden, receiving more positive feedback on patient care, improving ease of obtaining consults, decreasing ED crowding, and increasing intrafaculty social connection. Interventions were subsequently reviewed and scored based on relative importance and feasibility to create a departmental action plan for process improvement.\nConclusion: \nUsing the Maslach-Leiter organizational burnout framework, in conjunction with a facilitated solution-oriented faculty discussion, led to the creation of a departmental agenda focused on organizational solutions for augmenting professional fulfillment and reducing burnout. We propose that this process can be used by healthcare organizations to engage physicians and others in efforts to improve their work experiences, which in turn is likely also to support the provision of higher quality of care.", "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 burnout" } ], "section": "Provider Workforce", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/86b9q4br", "frozenauthors": [ { "first_name": "Joshua", "middle_name": "J.", "last_name": "Baugh", "name_suffix": "", "institution": "Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Ali", "middle_name": "S.", "last_name": "Raja", "name_suffix": "", "institution": "Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "James", "middle_name": "K.", "last_name": "Takayesu", "name_suffix": "", "institution": "Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" } ], "date_submitted": "2020-07-20T18:44:41Z", "date_accepted": "2020-07-20T18:44:41Z", "date_published": "2021-04-09T00:00:57Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14371/galley/7378/download/" } ] }, { "pk": 14262, "title": "Performance of Emergency Heart Failure Mortality Risk Grade in the Emergency Department", "subtitle": null, "abstract": "Introduction: \nThe purpose of this study was to validate and assess the performance of the Emergency Heart Failure Mortality Risk Grade (EHMRG) to predict seven-day mortality in US patients presenting to the emergency department (ED) with acute congestive heart failure (CHF) exacerbation.\nMethods:\n We performed a retrospective chart review on patients presenting to the ED with acute CHF exacerbation between January 2014–January 2016 across eight EDs in New York. We identified patients using codes from the International Classification of Diseases, 9th and 10 Revisions, or who were diagnosed with CHF in the ED. Inclusion criteria were patients ≥ 18 years of age who presented to the ED for acute CHF. Exclusion criteria included the following: end-stage renal disease related heart failure; < 18 years of age; pregnancy; palliative care; renal failure; and “do not resuscitate” directive. The primary outcome was seven-day mortality. We used mixed-effects logistic regression models to estimate C-statistics and continuous net reclassification index for events and nonevents.\nResults: \nWe identified 3,320 ED visits associated with suspected CHF among 2,495 unique patients. Of the 3,320 ED visits, 94.7% patients were admitted to the hospital and 3.4% were discharged. The median age was 78.6 (interquartile range 68.01 - 86.76). There was an overall seven-day mortality of 2%, an inpatient mortality rate of 2.4%, and no mortality among the discharge group. Adding EHMRG to the risk prediction model improved the C-statistic (from 0.748 to 0.772) and led to a higher degree of reclassification for both events and nonevents.\nConclusion: \nThe EHMRG can be used as a valuable and effective screening tool in the US while considering disposition decision for patients with acute CHF exacerbation. Emergency medical services transport and metolazone use is much higher in the US population as compared to the Canadian population. We observed minimal to no short-term mortality among discharged CHF patients from 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": [], "section": "Critical Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8nn623z2", "frozenauthors": [ { "first_name": "Nidhi", "middle_name": "", "last_name": "Garg", "name_suffix": "", "institution": "Northwell Health, Southside Hospital, Department of Emergency Medicine, Bayshore, New York", "department": "None" }, { "first_name": "Renee", "middle_name": "", "last_name": "Pekmezaris", "name_suffix": "", "institution": "Northwell Health, Department of Internal Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Gerin", "middle_name": "", "last_name": "Stevens", "name_suffix": "", "institution": "Northwell Health, Department of Cardiology, Manhasset, New York", "department": "None" }, { "first_name": "Adan", "middle_name": "Z.", "last_name": "Becerra", "name_suffix": "", "institution": "Rush University Medical Center, Department of Surgery, Chicago, Illinois", "department": "None" }, { "first_name": "Andrzej", "middle_name": "", "last_name": "Kozikowski", "name_suffix": "", "institution": "National Commission on Certification of Physicians Assistants, John’s Creek, Georgia", "department": "None" }, { "first_name": "Vidhi", "middle_name": "", "last_name": "Patel", "name_suffix": "", "institution": "Northwell Health, Department of Internal Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Ghania", "middle_name": "", "last_name": "Haddad", "name_suffix": "", "institution": "Northwell Health, Department of Emergency Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Phillip", "middle_name": "", "last_name": "Levy", "name_suffix": "", "institution": "Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "Pridha", "middle_name": "", "last_name": "Kumar", "name_suffix": "", "institution": "Northwell Health, Long Island Jewish Medical Center, Department of Emergency Medicine, New Hyde Park, New York", "department": "None" }, { "first_name": "Lance", "middle_name": "", "last_name": "Becker", "name_suffix": "", "institution": "Northwell Health, Long Island Jewish Medical Center, Department of Emergency Medicine, New Hyde Park, New York", "department": "None" } ], "date_submitted": "2020-07-06T15:15:28Z", "date_accepted": "2020-07-06T15:15:28Z", "date_published": "2021-04-08T23:41:09Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14262/galley/7352/download/" } ] }, { "pk": 14752, "title": "Presentation of Neuro-COVID is Broad and Pathogenesis Diverse", "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": [ { "word": "COVID-19" }, { "word": "SARS-CoV-2" }, { "word": "neurological" }, { "word": "nervous system" } ], "section": "Letters to the Editor", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/01z8q12d", "frozenauthors": [ { "first_name": "Josef", "middle_name": "", "last_name": "Finsterer", "name_suffix": "", "institution": "Klinik Landstrasse, Messerli Institute, Department of Neurology, Vienna, Austria", "department": "None" } ], "date_submitted": "2020-11-17T14:24:52Z", "date_accepted": "2020-11-17T14:24:52Z", "date_published": "2021-04-08T23:09:15Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14752/galley/7505/download/" } ] }, { "pk": 13821, "title": "Ultrasound Hypotension Protocol Time-motion Study Using the Multifrequency Single Transducer Versus a Multiple Transducer Ultrasound Device", "subtitle": null, "abstract": "Introduction:\n Ultrasound hypotension protocols (UHP) involve imaging multiple body areas, each with different transducers and imaging presets. The time for task switching between presets and transducers to perform an UHP has not been previously studied. A novel hand-carried ultrasound (HCU) has been developed that uses a multifrequency single transducer to image areas of the body (lung, heart, abdomen, superficial) that would typically require three transducers using a traditional cart-based ultrasound (CBU) system. Our primary aim was to compare the time to complete UHPs with a single transducer HCU to a multiple transducer CBU.\nMethods:\n We performed a randomized, crossover feasibility trial in the emergency department of an urban, safety-net hospital. This was a convenience sample of non-hypotensive emergency department patients presenting during a two-month period of time. Ultrasound hypotension protocols were performed by emergency physicians (EP) on patients using the HCU and the CBU. The EPs collected UHP views in sequential order using the most appropriate transducer and preset for the area/organ to be imaged. Time to complete each view, time for task switching, total time to complete the examination, and image diagnostic quality were recorded.\nResults:\n A total of 29 patients were scanned by one of eight EPs. When comparing the HCU to the CBU, the median time to complete the UHP was 4.3 vs 8.5 minutes (P <0.0001), respectively. When the transport and plugin times were excluded, the median times were 4.1 vs 5.8 minutes (P <0.0001), respectively. There was no difference in the diagnostic quality of images obtained by the two devices.\nConclusion: \nUltrasound hypotension protocols were performed significantly faster using the single transducer HCU compared to a multiple transducer CBU with no difference in the number of images deemed to be diagnostic quality.", "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 hypotension protocol, RUSH, task switching" } ], "section": "Technology in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2xf4n5tm", "frozenauthors": [ { "first_name": "Linda", "middle_name": "", "last_name": "Sabbadini", "name_suffix": "", "institution": "University of Brescia - Medicine and Surgery, Department of Clinical and Experimental Science, Brescia, Italy", "department": "None" }, { "first_name": "Rocco", "middle_name": "", "last_name": "Germano", "name_suffix": "", "institution": "University of Brescia - Medicine and Surgery, Department of Clinical and Experimental Science, Brescia, Italy", "department": "None" }, { "first_name": "Emily", "middle_name": "", "last_name": "Hopkins", "name_suffix": "", "institution": "Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado", "department": "None" }, { "first_name": "Jason", "middle_name": "S.", "last_name": "Haukoos", "name_suffix": "", "institution": "Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado\nUniversity of Colorado School of Medicine, Aurora, Colorado\nColorado School of Public Health, Aurora, Colorado", "department": "None" }, { "first_name": "John", "middle_name": "L.", "last_name": "Kendall", "name_suffix": "", "institution": "Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado\nUniversity of Colorado School of Medicine, Aurora, Colorado", "department": "None" } ], "date_submitted": "2020-04-24T16:45:22Z", "date_accepted": "2020-04-24T16:45:22Z", "date_published": "2021-04-08T22:27:38Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13821/galley/7200/download/" } ] }, { "pk": 1007, "title": "A Report of Two Cases: Unlearning Lactic Acidosis", "subtitle": null, "abstract": "Introduction:\n The term “lactic acidosis” reinforces the misconception that lactate contributes to acidemia. Although it is common to discover an anion gap acidosis with a concomitant elevated lactate concentration, the two are not mutually dependent.