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{ "count": 39139, "next": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=12600", "previous": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=12400", "results": [ { "pk": 39774, "title": "Degradation of mangrove forests and coral reefs in the coastal area of the southwestern region of Saudi Arabia", "subtitle": null, "abstract": "Abstract:\n \nThis study aimed to monitor the degradation of ecosystem biodiversity in one of the most diverse areas in Saudi Arabia. The coastal area of southwestern Saudi Arabia has a rich diversity of flora and fauna, particularly in mangrove and coral reef ecosystems. The total area covered with mangroves was approximately 40 km2 at the end of the 1900s but decreased to approximately 19 km2 by 2019. Coral reef decline was not as extreme, with a total decrease of approximately 330 km2 during the study period. Total reef area declined from approximately 2533.7 km2 in 1990 to approximately 2202 km2 in 2019. Population growth and urban sprawl, as well as overfishing, are among the main factors causing the degradation of both mangrove and coral reefs in this region.", "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": "biodiversity" }, { "word": "coastal area" }, { "word": "Coral reefs" }, { "word": "human activities" }, { "word": "mangrove" }, { "word": "marine ecosystem" }, { "word": "Satellite Images" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0n50738r", "frozenauthors": [ { "first_name": "Adel", "middle_name": "", "last_name": "Moatamed", "name_suffix": "", "institution": "King Khalid University, Saudi Arabia; Assiut University, Egypt", "department": "None" } ], "date_submitted": "2020-01-17T03:55:18-05:00", "date_accepted": "2020-01-17T03:55:18-05:00", "date_published": "2020-09-11T01:21:58-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/biogeographia/article/39774/galley/29956/download/" } ] }, { "pk": 915, "title": "Morel-Lavallée Lesion Following a Low-speed Injury: A Case Report", "subtitle": null, "abstract": "Introduction:\n Soft tissue injuries are a common presenting complaint seen in the emergency department following trauma. However, internal degloving injuries are not commonly seen by the emergency provider.\nCase Report:\n A 57-year-old male presented with right lower extremity pain, bruising, and swelling after a low-speed bicycle accident five days prior. Physical examination revealed an edematous and ecchymotic right lower extremity extending from the mid-thigh distally. Computed tomography of the thigh demonstrated a hyperdense foci within the fluid collection suggesting internal hemorrhage and internal de-gloving suggestive of a Morel-Lavallée lesion.\nDiscussion:\n The Morel-Lavallée lesion is a post-traumatic soft tissue injury that occurs as a result of shearing forces that create a potential space for the collection of blood, lymph, and fat. First described in 1853 by French physician Maurice Morel-Lavallée, this internal degloving injury can serve as a nidus of infection if not treated appropriately. Magnetic resonance imaging has become the diagnostic modality of choice due to its high resolution of soft tissue injuries. Treatment has been focused on either conservative management or surgical debridement after consultation with a surgeon.\nConclusion:\n The emergency physician should consider Morel-Lavallée lesions in patients with a traumatic hematoma formation to avoid complications that come from delayed diagnosis.", "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": "Morel-Lavallee" }, { "word": "Trauma" }, { "word": "internal degloving" } ], "section": "ACOEP Case Reports (Invitation Only)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4kk84720", "frozenauthors": [ { "first_name": "Daniel", "middle_name": "", "last_name": "Porter", "name_suffix": "", "institution": "Kingman Regional Medical Center, Department of Emergency Medicine, Kingman, Arizona", "department": "None" }, { "first_name": "Jeff", "middle_name": "", "last_name": "Conley", "name_suffix": "", "institution": "Kingman Regional Medical Center, Department of Emergency Medicine, Kingman, Arizona", "department": "None" }, { "first_name": "John", "middle_name": "", "last_name": "Ashurst", "name_suffix": "", "institution": "Kingman Regional Medical Center, Department of Emergency Medicine, Kingman, Arizona", "department": "None" } ], "date_submitted": "2020-09-09T21:21:20-05:00", "date_accepted": "2020-09-09T21:21:20-05:00", "date_published": "2020-09-09T21:23:14-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/915/galley/663/download/" } ] }, { "pk": 914, "title": "A Case Report of Pulmonary Sarcoidosis: An Uncommon Cause of Chest Pain", "subtitle": null, "abstract": "Introduction:\n Chest pain is one of the most common causes of emergency department visits on an annual basis and carries a high degree of morbidity and mortality if managed inappropriately.\nCase Report:\n A 36-year-old male presented with four months of left-sided chest pain with dyspnea on exertion. Physical examination and laboratory values were within normal limits. Chest radiograph depicted diffuse interstitial nodular opacities throughout the lungs bilaterally with bilateral perihilar consolidations. Computed tomography of the chest demonstrated mid and upper lung nodularity with a perilymphatic distribution involving the central peribronchial vascular regions as well as subpleural and fissural surfaces causing conglomerate in the upper lobes centrally with associated hilar and mediastinal lymphadenopathy. The next day the patient underwent bronchoscopy with endotracheal ultrasound and transbronchial biopsies and pathology revealed non-necrotizing, well-formed granulomas embedded in dense hyaline sclerosis consistent with sarcoidosis.\nDiscussion:\n Sarcoidosis is a multi-system granulomatous disease characterized by noncaseating granulomas on pathology. The worldwide epidemiology of sarcoidosis is currently unknown due to many patients being asymptomatic. However, patients may present with a persistent cough, dyspnea, or chest pain. Emergency department management should be aimed at minimizing long-term sequelae of the disease through obtaining labs and imaging after specialist consultation and arranging urgent follow-up.\nConclusion:\n Although not one of the six high-risk causes of chest pain, sarcoidosis should be included in the differential to minimize the risk of long-term morbidity associated with advanced forms of the disease.", "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": "chest pain" }, { "word": "pulmonary sarcoidosis" }, { "word": "sarcoidosis" } ], "section": "ACOEP Case Reports (Invitation Only)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9fg6s8nj", "frozenauthors": [ { "first_name": "Justina", "middle_name": "", "last_name": "Truong", "name_suffix": "", "institution": "Kingman Regional Medical Center, Department of Emergency Medicine, Kingman, Arizona", "department": "None" }, { "first_name": "John", "middle_name": "", "last_name": "Ashurst", "name_suffix": "", "institution": "Kingman Regional Medical Center, Department of Emergency Medicine, Kingman, Arizona", "department": "None" } ], "date_submitted": "2020-09-09T21:15:09-05:00", "date_accepted": "2020-09-09T21:15:09-05:00", "date_published": "2020-09-09T21:16:04-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/914/galley/662/download/" } ] }, { "pk": 913, "title": "Miller-Fisher Syndrome: A Case Report and Review of the Literature", "subtitle": null, "abstract": "Introduction:\n Neurological complaints are a common presenting symptom seen by the emergency physician. However, the Miller-Fisher variant of Guillain-Barré syndrome is a rare cause of neurological complaints seen in the emergency department.\nCase Report:\n A 26-year-old male presented with dysphonia and bilateral hand and feet paresthesia after a recent diarrheal illness. Examination revealed the absence of tricep, brachioradialis, patellar and Achilles tendon reflexes bilaterally, and difficulty with phonation. Lumbar puncture revealed the presence of anti-GQ1b antibodies, and the patient was diagnosed with Miller-Fisher variant of Guillain-Barré.\nDiscussion:\n Miller-Fisher syndrome is an acute, autoimmune response that typically follows either an upper respiratory or diarrheal illness. Typically associated with dysfunction of cranial nerves three, four, and six, Miller-Fisher syndrome may present with facial paralysis, opthalmoplegia, arefexia, or ataxia. Lumbar puncture with the presence of anti-GQ1b antibodies is indicative. Treatment could include supportive respiratory care, intravenous immunoglobulin therapy, or plasmapheresis.\nConclusion:\n Miller-Fisher syndrome is a rare form of Guillain-Barré syndrome that the emergency provider should include in the differential when faced with a patient with cranial nerve dysfunction.", "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": "Miller-Fisher syndrome" }, { "word": "Guillain-Barré syndrome" }, { "word": "neurological emergencies" } ], "section": "ACOEP Case Reports (Invitation Only)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/26t9f5mg", "frozenauthors": [ { "first_name": "Justina", "middle_name": "", "last_name": "Truong", "name_suffix": "", "institution": "Kingman Regional Medical Center, Department of Emergency Medicine, Kingman, Arizona", "department": "None" }, { "first_name": "Jeff", "middle_name": "", "last_name": "Conley", "name_suffix": "", "institution": "Kingman Regional Medical Center, Department of Emergency Medicine, Kingman, Arizona", "department": "None" }, { "first_name": "John", "middle_name": "", "last_name": "Ashurst", "name_suffix": "", "institution": "Kingman Regional Medical Center, Department of Emergency Medicine, Kingman, Arizona", "department": "None" } ], "date_submitted": "2020-09-09T21:07:41-05:00", "date_accepted": "2020-09-09T21:07:41-05:00", "date_published": "2020-09-09T21:09:05-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/913/galley/661/download/" } ] }, { "pk": 912, "title": "Immunocompromised Child on Infliximab: A Case Report of Listeria monocytogenes Meningitis", "subtitle": null, "abstract": "Introduction:\n Patients with naturally occurring, impaired cell-mediated immunity secondary to age and pregnancy are known to be at risk of developing severe and invasive Listeria monocytogenes infections. Immunosuppressant medications, particularly infliximab, are also known to increase this risk.\nCase Report:\n We present the case of a seven-year-old female on infliximab who was diagnosed with culture positive L. monocytogenes meningitis after a negative cerebral spinal fluid polymerase chain reaction (PCR).\nConclusion:\n Patients receiving infliximab who display signs of central nervous system infection should be suspected to have L. monocytogenes as an infecting agent, and empiric addition of ampicillin to their antibiotic regimen should be considered, with substitution of trimethoprim-sulfamethoxazole in cases of penicillin allergy, regardless of initial PCR results.", "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": "listeria monocytogenes" }, { "word": "infliximab" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/90w3z8m3", "frozenauthors": [ { "first_name": "Camille", "middle_name": "", "last_name": "Halfman", "name_suffix": "", "institution": "SUNY Upstate Medical University, Department of Emergency Medicine, Syracuse, New York", "department": "None" }, { "first_name": "Luke", "middle_name": "", "last_name": "Slate", "name_suffix": "", "institution": "SUNY Upstate Medical University, Department of Emergency Medicine, Syracuse, New York", "department": "None" }, { "first_name": "Julienne", "middle_name": "", "last_name": "Yamamoto", "name_suffix": "", "institution": "SUNY Upstate Medical University, Department of Emergency Medicine, Syracuse, New York", "department": "None" }, { "first_name": "Samantha", "middle_name": "", "last_name": "Jones", "name_suffix": "", "institution": "SUNY Upstate Medical University, Department of Emergency Medicine, Syracuse, New York", "department": "None" } ], "date_submitted": "2020-09-09T21:02:09-05:00", "date_accepted": "2020-09-09T21:02:09-05:00", "date_published": "2020-09-09T21:02:46-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/912/galley/660/download/" } ] }, { "pk": 45037, "title": "Behçet’s 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/3436p7p3", "frozenauthors": [ { "first_name": "Jing", "middle_name": "", "last_name": "Zhao", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-09T12:45:02-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45037/galley/33830/download/" } ] }, { "pk": 911, "title": "Case Report: Pediatric Patient with COVID-19 and Multisystem Inflammatory Syndrome in Children", "subtitle": null, "abstract": "Introduction:\n Coronavirus disease 2019 (COVID-19) rarely manifests with severe complications in pediatric patients. An association between COVID-19 and a Kawasaki-like inflammatory syndrome has recently presented in pediatric patients.\nCase Report:\n We report a unique case of multisystem inflammatory syndrome in children presenting with characteristic findings in a child who later developed cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation.\nConclusion:\n Recognition of these early signs and symptoms facilitates screening and risk stratification of pediatric COVID-19 cases associated with increased morbidity.", "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": "Kawasaki Disease" }, { "word": "PMI" }, { "word": "ECMO" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2wg4c6c2", "frozenauthors": [ { "first_name": "MacKenzie", "middle_name": "W.", "last_name": "Burger", "name_suffix": "", "institution": "Wayne State University School of Medicine, Detroit Medical Center Sinai-Grace Hospital, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "Marcus", "middle_name": "A.", "last_name": "Moore", "name_suffix": "", "institution": "Wayne State University School of Medicine, Detroit Medical Center Sinai-Grace Hospital, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "John", "middle_name": "M.", "last_name": "Wilburn", "name_suffix": "", "institution": "Wayne State University School of Medicine, Detroit Medical Center Sinai-Grace Hospital, Department of Emergency Medicine, Detroit, Michigan", "department": "None" } ], "date_submitted": "2020-09-08T13:16:44-05:00", "date_accepted": "2020-09-08T13:16:44-05:00", "date_published": "2020-09-08T13:17:42-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/911/galley/659/download/" } ] }, { "pk": 910, "title": "Spontaneous Pneumothorax as a Complication of COVID-19 Pneumonia: A Case Report", "subtitle": null, "abstract": "Introduction:\n Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2. It typically presents with respiratory symptoms such as fevers, cough, and shortness of breath. As the number of cases increases, however, COVID-19 is being increasingly recognized as being associated with a variety of other respiratory pathologies.\nCase Report:\n We present the case of a 59-year-old man with COVID-19 pneumonia who acutely decompensated after having been on the medicine floor for two weeks. He was found to have a tension pneumothorax. This was treated with a needle decompression followed by a chest tube insertion. The patient subsequently recovered and was discharged.\nConclusion:\n This case highlights the importance of considering tension pneumothorax as a possible cause of shortness of breath in patients with COVID-19 pneumonia.", "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": "tension pneumothorax" }, { "word": "necrotizing pneumonia" }, { "word": "point-of-care ultrasound" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/96k1x40c", "frozenauthors": [ { "first_name": "Leland", "middle_name": "", "last_name": "Perice", "name_suffix": "", "institution": "North Shore University Hospital – Northwell Health, Department of Emergency Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Zhanna", "middle_name": "", "last_name": "Roit", "name_suffix": "", "institution": "North Shore University Hospital – Northwell Health, Department of Emergency Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Ingrid", "middle_name": "", "last_name": "Llovera", "name_suffix": "", "institution": "North Shore University Hospital – Northwell Health, Department of Emergency Medicine, Manhasset, New York", "department": "None" }, { "first_name": "Mary", "middle_name": "G.", "last_name": "Flanagan-Kundle", "name_suffix": "", "institution": "Touro College School of Health Sciences, Physician Assistant Program, Bay Shore, New York", "department": "None" } ], "date_submitted": "2020-09-08T12:57:15-05:00", "date_accepted": "2020-09-08T12:57:15-05:00", "date_published": "2020-09-08T12:59:22-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/910/galley/658/download/" } ] }, { "pk": 909, "title": "Delirium Associated with Salicylate and Acetaminophen Overdose in a Patient with COVID-19: A Case Report", "subtitle": null, "abstract": "Introduction:\n The coronavirus disease 2019 (COVID-19) pandemic has created numerous clinical challenges for physicians, in part due to its wide range of clinical manifestations and associated complications.\nCase Report:\n Here we present the case of a 69-year-old man who was admitted to the emergency department with fever, dyspnea, and altered mental status. We believe the patient’s condition was precipitated by a COVID-19 infection-induced delirium, a setting in which he ingested aspirin and acetaminophen in overdose that required lifesaving interventions.\nConclusion:\n This case illustrates the potential for neuropsychiatric effects in COVID-19 patients due to both direct viral central nervous system pathology and pandemic-related psychosocial stressors.", "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": "delirium" }, { "word": "neuropsychiatric effects" }, { "word": "overdose" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/72j240x9", "frozenauthors": [ { "first_name": "Tyler", "middle_name": "H.", "last_name": "Wen", "name_suffix": "", "institution": "Columbia University Vagelos College of Physicians and Surgeons, New York, New York", "department": "None" }, { "first_name": "Jason", "middle_name": "", "last_name": "Chu", "name_suffix": "", "institution": "Columbia University Irving Medical Center, Department of Emergency Medicine, New York, New York", "department": "None" }, { "first_name": "Danielle", "middle_name": "M.", "last_name": "Allenspach", "name_suffix": "", "institution": "Columbia University Irving Medical Center, Department of Emergency Medicine, New York, New York", "department": "None" }, { "first_name": "David", "middle_name": "C.", "last_name": "Van", "name_suffix": "", "institution": "Columbia University Irving Medical Center, Department of Emergency Medicine, New York, New York", "department": "None" } ], "date_submitted": "2020-09-08T12:36:45-05:00", "date_accepted": "2020-09-08T12:36:45-05:00", "date_published": "2020-09-08T12:37:48-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/909/galley/657/download/" } ] }, { "pk": 13516, "title": "The Utility of Serum Creatinine Kinase in Emergency Department Patients with Possible Substance-use Related Conditions", "subtitle": null, "abstract": "Introduction:\n Our goal was to assess the diagnostic utility and temporal kinetics of serum creatine kinase (CK) measurement as a predictor of acute kidney injury (AKI) in emergency department (ED) patients who present with possible substance-use related conditions.\nMethods:\n This was a retrospective chart review of ED patients with a urine drug screen (UDS) ordered and resulted between 2009–2013. Data was extracted electronically from EPIC Systems electronic health records, populated into a Microsoft Excel file, and includes demographics, chief complaint, vital signs, neuro-psychiatric physical examination findings, laboratory findings, psychiatric consult order time, ED medications given, orders, disposition and its time, and diagnosis.\nResults: \nOf 74,970 patients with an ED UDS, 22,101 (29%) had at least one CK measured. After inclusion and exclusion criteria, 2858 (13%) remained. Mean (standard deviation [SD]) age was 43.3 (12.5) years, 73% were male, 61% Black, 22% White, and 17% Hispanic. Mean (SD) ED length of stay was 10.4 (5.8) hours, and 56.7% were hospitalized. On average, CK was higher at 6-12 hours (p<0.001) and 12-18 hours (p=0.016) compared to 6 hours. CK was lower at 42-56 hours (p = 0.011), 72 hours (p<0.001), and over 72 hours (p<0.001), compared to 6 hours. Maximum CK was determined in those with >2 CK measures. We defined AKI risk as a creatinine of >1.4 milligrams per deciliter based on RIFLE criteria. AKI risk was calculated among those with at least two creatinine values in 522 patients. We identified five (1%) patients as having AKI risk. The odds of AKI risk were not associated with increase in CK over time.\nConclusion:\n In 74,970 ED patients undergoing UDS testing for potential substance abuse, there was no identifiable CK level associated with AKI risk. In patients with possible substance-use conditions, CK continued to trend up even after six hours from door time and began to decrease after 42 hours. We found no value in repeated ED CK measures. Disposition should not be based solely on CK levels.", "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": "Creatine Kinase, CK, substance use, rhabdomyolysis, renal failure, kidney injury" } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4666g20b", "frozenauthors": [ { "first_name": "Mohammad", "middle_name": "S.", "last_name": "Alzahri", "name_suffix": "", "institution": "King Saud University, Department of Emergency Medicine, Riyadh, Saudi Arabia", "department": "None" } ], "date_submitted": "2020-01-23T09:01:04-05:00", "date_accepted": "2020-01-23T09:01:04-05:00", "date_published": "2020-09-04T21:33:26-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13516/galley/7078/download/" } ] }, { "pk": 908, "title": "Thyroid Storm, Rhabdomyolysis, and Pulmonary Embolism: An Unusual Triad Case Report", "subtitle": null, "abstract": "Introduction:\n Thyroid storm is a medical emergency associated with significant mortality. Hyperthyroid states have been associated with hypercoagulability as well as rhabdomyolysis. However, the pathophysiology of this association remains under investigation.\nCase Report:\n A 62-year-old male patient presented to the emergency department with weakness and was found to have thyroid storm with concurrent submassive pulmonary embolisms and rhabdomyolysis. To our knowledge, this is the first reported presentation of this triad.\nConclusion:\n This case highlights the potentially difficult diagnosis and management of thyroid storm, as well as associated life-threatening complications, including venous thromboemboli and rhabdomyolysis.", "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": "Thyroid storm" }, { "word": "rhabdomyolysis" }, { "word": "pulmonary embolism" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0xs760rh", "frozenauthors": [ { "first_name": "Montane", "middle_name": "B.", "last_name": "Silverman", "name_suffix": "", "institution": "Uniformed Services University F. Edward Hebert School of Medicine, Bethesda, Maryland", "department": "None" }, { "first_name": "Jesse", "middle_name": "", "last_name": "Wray", "name_suffix": "", "institution": "Brooke Army Medical Center, Department of Emergency Medicine, Fort Sam Houston, Texas", "department": "None" }, { "first_name": "Rachel", "middle_name": "E.", "last_name": "Bridwell", "name_suffix": "", "institution": "Brooke Army Medical Center, Department of Emergency Medicine, Fort Sam Houston, Texas", "department": "None" }, { "first_name": "Amber", "middle_name": "", "last_name": "Cibrario", "name_suffix": "", "institution": "Brooke Army Medical Center, Department of Emergency Medicine, Fort Sam Houston, Texas", "department": "None" } ], "date_submitted": "2020-09-03T17:53:08-05:00", "date_accepted": "2020-09-03T17:53:08-05:00", "date_published": "2020-09-03T17:54:19-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/908/galley/656/download/" } ] }, { "pk": 907, "title": "Appropriate Evaluation of Psychiatric Patients Highlighted by Creutzfeldt-Jakob Disease: A Case Report", "subtitle": null, "abstract": "Introduction:\n Determination of medical stability for patients presenting with psychiatric complaints is common for emergency clinicians. A thorough history and physical examination is important.\nCase Report:\n A 53-year-old male presented to the emergency department (ED) with depression, suicidal ideation, and decline in activities of daily living over six months. While his initial neurologic examination was non-focal, subsequent re-evaluations demonstrated significant changes, and he was ultimately diagnosed with Creutzfeldt-Jakob disease. \nConclusion:\n This case demonstrates how a detailed history of the present illness could have led to a more accurate and timely medical disposition 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": [ { "word": "Cruetzfeldt-Jakob disease" }, { "word": "psychiatric evaluation" } ], "section": "ACOEP Case Reports (Invitation Only)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4nd137md", "frozenauthors": [ { "first_name": "Kathryn", "middle_name": "", "last_name": "Bartlett", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network, Department of Emergency Medicine, Allentown, Pennsylvania", "department": "None" }, { "first_name": "Kathleen", "middle_name": "E.", "last_name": "Kane", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network, Department of Emergency Medicine, Allentown, Pennsylvania; University of South Florida Morsani College of Medicine, Department of Emergency Medicine, Tampa, Florida", "department": "None" }, { "first_name": "Bryan", "middle_name": "G.", "last_name": "Kane", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network, Department of Emergency Medicine, Allentown, Pennsylvania; University of South Florida Morsani College of Medicine, Department of Emergency Medicine, Tampa, Florida", "department": "None" }, { "first_name": "Kevin", "middle_name": "R.", "last_name": "Weaver", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network, Department of Emergency Medicine, Allentown, Pennsylvania; University of South Florida Morsani College of Medicine, Department of Emergency Medicine, Tampa, Florida", "department": "None" }, { "first_name": "Gavin", "middle_name": "C.", "last_name": "Barr", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network, Department of Emergency Medicine, Allentown, Pennsylvania; University of South Florida Morsani College of Medicine, Department of Emergency Medicine, Tampa, Florida", "department": "None" } ], "date_submitted": "2020-09-03T17:38:45-05:00", "date_accepted": "2020-09-03T17:38:45-05:00", "date_published": "2020-09-03T17:39:37-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/907/galley/655/download/" } ] }, { "pk": 906, "title": "The Evolution of Ultrasound in Medicine: A Case Report of Point-of-care Ultrasound in the Self-diagnosis of Acute Appendicitis", "subtitle": null, "abstract": "Introduction:\n Point-of-care ultrasound (POCUS) education during medical school develops physicians who are properly prepared for the next generation of medicine. The authors present the case of a first-year medical student who self-diagnosed appendicitis using POCUS.\nCase Report:\n A 25-year-old, first-year medical student presented to the emergency department with lower abdominal pain. What seemed like a straightforward appendicitis presentation came with a twist; the student brought self-performed ultrasound imaging of his appendix.\nConclusion:\n The student’s ultrasound skill set reflects favorably on the rapid evolution of ultrasound teaching in medical education.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "ultrasound" }, { "word": "point-of-care" }, { "word": "appendicitis" }, { "word": "education" }, { "word": "medical school" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3jg0m0sq", "frozenauthors": [ { "first_name": "Barry", "middle_name": "", "last_name": "Knapp", "name_suffix": "", "institution": "Eastern Virginia Medical School, Department of Emergency Medicine, Norfolk, Virginia", "department": "None" }, { "first_name": "Kean", "middle_name": "", "last_name": "Feyzeau", "name_suffix": "", "institution": "Eastern Virginia Medical School, Department of Emergency Medicine, Norfolk, Virginia", "department": "None" }, { "first_name": "Austin", "middle_name": "", "last_name": "Smith", "name_suffix": "", "institution": "Eastern Virginia Medical School, Department of Anatomy and Pathology, Norfolk, Virginia", "department": "None" }, { "first_name": "Donald", "middle_name": "", "last_name": "Byars", "name_suffix": "", "institution": "Eastern Virginia Medical School, Department of Emergency Medicine, Norfolk, Virginia", "department": "None" }, { "first_name": "Craig", "middle_name": "", "last_name": "Goodmurphy", "name_suffix": "", "institution": "Eastern Virginia Medical School, Department of Anatomy and Pathology, Norfolk, Virginia", "department": "None" }, { "first_name": "Matt", "middle_name": "", "last_name": "Jones", "name_suffix": "", "institution": "Eastern Virginia Medical School, Department of Emergency Medicine, Norfolk, Virginia", "department": "None" } ], "date_submitted": "2020-09-03T14:38:31-05:00", "date_accepted": "2020-09-03T14:38:31-05:00", "date_published": "2020-09-03T14:40:09-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/906/galley/654/download/" } ] }, { "pk": 45036, "title": "Preserving Legacy and Managing Existential Distress Through Dignity 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/67321564", "frozenauthors": [ { "first_name": "Angela", "middle_name": "", "last_name": "Yeh", "name_suffix": "DO", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Katelyn", "middle_name": "", "last_name": "Stepanyan", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-03T10:56:17-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45036/galley/33829/download/" } ] }, { "pk": 45035, "title": "When an Echocardiogram is Not Enough: Mixed Aortic Valve Disease Diagnosed in Cath Lab", "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/49d203g8", "frozenauthors": [ { "first_name": "Dhananjay", "middle_name": "", "last_name": "Chatterjee", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Stephen", "middle_name": "P.", "last_name": "Vampola", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-03T10:52:52-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45035/galley/33828/download/" } ] }, { "pk": 45034, "title": "Graves’ Disease: An Overview of Diagnosis 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/59r329jn", "frozenauthors": [ { "first_name": "Amy", "middle_name": "S.", "last_name": "Wang", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-03T10:50:19-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45034/galley/33827/download/" } ] }, { "pk": 45033, "title": "Levetiracetam Induced Acute Psychosis", "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/10t355zp", "frozenauthors": [ { "first_name": "Anne", "middle_name": "", "last_name": "Belzowski", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Brian", "middle_name": "", "last_name": "Yu", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-03T10:47:23-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45033/galley/33826/download/" } ] }, { "pk": 45032, "title": "Extensive Deep Vein Thrombosis Undetected by Multiple Modalities in a Patient with Breast 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/6xc846mg", "frozenauthors": [ { "first_name": "Zorawar", "middle_name": "", "last_name": "Noor", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-01T13:22:01-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45032/galley/33825/download/" } ] }, { "pk": 45029, "title": "Cefepime Induced Neurotoxicity", "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/5k2204n9", "frozenauthors": [ { "first_name": "Gurveen", "middle_name": "", "last_name": "Sandhu", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Julie", "middle_name": "", "last_name": "Magorien", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-01T11:48:22-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45029/galley/33822/download/" } ] }, { "pk": 45028, "title": "A Case of Orbital Myositis", "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/8nn6z4n1", "frozenauthors": [ { "first_name": "Rania", "middle_name": "", "last_name": "Shammas", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-01T11:45:58-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45028/galley/33821/download/" } ] }, { "pk": 45027, "title": "Malignant Common Bile Duct Stricture due to Metastatic Colon 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/8h1974kt", "frozenauthors": [ { "first_name": "Michael", "middle_name": "G.", "last_name": "Quon", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Rajinder", "middle_name": "", "last_name": "Kaushal", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-01T11:43:38-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45027/galley/33820/download/" } ] }, { "pk": 45026, "title": "Acronym Battle – RS3PE vs PMR vs RA?", "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/7205v38d", "frozenauthors": [ { "first_name": "Masoom", "middle_name": "", "last_name": "Modi", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-01T11:21:35-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45026/galley/33819/download/" } ] }, { "pk": 45025, "title": "A Popular Supplement Leads to Acute Liver Injury", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3nz4536q", "frozenauthors": [ { "first_name": "Rimma", "middle_name": "", "last_name": "Shaposhnikov", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Hamed", "middle_name": "", "last_name": "Nayeb-Hashemi", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-01T11:19:18-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45025/galley/33818/download/" } ] }, { "pk": 45024, "title": "False Negative Nuclear Stress Test", "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/0x2171fn", "frozenauthors": [ { "first_name": "Roman", "middle_name": "", "last_name": "Leibzon", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Boris", "middle_name": "", "last_name": "Arbit", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-01T10:57:48-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45024/galley/33817/download/" } ] }, { "pk": 45023, "title": "Diagnosis and Prognosis of Ocular Myasthenia Gravis", "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/0j65t663", "frozenauthors": [ { "first_name": "Amanda", "middle_name": "", "last_name": "Miller", "name_suffix": "", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Diana", "middle_name": "", "last_name": "Sarkisyan", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-01T10:55:43-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45023/galley/33816/download/" } ] }, { "pk": 45022, "title": "Vertigo from tenofovir disoproxil fumarate for Pre-exposure Prophylaxis for HIV", "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/3zj5p1bk", "frozenauthors": [ { "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": "2020-09-01T10:50:01-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45022/galley/33815/download/" } ] }, { "pk": 45021, "title": "Integrative East-West Approach to Treatment of Idiopathic Gastroparesis", "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/3rm3n1db", "frozenauthors": [ { "first_name": "Isabella", "middle_name": "", "last_name": "Lai", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Sara", "middle_name": "", "last_name": "Kohandani", "name_suffix": "", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Annie", "middle_name": "", "last_name": "Zhang", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-01T10:47:40-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45021/galley/33814/download/" } ] }, { "pk": 45020, "title": "Rectus Sheath Hematoma due to Rivaroxaban", "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/75t1b52k", "frozenauthors": [ { "first_name": "Duong", "middle_name": "Tommy", "last_name": "Hua", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Jaclyn", "middle_name": "", "last_name": "Spiegel", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-09-01T10:44:33-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45020/galley/33813/download/" } ] }, { "pk": 41730, "title": "First description of the fossil otolith-based sciaenid, \nEquetulus silverdalensis\n n. comb., in the Gulf Coastal Plain, USA, with comments on the enigmatic distribution of the species", "subtitle": null, "abstract": "The fossil otolith-based sciaenid genus \nEquetulus\n is known almost exclusively from South America, the Caribbean, and Central America, with the various species ranging in age from the late Oligocene to late Miocene. The only exception to this geographical distribution is the isolated occurrence of \nEquetulus silverdalensis\n n. comb. in the Belgrade Formation (latest Oligocene–early Miocene) in the Atlantic Coastal Plain of the USA (North Carolina) and a mention of its occurrence in the Chickasawhay Limestone (late Oligocene) in the Gulf Coastal Plain of the USA (Mississippi). However, sampling of the Paynes Hammock Sand (late Oligocene, Chattian) near Millry, Alabama, USA, resulted in the discovery of an otolith representing the first occurrence of \nE. silverdalensis\n in Alabama and the first systematic description of the species from the Gulf Coastal Plain of the USA. These occurrences suggest a potential distribution of this fossil species from Atlantic Coastal Plain of North Carolina to the central Gulf Coastal Plain of Alabama and possibly Mississippi.", "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": "otoliths, Alabama, Oligocene, Paynes Hammock Sand, fossil sciaenids, teleostean fish" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7c85q2cw", "frozenauthors": [ { "first_name": "Gary", "middle_name": "L.", "last_name": "Stringer", "name_suffix": "", "institution": "Museum of Natural History, 708 University Avenue, University of Louisiana at Monroe, Monroe, LA 71209", "department": "None" }, { "first_name": "Jun", "middle_name": "A.", "last_name": "Ebersole", "name_suffix": "", "institution": "McWane Science Center, 200 19th Street North, Birmingham, AL 35203", "department": "None" }, { "first_name": "Sandy", "middle_name": "M.", "last_name": "Ebersole", "name_suffix": "", "institution": "Geological Survey of Alabama, Mary Harmon Bryant Hall, 500 Hackberry Lane, Tuscaloosa, AL 35486", "department": "None" } ], "date_submitted": "2020-09-01T14:47:35-05:00", "date_accepted": "2020-09-01T14:47:35-05:00", "date_published": "2020-09-01T02:00:00-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucmp_paleobios/article/41730/galley/31208/download/" } ] }, { "pk": 45019, "title": "Recurrent Spontaneous Coronary Artery Dissection", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5177n654", "frozenauthors": [ { "first_name": "Ramona", "middle_name": "", "last_name": "Mehrinfar-Zadeh", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Ramtin", "middle_name": "", "last_name": "Anousheh", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-31T14:23:59-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45019/galley/33812/download/" } ] }, { "pk": 48220, "title": "Bringing Type 2 diabetes to theatre: Examining Appalachian audience reflections on The Sugar Plays", "subtitle": null, "abstract": "The Sugar Plays are a family-focused health intervention. The goal of the play is to explore the experience of living with a Type 2 Diabetes Mellitus (T2DM) diagnosis in Appalachia. This present study examined audience reactions using three data-collection methods: (1) open-ended questionnaires, (2) participatory sketches and (3) semi-structured personal interviews. This qualitative analysis of 30 audience members who participated in all three methods found that they articulated lessons learned from the plays, evaluated the characters’ behaviors, and engaged in reciprocal storytelling. The audience’s reactions demonstrated that narrative telling is relational and that audiences were critically engaged in the process. The plays also helped health practitioners foster conversations about diabetes, the impact of intergenerational dietary habits, and the role of intergenerational buffers.", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Appalachia, Narrative" }, { "word": "Theatre" }, { "word": "Type 2 Diabetes Mellitus" } ], "section": "Medical Humanities", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2t13v889", "frozenauthors": [ { "first_name": "Kallia", "middle_name": "Odette", "last_name": "Wright", "name_suffix": "", "institution": "Illinois College", "department": "None" } ], "date_submitted": "2019-02-19T15:18:49-05:00", "date_accepted": "2019-02-19T15:18:49-05:00", "date_published": "2020-08-31T12:59:44-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/cla_jlta/article/48220/galley/36317/download/" } ] }, { "pk": 45018, "title": "A Case of Severe Hypoglycemia in the Setting of Pneumonia and Concurrent Sulfonylurea Administration", "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/4td936mm", "frozenauthors": [ { "first_name": "Jeffrey", "middle_name": "", "last_name": "Chung", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Li", "middle_name": "", "last_name": "Zhou", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:54:33-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45018/galley/33811/download/" } ] }, { "pk": 45017, "title": "Resolution of a Parasitic Delusion – A Case Report", "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/3cb5g0j2", "frozenauthors": [ { "first_name": "Paul", "middle_name": "", "last_name": "Janoian", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:52:26-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45017/galley/33810/download/" } ] }, { "pk": 45016, "title": "Apical Hypertrophic Cardiomyopathy in Patients Presenting with SARS-CoV-2 Infection: Incidental Finding or Pathological Process?", "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/6k336573", "frozenauthors": [ { "first_name": "Daniel", "middle_name": "", "last_name": "O'Brien", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Adam", "middle_name": "", "last_name": "Custer", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Edward", "middle_name": "", "last_name": "Lee", "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": "2020-08-27T14:50:22-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45016/galley/33809/download/" } ] }, { "pk": 45015, "title": "A Young Woman with a Hypercoagulable Stroke and PFO", "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/2hk6t1pt", "frozenauthors": [ { "first_name": "Loc", "middle_name": "", "last_name": "Duong", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Daniel", "middle_name": "F.", "last_name": "Kupsky", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:48:09-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45015/galley/33808/download/" } ] }, { "pk": 45014, "title": "Severe Restless Legs Syndrome in the Setting of Iron Deficiency and Chronic Blood Loss", "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/7h938891", "frozenauthors": [ { "first_name": "Sam", "middle_name": "A.", "last_name": "Kashani", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:44:35-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45014/galley/33807/download/" } ] }, { "pk": 45013, "title": "Acupuncture for Refractory Dysmenorrhea", "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/3cz3g6x6", "frozenauthors": [ { "first_name": "Alan", "middle_name": "", "last_name": "Chu", "name_suffix": "MD, MPH", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Grant", "middle_name": "", "last_name": "Chu", "name_suffix": "MD, MSAOM", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:41:58-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45013/galley/33806/download/" } ] }, { "pk": 45012, "title": "Physical Examination: Is it a Lost Art?", "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/6gp3x9j4", "frozenauthors": [ { "first_name": "Anne", "middle_name": "Mae", "last_name": "Climaco", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Giselle", "middle_name": "", "last_name": "Namazie", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:39:27-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45012/galley/33805/download/" } ] }, { "pk": 45011, "title": "When Hypertension is Due to Primary Hyperaldosteronism", "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/86s68123", "frozenauthors": [ { "first_name": "Igor", "middle_name": "", "last_name": "Kagan", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Neema", "middle_name": "", "last_name": "Heivand", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:37:10-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45011/galley/33804/download/" } ] }, { "pk": 