\nCase Report:\n Here we describe two patients exhibiting high lactate concentrations in the setting of metabolic alkalemia.\nConclusion:\n Lactate is not necessarily the direct cause of acid-base disturbances, and there is no fixed relationship between lactate and the anion gap or between lactate and pH. The term “metabolic acidosis with hyperlactatemia” is more specific than “lactic acidosis” and thus more appropriate.", "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": "lactate" }, { "word": "anion gap" }, { "word": "acidosis" }, { "word": "alkalosis" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/64h7s607", "frozenauthors": [ { "first_name": "Sanjay", "middle_name": "", "last_name": "Mohan", "name_suffix": "", "institution": "NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York", "department": "None" }, { "first_name": "David", "middle_name": "S.", "last_name": "Goldfarb", "name_suffix": "", "institution": "NYU Grossman School of Medicine, Division of Nephrology, New York, New York", "department": "None" }, { "first_name": "Robert", "middle_name": "S.", "last_name": "Hoffman", "name_suffix": "", "institution": "NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York", "department": "None" } ], "date_submitted": "2021-04-08T20:19:21Z", "date_accepted": "2021-04-08T20:19:21Z", "date_published": "2021-04-08T20:21:50Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1007/galley/754/download/" } ] }, { "pk": 46318, "title": "False-positive Serum Protein Electrophoresis due to Natalizumab Therapy", "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/28k106tb", "frozenauthors": [ { "first_name": "Fukai", "middle_name": "Leo", "last_name": "Chuang", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Juan", "middle_name": "", "last_name": "Alcantar", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-08T16:44:18Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46318/galley/35049/download/" } ] }, { "pk": 46317, "title": "A Case of Hypopituitarism Presenting as Failure to Thrive in an Older Adult", "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/7fz1j0kr", "frozenauthors": [ { "first_name": "Katharine", "middle_name": "", "last_name": "Borthwick", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Mana", "middle_name": "", "last_name": "Khafaf", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-08T16:42:49Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46317/galley/35048/download/" } ] }, { "pk": 46316, "title": "Outcomes of Obese Intensive Care Patients with Acute Respiratory Failure", "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/89b4800s", "frozenauthors": [ { "first_name": "Tushar", "middle_name": "", "last_name": "Bajaj", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Samir", "middle_name": "", "last_name": "Salameh", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Ayham", "middle_name": "", "last_name": "Aboeed", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-08T16:39:36Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46316/galley/35047/download/" } ] }, { "pk": 46315, "title": "Growing Pains – A Case of Acromegaly", "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/57z8s42k", "frozenauthors": [ { "first_name": "Karen", "middle_name": "", "last_name": "Cheng", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Camelia", "middle_name": "", "last_name": "Davtyan", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-08T16:35:46Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46315/galley/35046/download/" } ] }, { "pk": 45132, "title": "Cold Deglutition as a Rare Cause of Complete Heart Block", "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/3nc8w00n", "frozenauthors": [ { "first_name": "Eric", "middle_name": "", "last_name": "Curcio", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Cecily", "middle_name": "", "last_name": "Gallup", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-04-08T16:26:12Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45132/galley/33925/download/" } ] }, { "pk": 14457, "title": "Utility Of An Emergency Department Clinical Protocol For Early Identification of Coronavirus Infection", "subtitle": null, "abstract": "Introduction:\n We assessed the utility of an emergency department (ED) protocol using clinical parameters to rapidly distinguish likelihood of novel coronavirus 2019 (COVID-19) infection; the applicability aimed to stratify infectious-risk pre-polymerase chain reaction (PCR) test results and accurately guide early patient cohorting decisions.\nMethods:\n We performed this prospective study over a two-month period during the initial surge of the 2020 COVID-19 pandemic in a busy urban ED of patients presenting with respiratory symptoms who were admitted for in-patient care. Per protocol, each patient received assessment consisting of five clinical parameters: presence of fever; hypoxia; cough; shortness of breath/dyspnea; and performance of a chest radiograph to assess for bilateral pulmonary infiltrates. All patients received nasopharyngeal COVID-19 PCR testing.\nResults: \nOf 283 patients studied, 221 (78%) were PCR+ and 62 (22%) PCR-. Chest radiograph revealed bilateral pulmonary infiltrates in 85%, which was significantly more common in PCR+ (94%) vs PCR- (52%) patients (P < 0.0001). The rate of manifesting all five positive clinical parameters was significantly greater in PCR+ (63%) vs PCR- (6.5%) patients (P < 0.0001). For PCR+ outcome, the presence of all five positive clinical parameters had a specificity of 94%, positive predictive value of 98%, and positive likelihood ratio of 10.\nConclusions:\n Using an ED protocol to rapidly assess five clinical parameters accurately distinguishes likelihood of COVID-19 infection prior to PCR test results, and can be used to augment early patient cohorting decisions.", "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, emergency department, cohorting" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6s60f9nb", "frozenauthors": [ { "first_name": "William", "middle_name": "", "last_name": "Bonadio", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, New York City, New York", "department": "None" }, { "first_name": "Kaedrea", "middle_name": "", "last_name": "Jackson", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, New York City, New York", "department": "None" }, { "first_name": "Lindsey", "middle_name": "", "last_name": "Gottlieb", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, New York City, New York", "department": "None" }, { "first_name": "Eric", "middle_name": "", "last_name": "Legome", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, New York City, New York", "department": "None" } ], "date_submitted": "2020-08-09T12:43:34Z", "date_accepted": "2020-08-09T12:43:34Z", "date_published": "2021-04-05T18:54:40Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14457/galley/7406/download/" } ] }, { "pk": 35519, "title": "Atypical Clinical and Imaging Presentation of a Large, Well-differentiated Hepatocellular Carcinoma: A Case Report", "subtitle": null, "abstract": "Hepatocellular carcinoma is the most common primary neoplasm of the liver that typically occurs in the setting of chronic liver disease. In this case report, we present an atypical case of well-differentiated hepatocellular carcinoma, which was detected in a 43-year-old man with no known symptoms of liver disease. We review the imaging features of the mass, which did not follow typical enhancement characteristics defined by the Liver Imaging Reporting and Data System criteria. The diagnosis was ultimately confirmed by histologic analysis of a surgically resected specimen.", "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": "atypical HCC, Hepatocellular carcinoma, LI-RADS, well-differentiated HCC" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4556j0h3", "frozenauthors": [ { "first_name": "Meghan", "middle_name": "L", "last_name": "Jardon", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" }, { "first_name": "Yipeng", "middle_name": "", "last_name": "Geng", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" }, { "first_name": "Bita", "middle_name": "V", "last_name": "Naini", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" }, { "first_name": "Victor", "middle_name": "", "last_name": "Sai", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" } ], "date_submitted": "2020-09-02T00:50:33Z", "date_accepted": "2020-09-02T00:50:33Z", "date_published": "2021-04-03T07:16:37Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucla_rsp/article/35519/galley/26437/download/" } ] }, { "pk": 35516, "title": "Watershed Infarctions and Hypereosinophilic Syndrome Secondary to Metastatic Lung Cancer: A Case Report", "subtitle": null, "abstract": "Watershed infarcts are traditionally attributed to ischemia caused by hypoperfusion, with or without vessel stenosis. Implicated diseases usually include atherosclerosis, congestive heart failure, hypotension, angiitis, and less commonly, sickle cell disease. In this report, we present an uncommon case of diffuse watershed infarctions possibly caused by reactive (secondary) hypereosinophilic syndrome. We also discuss the definition and causes of hypereosinophilic syndrome and its neuroradiologic manifestations.", "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": "Hypereosinophilic syndrome" }, { "word": "stroke" }, { "word": "watershed area infarctions" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0jz5j94b", "frozenauthors": [ { "first_name": "Brian", "middle_name": "Q", "last_name": "Tsui", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" }, { "first_name": "Mariam", "middle_name": "", "last_name": "Thomas", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" }, { "first_name": "Gasser", "middle_name": "", "last_name": "Hathout", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" } ], "date_submitted": "2020-05-30T20:03:21Z", "date_accepted": "2020-05-30T20:03:21Z", "date_published": "2021-04-03T07:15:24Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucla_rsp/article/35516/galley/26435/download/" } ] }, { "pk": 14729, "title": "Alteplase for Acute Ischemic Stroke Beyond 3 hours: Enthusiasm Outpaces Evidence", "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": [ { "word": "stroke" }, { "word": "alteplase" } ], "section": "Critical Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6rg5d2wd", "frozenauthors": [ { "first_name": "Ravi", "middle_name": "", "last_name": "Garg", "name_suffix": "", "institution": "Stritch School of Medicine at Loyola University, Department of Neurology, Division of Neurocritical Care, Maywood, Illinois", "department": "None" } ], "date_submitted": "2020-11-06T22:52:47Z", "date_accepted": "2020-11-06T22:52:47Z", "date_published": "2021-04-03T00:26:18Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14729/galley/7498/download/" } ] }, { "pk": 14368, "title": "Diabetes Patient Surveillance in the Emergency Department: Proof of Concept and Opportunities", "subtitle": null, "abstract": "Introduction: \nThe purpose of this study was to characterize the at-risk diabetes and prediabetes patient population visiting emergency department (ED) and urgent care (UC) centers in upstate South Carolina.\nMethods:\n We conducted this retrospective study at the largest non-profit healthcare system in South Carolina, using electronic health record (EHR) data of patients who had an ED or UC visit between February 2, 2016–July 31, 2018. Key variables including International Classification of Diseases, 10th Revision codes, laboratory test results, family history, medication, and demographic characteristics were used to classify the patients as healthy, having prediabetes, having diabetes, being at-risk for prediabetes, or being at-risk for diabetes. Patients who were known to have diabetes were classified further as having controlled diabetes, management challenged, or uncontrolled diabetes. Population analysis was stratified by the patient’s annual number of ED/UC visits.\nResults: \nThe risk stratification revealed 4.58% unique patients with unrecognized diabetes and 10.34% of the known patients with diabetes considered to be suboptimally controlled. Patients identified as diabetes management challenged had more ED/UC visits. Of note, 33.95% of the patients had unrecognized prediabetes/diabetes risk factors identified during their ED/UC with 87.95% having some form of healthcare insurance.\nConclusion:\n This study supports the idea that a single ED/UC unscheduled visit can identify individuals with unrecognized diabetes and an at-risk prediabetes population using EHR data. A patient’s ED/UC visit, regardless of their primary reason for seeking care, may be an opportunity to provide early identification and diabetes disease management enrollment to augment the medical care of our community.", "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": "Population surveillance" }, { "word": "Prediabetes state" }, { "word": "diabetes mellitus" }, { "word": "screening" }, { "word": "Emergency Service" }, { "word": "clinical decision-making" } ], "section": "Health Outcomes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3nf4g3d5", "frozenauthors": [ { "first_name": "M.", "middle_name": "Gabriela", "last_name": "Sava", "name_suffix": "", "institution": "Clemson University, Department of Management, Clemson, South Carolina", "department": "None" }, { "first_name": "Ronald", "middle_name": "G.", "last_name": "Pirrallo", "name_suffix": "", "institution": "University of South Carolina School of Medicine Greenville, Department of Emergency Medicine, Greenville, South Carolina", "department": "None" }, { "first_name": "Brian", "middle_name": "C.", "last_name": "Helsel", "name_suffix": "", "institution": "University of Kansas Medical Center, Department of Internal Medicine, Kansas City, Kansas", "department": "None" }, { "first_name": "Jingyuan", "middle_name": "", "last_name": "Tian", "name_suffix": "", "institution": "Clemson University, Department of Management, Clemson, South Carolina", "department": "None" }, { "first_name": "Patricia", "middle_name": "", "last_name": "Carbajales-Dale", "name_suffix": "", "institution": "Clemson University, Center for Geospatial Technologies, Clemson, South Carolina", "department": "None" }, { "first_name": "Kuang-Ching", "middle_name": "", "last_name": "Wang", "name_suffix": "", "institution": "Clemson University, Department of Electrical and Computer Engineering, Clemson, South Carolina", "department": "None" }, { "first_name": "John", "middle_name": "", "last_name": "Bruch", "name_suffix": "", "institution": "University of South Carolina School of Medicine Greenville, Department of Internal Medicine, Greenville, South Carolina", "department": "None" }, { "first_name": "Ronald", "middle_name": "W.", "last_name": "Gimbel", "name_suffix": "", "institution": "Clemson University, Department of Public Health Sciences, Clemson, South Carolina", "department": "None" } ], "date_submitted": "2020-08-03T14:09:13Z", "date_accepted": "2020-08-03T14:09:13Z", "date_published": "2021-04-02T17:23:37Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14368/galley/7377/download/" } ] }, { "pk": 14377, "title": "Rate of Decompensation of Normoxic Emergency Department Patients with SARS-CoV-2", "subtitle": null, "abstract": "Introduction:\n As of October 30, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 44 million people worldwide and killed over 1.1 million people. In the emergency department (ED), patients who need supplemental oxygen or respiratory support are admitted to the hospital, but the course of normoxic patients with SARS-CoV-2 infection is unknown. In our health system, the policy during the coronavirus 2019 (COVID-19) pandemic was to admit all patients with abnormal chest imaging (CXR) regardless of their oxygen level. We also admitted febrile patients with respiratory complaints who resided in congregate living. We describe the rate of decompensation among patients admitted with suspected SARS-CoV-2 infection but who were not hypoxemic in the ED.\nMethods:\n This is a retrospective observational study of patients admitted to our health system between March 1–May 5, 2020 with suspected SARS-CoV-2 infection. We queried our registry to find patients who were admitted to the hospital but had no recorded oxygen saturation of <92% in the ED and received no supplemental oxygen prior to admission. Our primary outcome was decompensation at 72 hours, defined by the need for respiratory support (oxygen, high-flow nasal cannula, non-invasive ventilation, or intubation).\nResults:\n A total of 840 patients met our inclusion criteria. Of those patients, 376 (45%) tested positive for SARS-CoV-2. Sixty patients (7.1%) with suspected COVID-19 required respiratory support at 72 hours including 27 (3%) of confirmed SARS-CoV-2 positive patients. Among the 376 patients who tested positive for SARS-CoV-2, 54 patients (14%) had normal CXR in the ED. One-third of patients with normal CXRs decompensated at 72 hours. Seven SARS-CoV-2 positive patients in our cohort died during their hospitalization, of whom five had normal CXRs on admission.\nConclusion: \nSixty (7.1%) of suspected COVID-19 patients hospitalized at 72 hours required respiratory support despite being normoxic in the ED. Further research should look to identify the normoxic SARS-CoV-2 patients at risk for decompensation.", "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": "coronovirus, pandemic, SARS, infectious disease" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6377m55b", "frozenauthors": [ { "first_name": "Kraftin", "middle_name": "E.", "last_name": "Schreyer", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Derek", "middle_name": "L.", "last_name": "Isenberg", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Wayne", "middle_name": "A.", "last_name": "Satz", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Nicole", "middle_name": "V.", "last_name": "Lucas", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Jennifer", "middle_name": "", "last_name": "Rosenbaum", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Gregory", "middle_name": "", "last_name": "Zandrow", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Nina", "middle_name": "T.", "last_name": "Gentle", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" } ], "date_submitted": "2020-07-22T02:04:15Z", "date_accepted": "2020-07-22T02:04:15Z", "date_published": "2021-04-02T17:13:29Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14377/galley/7381/download/" } ] }, { "pk": 1862, "title": "Learning Design and Student Behavior in a Fully Online Course", "subtitle": null, "abstract": "Student’s behavior in an online course is strongly influenced by the learning design of the course, however there are not many discipline-focused studies investigating how students engage with the Learning Management System and course materials. This paper investigates an asynchronous and fully online introductory statistics course with a collaboration component (Collaborative Keys). This study evaluates how students use these and other resources, if they are being used as intended, and how the use is related to performance. We extend the educational analytics literature and introduce a new measure to quantify how students transition between resources, and we evaluate how these transitions differ by student performance over the course of an entire term. The results suggest that the use of course’s resources is related to student achievement, with higher performing students focusing on video-related resources and showing more consistency and effectiveness in their use of resources throughout the term.", "language": "en", "license": null, "keywords": [ { "word": "Online learning, learning design, learning analytics, learning management system, behavior patterns, collaborative keys" } ], "section": "Investigations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4g18352f", "frozenauthors": [ { "first_name": "Anelise", "middle_name": "", "last_name": "Sabbag", "name_suffix": "", "institution": "California Polytechnic State University", "department": "None" }, { "first_name": "Samuel", "middle_name": "", "last_name": "Frame", "name_suffix": "", "institution": "California Polytechnic State University", "department": "None" } ], "date_submitted": "2020-02-26T16:55:35Z", "date_accepted": "2020-02-26T16:55:35Z", "date_published": "2021-04-02T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/tise/article/1862/galley/1263/download/" } ] }, { "pk": 14042, "title": "Importance of Mentoring on Workplace Engagement of Emergency Medicine Faculty: A Multi-institutional Study", "subtitle": null, "abstract": "Introduction:\n Mentoring in emergency medicine (EM) has not been well studied despite a larger body of literature that has described the value of mentoring in academic medicine on career satisfaction and scholarly output. Over half of all EM faculty nationally are of junior faculty ranks. The aim of this study was to identify the frequency and types of mentoring in EM, how types of mentoring in EM differ by gender, and how mentoring correlates with workplace satisfaction for EM faculty.\nMethods:\n Using descriptive statistics and chi-squared analysis, we analyzed data from a cohort of medical schools participating in the Association of American Medical Colleges StandPoint Faculty Engagement Survey.\nResults:\n A total of 514 EM faculty from 26 medical schools replied to the survey. Nearly 80% of EM faculty reported receiving some sort of mentoring; 43.4% reported receiving formal mentoring; 35.4% reported receiving only informal mentoring; and 21.2% received no mentoring at all. Women EM faculty received formal mentoring at lower rates than men (36.2% vs 47.5%) even though they were more likely to report that formal mentoring is important to them. Workplace satisfaction was highest for faculty receiving formal mentoring; informally or formally mentored faculty reported higher workplace satisfaction than faculty who are not mentored at all. Unmentored faculty are less likely to stay at their medical school than those formally mentored (69.8 % vs 80.4%).