45010, "title": "A Case of Idiopathic Fascicular Ventricular Tachycardia", "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/18b6m536", "frozenauthors": [ { "first_name": "Samuel", "middle_name": "", "last_name": "Daneshvar", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Roman", "middle_name": "", "last_name": "Leibzon", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:34:46-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45010/galley/33803/download/" } ] }, { "pk": 45009, "title": "The Role of Immunotherapy in Metastatic Endometrial 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/6pf225pb", "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": "2020-08-27T14:32:21-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45009/galley/33802/download/" } ] }, { "pk": 45008, "title": "A Case of Anti-NMDA Receptor Encephalitis Diagnosed as Bipolar Disorder with Psychotic Features", "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/9n76v3fz", "frozenauthors": [ { "first_name": "Duong", "middle_name": "Tommy", "last_name": "Hua", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Charles", "middle_name": "", "last_name": "Dac Pham", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:30:12-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45008/galley/33801/download/" } ] }, { "pk": 45007, "title": "A Case of Influenza-B Fulminant Myocarditis", "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/07n9r24q", "frozenauthors": [ { "first_name": "Hani", "middle_name": "", "last_name": "Hazani", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Shipra", "middle_name": "", "last_name": "Hingorany", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Pooya", "middle_name": "", "last_name": "Bokhoor", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:27:54-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45007/galley/33800/download/" } ] }, { "pk": 45006, "title": "Fear of Flight", "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/6pz59137", "frozenauthors": [ { "first_name": "Tamás ", "middle_name": "", "last_name": "Dolinay", "name_suffix": "MD, PhD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Brian", "middle_name": "", "last_name": "Shuch", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:25:26-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45006/galley/33799/download/" } ] }, { "pk": 45005, "title": "Confused about the Hypoxia: A Case of Dapsone-induced Methemoglobinemia", "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/3495d82s", "frozenauthors": [ { "first_name": "Hani", "middle_name": "", "last_name": "Hazani", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Estebes", "middle_name": "", "last_name": "Hernandez", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:22:52-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45005/galley/33798/download/" } ] }, { "pk": 45004, "title": "A Rare Case of Atrial Septal Defect Presenting as Postpartum Pulmonary Hypertension", "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/0ms4172t", "frozenauthors": [ { "first_name": "Salim", "middle_name": "F.", "last_name": "Ahmed", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Patrick", "middle_name": "", "last_name": "Baghdasaryan", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Pooya", "middle_name": "", "last_name": "Banankhah", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T14:20:41-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45004/galley/33797/download/" } ] }, { "pk": 45003, "title": "Gastroparesis: A Commonly Misdiagnosed Disease for Irritable Bowel 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/4fq6t2vq", "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": "2020-08-27T13:34:22-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45003/galley/33796/download/" } ] }, { "pk": 45002, "title": "Migratory Arthritis as a Presenting Symptom of Gastric 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/1sv8r224", "frozenauthors": [ { "first_name": "Melissa", "middle_name": "", "last_name": "Munsell", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Marian", "middle_name": "", "last_name": "Kaldas", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T13:31:55-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45002/galley/33795/download/" } ] }, { "pk": 45001, "title": "Wearable Devices in Arrhythmia Detection", "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/2ns4d52d", "frozenauthors": [ { "first_name": "Boris", "middle_name": "", "last_name": "Arbit", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Roman", "middle_name": "", "last_name": "Leibzon", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T13:29:33-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45001/galley/33794/download/" } ] }, { "pk": 45000, "title": "A Case of Metastatic Salivary Gland Carcinoma in Patient with NSCLC", "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/05z1j4qv", "frozenauthors": [ { "first_name": "Mana", "middle_name": "", "last_name": "Khafaf", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Katherine", "middle_name": "", "last_name": "Borthwick", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T13:26:25-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/45000/galley/33793/download/" } ] }, { "pk": 44999, "title": "Highly Elevated Low-Density Lipoprotein in a Patient with No Coronary Calcium", "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/6h9736ss", "frozenauthors": [ { "first_name": "Boris", "middle_name": "", "last_name": "Arbit", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Jeff", "middle_name": "E.", "last_name": "Borenstein", "name_suffix": "MD, MPH", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T13:17:40-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44999/galley/33792/download/" } ] }, { "pk": 44998, "title": "Recurrent Severe Bioprosthetic Tricuspid Valve Stenosis Treated with Transcatheter Valve Replacement", "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/72c2m70k", "frozenauthors": [ { "first_name": "Pooja", "middle_name": "", "last_name": "Desai", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Jamil", "middle_name": "", "last_name": "Aboulhosn", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Samuel", "middle_name": "", "last_name": "Daneshvar", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T13:13:30-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44998/galley/33791/download/" } ] }, { "pk": 44997, "title": "The Potential Dangers of Denosumab Cessation", "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/9wg524hv", "frozenauthors": [ { "first_name": "Deepashree", "middle_name": "", "last_name": "Gupta", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Olga", "middle_name": "", "last_name": "Popel", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T13:10:16-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44997/galley/33790/download/" } ] }, { "pk": 44996, "title": "Infection and Thrombocytosis: What to Do Now?", "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/6nv7k7ws", "frozenauthors": [ { "first_name": "Sarah", "middle_name": "", "last_name": "Ahmed", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Michael", "middle_name": "", "last_name": "Rotblatt", "name_suffix": "MD, PharmD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-27T13:07:44-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44996/galley/33789/download/" } ] }, { "pk": 13607, "title": "Patient Characteristics and Clinical Process Predictors of Patients Leaving Without Being Seen from the Emergency Department", "subtitle": null, "abstract": "Introduction: \nDelays in patient flow in the emergency department (ED) result in patients leaving without being seen (LWBS). This compromises patient experience and quality of care. Our primary goal was to develop a predictive model by evaluating associations between patients LWBS and ED process measures and patient characteristics.\nMethods:\n This was a cross-sectional study in a 95,000 annual visit adult ED comparing patients LWBS, with controls. Data were drawn from four seasonally adjusted four-week periods (30,679 total visits). Process measures included 1) arrivals per hour; 2) “door-to-provider” time; and the numbers of 3) patients in the waiting room; 4) boarding ED patients waiting for an inpatient bed; 5) providers and nurses (RN); and 6) patients per RN. Patient characteristics collected included 1) age; 2) gender; 3) race/ethnicity; 4) arrival mode (walk-in or via emergency medical services [EMS]); and 5) acuity based on Emergency Severity Index (ESI). Univariable analyses included t-tests and Pearson’s chi-square tests. We split the data randomly into derivation and validation cohorts. We used backward selection to develop the final derivation model, and factors with a p-value ≤ 0.05 were retained. Estimates were applied to the validation cohort and measures of discrimination (receiver operating characteristic) and model fit were assessed.\nResults:\n In the final model, the odds of LWBS increased with the number of patients in the waiting room (odds ratio [OR] 1.05; 95% confidence interval [CI], 1.03 to 1.06); number of boarding patients (OR 1.02; 95% CI, 1.01 to 1.03); arrival rate (OR 1.04; 95% CI, 1.02 to 1.05) and longer “door-to-provider” times (test of linear trend in the adjusted OR was p = 0.002). Patient characteristics associated with LWBS included younger age (OR 0.98; 95% CI, 0.98 to 0.99), and lower acuity (higher ESI category) (OR 2.01; 95% CI, 1.84 to 2.20). Arrival by EMS was inversely associated with LWBS (OR 0.29; 0.23 to 0.36). The area under the curve for the final model in the validation cohort was 0.85 (95% CI, 0.84 to 0.86). There was good agreement between the observed and predicted risk.\nConclusion:\n Arrival rate, “door-to-provider time,” and the numbers of patients in the waiting room and ED boarders are all associated with patients LWBS.", "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": "crowding" }, { "word": "Left without being seen" }, { "word": "boarding" } ], "section": "Emergency Department Operations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0xr732bm", "frozenauthors": [ { "first_name": "Niels", "middle_name": "", "last_name": "Rathlev", "name_suffix": "", "institution": "University of Massachusetts Medical School – Baystate, Department of Emergency Medicine, Springfield, Massachusetts", "department": "None" }, { "first_name": "Paul", "middle_name": "", "last_name": "Visintainer", "name_suffix": "", "institution": "University of Massachusetts Medical School – Baystate, Department of Epidemiology and Biostatistics Core, Springfield, Massachusetts", "department": "None" }, { "first_name": "Joseph", "middle_name": "", "last_name": "Schmidt", "name_suffix": "", "institution": "University of Massachusetts Medical School – Baystate, Department of Emergency Medicine, Springfield, Massachusetts", "department": "None" }, { "first_name": "Joeli", "middle_name": "", "last_name": "Hettler", "name_suffix": "", "institution": "University of Massachusetts Medical School – Baystate, Department of Emergency Medicine, Springfield, Massachusetts", "department": "None" }, { "first_name": "Vanna", "middle_name": "", "last_name": "Albert", "name_suffix": "", "institution": "University of Massachusetts Medical School – Baystate, Department of Emergency Medicine, Springfield, Massachusetts", "department": "None" }, { "first_name": "Haiping", "middle_name": "", "last_name": "Li", "name_suffix": "", "institution": "University of Massachusetts Medical School – Baystate, Department of Emergency Medicine, Springfield, Massachusetts", "department": "None" } ], "date_submitted": "2020-02-26T12:18:47-05:00", "date_accepted": "2020-02-26T12:18:47-05:00", "date_published": "2020-08-26T00:26:49-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13607/galley/7115/download/" } ] }, { "pk": 13391, "title": "Sepsis Alerts in Emergency Departments: A Systematic Review of Accuracy and Quality Measure Impact", "subtitle": null, "abstract": "Introduction: \nFor early detection of sepsis, automated systems within the electronic health record have evolved to alert emergency department (ED) personnel to the possibility of sepsis, and in some cases link them to suggested care pathways. We conducted a systematic review of automated sepsis-alert detection systems in the ED.\nMethods:\n We searched multiple health literature databases from the earliest available dates to August 2018. Articles were screened based on abstract, again via manuscript, and further narrowed with set inclusion criteria: 1) adult patients in the ED diagnosed with sepsis, severe sepsis, or septic shock; 2) an electronic system that alerts a healthcare provider of sepsis in real or near-real time; and 3) measures of diagnostic accuracy or quality of sepsis alerts. The final, detailed review was guided by QUADAS-2 and GRADE criteria. We tracked all articles using an online tool (Covidence), and the review was registered with PROSPERO registry of reviews. A two-author consensus was reached at the article choice stage and final review stage. Due to the variation in alert criteria and methods of sepsis diagnosis confirmation, the data were not combined for meta-analysis.\nResults:\n We screened 693 articles by title and abstract and 20 by full text; we then selected 10 for the study. The articles were published between 2009–2018. Two studies had algorithm-based alert systems, while eight had rule-based alert systems. All systems used different criteria based on systemic inflammatory response syndrome (SIRS) to define sepsis. Sensitivities ranged from 10-100%, specificities from 78-99%, and positive predictive value from 5.8-54%. Negative predictive value was consistently high at 99-100%. Studies showed some evidence for improved process-of-care markers, including improved time to antibiotics. Length of stay improved in two studies. One low quality study showed improved mortality.\nConclusion:\n The limited evidence available suggests that sepsis alerts in the ED setting can be set to high sensitivity. No high-quality studies showed a difference in mortality, but evidence exists for improvements in process of care. Significant further work is needed to understand the consequences of alert fatigue and sensitivity set points.", "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": "automated electronic alerts, sepsis, critical care, emergency medicine, emergency department, computerized physician order entry" } ], "section": "Emergency Department Operations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4wv4c7fk", "frozenauthors": [ { "first_name": "Matthew", "middle_name": "I.", "last_name": "Hwang", "name_suffix": "", "institution": "University of Illinois College of Medicine at Peoria, Peoria, Illinois", "department": "None" }, { "first_name": "William", "middle_name": "F.", "last_name": "Bond", "name_suffix": "", "institution": "University of Illinois College of Medicine at Peoria, OSF HealthCare, Jump Simulation and Department of Emergency Medicine, Peoria, Illinois", "department": "None" }, { "first_name": "Emilie", "middle_name": "S.", "last_name": "Powell", "name_suffix": "", "institution": "Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Department of Emergency Medicine, Chicago, Illinois", "department": "None" } ], "date_submitted": "2019-11-29T22:24:09-05:00", "date_accepted": "2019-11-29T22:24:09-05:00", "date_published": "2020-08-24T17:15:03-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13391/galley/7030/download/" } ] }, { "pk": 13641, "title": "Point-of-sale Naloxone: Novel Community-based Research to Identify Naloxone Availability", "subtitle": null, "abstract": "Introduction:\n Expanding naloxone availability is important to reduce opioid-related deaths. Recent data suggest low, variable urban naloxone availability. No reports describe naloxone availability at the point of sale (POSN). We characterize POSN without prescription across a Midwestern metropolitan area, via a unique poison center-based study.\nMethods:\n Pharmacies were randomly sampled within a seven-county metropolitan area, geospatially mapped, and distributed among seven investigators, who visited pharmacies and asked, “May I purchase naloxone here without a prescription from my doctor?” Following “No,” investigators asked, “Are you aware of the state statute that allows you to dispense naloxone to the public under a standing order?” Materials describing statutory support for POSN were provided. Responses were uploaded to REDCap in real time. We excluded specialty (veterinary, mail order, or infusion) pharmacies a priori. POSN availability is presented as descriptive statistics; characteristics of individual sites associated with POSN availability are reported.\nResults:\n In total, 150 pharmacies were prospectively randomized, with 52 subsequently excluded or unavailable for survey. Thus, 98 were included in the final analysis. POSN was available at 71 (72.5%) of 98 pharmacies. POSN availability was more likely at chain than independent pharmacies (84.7% vs 38.5%, p<0.001); rural areas were more commonly served by independent than chain pharmacies (47.4% vs 21.5%, p = 0.022). Five chain and five independent pharmacies (18.5% each) were unaware of state statutory support for collaborative POSN agreements. Statutory awareness was similar between independent and chain pharmacies (68.8% vs 54.6%, p = 0.453). Rationale for no POSN varied.\nConclusion: \nPOSN is widely available in this metropolitan area. Variability exists between chain and independent pharmacies, and among pharmacies of the same chain; awareness of statutory guidance does not. Poison centers can act to define local POSN availability via direct inquiry in their communities.", "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": "Naloxone, Poison Center, community-based research, advocacy, harm reduction" } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3r99w05w", "frozenauthors": [ { "first_name": "Travis", "middle_name": "D.", "last_name": "Olives", "name_suffix": "", "institution": "Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota\nMinnesota Poison Control System, Minneapolis, Minnesota", "department": "None" }, { "first_name": "Laurie", "middle_name": "A.", "last_name": "Willhite", "name_suffix": "", "institution": "Hennepin Healthcare, Minneapolis, Minnesota\nMinnesota Poison Control System, Minneapolis, Minnesota", "department": "None" }, { "first_name": "Samantha", "middle_name": "C.", "last_name": "Lee", "name_suffix": "", "institution": "Minnesota Poison Control System, Minneapolis, Minnesota", "department": "None" }, { "first_name": "Danika", "middle_name": "K.", "last_name": "Evans", "name_suffix": "", "institution": "Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota", "department": "None" }, { "first_name": "Ashley", "middle_name": "", "last_name": "Jensen", "name_suffix": "", "institution": "Minnesota Poison Control System, Minneapolis, Minnesota", "department": "None" }, { "first_name": "Hsiao-Ting", "middle_name": "", "last_name": "Regelman", "name_suffix": "", "institution": "Minnesota Poison Control System, Minneapolis, Minnesota", "department": "None" }, { "first_name": "Eric", "middle_name": "S.", "last_name": "McGillis", "name_suffix": "", "institution": "University of Calgary, Department of Emergency Medicine, Calgary, Alberta, Canada", "department": "None" } ], "date_submitted": "2020-04-09T13:37:25-05:00", "date_accepted": "2020-04-09T13:37:25-05:00", "date_published": "2020-08-24T16:52:42-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13641/galley/7124/download/" } ] }, { "pk": 13005, "title": "Development and Implementation of a Community Paramedicine Program in Rural United States", "subtitle": null, "abstract": "Introduction:\n Community paramedicine (CP) is an innovative care model focused on medical management for patients suffering from chronic diseases or other conditions that result in over-utilization of healthcare services. Despite their value, CP care models are not widely used in United States healthcare settings. More research is needed to understand the feasibility and effectiveness of implementing CP programs. Our objective was to develop a CP program to better meet the needs of complex, high-utilizer patients in a rural setting.\nMethods: \nWe conducted an observational descriptive case series in a community, 25-bed, critical access hospital and primary care clinic in a rural Wisconsin county. Multiple stakeholders from the local health system and associated ambulance service were active participants in program development and implementation. Eligible patients receiving the intervention were identified as complex or high need by a referring physician. Primary outcomes included measures of emergency department, hospital, and clinic utilization. Secondary measures included provider and patient satisfaction.\nResults: \nWe characterized 32 unique patients as high utilizers requiring assistance in medical management. These patients were enrolled into the program and categorized as high utilizers requiring assistance in medical management. The median age was 76 years, and 68.8% were female. After six months, we found a statistically significant decline in patient utilization for primary care (53.3%, p = .006) and ED visits (59.3%, p = .007), but not for hospitalizations (60%, p = .13, non-significant (NS), compared to the six months preceding enrollment. Overall, the total number of healthcare contacts was increased after implementation (623 before vs 790 after, + 167, +26.8%). Implementation of the CP program resulted in increased overall use of local healthcare resources in patients referred by physicians as high utilizers.\nConclusion: \nThe implementation of an in-home CP program targeting high users of healthcare resources resulted in a decrease in utilization in the hospital, ED, and primary care settings; however, it was balanced and exceeded by the number of CP visits. CP programs align well with population health strategies and could be better leveraged to fill gaps in care and promote appropriate access to healthcare services. Further study is required to determine whether the shift in type of healthcare access reduces or increases cost.", "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": "paramedic, emergency department, community paramedic" } ], "section": "Emergency Medical Services", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/30k1q0j8", "frozenauthors": [ { "first_name": "Lucas", "middle_name": "A.", "last_name": "Myers", "name_suffix": "", "institution": "Mayo Clinic, Mayo Clinic Ambulance Service, Rochester, Minnesota", "department": "None" }, { "first_name": "Peter", "middle_name": "N.", "last_name": "Carlson", "name_suffix": "", "institution": "Mayo Clinic, Mayo Clinic Ambulance Service, Rochester, Minnesota", "department": "None" }, { "first_name": "Paul", "middle_name": "W.", "last_name": "Krantz", "name_suffix": "", "institution": "Mayo Clinic Health System, Department of Emergency Medicine, Eau Claire, Wisconsin", "department": "None" }, { "first_name": "Hannah", "middle_name": "L.", "last_name": "Johnson", "name_suffix": "", "institution": "Mayo Clinic Health System, Department of Administration, Eau Claire, Wisconsin", "department": "None" }, { "first_name": "Matthew", "middle_name": "D.", "last_name": "Will", "name_suffix": "", "institution": "Mayo Clinic, Mayo Clinic Ambulance Service, Rochester, Minnesota", "department": "None" }, { "first_name": "Tasha", "middle_name": "M.", "last_name": "Bjork", "name_suffix": "", "institution": "Mayo Clinic Health System, Department of Administration, Eau Claire, Wisconsin", "department": "None" }, { "first_name": "Marlene", "middle_name": "", "last_name": "Dirkes", "name_suffix": "", "institution": "Mayo Clinic, Mayo Clinic Ambulance Service, Rochester, Minnesota", "department": "None" }, { "first_name": "Justin", "middle_name": "E.", "last_name": "Bowe", "name_suffix": "", "institution": "Mayo Clinic, Mayo Clinic Ambulance Service, Rochester, Minnesota", "department": "None" }, { "first_name": "Kirk", "middle_name": "A.", "last_name": "Gunderson", "name_suffix": "", "institution": "Mayo Clinic, Mayo Clinic Ambulance Service, Rochester, Minnesota", "department": "None" }, { "first_name": "Christopher", "middle_name": "S.", "last_name": "Russi", "name_suffix": "", "institution": "Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota", "department": "None" } ], "date_submitted": "2019-07-17T09:23:29-05:00", "date_accepted": "2019-07-17T09:23:29-05:00", "date_published": "2020-08-24T16:49:04-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13005/galley/6813/download/" } ] }, { "pk": 13500, "title": "Effect of Resident Physicians in a Supervisory Role on Efficiency in the Emergency Department", "subtitle": null, "abstract": "Introduction:\n While patient throughput and emergency department (ED) length of stay (LOS) are recognized as important metrics in the delivery of efficient care, they must be balanced with the educational mission of academic centers. Prior studies examining the impact of learners on throughput and LOS when staffing directly with attending physicians have yielded mixed results. Herein we sought to examine the impact of a staffing model involving a supervisory resident “pre-attending” (PAT) on ED throughput and LOS, as this model offers a valuable educational experience for residents, but may do so at the expense of operational efficiency.\nMethods:\n We retrospectively analyzed 26,702 unique patient encounters at a university-affiliated community ED between July 1, 2017–January 1,2019. The experimental group was comprised of patients seen primarily by midlevel providers, who staffed with a PAT, who subsequently staffed with an attending physician. The control group was comprised of patients seen by midlevel providers and staffed directly with attendings without a PAT. We used a parametric hazard model to analyze the effect of the presence of a PAT on service time, controlling for potential confounders including timing of presentation and patient demographics.\nResults:\n The presence of a PAT is associated with a statistically significant increase in service time of five minutes (p = 0.006). Holding other variables equal, predicted service time in the experimental group was 173 minutes (95% confidence interval (CI), 171-176), while that for controls was 168 minutes (95% CI, 165-171).\nConclusion:\n The presence of a PAT is associated with a statistically significant increase in service time, but the magnitude (five minutes) is likely operationally insignificant. The negligible increase in service time is offset by the benefit to residents’ training. The results of this study may be helpful for residency programs considering the addition of a PAT shift structure.", "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": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6f20g8c5", "frozenauthors": [ { "first_name": "Aaron", "middle_name": "S.", "last_name": "Kraut", "name_suffix": "", "institution": "University of Wisconsin School of Medicine and Public Health-BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin", "department": "None" }, { "first_name": "Lauren", "middle_name": "", "last_name": "Sheehy", "name_suffix": "", "institution": "University of Wisconsin School of Medicine and Public Health-BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin", "department": "None" }, { "first_name": "Benjamin", "middle_name": "H.", "last_name": "Schnapp", "name_suffix": "", "institution": "University of Wisconsin School of Medicine and Public Health-BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin", "department": "None" }, { "first_name": "Brian", "middle_name": "", "last_name": "Patterson", "name_suffix": "", "institution": "University of Wisconsin School of Medicine and Public Health-BerbeeWalsh, Department of Emergency Medicine, Madison, Wisconsin \nUniversity of Wisconsin-Madison, Department of Industrial and Systems Engineering and Department of Biostatistics and Medical Informatics, Madison, Wisconsin", "department": "None" } ], "date_submitted": "2020-01-17T14:25:37-05:00", "date_accepted": "2020-01-17T14:25:37-05:00", "date_published": "2020-08-24T16:43:42-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13500/galley/7074/download/" } ] }, { "pk": 13492, "title": "Resident Research in Emergency Medicine: An Introduction and Primer", "subtitle": null, "abstract": "Training in research methodology represents an important aspect of emergency medicine (EM) resident education, but best methods for design, implementation, and dissemination of resident research remain elusive. Here we describe recommendations and best practices from the existing literature on EM resident research, including helpful tips on how to best implement a resident research program.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "resident, research, emergency medicine, academic" } ], "section": "Research Methods", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5rg1q4tz", "frozenauthors": [ { "first_name": "James", "middle_name": "H.", "last_name": "Paxton", "name_suffix": "", "institution": "Wayne State University, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "Anne", "middle_name": "M.", "last_name": "Messman", "name_suffix": "", "institution": "Wayne State University, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "Nicholas", "middle_name": "E.", "last_name": "Harrison", "name_suffix": "", "institution": "Wayne State University, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "Adrienne", "middle_name": "M.", "last_name": "Malik", "name_suffix": "", "institution": "Kansas University Medical Center, Department of Emergency Medicine, Kansas City, Kansas", "department": "None" }, { "first_name": "Raina", "middle_name": "J.", "last_name": "Burke", "name_suffix": "", "institution": "Wheeling Hospital, Department of Emergency Medicine, Wheeling, West Virginia", "department": "None" }, { "first_name": "Phillip", "middle_name": "D.", "last_name": "Levy", "name_suffix": "", "institution": "Wayne State University, Department of Emergency Medicine, Detroit, Michigan", "department": "None" } ], "date_submitted": "2020-01-14T02:26:14-05:00", "date_accepted": "2020-01-14T02:26:14-05:00", "date_published": "2020-08-24T16:35:35-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13492/galley/7070/download/" } ] }, { "pk": 13831, "title": "Dumpster Diving in the Emergency Department: Quantity and Characteristics of Waste at a Level I Trauma Center", "subtitle": null, "abstract": "Introduction:\n Healthcare contributes 10% of greenhouse gases in the United States and generates two milion tons of waste each year. Reducing healthcare waste can reduce the environmental impact of healthcare and lower hospitals’ waste disposal costs. However, no literature to date has examined US emergency department (ED) waste management. The purpose of this study was to quantify and describe the amount of waste generated by an ED, identify deviations from waste policy, and explore areas for waste reduction.\nMethods:\n We conducted a 24-hour (weekday) ED waste audit in an urban, tertiary-care academic medical center. All waste generated in the ED during the study period was collected, manually sorted into separate categories based on its predominant material, and weighed. We tracked deviations from hospital waste policy using the hospital’s Infection Control Manual, state regulations, and Health Insurance Portability and Accountability Act standards. Lastly, we calculated direct pollutant emissions from ED waste disposal activities using the M+WasteCare Calculator.\nResults:\n The ED generated 671.8 kilograms (kg) total waste during a 24-hour collection period. On a per-patient basis, the ED generated 1.99 kg of total waste per encounter. The majority was plastic (64.6%), with paper-derived products (18.4%) the next largest category. Only 14.9% of waste disposed of in red bags met the criteria for regulated medical waste. We identified several deviations from waste policy, including loose sharps not placed in sharps containers, as well as re-processable items and protected health information thrown in medical and solid waste. We also identified over 200 unused items. Pollutant emissions resulting per day from ED waste disposal include 3110 kg carbon dioxide equivalent and 576 grams of other criteria pollutants, heavy metals, and toxins.\nConclusion:\n The ED generates significant amounts of waste. Current ED waste disposal practices reveal several opportunities to reduce total waste generated, increase adherence to waste policy, and reduce environmental impact. While our results will likely be similar to other urban tertiary EDs that serve as Level I trauma centers, future studies are needed to compare results across EDs with different patient volumes or waste generation rates.", "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": "Waste Audit, Emergency Department, Healthcare waste, Carbon Footprint, medical waste, solid waste" } ], "section": "Emergency Department Operations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1p78w8s6", "frozenauthors": [ { "first_name": "Sarah", "middle_name": "", "last_name": "Hsu", "name_suffix": "", "institution": "Warren Alpert Medical School of Brown University, Providence, Rhode Island", "department": "None" }, { "first_name": "Cassandra", "middle_name": "", "last_name": "Thiel", "name_suffix": "", "institution": "New York University Grossman School of Medicine, Department of Population Health, New York, New York", "department": "None" }, { "first_name": "Michael", "middle_name": "J.", "last_name": "Mello", "name_suffix": "", "institution": "Warren Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island", "department": "None" }, { "first_name": "Jonathan", "middle_name": "E.", "last_name": "Slutzman", "name_suffix": "", "institution": "Massachusetts General Hospital and Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" } ], "date_submitted": "2020-04-27T10:58:38-05:00", "date_accepted": "2020-04-27T10:58:38-05:00", "date_published": "2020-08-24T16:32:21-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13831/galley/7205/download/" } ] }, { "pk": 13458, "title": "Post-traumatic Stress Disorder in Family-witnessed Resuscitation of Emergency Department Patients", "subtitle": null, "abstract": "Introduction: \nFamily presence during emergency resuscitations is increasingly common, but the question remains whether the practice results in psychological harm to the witness. We examine whether family members who witness resuscitations have increased post-traumatic stress disorder (PTSD) symptoms at one month following the event.\nMethods: \nWe identified family members of critically ill patients via our emergency department (ED) electronic health record. Patients were selected based on their geographic triage to an ED critical care room. Family members were called a median of one month post-event and administered the Impact of Event Scale-Revised (IES-R), a 22-item validated scale that measures post-traumatic distress symptoms and correlates closely with Diagnostic and Statistical Manual of Mental Disorders-IV criteria for post-traumatic stress disorder (PTSD). Family members were placed into two groups based on whether they stated they had witnessed the resuscitation (FWR group) or not witnessed the resuscitation (FNWR group). Data analyses included chi-square test, independent sample t-test, and linear regression controlling for gender and age.\nResults:\n A convenience sample of 423 family members responded to the phone interview: 250 FWR and 173 FNWR. The FWR group had significantly higher mean total IES-R scores: 30.4 vs 25.6 (95% confidence interval [CI], -8.73 to -0.75; P<.05). Additionally, the FWR group had significantly higher mean score for the subscales of avoidance (10.6 vs 8.1; 95% CI, -4.25 to -0.94; P<.005) and a trend toward higher score for the subscale of intrusion (13.0 vs 11.4; 95% CI, -3.38 to .028; P = .054). No statistical significant difference was noted between the groups in the subscale of hyperarousal (6.95 vs 6.02; 95% CI, -2.08 to 0.22; P=.121). All findings were consistent after controlling for age, gender, and immediate family member (spouse, parent, children, and grandchildren).\nConclusion:\n Our results suggest that family members who witness ED resuscitations may be at increased risk of PTSD symptoms at one month. This is the first study that examines the effects of family visitation for an unsorted population of very sick patients who would typically be seen in the critical care section of a busy 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": "PTSD" }, { "word": "Family witnessed resuscitation" }, { "word": "emergency department" } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1kc5n9gs", "frozenauthors": [ { "first_name": "Mert", "middle_name": "", "last_name": "Erogul", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "Antonios", "middle_name": "", "last_name": "Likourezos", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "Jodee", "middle_name": "", "last_name": "Meddy", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "Victoria", "middle_name": "", "last_name": "Terentiev", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "D'anna", "middle_name": "", "last_name": "Davydkina", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "Ralph", "middle_name": "", "last_name": "Monfort", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "Illya", "middle_name": "", "last_name": "Pushcar", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "Thomas", "middle_name": "", "last_name": "Vu", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "Madhu", "middle_name": "", "last_name": "Achalla", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "Christian", "middle_name": "", "last_name": "Fromm", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" }, { "first_name": "John", "middle_name": "", "last_name": "Marshall", "name_suffix": "", "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York", "department": "None" } ], "date_submitted": "2019-12-25T11:43:42-05:00", "date_accepted": "2019-12-25T11:43:42-05:00", "date_published": "2020-08-24T16:27:21-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13458/galley/7054/download/" } ] }, { "pk": 13479, "title": "Buprenorphine for Opioid Use Disorder in the Emergency Department: A Retrospective Chart Review", "subtitle": null, "abstract": "Introduction: \nEmergency care providers routinely treat patients with acute presentations and sequelae of opioid use disorder. An emergency physician and pharmacist implemented a protocol using buprenorphine for the treatment of patients with opioid withdrawal at an academic, Level I trauma center. We describe our experience regarding buprenorphine implementation in the emergency department (ED), characteristics of patients who received buprenorphine, and rates of outpatient follow-up.\nMethods:\n We conducted a retrospective chart review of all patients in the ED for whom buprenorphine was administered to treat opioid withdrawal during an 18-month period from January 30, 2017–July 31, 2018. Data extraction of a priori-defined variables was recorded. We used descriptive statistics to characterize the cohort of patients.\nResults:\n A total of 77 patients were included for analysis. Thirty-three patients (43%) who received buprenorphine did not present with the chief complaint of opioid withdrawal. Most patients (74%) who received buprenorphine last used heroin, and presented in moderate opioid withdrawal. One case of precipitated withdrawal occurred after buprenorphine administration. Twenty-three (30%) patients received outpatient follow-up.\nConclusions:\n This study underscores the safety of ED-initiated buprenorphine and that buprenorphine administration in the ED is feasible and effective.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1z73c517", "frozenauthors": [ { "first_name": "Kathy", "middle_name": "T.", "last_name": "LeSaint", "name_suffix": "", "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California", "department": "None" }, { "first_name": "Brent", "middle_name": "", "last_name": "Klapthor", "name_suffix": "", "institution": "Kaiser Permanente San Diego Medical Center, Department of Emergency Medicine, San Diego, California", "department": "None" }, { "first_name": "Ralph", "middle_name": "C.", "last_name": "Wang", "name_suffix": "", "institution": "University of California, San Francisco, Department of Emergency Medicine, San Francisco, California", "department": "None" }, { "first_name": "Curtis", "middle_name": "", "last_name": "Geier", "name_suffix": "", "institution": "University of California, San Francisco, Department of Clinical Pharmacy, San Francisco, California", "department": "None" } ], "date_submitted": "2020-01-06T16:57:13-05:00", "date_accepted": "2020-01-06T16:57:13-05:00", "date_published": "2020-08-24T16:22:48-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13479/galley/7063/download/" } ] }, { "pk": 13426, "title": "Creation and Implementation of a Mastery Learning Curriculum for Emergency Department Thoracotomy", "subtitle": null, "abstract": "Introduction: \nEmergency department thoracotomy (EDT) is a lifesaving procedure within the scope of practice of emergency physicians. Because EDT is infrequently performed, emergency medicine (EM) residents lack opportunities to develop procedural competency. There is no current mastery learning curriculum for residents to learn EDT. The purpose of this study was to develop and implement a simulation-based mastery learning curriculum to teach and assess EM residents’ performance of the EDT. \nMethods:\n We developed an EDT curriculum using a mastery learning framework. The minimum passing standard (MPS) for a previously developed 22-item checklist was determined using the Mastery Angoff approach. EM residents at a four-year academic EM residency program underwent baseline testing in performing an EDT on a simulation trainer. Performance was scored by two raters using the checklist. Learners then participated in a novel mastery learning EDT curriculum that included an educational video, hands-on instruction, and deliberate practice. After a three-month period, residents then completed initial post testing. Residents who did not meet the minimum passing standard after post testing participated in additional deliberate practice until mastery was obtained. Baseline and post-test scores, and time to completion of the procedure were compared with paired t-tests.\nResults:\n Of 56 eligible EM residents, 54 completed baseline testing. Fifty-two residents completed post-testing until mastery was reached. The minimum passing standard was 91.1%, (21/22 items correct on the checklist). No participants met the MPS at the baseline assessment. After completion of the curriculum, all residents subsequently reached the MPS, with deliberate practice sessions not exceeding 40 minutes. Scores from baseline testing to post-testing significantly improved across all postgraduate years from a mean score of 10.2/22 to 21.4/22 (p <0.001). Mean time to complete the procedure improved from baseline testing (6 minutes [min] and 21 seconds [sec], interquartile range [IQR] = 4 min 54 sec - 7 min 51 sec) to post-testing (5 min 19 seconds, interquartile range 4 min 17sec - 6 min 15 sec; p = 0.001).