\nConclusion:\n Institutions and department chairs should focus on mentoring EM faculty, particularly women, to increase engagement and reduce attrition.", "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": "Mentorship" }, { "word": "faculty engagement, academic emergency medicine" } ], "section": "Health Equity", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9pq4f32b", "frozenauthors": [ { "first_name": "Raymond", "middle_name": "H", "last_name": "Lucas", "name_suffix": "", "institution": "George Washington University, School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, District of Columbia", "department": "None" }, { "first_name": "Valerie", "middle_name": "", "last_name": "Dandar", "name_suffix": "", "institution": "Association of American Medical Colleges, Washington, District of Columbia", "department": "None" } ], "date_submitted": "2020-06-01T14:55:12Z", "date_accepted": "2020-06-01T14:55:12Z", "date_published": "2021-03-31T20:37:41Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14042/galley/7284/download/" } ] }, { "pk": 14387, "title": "Establishment of an Alternate Care Site (ACS) in Imperial County During COVID-19", "subtitle": null, "abstract": "Imperial County is in southern California, one of the state’s two counties at the international United States-Mexico border. The county is one of the most resource-limited in the state, with only two hospitals serving its 180,000 citizens, and no tertiary care centers. A significant portion of the population cared for at the local hospitals commutes from Mexicali, a large city of 1.2 million persons, just south of Imperial County’s ports of entry. Since May 2020, following an outbreak in Mexicali, Imperial County has seen a significant increase in the number of COVID-19 patients, quickly outpacing its local resources. In response to this surge an alternate care site (ACS) was created as part of a collaboration between the California State Emergency Medical Service Authority (EMSA) and the county. In the first month of operations (May 26–June 26, 2020) the ACS received 106 patients with an average length of stay of 3.6 days. The average patient age was 55.5 years old with a range of 19-95 years. Disposition of patients included 25.5% sent to the emergency department for acute care needs, 1.8% who left against medical advice, and 72.7% who were discharged home or to a skilled nursing facility. There were no deaths on site. This study shares early experiences, challenges, and innovations created with the implementation of this ACS. Improving communication with local partners was the single most significant step in overcoming initial barriers.", "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, Alternate Care Site, Disaster Medicine" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7652c827", "frozenauthors": [ { "first_name": "Amelia", "middle_name": "M.", "last_name": "Breyre", "name_suffix": "", "institution": "University of California San Francisco, Department of Emergency Medicine, San Francisco, California", "department": "None" }, { "first_name": "Bryan", "middle_name": "", "last_name": "Sloane", "name_suffix": "", "institution": "Stanford University, Department of Emergency Medicine, Stanford, California;\nEmergency Medical Services/Bioterrorism Preparedness Manager, Imperial County", "department": "None" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Herring", "name_suffix": "", "institution": "Imperial County Public Health Department", "department": "None" }, { "first_name": "Howard", "middle_name": "", "last_name": "Backer", "name_suffix": "", "institution": "California Emergency Medical Services Authority, Rancho Cordova, California", "department": "None" }, { "first_name": "Thomas", "middle_name": "", "last_name": "McGinnis", "name_suffix": "", "institution": "California Emergency Medical Services Authority, Rancho Cordova, California", "department": "None" }, { "first_name": "Katherine", "middle_name": "", "last_name": "Staats", "name_suffix": "", "institution": "Stanford University, Department of Emergency Medicine, Stanford, California;\nEmergency Medical Services/Bioterrorism Preparedness Manager, Imperial County", "department": "None" } ], "date_submitted": "2020-08-14T22:11:58Z", "date_accepted": "2020-08-14T22:11:58Z", "date_published": "2021-03-25T18:31:02Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14387/galley/7387/download/" } ] }, { "pk": 1006, "title": "Pneumopericardium after Laparoscopic Hernia Repair Presents with ST-segment Changes: A Case Report", "subtitle": null, "abstract": "Introduction:\n Although rare, iatrogenic cases of pneumopericardium have been documented following laparoscopic surgery and mechanical ventilation. Electrocardiogram (ECG) changes, including ST-segment depressions and T-wave inversions, have been documented in cases of pneumopericardium, and can mimic more concerning causes of chest pain including myocardial ischemia or pulmonary embolism.\nCase Report:\n This unique case describes a patient who presented with chest pain and ST-segment changes on ECG hours after a laparoscopic inguinal hernia repair and who was found to have pneumopericardium.\nConclusion:\n While iatrogenic pneumopericardium is often self-limiting and rarely requires intervention, it is critical to differentiate pneumopericardium from other etiologies of chest pain, including myocardial ischemia and pulmonary embolism, to prevent unnecessary intervention.", "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": "pneumopericardium" }, { "word": "Hamman’s sign" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4hw3w1hm", "frozenauthors": [ { "first_name": "Demi", "middle_name": "", "last_name": "Galindo", "name_suffix": "", "institution": "University of Washington School of Medicine, Seattle, Washington", "department": "None" }, { "first_name": "Emily", "middle_name": "", "last_name": "Martin", "name_suffix": "", "institution": "University of Washington, Department of Emergency Medicine, Seattle, Washington", "department": "None" }, { "first_name": "Douglas", "middle_name": "", "last_name": "Franzen", "name_suffix": "", "institution": "University of Washington, Department of Emergency Medicine, Seattle, Washington", "department": "None" } ], "date_submitted": "2021-03-25T02:27:47Z", "date_accepted": "2021-03-25T02:27:47Z", "date_published": "2021-03-25T02:28:26Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1006/galley/753/download/" } ] }, { "pk": 1005, "title": "Acute Demyelinating Encephalomyelitis Following Measles Infection Due to Vaccine Failure: A Case Report", "subtitle": null, "abstract": "Introduction:\n Local outbreaks of measles infection are primarily mediated by international travel of persons from endemic areas, with subsequent spread of the virus via undervaccinated populations. Recent resurgences of measles in communities where vaccination rates are non-ideal secondary to philosophical objections require the emergency physician to more routinely consider the diagnosis. In cases of measles complicated by acute encephalitis or encephalopathy, the diagnosis can be especially difficult to make due to lack of a reliable primary historian.\nCase report:\n Here we present a case of altered mental status and new-onset bilateral lower extremity weakness in a fully vaccinated young woman diagnosed with measles infection caused by acute disseminated encephalomyelitis in the setting of vaccine failure.\nConclusion:\n Despite a documented history of immunization, acute measles infection and its uncommon sequelae are possible. Recognizing vaccine failure and appropriately isolating patients are of paramount importance.", "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": "Measles" }, { "word": "acute demyelinating encephalomyelitis" }, { "word": "vaccine failure" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4nj8j8mk", "frozenauthors": [ { "first_name": "Robert", "middle_name": "J.", "last_name": "McMickle", "name_suffix": "", "institution": "Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California", "department": "None" }, { "first_name": "Lauren", "middle_name": "", "last_name": "Fryling", "name_suffix": "", "institution": "Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California", "department": "None" }, { "first_name": "Ross", "middle_name": "J.", "last_name": "Fleischman", "name_suffix": "", "institution": "Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California", "department": "None" } ], "date_submitted": "2021-03-25T02:18:03Z", "date_accepted": "2021-03-25T02:18:03Z", "date_published": "2021-03-25T02:19:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1005/galley/752/download/" } ] }, { "pk": 1004, "title": "Case of Displaced Glenoid Fracture After Fall: Subtle Findings with Significant Implications for Trauma Patients", "subtitle": null, "abstract": "<p><strong>Case Presentation:</strong> A 64-year-old man presented to the emergency department with a chief complaint of left shoulder pain after a mechanical fall from standing. Plain radiography revealed a displaced fracture of the inferior glenoid rim. A computed tomography further characterized the fracture and the patient was taken emergently by an orthopedic surgeon for open reduction and internal fixation.</p>\n<p><strong>Discussion:</strong> Scapula fractures, especially isolated glenoid rim fractures, are rare and most typical of high-energy mechanism traumas. A missed or delayed diagnosis can result in long-term suffering and disability. Awareness of radiographic as well as physical findings and the subsequent classification system described below can optimize outcomes for trauma patients with glenoid fractures.</p>", "language": null, "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": "Scapula fracture" }, { "word": "Trauma" }, { "word": "glenoid fracture" }, { "word": "case report" } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2s07x26n", "frozenauthors": [ { "first_name": "Solomon", "middle_name": "", "last_name": "Sebt", "name_suffix": "", "institution": "Eisenhower Medical Center, Department of Emergency Medicine, Rancho Mirage, California", "department": "None" }, { "first_name": "Matthias", "middle_name": "", "last_name": "Barden", "name_suffix": "", "institution": "Eisenhower Medical Center, Department of Emergency Medicine, Rancho Mirage, California", "department": "None" }, { "first_name": "Eric", "middle_name": "", "last_name": "Leroux", "name_suffix": "", "institution": "Eisenhower Medical Center, Department of Emergency Medicine, Rancho Mirage, California", "department": "None" } ], "date_submitted": "2021-03-25T02:07:58Z", "date_accepted": "2021-03-25T02:07:58Z", "date_published": "2021-03-25T02:08:42Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1004/galley/24649/download/" } ] }, { "pk": 1003, "title": "A Young Boy with Neck Pain", "subtitle": null, "abstract": "Case Presentation:\n A five-year-old boy presented to our emergency department with severe posterior neck pain that was exacerbated upon neck movement. Cervical spine radiography revealed calcification in the cervical intervertebral disk 3-4.