\nConclusion:\n This simulation-based mastery learning curriculum resulted in all residents performing an EDT at a level that met or exceeded the MPS with an overall decrease in time needed to perform the procedure.", "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 Department Thoracotomy, Mastery Learning" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/75z8g2kt", "frozenauthors": [ { "first_name": "Danielle", "middle_name": "T.", "last_name": "Miller", "name_suffix": "", "institution": "Stanford University School of Medicine, Department of Emergency Medicine, Palo Alto, California", "department": "None" }, { "first_name": "Hashim", "middle_name": "Q.", "last_name": "Zaidi", "name_suffix": "", "institution": "University of Chicago School of Medicine, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Priyanka", "middle_name": "", "last_name": "Sista", "name_suffix": "", "institution": "Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, Tennessee", "department": "None" }, { "first_name": "Sarah", "middle_name": "S.", "last_name": "Dhake", "name_suffix": "", "institution": "NorthShore University Health System, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Matthew", "middle_name": "J.", "last_name": "Pirotte", "name_suffix": "", "institution": "Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, Tennessee", "department": "None" }, { "first_name": "Abra", "middle_name": "L.", "last_name": "Fant", "name_suffix": "", "institution": "Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "David", "middle_name": "H.", "last_name": "Salzman", "name_suffix": "", "institution": "Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois", "department": "None" } ], "date_submitted": "2020-01-12T19:09:08-05:00", "date_accepted": "2020-01-12T19:09:08-05:00", "date_published": "2020-08-24T16:18:35-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13426/galley/7045/download/" } ] }, { "pk": 14500, "title": "2020 CORD Abstracts Special Issue", "subtitle": null, "abstract": "n/a", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "WestJEM Full-Text Issue", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7wq0b6g3", "frozenauthors": [ { "first_name": "Christine", "middle_name": "", "last_name": "Louis", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2020-08-24T15:36:50-05:00", "date_accepted": "2020-08-24T15:36:50-05:00", "date_published": "2020-08-24T15:39:14-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14500/galley/7417/download/" } ] }, { "pk": 57226, "title": "Atlas of multilingualism in Daghestan: A case study in diachronic sociolinguistics", "subtitle": null, "abstract": "This paper introduces the future \nAtlas of Multilingualism in Daghestan\n, a project based on extensive field study of the language repertoires of the residents of rural highland Daghestan. The Atlas will provide quantitative data on multilingualism across a relatively compact linguistic area, which is, culturally and socially, both homogeneous and diverse. It will represent a wide range of ethnic contact situations in a qualitatively and quantitatively comparable way. The data are collected by the method of retrospective family interviews, which is designed to obtain data about bilingualism in the past. The paper gives a brief sociolinguistic overview of Daghestan, describes the method and its restrictions, explains the design of the future Atlas, and provides two sample chapters. One of the chapters describes three villages in northeast Daghestan, and the other describes two villages in southern Daghestan.", "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": "multilingualism" }, { "word": "Daghestan" }, { "word": "Language Contact" }, { "word": "Sociolinguistics" }, { "word": "linguistic cartography" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6nw5x35t", "frozenauthors": [ { "first_name": "Nina", "middle_name": "", "last_name": "Dobrushina", "name_suffix": "", "institution": "National Research University Higher School of Economics, Russian Federation", "department": "" }, { "first_name": "Michael", "middle_name": "", "last_name": "Daniel", "name_suffix": "", "institution": "National Research University Higher School of Economics, Russian Federation", "department": "" }, { "first_name": "Yuri", "middle_name": "", "last_name": "Koryakov", "name_suffix": "", "institution": "Institute of Linguistics, Russian Academy of Sciences, Moscow", "department": "" } ], "date_submitted": "2020-08-22T16:29:40-05:00", "date_accepted": "2020-08-22T16:29:40-05:00", "date_published": "2020-08-22T02:00:00-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/languagesofcaucasus/article/57226/galley/43409/download/" } ] }, { "pk": 61792, "title": "Non-Invasive Ventilation in the Elderly in the Emergency Department: Epidemiological Data and Results", "subtitle": null, "abstract": "Introduction: Non-invasive ventilation (NIV) could be a good alternative in elderly people with acute respiratory failure (ARF), to procure them a respiratory support while avoiding as much as possible the complications of invasive ventilation.\nMethods: This is an observational retrospective study conducted at the emergency department (ED) of a tertiary care, university-based teaching hospital. Data of elderly patients (≥ 65 years) admitted to ED between January 2017 and April 2018 for ARF and requiring NIV were collected and analyzed using SPSS 22 software.\nResults: Sixty six patients (≥ 65 years) requiring NIV for acute respiratory failure (ARF) were included. The mean age was 76 years (± 7), the median Charlson index was 5. Acute respiratory failure was related to acute heart failure in 68%, acute exacerbation of chronic obstructive pulmonary disease in 53% and pneumonia in 39% of cases. Forty eight percent had more than one etiologic diagnosis. Hypercapnic acute respiratory failure was observed in 61%. On initiation of NIV, the average pH was 7.31 (± 0.11) and PaCO2 56 mmHg (± 21), After NIV, the average pH was 7.38 (± 0.11) and PaCO2 53 mmHg (± 26). Improvement of pH was significant (p < 0.05). 61% of patients were discharged at home, 9% were admitted to intensive care unit. Invasive ventilation was performed in 4%, of which 23% died. Success of NIV was observed in 68% of patients.\nConclusion: NIV can be of a great interest in elderly people. Our study showed that it can be used successfully in the studied settings.", "language": "english", "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": "Emergency Medicine" }, { "word": "ventilation" }, { "word": "acute care" } ], "section": "Original Research", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4fv2k09r", "frozenauthors": [ { "first_name": "Yosra", "middle_name": "", "last_name": "Yahia", "name_suffix": "", "institution": "Faculty of Medicine of Tunis", "department": "" }, { "first_name": "Hamida", "middle_name": "", "last_name": "Maghraoui", "name_suffix": "", "institution": "Faculty of Medicine of Tunis", "department": "" }, { "first_name": "Khedija", "middle_name": "", "last_name": "Zaouche", "name_suffix": "", "institution": "Faculty of Medicine of Tunis", "department": "" }, { "first_name": "Abdelwahab", "middle_name": "", "last_name": "Mghirbi", "name_suffix": "", "institution": "Faculty of Medicine of Tunis", "department": "" }, { "first_name": "Amani", "middle_name": "", "last_name": "Slama", "name_suffix": "", "institution": "Faculty of Medicine of Tunis", "department": "" }, { "first_name": "Mohamed", "middle_name": "", "last_name": "Kilani", "name_suffix": "", "institution": "Faculty of Medicine of Tunis", "department": "" }, { "first_name": "Abderrahim", "middle_name": "", "last_name": "Achouri", "name_suffix": "", "institution": "Faculty of Medicine of Tunis", "department": "" }, { "first_name": "Manel", "middle_name": "", "last_name": "Kallel", "name_suffix": "", "institution": "Faculty of Medicine of Tunis", "department": "" }, { "first_name": "Hedia", "middle_name": "", "last_name": "Gnenna", "name_suffix": "", "institution": "Faculty of Medicine of Tunis", "department": "" }, { "first_name": "Kamel", "middle_name": "", "last_name": "Majed", "name_suffix": "", "institution": "Faculty of Medicine of Tunis", "department": "" } ], "date_submitted": "2020-08-03T08:21:25-05:00", "date_accepted": "2020-08-03T08:21:25-05:00", "date_published": "2020-08-22T02:00:00-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_medjem/article/61792/galley/47672/download/" } ] }, { "pk": 13616, "title": "Academic Emergency Medicine Faculty Experiences with Racial and Sexual Orientation Discrimination", "subtitle": null, "abstract": "Introduction:\n Despite the increasing diversity of individuals entering medicine, physicians from racial and sexual minority groups continue to experience bias and discrimination in the workplace. The objective of this study was to determine the current experiences and perceptions of discrimination on the basis of race and sexual orientation among academic emergency medicine (EM) faculty.\nMethods: \nWe conducted a cross-sectional survey of a convenience sample of EM faculty across six programs. Survey items included the Overt Gender Discrimination at Work (OGDW) Scale adapted for race and sexual orientation, and the frequency and source of experienced and observed discrimination. Group comparisons were made using t-tests or chi-square analyses, and relationships between race or sexual orientation, and we evaluated physicians’ experiences using correlation analyses.\nResults:\n A total of 141 out of 352 (40.1%) subjects completed at least a portion of the survey. Non-White physicians reported higher mean racial OGDW scores than their White counterparts (13.4 vs 8.6; 95% confidence interval (CI) for difference, -7.7 – -2.9). Non-White EM faculty were also more likely to report having experienced discriminatory treatment based on race than were White EM faculty (48.0% vs 12.6%; CI for difference, 16.6% – 54.2%), although both groups were equally likely to report having observed race-based discrimination of another physician. EM faculty who identified as sexual minorities reported higher mean sexual minority OGDW scores than their heterosexual counterparts (11.1 vs 7.1; 95% CI for difference, -7.3 – -0.6). There were no significant differences between sexual minority and heterosexual faculty in their reports of experiencing or observing discrimination based on sexual orientation.\nConclusion: \nEM faculty from racial and sexual minority groups perceived more discrimination based on race or sexual orientation in their workplace than their majority counterparts. EM faculty regardless of race or sexual orientation were similar in their observations of discriminatory treatment of another physician based on race or sexual orientation.", "language": "", "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": "Minority Groups" }, { "word": "sexual and gender minorities" }, { "word": "workplace" }, { "word": "racism" }, { "word": "physicians" }, { "word": "faculty" } ], "section": "Health Equity", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7rc327wf", "frozenauthors": [ { "first_name": "Dave", "middle_name": "W.", "last_name": "Lu", "name_suffix": "", "institution": "University of Washington School of Medicine, Department of Emergency Medicine, Seattle, Washington", "department": "None" }, { "first_name": "Ava", "middle_name": "", "last_name": "Pierce", "name_suffix": "", "institution": "University of Texas Southwestern Medical School, Department of Emergency Medicine, Dallas, Texas", "department": "None" }, { "first_name": "Joshua", "middle_name": "", "last_name": "Jauregui", "name_suffix": "", "institution": "University of Washington School of Medicine, Department of Emergency Medicine, Seattle, Washington", "department": "None" }, { "first_name": "Sheryl", "middle_name": "", "last_name": "Heron", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Michelle", "middle_name": "D.", "last_name": "Lall", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Jennifer", "middle_name": "", "last_name": "Mitzman", "name_suffix": "", "institution": "The Ohio State University College of Medicine, Department of Emergency Medicine, Columbus, Ohio", "department": "None" }, { "first_name": "Danielle", "middle_name": "M.", "last_name": "McCarthy", "name_suffix": "", "institution": "Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Nicholas", "middle_name": "D.", "last_name": "Hartman", "name_suffix": "", "institution": "Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina", "department": "None" }, { "first_name": "Tania", "middle_name": "D.", "last_name": "Strout", "name_suffix": "", "institution": "Tufts University School of Medicine – Maine Medical Center, Department of Emergency Medicine, Portland, Maine", "department": "None" } ], "date_submitted": "2020-02-28T20:00:29-05:00", "date_accepted": "2020-02-28T20:00:29-05:00", "date_published": "2020-08-21T15:58:52-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13616/galley/7118/download/" } ] }, { "pk": 12826, "title": "A Method for Grouping Emergency Department Visits by Severity and Complexity", "subtitle": null, "abstract": "Introduction: \nTriage functions to quickly prioritize care and sort patients by anticipated resource needs. Despite widespread use of the Emergency Severity Index (ESI), there is still no universal standard for emergency department (ED) triage. Thus, it can be difficult to objectively assess national trends in ED acuity and resource requirements. We sought to derive an ESI from National Hospital Ambulatory Medical Care Survey (NHAMCS) survey items (NHAMCS-ESI) and to assess the performance of this index with respect to stratifying outcomes, including hospital admission, waiting times, and ED length of stay (LOS).\nMethods:\n We used data from the 2010-2015 NHAMCS, to create a measure of ED visit complexity based on variables within NHAMCS. We used NHAMCS data on chief complaint, vitals, resources used, interventions, and pain level to group ED visits into five levels of acuity using a stepwise algorithm that mirrored ESI. In addition, we examined associations of NHAMCS-ESI with typical indicators of acuity such as waiting time, LOS, and disposition. The NHAMCS-ESI categorization was also compared against the “immediacy” variable across all of these outcomes. Visit counts used weighted scores to estimate national levels of ED visits.\nResults:\n The NHAMCS ED visits represent an estimated 805,726,000 ED visits over this time period. NHAMCS-ESI categorized visits somewhat evenly, with most visits (42.5%) categorized as a level 3. The categorization pattern is distinct from that of the “immediacy” variable within NHAMCS. Of admitted patients, 89% were categorized as NHAMCS-ESI level 2-3. Median ED waiting times increased as NHAMCS-ESI levels decreased in acuity (from approximately 14 minutes to 25 minutes). Median LOS decreased as NHAMCS-ESI decreased from almost 200 minutes for level 1 patients to nearly 80 minutes for level 5 patients.\nConclusion:\n We derived an objective tool to measure an ED visit’s complexity and resource use. This tool can be validated and used to compare complexity of ED visits across hospitals and regions, and over time.", "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": "Administration, Health Services Research, Overcrowding, Triage, Emergency Department" } ], "section": "Healthcare Utilization", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5zx5k2sj", "frozenauthors": [ { "first_name": "B.", "middle_name": "Jason", "last_name": "Theiling", "name_suffix": "", "institution": "Duke University School of Medicine, Department of Emergency Medicine, Durham, North Carolina", "department": "None" }, { "first_name": "Kendrick", "middle_name": "V.", "last_name": "Kennedy", "name_suffix": "", "institution": "Duke University School of Medicine, Department of Emergency Medicine, Durham, North Carolina", "department": "None" }, { "first_name": "Alexander", "middle_name": "T.", "last_name": "Limkakeng Jr.", "name_suffix": "", "institution": "Duke University School of Medicine, Department of Emergency Medicine, Durham, North Carolina", "department": "None" }, { "first_name": "Pratik", "middle_name": "", "last_name": "Manandhar", "name_suffix": "", "institution": "Duke University School of Medicine, Department of Biostatistics and Bioinformatics, Durham, North Carolina", "department": "None" }, { "first_name": "Alaattin", "middle_name": "", "last_name": "Erkanli", "name_suffix": "", "institution": "Duke University School of Medicine, Department of Biostatistics and Bioinformatics, Durham, North Carolina", "department": "None" }, { "first_name": "Stephen", "middle_name": "R.", "last_name": "Pitts", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" } ], "date_submitted": "2019-08-09T14:51:53-05:00", "date_accepted": "2019-08-09T14:51:53-05:00", "date_published": "2020-08-21T15:54:05-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/12826/galley/6758/download/" } ] }, { "pk": 13410, "title": "Triage in The Time of Diphtheria", "subtitle": null, "abstract": "Introduction: \nA diphtheria outbreak occurred in 2017 in Jakarta, Indonesia, during which our hospital was appointed as a referral hospital where patients with upper respiratory tract symptoms were sent for confirmation of the diagnosis and medical intervention. In this study we review the implementation of the emergency department (ED) triage process and patient flow management during the diphtheria outbreak. No previous study in Indonesia has provided a detailed report on the triage process during infectious disease outbreaks.\nMethod:\n We modified our pre-existing hospital triage method according to the “identify, isolate, and inform” principle. We developed novel criteria for triage to identify triage-suspected cases and also a diphtheria package to simplify the diagnostic process. Four separate rooms were modified to isolation spaces to enable medical staff to observe these patients. We obtained data from the ED outbreak registry and electronic health records.\nResults: \nOf 60 cases of triage-suspected diphtheria, six were classified as suspected diphtheria. The mean time from “identify” to “isolate” was 3.5 minutes, and from “isolate” to “inform” was 10 minutes. Mean ED length of stay for probable diphtheria was 24.46 hours. No medical personnel in the ED showed any signs of diphtheria 30 days after the outbreak had abated.\nConclusion:\n The modified criteria can help triage officers detect suspected diphtheria cases and measure the triage response time. Use of the diphtheria package and four separate rooms in the ED could act as an infection control procedure and facilitate the improvement of the diagnostic process.", "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": "Triage, Diphtheria, Emergency" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7733421r", "frozenauthors": [ { "first_name": "Hadiki", "middle_name": "", "last_name": "Habib", "name_suffix": "", "institution": "Emergency Unit, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia", "department": "None" }, { "first_name": "Hesty", "middle_name": "", "last_name": "Kurniawaty", "name_suffix": "", "institution": "Emergency Unit, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia", "department": "None" } ], "date_submitted": "2019-12-06T20:03:39-05:00", "date_accepted": "2019-12-06T20:03:39-05:00", "date_published": "2020-08-21T15:49:55-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13410/galley/7041/download/" } ] }, { "pk": 13593, "title": "Paramedic Pain Management Practice with Introduction of a Non-opiate Treatment Protocol", "subtitle": null, "abstract": "Introduction: \nThere is concern about the initiation of opiates in healthcare settings due to the risk of future misuse. Although opiate medications have historically been at the core of prehospital pain management, several states are introducing non-opiate alternatives to prehospital care. Prior studies suggest that non-opiate analgesics are non-inferior to opiates for many acute complaints, yet there is little literature describing practice patterns of pain management in prehospital care. Our goal was to describe the practice patterns and attitudes of paramedics toward pain management after the introduction of non-opiates to a statewide protocol.\nMethods: \nThis study was two-armed. The first arm employed a pre/post retrospective chart review model examining medication administrations reported to the Massachusetts Ambulance Trip Information System between January 1, 2017–December 31, 2018. We abstracted instances of opiate and non-opiate utilizations along with patients’ clinical course. The second arm consisted of a survey administered to paramedics one year after implementation of non-opiates in the state protocol, which used binary questions and Likert scales to describe beliefs pertaining to prehospital analgesia.\nResults:\n Pain medications were administered in 1.6% of emergency medical services incidents in 2017 and 1.7% of incidents in 2018. The rate of opiate analgesic use was reduced by 9.4% in 2018 compared to 2017 (90.6% vs 100.0%). The absolute reduction in opiate use in 2018 was 3.6%. Women were less likely (odds ratio [OR] = 0.78, 95% confidence interval [CI], 0.69-0.89) and trauma patients were more likely to receive opiates (OR = 2.36, CI, 1.96-2.84). Mean transport times were longer in opiate administration incidents (36.97 vs 29.35 minutes, t = 17.34, p<0.0001). We surveyed 100 paramedics (mean age 41.98, 84% male). Compositely, 85% of paramedics planned to use non-opiates and 35% reported having done so. Participants planning to use non-opiates were younger and less experienced. Participants indicated that concern about adverse effects, efficacy, and time to effect impacted their practice patterns.\nConclusion:\n The introduction of non-opiate pain medication to state protocols led to reduced opiate administration. Men and trauma patients were more likely to receive opiates. Paramedics reported enthusiasm for non-opiate medications. Beliefs about non-opioid analgesics pertaining to adverse effects, onset time, and efficacy may influence their utilization.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Prehospital Care, Pain, Emergency Medical Services" } ], "section": "Emergency Medical Services", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0785191w", "frozenauthors": [ { "first_name": "Laurel", "middle_name": "", "last_name": "O'Connor", "name_suffix": "", "institution": "University of Massachusetts Medical School, Department of Emergency Medicine, Worcester, Massachusetts", "department": "None" }, { "first_name": "Julianne", "middle_name": "", "last_name": "Dugas", "name_suffix": "", "institution": "Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Jeffrey", "middle_name": "", "last_name": "Brady", "name_suffix": "", "institution": "University of Massachusetts Medical School, Department of Emergency Medicine, Worcester, Massachusetts", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Kamilaris", "name_suffix": "", "institution": "University of Massachusetts Medical School, Department of Emergency Medicine, Worcester, Massachusetts", "department": "None" }, { "first_name": "Steven", "middle_name": "K.", "last_name": "Shiba", "name_suffix": "", "institution": "Charles E. Schmidt College of Medicine at Florida Atlantic University, Boca Raton, Florida", "department": "None" }, { "first_name": "Ricky", "middle_name": "C.", "last_name": "Kue", "name_suffix": "", "institution": "South Shore Health, Department of Emergency Medicine, South Weymouth, Massachusetts", "department": "None" }, { "first_name": "John", "middle_name": "P.", "last_name": "Broach", "name_suffix": "", "institution": "University of Massachusetts Medical School, Department of Emergency Medicine, Worcester, Massachusetts", "department": "None" } ], "date_submitted": "2020-02-20T20:09:33-05:00", "date_accepted": "2020-02-20T20:09:33-05:00", "date_published": "2020-08-21T15:47:05-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13593/galley/7111/download/" } ] }, { "pk": 13499, "title": "Using an Online Vaccination Registry to Confirm Tetanus Status in Children with Tetanus-prone Wounds", "subtitle": null, "abstract": "Introduction\n: Tetanus vaccination status is an important consideration for emergency physicians managing patients with tetanus-prone wounds. Physicians must identify at-risk patients, but vaccination histories are often unknown and commonly lack documentation. The study objective was to determine the potential impact of an online immunization registry (Florida SHOTS – State Health Online Tracking System) on the appropriate administration of tetanus prophylaxis for pediatric patients managed in the emergency department (ED).\n \nMethods\n: We conducted a retrospective review of all patients less than 18 years old who received ED tetanus prophylaxis at two separate sites between January 2011–May 2015. The Florida SHOTS database was accessed to determine vaccination status for each patient in the study group at the time of the encounter. We compared vaccination status for each patient, as documented in the electronic health record (EHR), with Florida SHOTS data to determine whether tetanus prophylaxis was indicated. The proportion of patients receiving tetanus prophylaxis in the ED, who were subsequently identified as up to date with tetanus vaccination per Florida SHOTS, was determined.\n \nResults\n: We identified 743 patients who received ED tetanus prophylaxis. Forty-three (6%) were listed as “up to date” on the EHR and 656 (93%) were listed as “not up to date.” In comparison, 209 (30%) of the study group were identified as “up to date” via Florida SHOTS, and 477 (70%) were not. We accessed the Florida SHOTS record retrospectively to determine whether the vaccine was required. It was determined that 174 (25%) of the patients received tetanus prophylaxis unnecessarily as they were already up to date per Florida SHOTS documentation.\n \nConclusions\n: Twenty-five percent of patients vaccinated for tetanus in the ED could have been spared if Florida SHOTS data had been used by providers at the time of the encounter. Access to Florida SHOTS provides valuable information regarding vaccination status that impacts patient care and resource utilization 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": "Tetanus" }, { "word": "Vaccine" }, { "word": "pediatric" }, { "word": "emergency department" }, { "word": "Vaccination Registry" } ], "section": "Pediatrics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/25g3c6s7", "frozenauthors": [ { "first_name": "Cristina", "middle_name": "", "last_name": "Zeretzke-Bien", "name_suffix": "", "institution": "University of Florida in Gainesville, Department of Emergency Medicine, Gainesville, Florida", "department": "None" }, { "first_name": "Janelle", "middle_name": "", "last_name": "McCall", "name_suffix": "", "institution": "University of Texas Southwestern, Department of Emergency Medicine, Dallas, Texas", "department": "None" }, { "first_name": "Todd", "middle_name": "", "last_name": "Wylie", "name_suffix": "", "institution": "University of Florida in Jacksonville, Department of Emergency Medicine, Jacksonville, Florida", "department": "None" }, { "first_name": "Muhammad", "middle_name": "A.B.", "last_name": "Chowdhury", "name_suffix": "", "institution": "University of Florida in Gainesville, Department of Emergency Medicine, Gainesville, Florida", "department": "None" }, { "first_name": "Meenakshi", "middle_name": "", "last_name": "Balakrishnan", "name_suffix": "", "institution": "University of Florida in Gainesville, Department of Emergency Medicine, Gainesville, Florida", "department": "None" }, { "first_name": "Phyllis", "middle_name": "", "last_name": "Hendry", "name_suffix": "", "institution": "University of Florida in Jacksonville, Department of Emergency Medicine, Jacksonville, Florida", "department": "None" }, { "first_name": "Colleen", "middle_name": "", "last_name": "Kalynych", "name_suffix": "", "institution": "University of Florida in Jacksonville, Office of Educational Affairs, Jacksonville, Florida", "department": "None" }, { "first_name": "Hac-Tu", "middle_name": "J.", "last_name": "Chung", "name_suffix": "", "institution": "University of Florida in Gainesville, Department of Emergency Medicine, Gainesville, Florida", "department": "None" } ], "date_submitted": "2020-01-16T19:40:54-05:00", "date_accepted": "2020-01-16T19:40:54-05:00", "date_published": "2020-08-21T15:41:44-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13499/galley/7073/download/" } ] }, { "pk": 13654, "title": "Intention to Leave Emergency Medicine: Mid-career Women Are at Increased Risk", "subtitle": null, "abstract": "Introduction:\n Burnout is prevalent among emergency physicians and may cause physicians to consider leaving the practice of emergency medicine (EM). This study sought to determine whether there is a gender difference in reporting burnout and seriously considering leaving the specialty of EM, and secondarily to explore the factors reported as contributing to burnout.\nMethods:\n This was a secondary analysis of the 2014 American Board of Emergency Medicine Longitudinal Survey of Emergency Physicians. We used multiple logistic regression to determine which factors were associated with reporting serious consideration of leaving EM, when stratified by years in practice and adjusting for individual, departmental, and institutional factors.\nResults:\n The response rate was 82%, (n = 868); 22.6% (194) were female and 77.4% (664) were males; and 83.9% (733) White. The mean age of men responding was significantly higher than women (52.7±11.9 vs. 44.9±10.4, p<0.001). Overall, there were no significant gender differences in reporting having had serious thoughts of leaving EM in either unmatched or age-matched analyses. More women reported that burnout was a significant problem, while men more often were equivocal as to whether it was a problem. When stratified by years in practice, mid-career women had a seven-fold increase in the odds ratio (OR) of seriously considered leaving EM, compared to men of similar years in practice (OR 7.07, 95% confidence interval, 2.45-20.39). Autonomy at work, control over working conditions, fair compensation, personal reward, and a sense of ownership were factors associated with a lower rate of reporting considering leaving EM.\nConclusion:\n Our findings suggest that the intention to leave EM is not more prevalent in women. However, mid-career women more often reported seriously considering leaving the specialty than mid-career men. Further research on the factors behind this finding in mid-career women in EM is needed.", "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 Women" }, { "word": "Mid-career" }, { "word": "Women" }, { "word": "Attrition" } ], "section": "Provider Workforce", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1s08f9bh", "frozenauthors": [ { "first_name": "Michelle", "middle_name": "D.", "last_name": "Lall", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Sarah", "middle_name": "M.", "last_name": "Perman", "name_suffix": "", "institution": "University of Colorado School of Medicine, Department of Emergency Medicine, Denver, Colorado", "department": "None" }, { "first_name": "Nidhi", "middle_name": "", "last_name": "Garg", "name_suffix": "", "institution": "Hofstra/Northwell Health, Department of Emergency Medicine, Long Island, New York", "department": "None" }, { "first_name": "Nina", "middle_name": "", "last_name": "Kohn", "name_suffix": "", "institution": "Northwell Health, Feinstein Institutes for Medical Research, Long Island, New York", "department": "None" }, { "first_name": "Kristy", "middle_name": "", "last_name": "Whyte", "name_suffix": "", "institution": "Vituity/DeKalb Emergency Physicians, Emory Decatur Hospital, Emory Hillandale Hospital, Atlanta, Georgia", "department": "None" }, { "first_name": "Alexa", "middle_name": "", "last_name": "Gips", "name_suffix": "", "institution": "University of Colorado School of Medicine, Department of Hospice & Palliative Medicine, Denver, Colorado", "department": "None" }, { "first_name": "Tracy", "middle_name": "", "last_name": "Madsen", "name_suffix": "", "institution": "Alpert Medical School, Brown University, Department of Emergency Medicine, Providence, Rhode Island", "department": "None" }, { "first_name": "Jill", "middle_name": "M.", "last_name": "Baren", "name_suffix": "", "institution": "Perelman School of Medicine, University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Judith", "middle_name": "", "last_name": "Linden", "name_suffix": "", "institution": "Boston University Medical Center, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" } ], "date_submitted": "2020-03-16T14:30:09-05:00", "date_accepted": "2020-03-16T14:30:09-05:00", "date_published": "2020-08-21T15:36:41-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13654/galley/7129/download/" } ] }, { "pk": 13553, "title": "Insurance Does Not Affect Adverse Events While Awaiting Surgery for Ankle Trauma in One System", "subtitle": null, "abstract": "Introduction:\n Ankle injuries that are not properly cared for can have devastating effects on a patient’s health and ability to maintain an active lifestyle. Recommended outpatient surgery may be difficult to obtain for many groups of patients, including those without insurance or minority races. Patients who are of low socioeconomic status also have worse outcomes following trauma. The purpose of this study was to examine whether insurance status impacts the number of adverse events that patients face prior to receiving surgical treatment following an emergency department (ED) visit for an acute ankle injury.\nMethods:\n We conducted a retrospective chart review at two medical centers within the same healthcare system. The sample included 192 patients presenting to the ED with an unstable ankle injury between October 1, 2015– May 1, 2018. We used chi-square and t-test analysis to determine differences in rates of adverse events occurring while awaiting surgery.\nResults:\n Few (4%) patients presented as being self-pay. Neither Medicare (χ2 (1) (N = 192) = 2.389, p = .122), Medicaid (χ2 (1), (N = 192) = .084, p = .772), other insurances (χ2 (1) (N = 192) = .567, p = .452), or private insurance (χ2 (1) (N=192) = .000, p = .982) was associated with a difference in rates of adverse events. Likewise, gender (χ2 (1) (N = 192) = .402, p = .526), race (χ2 (3) (N = 192) = 2.504, p = .475), and all other demographic variables failed to show a difference in occurrence of adverse events. Those admitted to the hospital did show a lower rate of adverse events compared to those sent home from the ED (χ2 (1) (N = 192) = 5.452, p = .020). Sampled patients were admitted to the hospital at a high rate (49%).\nConclusion:\n The sampled facilities did not have adverse event rates that differed based on insurance status or demographic features. These facilities, with hospital-based subsidy programs and higher than expected admission rates, may manage their vulnerable populations well and may indicate their efforts to eliminate health disparity are effective.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Health Outcomes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3mg3173m", "frozenauthors": [ { "first_name": "Adam", "middle_name": "B.", "last_name": "Dobbins", "name_suffix": "", "institution": "University of Kansas Medical Center, School of Nursing, Department, Kansas City, Kansas", "department": "None" }, { "first_name": "John", "middle_name": "", "last_name": "Krumme", "name_suffix": "", "institution": "Washington Cancer Institute, Department of Musculoskeletal Oncology, Washington DC, Maryland", "department": "None" }, { "first_name": "Monica", "middle_name": "", "last_name": "Gaddis", "name_suffix": "", "institution": "University of Missouri Kansas City, Department of Emergency Medicine, Kansas City, Missouri\nUniversity of Missouri Kansas City, Department of Biomedical and Health Informatics, Kansas City, Missouri", "department": "None" }, { "first_name": "Shin Hye", "middle_name": "", "last_name": "Park", "name_suffix": "", "institution": "University of Kansas Medical Center, School of Nursing, Department, Kansas City, Kansas", "department": "None" }, { "first_name": "Manna", "middle_name": "", "last_name": "Varghese", "name_suffix": "", "institution": "University of Missouri Kansas City, School of Medicine, Department, Kansas City, Missouri", "department": "None" }, { "first_name": "Michael", "middle_name": "R.", "last_name": "Brancato", "name_suffix": "", "institution": "University of Missouri Kansas City, School of Medicine, Department, Kansas City, Missouri", "department": "None" }, { "first_name": "Christopher", "middle_name": "M.", "last_name": "Shaw", "name_suffix": "", "institution": "University of Missouri Kansas City, Department of Orthopaedic Surgery, Kansas City, Missouri", "department": "None" }, { "first_name": "Karen", "middle_name": "", "last_name": "Wambach", "name_suffix": "", "institution": "University of Kansas Medical Center, School of Nursing, Department, Kansas City, Kansas", "department": "None" } ], "date_submitted": "2020-02-06T12:59:33-05:00", "date_accepted": "2020-02-06T12:59:33-05:00", "date_published": "2020-08-20T18:00:11-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13553/galley/7090/download/" } ] }, { "pk": 13584, "title": "Two-Item Fall Screening Tool Identifies Older Adults at Increased Risk of Falling after Emergency Department Visit", "subtitle": null, "abstract": "Introduction:\n Few emergency department (ED)-specific fall-risk screening tools exist. The goals of this study were to externally validate Tiedemann et al’s two-item, ED-specific fall screening tool and test handgrip strength to determine their ability to predict future falls. We hypothesized that both the two-item fall screening and handgrip strength would identify older adults at increased risk of falling.\nMethods: \nA convenience sample of patients ages 65 and older presenting to a single-center academic ED were enrolled. Patients were asked screening questions and had their handgrip strength measured during their ED visit. Patients were given one point if they answered “yes” to “Are you taking six or more medications?” and two points for answering “yes” to “Have you had two or more falls in the past year?” to give a cumulative score from 0 to 3. Participants had monthly follow- ups, via postcard questionnaires, for six months after their ED visit. We performed sensitivity and specificity analyses, and used likelihood ratios and frequencies to assess the relationship between risk factors and falls, fall-related injury, and death.\nResults: \nIn this study, 247 participants were enrolled with 143 participants completing follow-up (58%). During the six-month follow-up period, 34% of participants had at least one fall and 30 patients died (12.1%). Fall rates for individual Tiedemann scores were 14.3%, 33.3%, 60.0% and 72.2% for scores of 0,1, 2 and 3, respectively. Low handgrip strength was associated with a higher proportion of falls (46.3%), but had poor sensitivity (52.1%).\nConclusion:\n Handgrip strength was not sensitive in screening older adults for future falls. The Tiedemann rule differentiated older adults who were at high risk for future falls from low risk individuals, and can be considered by EDs wanting to screen older adults for future fall risk.", "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": "Falls, Geriatrics, Fall Risk Screening" } ], "section": "Geriatrics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6wc4617n", "frozenauthors": [ { "first_name": "Christopher", "middle_name": "J.", "last_name": "Solie", "name_suffix": "", "institution": "University of Iowa Hospitals and Clinics, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Morgan", "middle_name": "B.", "last_name": "Swanson", "name_suffix": "", "institution": "University of Iowa Hospitals and Clinics, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Kari", "middle_name": "", "last_name": "Harland", "name_suffix": "", "institution": "University of Iowa Hospitals and Clinics, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Blum", "name_suffix": "", "institution": "University of Iowa Hospitals and Clinics, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Kevin", "middle_name": "", "last_name": "Kin", "name_suffix": "", "institution": "University of Iowa Hospitals and Clinics, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Nicholas", "middle_name": "", "last_name": "Mohr", "name_suffix": "", "institution": "University of Iowa Hospitals and Clinics, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" } ], "date_submitted": "2020-02-17T13:53:34-05:00", "date_accepted": "2020-02-17T13:53:34-05:00", "date_published": "2020-08-20T17:53:56-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13584/galley/7105/download/" } ] }, { "pk": 13502, "title": "Feasibility of Health Literacy Tools for Older Patients in the Emergency Department", "subtitle": null, "abstract": "Introduction: \nThis study evaluates the feasibility of using a volunteer research associate (RA) to administer two separate health literacy assessment tools in the emergency department (ED), specifically in an older population of patients. The outcomes measured were administration time and interruptions.\nMethods:\n Using a prospective, cross-sectional study with a convenience sample, adult patients over the age of 55 presenting between June–August 2018 to one urban, academic ED were evaluated by a volunteer RA using either the Newest Vital Sign (NVS) or the Short Assessment of Health Literacy (SAHL). All patients 55 years of age or older who consented to participate were included. We excluded from this study the following: patients with dementia or other disability involving reading, speech, or cognitive function, as noted in their medical record or by their attending physician; prisoners; and those subjectively deemed in extremis or too ill to participate by their attending physician.\nResults: \nHealth literacy was assessed in 202 patients using either the NVS or SAHL. Mean time of administration was 214.0 seconds for the NVS, and 206.8 for the SAHL. The maximum time of administration for the NVS was 563 seconds, compared to 607 seconds for the SAHL. We found that 95.2% of NVS and 93.9% of SAHL tests incurred no interruptions during administration.\nConclusion:\n No significant difference was found between the length of time needed to administer the NVS or SAHL to older patients in the ED. Both tools averaged an administration time of around three to four minutes, and neither incurred regular interruptions to its administration by a volunteer RA. Further study is needed to assess validity of these tools in an ED setting.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Health Literacy" }, { "word": "emergency department" }, { "word": "Newest Vital Sign" }, { "word": "SAHL" } ], "section": "Geriatrics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3wm2z2mj", "frozenauthors": [ { "first_name": "Matthew", "middle_name": "J.", "last_name": "McGuinness", "name_suffix": "", "institution": "Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey", "department": "None" }, { "first_name": "Joshua", "middle_name": "", "last_name": "Bucher", "name_suffix": "", "institution": "Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, New Jersey", "department": "None" }, { "first_name": "James", "middle_name": "", "last_name": "Karz", "name_suffix": "", "institution": "Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, New Jersey", "department": "None" }, { "first_name": "Carla", "middle_name": "", "last_name": "Pardee", "name_suffix": "", "institution": "Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, New Jersey", "department": "None" }, { "first_name": "Laryssa", "middle_name": "", "last_name": "Patti", "name_suffix": "", "institution": "Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, New Jersey", "department": "None" }, { "first_name": "Pamela", "middle_name": "", "last_name": "Ohman-Strickland", "name_suffix": "", "institution": "Rutgers School of Public Health, Piscataway, New Jersey", "department": "None" }, { "first_name": "Jonathan", "middle_name": "V.", "last_name": "McCoy", "name_suffix": "", "institution": "Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, New Jersey", "department": "None" } ], "date_submitted": "2020-01-18T16:20:18-05:00", "date_accepted": "2020-01-18T16:20:18-05:00", "date_published": "2020-08-20T17:50:13-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13502/galley/7075/download/" } ] }, { "pk": 13543, "title": "Age-adjusted and Expanded Lactate Thresholds as Predictors of All-Cause Mortality in the Emergency Department", "subtitle": null, "abstract": "Introduction:\n While numerous studies have found emergency department (ED) lactate levels to be associated with increased in-hospital mortality, little information is available on the role age plays in this association. This study investigates whether age is a necessary variable to consider when using lactate levels as a marker of prognosis and a guide for management decisions in the ED.\nMethods:\n This was a retrospective cohort study in an urban, tertiary-care teaching hospital. A total of 13,506 lactate levels were obtained over a 4.5-year period. All adult patients who had a lactate level obtained by the treating provider in the ED were screened for inclusion. The main outcome measure was in-hospital mortality using age-adjusted cohorts and expanded lactate thresholds with secondary outcomes comparing mortality based on the primary clinical impression.\nResults:\n Of the 8796 patients in this analysis, there were 474 (5.4%) deaths. Mortality rates increased with both increasing lactate levels and increasing age. For all ages, mortality rates increased from 2.8% in the less than 2.0 millimoles per liter (mmol/L) lactate level, to 5.6% in the 2.0-2.9 mmol/L lactate level, to 8.0% in the 3.0-3.9 mmol/L lactate level, to 13.9% in the 4.0-4.9 mmol/L lactate level, to 13.7% in the 5.0-5.9 mmol/L lactate level, and to 39.1% in the 6.0 mmol/L or greater lactate level (p <0.0001). Survivors, regardless of age, had a mean lactate level <2.0 whereas non-survivors had mean lactate levels of 6.5, 4.5, and 3.7 mmol/L for age cohorts 18-39, 40-64, and ≥ 65 years, respectively.\nConclusion:\n Our findings suggest that although lactate levels can be used as a prognostic tool to risk stratify ED patients, the traditional lactate level thresholds may need to be adjusted to account for varying risk based on age and clinical impressions.