\nDiscussion:\n Pediatric idiopathic intervertebral disk calcification is a benign, rare condition that might be complicated by associated severe neurological symptoms. In this case, the symptoms gradually subsided with conservative management alone.", "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": "Pediatric idiopathic intervertebral disk calcification" }, { "word": "neck pain" }, { "word": "PIIVDC calcification" } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3306v9rj", "frozenauthors": [ { "first_name": "Hirofumi", "middle_name": "", "last_name": "Ohno", "name_suffix": "", "institution": "Toyohashi Municipal Hospital, Department of Orthopedic Surgery, Toyohashi, Japan", "department": "None" }, { "first_name": "Shinsuke", "middle_name": "", "last_name": "Takeda", "name_suffix": "", "institution": "Toyohashi Municipal Hospital, Department of Orthopedic Surgery, Toyohashi, Japan; Toyohashi Municipal Hospital, Department of Trauma and Microsurgery, Toyohashi, Japan", "department": "None" }, { "first_name": "So", "middle_name": "", "last_name": "Mitsuya", "name_suffix": "", "institution": "Toyohashi Municipal Hospital, Department of Orthopedic Surgery, Toyohashi, Japan; Toyohashi Municipal Hospital, Department of Trauma and Microsurgery, Toyohashi, Japan", "department": "None" }, { "first_name": "Hisatake", "middle_name": "", "last_name": "Yoshihara", "name_suffix": "", "institution": "Toyohashi Municipal Hospital, Department of Orthopedic Surgery, Toyohashi, Japan; Toyohashi Municipal Hospital, Department of Spine Surgery, Toyohashi, Japan", "department": "None" }, { "first_name": "Ken-ichi", "middle_name": "", "last_name": "Yamauchi", "name_suffix": "", "institution": "Toyohashi Municipal Hospital, Department of Orthopedic Surgery, Toyohashi, Japan", "department": "None" } ], "date_submitted": "2021-03-25T01:58:40Z", "date_accepted": "2021-03-25T01:58:40Z", "date_published": "2021-03-25T01:59:36Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1003/galley/750/download/" } ] }, { "pk": 1002, "title": "Adolescent Male with Severe Groin Pain Due to Traumatic Injury", "subtitle": null, "abstract": "Case Presentation:\n A 14-year-old boy presented to the emergency department complaining of severe groin pain on the right side following a minor fall. Computed tomography and magnetic resonance imaging revealed a hematoma in his right iliacus muscle. He was diagnosed with a traumatic iliacus hematoma, and he recovered spontaneously with short-term oral analgesics.\nDiscussion:\n Traumatic iliacus hematomas are rare entities and subside with conservative management in most cases. However, this condition may be associated with femoral nerve palsy, and surgery is indicated in severe cases. Traumatic iliacus hematoma should be considered in the differential diagnosis of severe groin 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": "Traumatic iliacus hematomas" }, { "word": "Iliacus hematomas" } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3bs2r8c1", "frozenauthors": [ { "first_name": "Hirofumi", "middle_name": "", "last_name": "Ohno", "name_suffix": "", "institution": "Toyohashi Municipal Hospital, Department of Orthopedic Surgery, Toyohashi Aichi, Japan", "department": "None" }, { "first_name": "Shinsuke", "middle_name": "", "last_name": "Takeda", "name_suffix": "", "institution": "Toyohashi Municipal Hospital, Department of Orthopedic Surgery, Toyohashi Aichi, Japan; Toyohashi Municipal Hospital, Trauma and Microsurgery Center, Toyohashi Aichi, Japan", "department": "None" }, { "first_name": "So", "middle_name": "", "last_name": "Mitsuya", "name_suffix": "", "institution": "Toyohashi Municipal Hospital, Department of Orthopedic Surgery, Toyohashi Aichi, Japan; Toyohashi Municipal Hospital, Trauma and Microsurgery Center, Toyohashi Aichi, Japan", "department": "None" }, { "first_name": "Ken-ichi", "middle_name": "", "last_name": "Yamauchi", "name_suffix": "", "institution": "Toyohashi Municipal Hospital, Department of Orthopedic Surgery, Toyohashi Aichi, Japan", "department": "None" } ], "date_submitted": "2021-03-24T21:55:41Z", "date_accepted": "2021-03-24T21:55:41Z", "date_published": "2021-03-24T21:59:54Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1002/galley/749/download/" } ] }, { "pk": 14250, "title": "Sternal Intraosseous Devices: Review of the Literature", "subtitle": null, "abstract": "Introduction:\n The intraosseous (IO) route is one of the primary means of vascular access in critically ill and injured patients. The most common sites used are the proximal humerus, proximal tibia, and sternum. Sternal IO placement remains an often-overlooked option in emergency and prehospital medicine. Due to the conflicts in Afghanistan and Iraq the use of sternal IOs have increased.\nMethods: \nThe authors conducted a limited review, searching PubMed and Google Scholar databases for “sternal IO,” “sternal intraosseous,” and “intraosseous” without specific date limitations. A total of 47 articles were included in this review.\nResults:\n Sternal IOs are currently FDA approved for ages 12 and older. Sternal IO access offers several anatomical, pharmacokinetic, hemodynamic, and logistical advantages over peripheral intravenous and other IO points of access. Sternal IO use carries many of the same risks and limitations as the humeral and tibial sites. Sternal IO gravity flow rates are sufficient for transfusing blood and resuscitation. In addition, studies demonstrated they are safe during active CPR.\nConclusion:\n The sternal IO route remains underutilized in civilian settings. When considering IO vascular access in adults or older children, medical providers should consider the sternum as the recommended IO access, particularly if the user is a novice with IO devices, increased flow rates are required, the patient has extremity trauma, or administration of a lipid soluble drug is anticipated.", "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": "Intraosseous" }, { "word": "resuscitation" }, { "word": "Trauma" }, { "word": "Sternum" }, { "word": "intravenous" } ], "section": "Critical Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9x34k0kq", "frozenauthors": [ { "first_name": "Jared", "middle_name": "A.", "last_name": "Laney", "name_suffix": "", "institution": "Texas A&M University College of Medicine, Bryan, Texas", "department": "None" }, { "first_name": "Jonathan", "middle_name": "", "last_name": "Friedman", "name_suffix": "", "institution": "Washington County Ambulance District, Mineral Point, Missouri", "department": "None" }, { "first_name": "Andrew", "middle_name": "D.", "last_name": "Fisher", "name_suffix": "", "institution": "Medical Command, Texas Army National Guard, Austin, Texas\nUniversity of New Mexico School of Medicine, Department of Surgery, Albuquerque, New Mexico", "department": "None" } ], "date_submitted": "2020-07-02T03:55:19Z", "date_accepted": "2020-07-02T03:55:19Z", "date_published": "2021-03-24T17:42:22Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14250/galley/7348/download/" } ] }, { "pk": 14392, "title": "Paramedic-performed Prehospital Point-of-care Ultrasound for Patients with Undifferentiated Dyspnea: A Pilot Study", "subtitle": null, "abstract": "Introduction:\n Thoracic ultrasound is frequently used in the emergency department (ED) to determine the etiology of dyspnea, yet its use is not widespread in the prehospital setting. We sought to investigate the feasibility and diagnostic performance of paramedic acquisition and assessment of thoracic ultrasound images in the prehospital environment, specifically for the detection of B-lines in congestive heart failure (CHF).\nMethods:\n This was a prospective observational study of a convenience sample of adult patients with a chief complaint of dyspnea. Paramedics participated in a didactic and hands-on session instructing them how to use a portable ultrasound device. Paramedics assessed patients for the presence of B-lines. Sensitivity and specificity for the presence of bilateral B-lines and any B-lines were calculated based on discharge diagnosis. Clips archived to the ultrasound units were reviewed and paramedic interpretations were compared to expert sonologist interpretations.\nResults:\n A total of 63 paramedics completed both didactic and hands-on training, and 22 performed ultrasounds in the field. There were 65 patients with B-line findings recorded and a discharge diagnosis for analysis. The presence of bilateral B-lines for diagnosis of CHF yielded a sensitivity of 80.0% (95% confidence interval [CI], 51.4-94.7%) and specificity of 72.0% (95% CI, 57.3-83.3), while presence of any B-lines was 93.3% sensitive (95% CI, 66.0-99.7%), and 50% specific (95% CI, 35.7-64.2%) for CHF. Paramedics archived 117 ultrasound clips of which 63% were determined to be adequate for interpretation. Comparison of paramedic and expert sonologist interpretation of images showed good inter-rater agreement for detection of any B-lines (k = 0.60; 95% CI, 0.36-0.84).\nConclusion:\n This observational pilot study suggests that prehospital lung ultrasound for B-lines may aid in identifying or excluding CHF as a cause of dyspnea. The presence of bilateral B-lines as determined by paramedics is reasonably sensitive and specific for the diagnosis of CHF and pulmonary edema, while the absence of B lines is likely to exclude significant decompensated heart failure. The study was limited by being a convenience sample and highlighted some of the difficulties related to prehospital research. Larger funded trials will be needed to provide more definitive data.", "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": "ultrasonography" }, { "word": "emergency medical services" }, { "word": "Emergency Medical Technicians" }, { "word": "Dyspnea" }, { "word": "pulmonary edema" } ], "section": "Emergency Medical Services", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7j48n6k4", "frozenauthors": [ { "first_name": "Jacob", "middle_name": "H.", "last_name": "Schoeneck", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut\nWake Forest University School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina", "department": "None" }, { "first_name": "Ryan", "middle_name": "F.", "last_name": "Coughlin", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Cristiana", "middle_name": "", "last_name": "Baloescu", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "David", "middle_name": "C.", "last_name": "Cone", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Rachel", "middle_name": "B.", "last_name": "Liu", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Sharmin", "middle_name": "", "last_name": "Kalam", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Amanda", "middle_name": "", "last_name": "Medoro", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Ian", "middle_name": "", "last_name": "Medoro", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Joseph", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Kevin", "middle_name": "", "last_name": "Burns", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Jesse", "middle_name": "I.", "last_name": "Bohrer-Clancy", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Christopher", "middle_name": "L.", "last_name": "Moore", "name_suffix": "", "institution": "Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" } ], "date_submitted": "2020-07-26T08:44:10Z", "date_accepted": "2020-07-26T08:44:10Z", "date_published": "2021-03-24T17:39:14Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14392/galley/7390/download/" } ] }, { "pk": 13936, "title": "Climate Change Adaptation: Prehospital Data Facilitate the Detection of Acute Heat Illness in India", "subtitle": null, "abstract": "Introduction:\n Extreme heat is a significant cause of morbidity and mortality, and the incidence of acute heat illness (AHI) will likely increase secondary to anthropogenic climate change. Prompt diagnosis and treatment of AHI are critical; however, relevant diagnostic and surveillance tools have received little attention. In this exploratory cross-sectional and diagnostic accuracy study, we evaluated three tools for use in the prehospital setting: 1) case definitions; 2) portable loggers to measure on-scene heat exposure; and 3) prevalence data for potential AHI risk factors.