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Health Outcomes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7m52m7nn", "frozenauthors": [ { "first_name": "Chad", "middle_name": "M.", "last_name": "Cannon", "name_suffix": "", "institution": "University of Kansas Medical Center, Department of Emergency Medicine, Kansas City, Kansas", "department": "None" }, { "first_name": "Ross", "middle_name": "T.", "last_name": "Miller", "name_suffix": "", "institution": "University of Kansas Medical Center, Department of Emergency Medicine, Kansas City, Kansas", "department": "None" }, { "first_name": "Krista", "middle_name": "L.", "last_name": "Grow", "name_suffix": "", "institution": "University of Kansas Medical Center, Department of Emergency Medicine, Kansas City, Kansas", "department": "None" }, { "first_name": "Seth", "middle_name": "", "last_name": "Purcell", "name_suffix": "", "institution": "University of Kansas Medical Center, Department of Emergency Medicine, Kansas City, Kansas", "department": "None" }, { "first_name": "Niaman", "middle_name": "", "last_name": "Nazir", "name_suffix": "", "institution": "University of Kansas Medical Center, Department of Preventative Medicine and Public Health, Kansas City, Kansas", "department": "None" } ], "date_submitted": "2020-02-03T20:18:55-05:00", "date_accepted": "2020-02-03T20:18:55-05:00", "date_published": "2020-08-20T17:38:51-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13543/galley/7088/download/" } ] }, { "pk": 13573, "title": "Counseling on Access to Lethal Means-Emergency Department (CALM-ED): A Quality Improvement Program for Firearm Injury Prevention", "subtitle": null, "abstract": "Introduction: \nSuicide is the 10th leading cause of death in the United States, with firearms reported as the cause of death in up to 50% of these cases. Our goal was to evaluate the feasibility of the Counseling on Access to Lethal Means intervention in the Emergency Department (CALM-ED) by non-physician personnel.\nMethods:\n We conducted this single-center, prospective, quality improvement study (QI) in an urban, academic ED with over 90,000 annual patient visits. The study looked at adult patients who were discharged after presenting to the ED with suicidal crisis. Assessment of access to lethal means was conducted at the bedside, followed by a counseling session regarding safe storage of lethal means and follow-up via telephone call 48-72 hours after ED discharge. We collected data on patient’s sociodemographics, psychiatric history, access to lethal means, lethal means storage methods, the patient’s specific plans for lethal means storage after discharge, and post-discharge follow-up care.\nResults: \nOf 215 eligible patients, 166 voluntarily agreed to participate in CALM-ED, of whom 84 (51%) reported access to lethal means. Following the intervention, 75% of patients described a specific storage plan for their lethal means. Patients with and without access to firearms were equally likely to participate in the follow-up telephone call.\nConclusion:\n An ED-based CALM QI intervention is feasible for implementation by non-physician personnel and is well received by patients and families. This intervention has the potential to help saves lives at times of suicide crisis.", "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": "Suicide Prevention" }, { "word": "risk assessment" }, { "word": "firearm suicide prevention" }, { "word": "Quality Improvement" } ], "section": "Injury Prevention and Population Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/69b9m0zv", "frozenauthors": [ { "first_name": "Kristen", "middle_name": "L.", "last_name": "Mueller", "name_suffix": "", "institution": "Washington University in St. Louis School of Medicine, Department of Emergency Medicine, St. Louis, Missouri", "department": "None" }, { "first_name": "Sonya", "middle_name": "", "last_name": "Naganathan", "name_suffix": "", "institution": "Warren Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island", "department": "None" }, { "first_name": "Richard", "middle_name": "T.", "last_name": "Griffey", "name_suffix": "", "institution": "Washington University in St. Louis School of Medicine, Department of Emergency Medicine, St. Louis, Missouri", "department": "None" } ], "date_submitted": "2020-02-14T10:06:24-05:00", "date_accepted": "2020-02-14T10:06:24-05:00", "date_published": "2020-08-20T17:34:59-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13573/galley/7098/download/" } ] }, { "pk": 13494, "title": "Improving Understanding of Screening Questions for Social Risk and Social Need Among Emergency Department Patients", "subtitle": null, "abstract": "Introduction: \nWith recent healthcare policy changes, including the creation of accountable care organizations, screening for social risks such as food and housing insecurity has become increasingly common in the healthcare system. However, the wide variety of different tools used for screening makes it challenging to compare across systems. In addition, the majority of tools used to measure social risks have only been tested in primary care settings and may not be optimal for emergency department (ED) use. Therefore, the goal of this study was to create a brief social screening tool for use in EDs.\nMethods:\n We developed an initial tool using publicly available questions corresponding to the five core categories of the Centers for Medicare & Medicaid Services’ Accountable Health Communities Screening Tool. Iterative cycles of cognitive interviews with purposively sampled participants were performed using a hybrid model of think-aloud and verbal probing to understand/experience answering questions and potential comprehension challenges. After thematic saturation was reached in one cycle, the tool was changed per participant input; cycles were completed until thematic saturation was reached overall.\nResults: \nA total of 16 participants (six patient guardians and 10 patients) completed cognitive interviews throughout three cycles. Participant feedback included suggestions for further clarification and simplification of survey questions for improved comprehension. The survey was thus reduced and simplified from 16 questions concerning five domains to 10 questions concerning four domains.\nConclusion:\n We used an iterative cognitive interviewing process to develop a social screening tool for use in EDs. This process demonstrates the importance of patient input to refine questionnaires, and provides a brief screening tool for ED use.", "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, social determinants of health, social risk, social need" } ], "section": "Health Equity", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3hx155tn", "frozenauthors": [ { "first_name": "Gia", "middle_name": "", "last_name": "Ciccolo", "name_suffix": "", "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Alexa", "middle_name": "", "last_name": "Curt", "name_suffix": "", "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Carlos", "middle_name": "A.", "last_name": "Camargo Jr.", "name_suffix": "", "institution": "Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Margaret", "middle_name": "", "last_name": "Samuels-Kalow", "name_suffix": "", "institution": "Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" } ], "date_submitted": "2020-01-15T14:33:29-05:00", "date_accepted": "2020-01-15T14:33:29-05:00", "date_published": "2020-08-20T17:30:47-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13494/galley/7071/download/" } ] }, { "pk": 13947, "title": "COVID-19: A Driver for Disruptive Innovation of the Emergency Medicine Residency Application Process", "subtitle": null, "abstract": "Recommendations from the Council of Residency Directors Application Process Improvement Committee (CORD-APIC)\nThe coronavirus disease (COVID-19) pandemic has had a significant impact on undergraduate medical education with limitation of patient care activities and disruption to medical licensing examinations. In an effort to promote both safety and equity, the emergency medicine (EM) community has recommended no away rotations for EM applicants and entirely virtual interviews during this year’s residency application cycle. These changes affect the components of the EM residency application most highly regarded by program directors – Standardized Letters of Evaluation from EM rotations, board scores, and interactions during the interview. The Council of Residency Directors in Emergency Medicine Application Process Improvement Committee suggests solutions not only for the upcoming year but also to address longstanding difficulties within the process, encouraging residency programs to leverage these challenges as an opportunity for disruptive innovation.", "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": "residency application, interviews, away rotations, COVID-19" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/687977vr", "frozenauthors": [ { "first_name": "Alexis", "middle_name": "", "last_name": "Pelletier-Bui", "name_suffix": "", "institution": "Cooper Medical School of Rowan University, Department of Emergency Medicine, Camden, New Jersey", "department": "None" }, { "first_name": "Doug", "middle_name": "", "last_name": "Franzen", "name_suffix": "", "institution": "University of Washington School of Medicine, Department of Emergency Medicine, Seattle, Washington", "department": "None" }, { "first_name": "Liza", "middle_name": "", "last_name": "Smith", "name_suffix": "", "institution": "University of Massachusetts Medical School Baystate Health, Department of Emergency Medicine, Springfield, Massachusetts", "department": "None" }, { "first_name": "Laura", "middle_name": "", "last_name": "Hopson", "name_suffix": "", "institution": "University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan", "department": "None" }, { "first_name": "Lucienne", "middle_name": "", "last_name": "Lutfy-Clayton", "name_suffix": "", "institution": "University of Massachusetts Medical School Baystate Health, Department of Emergency Medicine, Springfield, Massachusetts", "department": "None" }, { "first_name": "Kendra", "middle_name": "", "last_name": "Parekh", "name_suffix": "", "institution": "Vanderbilt University School of Medicine, Department of Emergency Medicine, Nashville, Tennessee", "department": "None" }, { "first_name": "Mark", "middle_name": "", "last_name": "Olaf", "name_suffix": "", "institution": "Geisinger Commonwealth School of Medicine, Department of Emergency Medicine, Scranton, Pennsylvania", "department": "None" }, { "first_name": "Tom", "middle_name": "", "last_name": "Morrissey", "name_suffix": "", "institution": "University of Florida College of Medicine-Jacksonville, Department of Emergency Medicine, Jacksonville, Florida", "department": "None" }, { "first_name": "David", "middle_name": "", "last_name": "Gordon", "name_suffix": "", "institution": "Duke University, Division of Emergency Medicine, Durham, North Carolina", "department": "None" }, { "first_name": "Erin", "middle_name": "", "last_name": "McDonough", "name_suffix": "", "institution": "University of Cincinnati College of Medicine, Department of Emergency Medicine, Cincinnati, Ohio", "department": "None" }, { "first_name": "Benjamin", "middle_name": "", "last_name": "Schnapp", "name_suffix": "", "institution": "University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin", "department": "None" }, { "first_name": "Mary Ann", "middle_name": "", "last_name": "Edens", "name_suffix": "", "institution": "Louisiana State University Health Shreveport, Department of Emergency Medicine, Shreveport, Louisiana", "department": "None" }, { "first_name": "Michael", "middle_name": "", "last_name": "Kiemeney", "name_suffix": "", "institution": "Loma Linda University School of Medicine, Department of Emergency Medicine, Loma Linda, California", "department": "None" } ], "date_submitted": "2020-05-20T10:51:58-05:00", "date_accepted": "2020-05-20T10:51:58-05:00", "date_published": "2020-08-19T18:59:50-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13947/galley/7246/download/" } ] }, { "pk": 13941, "title": "Development and Usability Testing of a Web-based COVID-19 Self-triage Platform", "subtitle": null, "abstract": "Introduction:\n The development and deployment of a web-based, self-triage tool for severe respiratory syndrome coronavirus 2 (COVID-19 disease) aimed at preventing surges in healthcare utilization could provide easily understandable health guidance with the goal of mitigating unnecessary emergency department (ED) and healthcare visits. We describe the iterative development and usability testing of such a tool. We hypothesized that adult users could understand and recall the recommendations provided by a COVID-19 web-based, self-triage tool.\nMethods:\n We convened a multidisciplinary panel of medical experts at two academic medical schools in an iterative redesign process of a previously validated web-based, epidemic screening tool for the current COVID-19 pandemic. We then conducted a cross-sectional usability study over a 24-hour period among faculty, staff, and students at the two participating universities. Participants were randomly assigned a pre-written health script to enter into the self-triage website for testing. The primary outcome was immediate recall of website recommendations. Secondary outcomes included usability measures. We stratified outcomes by demographic characteristics.\nResults:\n A final sample of 877 participants (mean age, 32 years [range, 19-84 years]; 65.3% female) was used in the analysis. We found that 79.4% of the participants accurately recalled the recommendations provided by the website. Almost all participants (96.9%) found the website easy to use and navigate.\nConclusion:\n Adult users of a COVID-19 self-triage website, recruited from an academic setting, were able to successfully recall self-care instructions from the website and found it user-friendly. This website appears to be a feasible way to provide evidence-based health guidance to adult patients during a pandemic. Website guidance could be used to reduce unnecessary ED and healthcare visits.", "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": "Disaster Medicine" }, { "word": "COVID 19" }, { "word": "self triage" }, { "word": "surge mitigation" }, { "word": "self assessment" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5495v8w1", "frozenauthors": [ { "first_name": "Justin", "middle_name": "D.", "last_name": "Schrager", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Keke", "middle_name": "", "last_name": "Schuler", "name_suffix": "", "institution": "National Center for Disaster Medicine and Public Health, Department, Bethesda, Maryland", "department": "None" }, { "first_name": "Alexander", "middle_name": "P.", "last_name": "Isakov", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "David", "middle_name": "W.", "last_name": "Wright", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Anna", "middle_name": "Q.", "last_name": "Yaffee", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Kara", "middle_name": "L.", "last_name": "Jacobson", "name_suffix": "", "institution": "Rollins School of Public Health, Department of Health Policy and Management, Atlanta, Georgia", "department": "None" }, { "first_name": "Ruth", "middle_name": "M.", "last_name": "Parker", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Craig", "middle_name": "", "last_name": "Goolsby", "name_suffix": "", "institution": "Uniformed Services University of the Health Sciences, Department of Military and Emergency Medicine, Bethesda, Maryland", "department": "None" } ], "date_submitted": "2020-05-15T08:42:10-05:00", "date_accepted": "2020-05-15T08:42:10-05:00", "date_published": "2020-08-19T18:55:12-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13941/galley/7245/download/" } ] }, { "pk": 14070, "title": "Barrier Enclosure for Endotracheal Intubation in a Simulated COVID-19 Scenario: A Crossover Study", "subtitle": null, "abstract": "Introduction:\n Barrier enclosures have been developed to reduce the risk of COVID-19 transmission to healthcare providers during intubation, but little is known about their impact on procedure performance. We sought to determine whether a barrier enclosure delays time to successful intubation by experienced airway operators.\nMethods:\n We conducted a crossover simulation study at a tertiary academic hospital. Participants watched a four-minute video, practiced one simulated intubation with a barrier enclosure, and then completed one intubation with and one without the barrier enclosure (randomized to determine order). The primary outcome measure was time from placement of the video laryngoscope at the lips to first delivered ventilation. Secondary outcomes were periprocedural complications and participant responses to a post-study survey.\nResults:\n Proceduralists (n = 50) from emergency medicine and anesthesiology had median intubation times of 23.6 seconds with practice barrier enclosure, 20.5 seconds with barrier enclosure, and 16.7 seconds with no barrier. Intubation with barrier enclosure averaged 4.5 seconds longer (95% confidence interval, 2.7-6.4, p < .001) than without, but was less than the predetermined clinical significance threshold of 10 seconds. Three complications occurred, all during the practice intubation. Barrier enclosure made intubation more challenging according to 48%, but 90% indicated they would consider using it in clinical practice.\nConclusion:\n Experienced airway operators performed intubation using a barrier enclosure with minimal increased time to procedure completion in this uncomplicated airway model. Given potential to reduce droplet spread, use of a barrier enclosure may be an acceptable adjunct to endotracheal intubation for those familiar with its use.", "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": "Barrier Enclosure" }, { "word": "COVID-19" }, { "word": "Simulation" }, { "word": "endotracheal intubation" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7cp821wt", "frozenauthors": [ { "first_name": "Torrey", "middle_name": "A", "last_name": "Laack", "name_suffix": "", "institution": "Mayo Medical School", "department": "None" }, { "first_name": "Franziska", "middle_name": "", "last_name": "Pollok", "name_suffix": "", "institution": "Mayo Clinic, Mayo Clinic Multidisciplinary Simulation Center, Rochester, Minnesota", "department": "None" }, { "first_name": "Benjamin", "middle_name": "J.", "last_name": "Sandefur", "name_suffix": "", "institution": "Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota", "department": "None" }, { "first_name": "Aidan", "middle_name": "F.", "last_name": "Mullan", "name_suffix": "", "institution": "Mayo Clinic, Division of Biomedical Statistics and Informatics, Rochester, Minnesota", "department": "None" }, { "first_name": "Christopher", "middle_name": "S.", "last_name": "Russi", "name_suffix": "", "institution": "Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota", "department": "None" }, { "first_name": "Suraj", "middle_name": "M.", "last_name": "Yalamuri", "name_suffix": "", "institution": "Mayo Clinic, Department of Anesthesiology, Rochester, Minnesota", "department": "None" } ], "date_submitted": "2020-06-05T08:04:21-05:00", "date_accepted": "2020-06-05T08:04:21-05:00", "date_published": "2020-08-17T16:54:13-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14070/galley/7294/download/" } ] }, { "pk": 14129, "title": "The Impact of COVID-19 on Healthcare Worker Wellness: A Scoping Review", "subtitle": null, "abstract": "At the heart of the unparalleled crisis of COVID-19, healthcare workers (HCWs) face several challenges treating patients with COVID-19: reducing the spread of infection; developing suitable short-term strategies; and formulating long-term plans. The psychological burden and overall wellness of HCWs has received heightened awareness in news and research publications. The purpose of this study was to provide a review on current publications measuring the effects of COVID-19 on wellness of healthcare providers to inform interventional strategies. Between April 6–May 17, 2020, we conducted systematic searches using combinations of these keywords and synonyms in conjunction with the controlled vocabulary of the database: “physician,” “wellness, “wellbeing,” “stress,” “burnout,” “COVID-19,” and “SARS-CoV-2.” We excluded articles without original data, research studies regarding the wellness of non-healthcare occupations or the general public exclusively, other outbreaks, or wellness as an epidemic. A total of 37 studies were included in this review. The review of literature revealed consistent reports of stress, anxiety, and depressive symptoms in HCWs as a result of COVID-19. We describe published data on HCW distress and burnout but urge future research on strategies to enhance HCW well-being.", "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": "Wellness" }, { "word": "healthcare" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/11w7372f", "frozenauthors": [ { "first_name": "Jacob", "middle_name": "", "last_name": "Shreffler", "name_suffix": "", "institution": "University of Louisville, Department of Emergency Medicine, Louisville, Kentucky", "department": "None" }, { "first_name": "Jessica", "middle_name": "", "last_name": "Petrey", "name_suffix": "", "institution": "University of Louisville, Kornhauser Library, Louisville, Kentucky", "department": "None" }, { "first_name": "Martin", "middle_name": "", "last_name": "Huecker", "name_suffix": "", "institution": "University of Louisville, Department of Emergency Medicine, Louisville, Kentucky", "department": "None" } ], "date_submitted": "2020-06-12T11:42:37-05:00", "date_accepted": "2020-06-12T11:42:37-05:00", "date_published": "2020-08-17T16:49:11-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14129/galley/7312/download/" } ] }, { "pk": 14162, "title": "Homeless Shelter Characteristics and Prevalence of SARS-CoV-2", "subtitle": null, "abstract": "Introduction:\n The unfolding COVID-19 pandemic has predictably followed the familiar contours of well established socioeconomic health inequities, exposing and often amplifying preexisting disparities. People living in homeless shelters are at higher risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared to the general population. The purpose of this study was to identify shelter characteristics that may be associated with higher transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).