\nMethods:\n We enrolled 480 patients who presented to emergency medical services with chief complaints consistent with AHI in Ahmedabad, India, from April–June 2016 in a cross-sectional study. We evaluated AHI case definition test characteristics in reference to trained prehospital provider impressions, compared on-scene heat index measured by portable loggers to weather station measurements, and identified AHI behavioral and environmental risk factors using logistic regression.\nResults: \nThe case definition for heat exhaustion was 23.8% (12.1-39.5%) sensitive and 93.6% (90.9-95.7%) specific. The positive and negative predictive values were 33.5% (20.8-49.0%) and 90.1% (88.5-91.5%), respectively. Mean scene heat index was 6.7°C higher than the mean station heat index (P < 0.001), and station data systematically underestimated heat exposure, particularly for AHI cases. Heat exhaustion cases were associated with on-scene heat index ≥ 49°C (odds ratio [OR] 2.66 [1.13–6.25], P = 0.025) and a history of recent exertion (OR 3.66 [1.30–10.29], P = 0.014), while on-scene air conditioning was protective (OR 0.29 [0.10–0.85], P = 0.024).\nConclusion:\n Systematic collection of prehospital data including recent activity history and presence of air conditioning can facilitate early AHI detection, timely intervention, and surveillance. Scene temperature data can be reliably collected and improve heat exposure and AHI risk assessment. Such data may be important elements of surveillance, clinical practice, and climate change adaptation.", "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": "Acute heat illness" }, { "word": "Heat exhaustion" }, { "word": "emergency medical services" }, { "word": "Pre-hospital Medicine" }, { "word": "climate change" }, { "word": "adaptation" }, { "word": "Disaster Medicine" } ], "section": "Emergency Medical Services", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4jd7q71p", "frozenauthors": [ { "first_name": "Nikhil", "middle_name": "", "last_name": "Ranadive", "name_suffix": "", "institution": "University of California, San Francisco-Fresno, Department of Emergency Medicine, Fresno, California\nUniversity of Washington, Center for Health and the Global Environment, Seattle, Washington", "department": "None" }, { "first_name": "Jayraj", "middle_name": "", "last_name": "Desai", "name_suffix": "", "institution": "GVK-Emergency Management and Research Institute, Department of Emergency Medicine Learning & Care (Gujarat), Gujurat, India", "department": "None" }, { "first_name": "Sathish", "middle_name": "", "last_name": "LM", "name_suffix": "", "institution": "Indian Institute of Public Health, Gandhinagar, Gujarat, India", "department": "None" }, { "first_name": "Kim", "middle_name": "", "last_name": "Knowlton", "name_suffix": "", "institution": "Natural Resources Defense Council, New York City, New York", "department": "None" }, { "first_name": "Priya", "middle_name": "", "last_name": "Dutta", "name_suffix": "", "institution": "Indian Institute of Public Health, Gandhinagar, Gujarat, India", "department": "None" }, { "first_name": "Parthasarathi", "middle_name": "", "last_name": "Ganguly", "name_suffix": "", "institution": "Indian Institute of Public Health, Gandhinagar, Gujarat, India", "department": "None" }, { "first_name": "Abhiyant", "middle_name": "", "last_name": "Tiwari", "name_suffix": "", "institution": "Indian Institute of Public Health, Gandhinagar, Gujarat, India", "department": "None" }, { "first_name": "Anjali", "middle_name": "", "last_name": "Jaiswal", "name_suffix": "", "institution": "Natural Resources Defense Council, New York City, New York", "department": "None" }, { "first_name": "Tejas", "middle_name": "", "last_name": "Shah", "name_suffix": "", "institution": "Ahmedabad Municipal Corporation, Gujarat, India", "department": "None" }, { "first_name": "Bhavin", "middle_name": "", "last_name": "Solanki", "name_suffix": "", "institution": "Ahmedabad Municipal Corporation, Gujarat, India", "department": "None" }, { "first_name": "Dileep", "middle_name": "", "last_name": "Mavalankar", "name_suffix": "", "institution": "Indian Institute of Public Health, Gandhinagar, Gujarat, India", "department": "None" }, { "first_name": "Jeremy", "middle_name": "J.", "last_name": "Hess", "name_suffix": "", "institution": "University of Washington, Department of Emergency Medicine, Seattle, Washington\nUniversity of Washington, Department of Environmental and Occupational Health Sciences, Seattle, Washington\nUniversity of Washington, Department of Global Health, Seattle, Washington", "department": "None" } ], "date_submitted": "2020-05-15T04:36:10Z", "date_accepted": "2020-05-15T04:36:10Z", "date_published": "2021-03-24T17:34:10Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13936/galley/7241/download/" } ] }, { "pk": 13640, "title": "Intracranial Traumatic Hematoma Detection in Children Using a Portable Near-infrared Spectroscopy Device", "subtitle": null, "abstract": "Introduction:\n We sought to validate a handheld, near-infrared spectroscopy (NIRS) device for detecting intracranial hematomas in children with head injury.\nMethods:\n Eligible patients were those <18 years old who were admitted to the emergency department at three academic children’s hospitals with head trauma and who received a clinically indicated head computed tomography (HCT). Measurements were obtained by a blinded operator in bilateral frontal, temporal, parietal, and occipital regions. Qualifying hematomas were a priori determined to be within the brain scanner’s detection limits of >3.5 milliliters in volume and <2.5 centimeters from the surface of the brain. The device’s measurements were positive if the difference in optical density between hemispheres was >0.2 on three successive scans. We calculated diagnostic performance measures with corresponding exact two-sided 95% Clopper-Pearson confidence intervals (CI). Hypothesis test evaluated whether predictive performance exceeded chance agreement (predictive Youden’s index > 0).\nResults:\n A total of 464 patients were enrolled and 344 met inclusion for primary data analysis: 10.5% (36/344) had evidence of a hematoma on HCT, and 4.7% (16/344) had qualifying hematomas. The handheld brain scanner demonstrated a sensitivity of 58.3% (21/36) and specificity of 67.9% (209/308) for hematomas of any size. For qualifying hematomas the scanner was designed to detect, sensitivity was 81% (13/16) and specificity was 67.4% (221/328). Predictive performance exceeded chance agreement with a predictive Youden’s index of 0.11 (95% CI, 0.10 – 0.15; P < 0.001) for all hematomas, and 0.09 (95% CI, 0.08 – 0.12; P < 0.001) for qualifying hematomas.\nConclusion:\n The handheld brain scanner can non-invasively detect a subset of intracranial hematomas in children and may serve an adjunctive role to head-injury neuroimaging decision rules that predict the risk of clinically significant intracranial pathology after head trauma.", "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": "intracranial hematoma" }, { "word": "brain injury" }, { "word": "Head injury" }, { "word": "spectroscopy" } ], "section": "Pediatrics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/15d0z8w8", "frozenauthors": [ { "first_name": "Matthew", "middle_name": "P.", "last_name": "Kirschen", "name_suffix": "", "institution": "Children’s Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Philadelphia, Pennsylvania\nChildren’s Hospital of Philadelphia, Division of Neurology, Philadelphia, Pennsylvania\nChildren’s Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Sage", "middle_name": "R.", "last_name": "Myers", "name_suffix": "", "institution": "Children’s Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pennsylvania\nChildren’s Hospital of Philadelphia, Division of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Mark", "middle_name": "I.", "last_name": "Neuman", "name_suffix": "", "institution": "Boston Children’s Hospital, Division of Emergency Medicine, Department of Pediatrics, Boston, Massachusetts", "department": "None" }, { "first_name": "Joseph", "middle_name": "A.", "last_name": "Grubenhoff", "name_suffix": "", "institution": "University of Colorado, Department of Pediatrics, Aurora, Colorado", "department": "None" }, { "first_name": "Rebekah", "middle_name": "", "last_name": "Mannix", "name_suffix": "", "institution": "Boston Children’s Hospital, Division of Emergency Medicine, Department of Pediatrics, Boston, Massachusetts", "department": "None" }, { "first_name": "Nicholas", "middle_name": "", "last_name": "Stence", "name_suffix": "", "institution": "Children’s Hospital Colorado, Department of Radiology, Aurora, Colorado", "department": "None" }, { "first_name": "Edward", "middle_name": "", "last_name": "Yang", "name_suffix": "", "institution": "Boston Children’s Hospital, Department of Radiology, Boston, Massachusetts", "department": "None" }, { "first_name": "Ashley", "middle_name": "L.", "last_name": "Woodford", "name_suffix": "", "institution": "Cooper Medical School of Rowan University, Camden, New Jersey", "department": "None" }, { "first_name": "Tyson", "middle_name": "", "last_name": "Rogers", "name_suffix": "", "institution": "North American Science Associates Inc., Minneapolis, Minnesota", "department": "None" }, { "first_name": "Anna", "middle_name": "", "last_name": "Nordell", "name_suffix": "", "institution": "North American Science Associates Inc., Minneapolis, Minnesota", "department": "None" }, { "first_name": "Arastoo", "middle_name": "", "last_name": "Vossough", "name_suffix": "", "institution": "Children’s Hospital of Philadelphia, Department of Radiology, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Mark", "middle_name": "R.", "last_name": "Zonfrillo", "name_suffix": "", "institution": "Alpert Medical School of Brown University, Departments of Emergency Medicine and Pediatrics, Providence, Rhode Island", "department": "None" } ], "date_submitted": "2020-03-06T15:35:55Z", "date_accepted": "2020-03-06T15:35:55Z", "date_published": "2021-03-24T17:09:38Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13640/galley/7123/download/" } ] }, { "pk": 14374, "title": "Clinical Prediction Tool to Assess the Likelihood of a Positive SARS-Cov-2 (COVID-19) Polymerase Chain Reaction Test in Patients with Flu-like Symptoms", "subtitle": null, "abstract": "Introduction: \nThe clinical presentation of coronavirus disease 2019 (COVID-19) overlaps with many other common cold and influenza viruses. Identifying patients with a higher probability of infection becomes crucial in settings with limited access to testing. We developed a prediction instrument to assess the likelihood of a positive polymerase chain reaction (PCR) test, based solely on clinical variables that can be determined within the time frame of an emergency department (ED) patient encounter.\nMethods:\n We derived and prospectively validated a model to predict SARS-CoV-2 PCR positivity in patients visiting the ED with symptoms consistent with the disease.\nResults:\n Our model was based on 617 ED visits. In the derivation cohort, the median age was 36 years, 43% were men, and 9% had a positive result. The median time to testing from the onset of initial symptoms was four days (interquartile range [IQR]: 2-5 days, range 0-23 days), and 91% of all patients were discharged home. The final model based on a multivariable logistic regression included a history of close contact (adjusted odds ratio [AOR] 2.47, 95% confidence interval [CI], 1.29-4.7); fever (AOR 3.63, 95% CI, 1.931-6.85); anosmia or dysgeusia (AOR 9.7, 95% CI, 2.72-34.5); headache (AOR 1.95, 95% CI, 1.06-3.58), myalgia (AOR 2.6, 95% CI, 1.39-4.89); and dry cough (AOR 1.93, 95% CI, 1.02-3.64). The area under the curve (AUC) from the derivation cohort was 0.79 (95% CI, 0.73-0.85) and AUC 0.7 (95% CI, 0.61-0.75) in the validation cohort (N = 379).\nConclusion:\n We developed and validated a clinical tool to predict SARS-CoV-2 PCR positivity in patients presenting to the ED to assist with patient disposition in environments where COVID-19 tests or timely results are not readily available.", "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": "COVID19, polymerase chain reaction, prediction tool" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8gz205xh", "frozenauthors": [ { "first_name": "Barbara", "middle_name": "A.", "last_name": "Lara", "name_suffix": "", "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile", "department": "None" }, { "first_name": "Francisco", "middle_name": "", "last_name": "Torres", "name_suffix": "", "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile", "department": "None" }, { "first_name": "Patricia", "middle_name": "", "last_name": "Holger", "name_suffix": "", "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile", "department": "None" }, { "first_name": "Claudia", "middle_name": "", "last_name": "Perales", "name_suffix": "", "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile", "department": "None" }, { "first_name": "Sofia", "middle_name": "", "last_name": "Basauri", "name_suffix": "", "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile", "department": "None" }, { "first_name": "Hans", "middle_name": "", "last_name": "Clausdorff", "name_suffix": "", "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile", "department": "None" }, { "first_name": "Ernesto", "middle_name": "", "last_name": "Escobedo", "name_suffix": "", "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile", "department": "None" }, { "first_name": "Fernando", "middle_name": "", "last_name": "Saldias", "name_suffix": "", "institution": "Pontificia Universidad Católica de Chile, Department of Respiratory Diseases, Santiago, Chile", "department": "None" }, { "first_name": "Stuart", "middle_name": "", "last_name": "Swadron", "name_suffix": "", "institution": "Keck School of Medicine, Department of Emergency Medicine, University of Southern California, Los Angeles, California", "department": "None" }, { "first_name": "Pablo", "middle_name": "", "last_name": "Aguilera", "name_suffix": "", "institution": "Pontificia Universidad Católica de Chile, Section of Emergency Medicine, Santiago, Chile", "department": "None" } ], "date_submitted": "2020-07-25T04:15:54Z", "date_accepted": "2020-07-25T04:15:54Z", "date_published": "2021-03-24T17:04:23Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14374/galley/7379/download/" } ] }, { "pk": 14380, "title": "Emergency Medicine Influencers’ Twitter Use During the COVID-19 Pandemic: A Mixed-methods Analysis", "subtitle": null, "abstract": "Introduction: \nThe objective of this study was to analyze the messages of influential emergency medicine (EM) Twitter users in the United States (US) during the early stages of the coronavirus disease 2019 (COVID-19) global pandemic by characterizing the themes, emotional tones, temporal viewpoints, and depth of engagement with the tweets.\nMethods: \nWe performed a retrospective mixed-methods analysis of publicly available Twitter data derived from the publicly available “Coronavirus Tweet IDs” dataset, March 3, 2020–May 1, 2020. Original tweets and modified retweets in the dataset by 50 influential EM Twitter users in the US were analyzed using linguistic software to report the emotional tone and temporal viewpoint. We qualitatively analyzed a 25% random subsample and report themes.\nResults:\n There were 1315 tweets available in the dataset from 36/50 influential EM Twitter users in the US. The majority of tweets were either positive (455/1315, 34.6%) or neutral (407/1315, 31%) in tone and focused on the present (1009/1315, 76.7%). Qualitative analysis identified six distinct themes, with users most often sharing news or clinical information.\nConclusions:\n During the early weeks of the COVID-19 pandemic, influential EM Twitter users in the US delivered mainly positive or neutral messages, most often pertaining to news stories or information directly relating to patient care. The majority of these messages led to engagement by other users. This study underscores how EM influencers can leverage social media in public health outbreaks to bring attention to topics of importance.", "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/5bq5n5tf", "frozenauthors": [ { "first_name": "Maren", "middle_name": "K.", "last_name": "Leibowitz", "name_suffix": "", "institution": "Northwestern University, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Michael", "middle_name": "R.", "last_name": "Scudder", "name_suffix": "", "institution": "Vanderbilt University, Nashville, Tennessee", "department": "None" }, { "first_name": "Meghan", "middle_name": "", "last_name": "McCabe", "name_suffix": "", "institution": "Saint Louis University, St. Louis, Missouri", "department": "None" }, { "first_name": "Jennifer", "middle_name": "L.", "last_name": "Chan", "name_suffix": "", "institution": "Northwestern University, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Matthew", "middle_name": "R.", "last_name": "Klein", "name_suffix": "", "institution": "Northwestern University, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "N.", "middle_name": "Seth", "last_name": "Trueger", "name_suffix": "", "institution": "Northwestern University, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Danielle", "middle_name": "M.", "last_name": "McCarthy", "name_suffix": "", "institution": "Northwestern University, Center for Health Services & Outcomes Research, Department of Emergency Medicine, Chicago, Illinois", "department": "None" } ], "date_submitted": "2020-07-24T01:18:57Z", "date_accepted": "2020-07-24T01:18:57Z", "date_published": "2021-03-22T18:30:57Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14380/galley/7383/download/" } ] }, { "pk": 5589, "title": "Understanding and assessing emotions in marine mammals under professional care", "subtitle": null, "abstract": "In the last 30 years, concerns about animal emotions have emerged from the general public but also from animal professionals and scientists. Animals are now considered as sentient beings, capable of experiencing emotions such as fear or pleasure. Understanding animals’ emotions is complex and important if we want to guarantee them the best care, management, and welfare. The main objectives of the paper are, first, to give a brief overview of various and contemporary assessments of emotions in animals, then to focus on particular zoo animals, that is, marine mammals, since they have drawn a lot of attention lately in regards of their life under professional care. We discuss here 1 approach to monitor their emotions by examining their laterality to finally conclude the importance of understanding animal emotion from a holistic welfare 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": "Behavior, Cetaceans, Cognition, Emotions, Pinnipeds" } ], "section": "Brief Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5bs1s9t3", "frozenauthors": [ { "first_name": "Fabienne", "middle_name": "", "last_name": "Delfour", "name_suffix": "", "institution": "Parc Astérix", "department": "None" }, { "first_name": "Aviva", "middle_name": "", "last_name": "Charles", "name_suffix": "", "institution": "Parc Astérix", "department": "None" } ], "date_submitted": "2020-11-12T08:36:54Z", "date_accepted": "2020-11-12T08:36:54Z", "date_published": "2021-03-22T15:36:17Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uclapsych_ijcp/article/5589/galley/3384/download/" } ] }, { "pk": 60816, "title": "Can the U.S. Constitution Encompass a Right to a Stable Climate? (Yes, it Can.)", "subtitle": null, "abstract": "Can the U.S. Constitution encompass a right to a stable climate? Courts around the world are finding that their constitutions afford a right to a clean and healthy environment, including to a safe climate. In the United States, this claim is being tested in the case of \nJuliana v. U.S.\n, brought by 21 children arguing that governmental actions and inaction have caused or contributed to an “environmental apocalypse” in violation of a fundamental constitutional right to a stable climate. In concluding that the Constitution can encompass a right to a stable climate, we make three principal arguments. First, the Constitution is relevant to the protection of people’s lives and liberties—a position that should be beyond cavil after more than 230 years of our constitutional experiment. Second, the Constitution’s protection is not abrogated simply because the threat to life and liberty comes from decades of governmental action contributing to climate change. The Constitution does not have a climate change, or even an environmental, exception. And third, the federal judiciary is the body that, in our constitutional system, is best suited to hold accountable government actors when they imperil constitutional rights. Five years after it was filed, the case was dismissed by the Ninth Circuit; as of this writing, plaintiffs are considering seeking review before the U.S. Supreme Court, and settlement with the Biden Administration.", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "climate" }, { "word": "Human Rights" }, { "word": "Juliana v. U.S." } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/184274ww", "frozenauthors": [ { "first_name": "James", "middle_name": "R.", "last_name": "May", "name_suffix": "", "institution": "", "department": "" }, { "first_name": "Erin", "middle_name": "", "last_name": "Daly", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2021-03-19T18:00:35Z", "date_accepted": "2021-03-19T18:00:35Z", "date_published": "2021-03-19T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uclalaw_jelp/article/60816/galley/46778/download/" } ] }, { "pk": 60817, "title": "Climate Change and the Vulnerable Occupied Palestinian Territories", "subtitle": null, "abstract": "Two of the most commonly discussed responses to climate change are mitigation and adaptation. It is necessary that the world continues to mitigate greenhouse gases in the atmosphere to prevent the most severe effects of climate change, but it is just as important that adaptation measures are implemented to prepare for the unmitigable effects. With the ongoing Israeli occupation—now reaching its fifty-third year—Palestinians in the Occupied Palestinian Territory (OPT) are prohibited from accessing resources and pursuing necessary measures to repair their existing infrastructure or prepare for the environmental effects of climate change. As such, this Comment sheds light on the Palestinian voice, struggle, and experience while examining climate impacts under occupation by analyzing the environmental, political, legal, and humanitarian impacts of climate change on Palestinians in the OPT.", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "climate change" }, { "word": "OPT" }, { "word": "Occupied Palestinian Territory" }, { "word": "Human Rights" } ], "section": "Comments", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5tf728m4", "frozenauthors": [ { "first_name": "Lena", "middle_name": "", "last_name": "Freij", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2021-03-19T18:03:08Z", "date_accepted": "2021-03-19T18:03:08Z", "date_published": "2021-03-19T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uclalaw_jelp/article/60817/galley/46779/download/" } ] }, { "pk": 60818, "title": "Fracking in Pueblo and Diné Communities", "subtitle": null, "abstract": "Fracking must be regulated from a tribal perspective and ultimately phased out by renewable energy sources in order to prevent environmental contamination and threats to health and safety. Like many other components of extractive industry, fracking disproportionately harms indigenous communities due to the socioeconomic status of indigenous communities, their unique relationship to the land (and specifically to water), and other harmful effects of colonization and racialization. This Comment explores the proposed and ongoing fracking near Chaco Canyon and discusses the environmental justice issues this raises for indigenous communities in New Mexico. This discussion is timely, as the Bureau of Land Management and the Bureau of Indian Affairs recently released the long-awaited Farmington Mancos-Gallup Draft Resource Management Plan Amendment and Environmental Impact Statement, which amends the original Environmental Impact Statement for the Chaco Canyon area. This Comment highlights the unregulated nature of fracking (specifically the uncertainty of spills, cleanup and remediation), its exemption from several environmental statutes, and the threats it poses to groundwater and general water quality. The pervasiveness of these issues suggests that the most direct solution lies in cultural sovereignty and decolonial approaches to land management.", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Fracking" }, { "word": "Pueblo" }, { "word": "Diné" }, { "word": "environmental justice" }, { "word": "indigenous community" } ], "section": "Comments", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5d14z9dd", "frozenauthors": [ { "first_name": "Melodie", "middle_name": "", "last_name": "Meyer", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2021-03-19T18:05:30Z", "date_accepted": "2021-03-19T18:05:30Z", "date_published": "2021-03-19T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uclalaw_jelp/article/60818/galley/46780/download/" } ] }, { "pk": 60814, "title": "Front Matter", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [], "section": "Front Matter", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2cz0v683", "frozenauthors": [ { "first_name": "Editors", "middle_name": "", "last_name": "Editors", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2021-03-19T17:54:31Z", "date_accepted": "2021-03-19T17:54:31Z", "date_published": "2021-03-19T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uclalaw_jelp/article/60814/galley/46776/download/" } ] }, { "pk": 60815, "title": "Retooling Environmental Justice", "subtitle": null, "abstract": "This Article responds to environmental justice arguments that undermine, rather than safeguard, health and environmental quality for low-income and minority populations. Efforts by scholars and practitioners to clearly define “environmental injustice” to facilitate use of racial discrimination legal frameworks have had minimal success and are ultimately limiting the ability to embrace a broader arsenal of weapons in the fight against injustice. The greatest weapon of the environmental justice movement is its people. Environmental justice must evolve more rapidly beyond efforts to merely give communities voice, and actually redistribute power and decision making to open up opportunities for social movement intersection. The struggle to define environmental justice is difficult because it attempts to crystalize the efforts of converging social movements that continue. This Article advocates more explicit acceptance of environmental justice as a movement which requires focus on new strategies and tools that address historic pollution and prevent future inequitable environmental impacts. Considering the past, present, and future of environmental justice, this article advocates for expedited cleanups of historically polluted areas, mandatory environmental justice assessments (EJA) in existing planning processes, and robust environmental justice components in local land use plans; these coordinated strategies would empower communities to realize a vison of land use freed of the historic imposition of inequity.", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "environmental justice" }, { "word": "EJA" }, { "word": "environmental justice assessments" }, { "word": "Pollution" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3c3285qn", "frozenauthors": [ { "first_name": "Rachel", "middle_name": "", "last_name": "Salcido", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2021-03-19T17:57:27Z", "date_accepted": "2021-03-19T17:57:27Z", "date_published": "2021-03-19T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uclalaw_jelp/article/60815/galley/46777/download/" } ] }, { "pk": 60813, "title": "Table of Contents", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [], "section": "Table of Contents", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3165s4zs", "frozenauthors": [ { "first_name": "Editors", "middle_name": "", "last_name": "Editors", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2021-03-19T17:53:36Z", "date_accepted": "2021-03-19T17:53:36Z", "date_published": "2021-03-19T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uclalaw_jelp/article/60813/galley/46775/download/" } ] }, { "pk": 46485, "title": "Frailty and Functional Status Decline: Assessment, Consequences and Management", "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/8h6947pg", "frozenauthors": [ { "first_name": "Amy", "middle_name": "Z.", "last_name": "Sun", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Lucia", "middle_name": "L.", "last_name": "Dattoma", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-03-17T21:30:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46485/galley/35215/download/" } ] }, { "pk": 46388, "title": "A Case of Disseminated Cutaneous, Genital & Pulmonary Coccidioidomycosis", "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/00f1130h", "frozenauthors": [ { "first_name": "Natalie", "middle_name": "", "last_name": "Abrahamian", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-03-17T20:11:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46388/galley/35119/download/" } ] }, { "pk": 46460, "title": "A Case of Ground Glass Opacities and Hypoxia", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, 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"url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2x7548t4", "frozenauthors": [ { "first_name": "Nikhita", "middle_name": "", "last_name": "Kathuria-Prakash", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Giulia", "middle_name": "", "last_name": "Michelini", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-03-17T20:11:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46458/galley/35188/download/" } ] }, { "pk": 46484, "title": "An Uncommon Risk of Vaginal Estrogen Therapy", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": 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"frozenauthors": [ { "first_name": "Scott", "middle_name": "", "last_name": "Hahm", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-03-17T20:11:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46457/galley/35187/download/" } ] }, { "pk": 46461, "title": "Auricular Acupuncture Using Battlefield Acupuncture (BFA) Protocol for Chronic Pain Related to Metastatic Breast CA and Bilateral Hip AVN", "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/8ts051x3", "frozenauthors": [ { "first_name": "David", "middle_name": "R.", "last_name": "Schulze", "name_suffix": "DO", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Rebecca", "middle_name": "", "last_name": "Ovsiowitz", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-03-17T20:11:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46461/galley/35191/download/" } ] }, { "pk": 46394, "title": "COVID-19 Intensive Care Survivors: Extubation to Discharge", "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/25v9b8xh", "frozenauthors": [ { "first_name": "Caroline", "middle_name": "", "last_name": "Koan", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Timothy", "middle_name": "", "last_name": "Hatlen", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Charles", "middle_name": "", "last_name": "Pham", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Jessica", "middle_name": "", "last_name": "Lo", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Mallory", "middle_name": "", "last_name": "Witt", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2021-03-17T20:11:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": 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