\nMethods: \nWe conducted a cross-sectional assessment of five congregate shelters in Rhode Island. Shelter residents 18 years old and older were tested for SARS-CoV-2 from April 19–April 24, 2020. At time of testing, we collected participant characteristics, symptomatology, and vital signs. Shelter characteristics and infection control strategies were collected through a structured phone questionnaire with shelter administrators.\nResults:\n A total of 299 shelter residents (99%, 299/302) participated. Thirty-five (11.7%) tested positive for SARS-CoV-2. Shelter-level prevalence ranged from zero to 35%. Symptom prevalence did not vary by test result. Shelters with positive cases of SARS-CoV-2 were in more densely populated areas, had more transient resident populations, and instituted fewer physical distancing practices compared to shelters with no cases.\nConclusion:\n SARS-CoV-2 prevalence varies with shelter characteristics but not individual symptoms. Policies that promote resident stability and physical distancing may help reduce SARS-CoV-2 transmission. Symptom screening alone is insufficient to prevent SARS-CoV-2 transmission. Frequent universal testing and congregate housing alternatives that promote stability may help reduce spread of infection.", "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, homelessness" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0rg9c977", "frozenauthors": [ { "first_name": "Rebecca", "middle_name": "", "last_name": "Karb", "name_suffix": "", "institution": "Alpert School of Medicine of Brown University, Department of Emergency Medicine, Providence, Rhode Island", "department": "None" }, { "first_name": "Elizabeth", "middle_name": "", "last_name": "Samuels", "name_suffix": "", "institution": "Alpert School of Medicine of Brown University, Department of Emergency Medicine, Providence, Rhode Island", "department": "None" }, { "first_name": "Rahul", "middle_name": "", "last_name": "Vanjani", "name_suffix": "", "institution": "Alpert School of Medicine of Brown University, Department of Internal Medicine, Providence, Rhode Island", "department": "None" }, { "first_name": "Catherine", "middle_name": "", "last_name": "Trimbur", "name_suffix": "", "institution": "Alpert School of Medicine of Brown University, Department of Internal Medicine, Providence, Rhode Island", "department": "None" }, { "first_name": "Anthony", "middle_name": "", "last_name": "Napoli", "name_suffix": "", "institution": "Alpert School of Medicine of Brown University, Department of Emergency Medicine, Providence, Rhode Island", "department": "None" } ], "date_submitted": "2020-06-15T02:36:29-05:00", "date_accepted": "2020-06-15T02:36:29-05:00", "date_published": "2020-08-17T16:29:47-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14162/galley/7322/download/" } ] }, { "pk": 14217, "title": "Diagnostic and Prognostic Value of Chest Radiographs for COVID-19 at Presentation", "subtitle": null, "abstract": "Introduction:\n Pulmonary opacities in COVID-19 increase throughout the illness and peak after ten days. The radiological literature mainly focuses on CT findings. The purpose of this study was to assess the diagnostic and prognostic value of chest radiographs (CXR) for coronavirus disease 2019 (COVID-19) at presentation.\nMethods:\n We retrospectively identified consecutive reverse transcription polymerase reaction-confirmed COVID-19 patients (n = 104, 75% men) and patients (n = 75, 51% men) with repeated negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests. Two radiologists blindly and independently reviewed the CXRs, documented findings, assigned radiographic assessment of lung edema (RALE) scores, and predicted the patients’ COVID-19 status. We calculated interobserver reliability. The score use for diagnosis and prognosis of COVID-19 was evaluated with the area under the receiver operating characteristic curve.\nResults:\n The overall RALE score failed to identify COVID-19 patients at presentation. However, the score was inversely correlated with a COVID-19 diagnosis within ≤2 days, and a positive correlation was found six days after symptom onset.Interobserver agreement with regard to separating normal from abnormal CXRs was moderate (k = 0.408) with low specificity (25% and 27%). Definite pleural effusion had almost perfect agreement (k = 0.833) and substantially reduced the odds of a COVID-19 diagnosis. Disease distribution and experts’ opinion on COVID-19 status had only fair interobserver agreement. The RALE score interobserver reliability was moderate to good (intraclass correlation coefficient = 0.745). A high RALE score predicted a poor outcome (intensive care unit hospitalization, intubation, or death) in COVID-19 patients; a score of ≥5 substantially increased the odds of having a poor outcome.\nConclusion: \nChest radiography was found not to be a valid diagnostic tool for COVID-19, as normal or near-normal CXRs are more likely early in the disease course. Pleural effusions at presentation suggest a diagnosis other than COVID-19. More extensive lung opacities at presentation are associated with poor outcome in COVID-19 patients. Thus, patients with more than minimal opacities should be monitored closely for clinical deterioration. This clinical application of CXR is its greatest strength in COVID-19 as it impacts patient 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": "COVID-19" }, { "word": "SARS-CoV-2" }, { "word": "Chest radiograph" }, { "word": "CXR" }, { "word": "Diagnostic tests" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/20s5v5k7", "frozenauthors": [ { "first_name": "Ariel", "middle_name": "", "last_name": "Kerpel", "name_suffix": "", "institution": "Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel", "department": "None" }, { "first_name": "Sara", "middle_name": "", "last_name": "Apter", "name_suffix": "", "institution": "Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel", "department": "None" }, { "first_name": "Noam", "middle_name": "", "last_name": "Nissan", "name_suffix": "", "institution": "Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel", "department": "None" }, { "first_name": "Esther", "middle_name": "", "last_name": "Houri-Levi", "name_suffix": "", "institution": "Department of Medicine ‘B’, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel", "department": "None" }, { "first_name": "Maximiliano", "middle_name": "", "last_name": "Klug", "name_suffix": "", "institution": "Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel", "department": "None" }, { "first_name": "Sharon", "middle_name": "", "last_name": "Amit", "name_suffix": "", "institution": "Clinical Microbiology, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel", "department": "None" }, { "first_name": "Eli", "middle_name": "", "last_name": "Konen", "name_suffix": "", "institution": "Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel", "department": "None" }, { "first_name": "Edith", "middle_name": "M.", "last_name": "Marom", "name_suffix": "", "institution": "Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel", "department": "None" } ], "date_submitted": "2020-06-24T12:05:45-05:00", "date_accepted": "2020-06-24T12:05:45-05:00", "date_published": "2020-08-17T16:25:06-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14217/galley/7337/download/" } ] }, { "pk": 14232, "title": "United States Congressional COVID-19 Legislation: Recent Laws and Future Topics", "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": "health policy, health law, Congress, COVID-19, coronavirus" } ], "section": "Health Policy Analysis", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/748005vg", "frozenauthors": [ { "first_name": "Marisa", "middle_name": "K.", "last_name": "Dowling", "name_suffix": "", "institution": "George Washington University Medical Faculty Associates, Department of Emergency Medicine, Washington, District of Columbia", "department": "None" }, { "first_name": "Aisha", "middle_name": "T.", "last_name": "Terry", "name_suffix": "", "institution": "George Washington University Medical Faculty Associates, Department of Emergency Medicine, Washington, District of Columbia", "department": "None" }, { "first_name": "Natalie", "middle_name": "L.", "last_name": "Kirilichin", "name_suffix": "", "institution": "George Washington University Medical Faculty Associates, Department of Emergency Medicine, Washington, District of Columbia", "department": "None" }, { "first_name": "Jennifer", "middle_name": "S.", "last_name": "Lee", "name_suffix": "", "institution": "George Washington University Medical Faculty Associates, Department of Emergency Medicine, Washington, District of Columbia", "department": "None" }, { "first_name": "Janice", "middle_name": "C.", "last_name": "Blanchard", "name_suffix": "", "institution": "George Washington University Medical Faculty Associates, Department of Emergency Medicine, Washington, District of Columbia", "department": "None" } ], "date_submitted": "2020-06-26T22:34:04-05:00", "date_accepted": "2020-06-26T22:34:04-05:00", "date_published": "2020-08-17T16:19:57-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14232/galley/7342/download/" } ] }, { "pk": 13692, "title": "MIST (Modified Intubating Sequence for Transmissibility) Bundle for Infectious Diseases with Aerosol Hazard", "subtitle": null, "abstract": "The current global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has magnified the risk to healthcare providers when inititiating airway management, and safe tracheal intubation has become of paramount importance. Mitigation of risk to frontline providers requires airway management to be an orchestrated exercise based on training and purposeful simulation. Role allocation and closed-loop communication form the foundation of this exercise. We describe a methodical, 10-step approach from decision-making and meticulous drug and equipment choices to donning of personal protective equipment, and procedural concerns. This bundled approach will help reduce unplanned actions, which in turn may reduce the risk of aerosol transmission during airway management in resource-limited settings.", "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": "Airway Management" }, { "word": "Resource limited setting" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0g21h3dn", "frozenauthors": [ { "first_name": "Jayaraj", "middle_name": "M.", "last_name": "Balakrishnan", "name_suffix": "", "institution": "Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India", "department": "None" }, { "first_name": "Sanjan", "middle_name": "", "last_name": "Asanaru Kunju", "name_suffix": "", "institution": "Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India", "department": "None" }, { "first_name": "William", "middle_name": "", "last_name": "Wilson", "name_suffix": "", "institution": "Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India", "department": "None" }, { "first_name": "Sachin", "middle_name": "", "last_name": "Nayak Sujir", "name_suffix": "", "institution": "Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India", "department": "None" }, { "first_name": "Rachana", "middle_name": "", "last_name": "Bhat", "name_suffix": "", "institution": "Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India", "department": "None" }, { "first_name": "K.E.", "middle_name": "", "last_name": "Vandana", "name_suffix": "", "institution": "Department of Microbiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India", "department": "None" } ], "date_submitted": "2020-03-29T05:10:45-05:00", "date_accepted": "2020-03-29T05:10:45-05:00", "date_published": "2020-08-17T16:16:13-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13692/galley/7151/download/" } ] }, { "pk": 14107, "title": "Point-of-Care Ultrasound for Intubation Confirmation of COVID-19 Patients", "subtitle": null, "abstract": "The novel coronavirus disease of 2019 (COVID-19) is associated with significant morbidity and mortality, as well as large numbers of patients requiring endotracheal intubation. While much of the literature has focused on the intubation technique, there is scant discussion of intubation confirmation. Herein, we discuss the limitations of traditional confirmatory approaches, summarize the literature supporting a role for point-of-care ultrasound in this application, and propose an algorithm for intubation confirmation among COVID-19 patients.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "intubation" }, { "word": "ultrasound" }, { "word": "POCUS" }, { "word": "COVID" } ], "section": "Technology in Emergency Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/91m0k0gr", "frozenauthors": [ { "first_name": "Michael", "middle_name": "", "last_name": "Gottlieb", "name_suffix": "", "institution": "Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois", "department": "None" }, { "first_name": "Stephen", "middle_name": "", "last_name": "Alerhand", "name_suffix": "", "institution": "Rutgers New Jersey Medical School, Department of Emergency Medicine, Newark, New Jersey", "department": "None" }, { "first_name": "Brit", "middle_name": "", "last_name": "Long", "name_suffix": "", "institution": "Brooke Army Medical Center, Department of Emergency Medicine, San Antonio, Texas", "department": "None" } ], "date_submitted": "2020-06-10T15:58:10-05:00", "date_accepted": "2020-06-10T15:58:10-05:00", "date_published": "2020-08-17T16:09:47-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14107/galley/7307/download/" } ] }, { "pk": 14057, "title": "Streamlining Care in Crisis: Rapid Creation and Implementation of a Digital Support Tool for COVID-19", "subtitle": null, "abstract": "The unprecedented COVID-19 pandemic has resulted in rapidly evolving best practices for transmission reduction, diagnosis, and treatment. A regular influx of new information has upended traditionally static hospital protocols, adding additional stress and potential for error to an already overextended system. To help equip frontline emergency clinicians with up-to-date protocols throughout the evolving COVID-19 crisis, our team set out to create a dynamic digital tool that centralized and standardized resources from a broad range of platforms across our hospital. Using a design thinking approach, we rapidly built, tested, and deployed a solution using simple, out-of-the-box web technology that enables clinicians to access the specific information they seek within moments. This platform has been rapidly adopted throughout the emergency department, with up to 70% of clinicians using the digital tool on any given shift and 78.6% of users reporting that they “agree” or “strongly agree” that the platform has affected their management of COVID-19 patients. The tool has also proven easily adaptable, with multiple protocols being updated nearly 20 times over two months without issue. This paper describes our development process, challenges, and results to enable other institutions to replicate this process to ensure consistent, high-quality care for patients as the COVID-19 pandemic continues its unpredictable course.", "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, Medicine, Emergency Management, Information Technology" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0vj3s17g", "frozenauthors": [ { "first_name": "Nicholas", "middle_name": "", "last_name": "Stark", "name_suffix": "", "institution": "University of California San Francisco, Department of Emergency Medicine, San Francisco, California", "department": "None" }, { "first_name": "Michaela", "middle_name": "", "last_name": "Kerrissey", "name_suffix": "", "institution": "Harvard School of Public Health, Department of Health Policy and Management, Boston, Massachusetts", "department": "None" }, { "first_name": "Madeline", "middle_name": "", "last_name": "Grade", "name_suffix": "", "institution": "University of California San Francisco, Department of Emergency Medicine, San Francisco, California", "department": "None" }, { "first_name": "Beth", "middle_name": "", "last_name": "Berrean", "name_suffix": "", "institution": "University of California San Francisco, School of Medicine Tech Division, San Francisco, California", "department": "None" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Peabody", "name_suffix": "", "institution": "University of California San Francisco, Department of Emergency Medicine, San Francisco, California", "department": "None" } ], "date_submitted": "2020-06-08T10:16:33-05:00", "date_accepted": "2020-06-08T10:16:33-05:00", "date_published": "2020-08-17T16:05:57-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/14057/galley/7291/download/" } ] }, { "pk": 13830, "title": "Impact of Social Distancing on Individuals Who Use Drugs: Considerations for Emergency Department Providers", "subtitle": null, "abstract": "The isolation that comes from social distancing during the COVID-19 pandemic can be particularly detrimental to the United States’ population of people who use drugs. People with substance use disorders may be at risk for return to use, exacerbation of existing mental health disorders, and risky drug practices. In this commentary, we review the risk to people who use drugs and how emergency department providers can best support these individuals during the unprecedented time of social distancing.", "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": "social distancing, COVID-19, harm reduction" } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6c34486s", "frozenauthors": [ { "first_name": "Kathy", "middle_name": "T.", "last_name": "LeSaint", "name_suffix": "", "institution": "University of California San Francisco, Department of Emergency Medicine, San Francisco, California\nCalifornia Poison Control System, San Francisco, California", "department": "None" }, { "first_name": "Hannah", "middle_name": "R.", "last_name": "Snyder", "name_suffix": "", "institution": "University of California San Francisco, Department of Family and Community Medicine, San Francisco, California", "department": "None" } ], "date_submitted": "2020-04-26T12:04:36-05:00", "date_accepted": "2020-04-26T12:04:36-05:00", "date_published": "2020-08-17T16:01:21-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/13830/galley/7204/download/" } ] }, { "pk": 3812, "title": "Editors’ Note", "subtitle": null, "abstract": "", "language": "en", "license": null, "keywords": [], "section": "Editorial Notes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/17z7211d", "frozenauthors": [ { "first_name": "Yanin", "middle_name": "", "last_name": "Kramsky", "name_suffix": "", "institution": "UC Berkeley", "department": "None" }, { "first_name": "Giselle", "middle_name": "", "last_name": "Mendonça Abreu", "name_suffix": "", "institution": "UC Berkeley", "department": "None" }, { "first_name": "Priscila", "middle_name": "", "last_name": "Coli", "name_suffix": "", "institution": "UC Berkeley", "department": "None" } ], "date_submitted": "2020-08-17T13:36:32-05:00", "date_accepted": "2020-08-17T13:36:32-05:00", "date_published": "2020-08-17T13:38:03-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/ucb_crp_bpj/article/3812/galley/2471/download/" } ] }, { "pk": 2291, "title": "L2 Multimodal Composing Abroad: Remixing Languages, Cultures, and Identities", "subtitle": null, "abstract": "This paper explores the second language, digital multimodal composing practices of 12 American undergraduates studying French abroad in Paris. Drawing on multiliteracies, multimodality, and translanguaging frameworks, this study utilizes a qualitative lens and multimodal composing timescapes to analyze how students leveraged languages and modes across 72 digital multimodal reflections and vlogs. Findings demonstrate how reflective multimodal composing developed multilingual identities by fostering metalinguistic awareness and goal-setting practices. Through their vlogs, students additionally participated in transcultural repositioning by making cross-cultural connections and sharing emotional experiences. Throughout the term students increased in traversals of modes, languages, spaces, and places as they became more comfortable with the French language, living in France, and multimodal composing. These results illustrate how digital multimodal composing can enhance learners’ linguistic and intercultural competencies while studying abroad. The article concludes with implications for multimodal composing to learn languages and calls for further research on the reflective multimodal composing practices of second language learners.", "language": "fr", "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.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\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-nc-nd/4.0" }, "keywords": [ { "word": "Multimodal Composing" }, { "word": "multiliteracies" }, { "word": "Translanguaging" }, { "word": "Study abroad" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4qh4p8t3", "frozenauthors": [ { "first_name": "Natalie", "middle_name": "", "last_name": "Amgott", "name_suffix": "", "institution": "University of Arizona", "department": "None" } ], "date_submitted": "2020-02-22T20:42:40-05:00", "date_accepted": "2020-02-22T20:42:40-05:00", "date_published": "2020-08-15T16:18:22-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/l2/article/2291/galley/1436/download/" } ] }, { "pk": 2279, "title": "Developing Performative Competence and Teacher Artistry: A Pedagogical Imperative in the Multicultural Classroom", "subtitle": null, "abstract": "Teaching performatively is an art that must be honed and developed through sustained practice. In this paper, I explore the theoretical considerations of a \nperformative-humanistic\n \napproach to second language acquisition and the practical applications for a performance-based pedagogy, which is meant to offer readers an occasion to reflect on what it means to prepare students to become reflective and critical performers on the world stage. Particular attention is placed on the unique roles teachers play, and the responsibilities inherent in those roles. The paper is also an invitation to revisit existing approaches and practices through a performative lens engaging in a dynamic interdisciplinary dialogue, reflecting on the aesthetic dimension of language learning, and exploring the potential of the theatrical experience in the construction of a Self able to represent, perceive, create, and reflect.", "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.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\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-nc-nd/4.0" }, "keywords": [ { "word": "performative competence" }, { "word": "aesthetic dimension of language" }, { "word": "drama pedagogy" }, { "word": "performative-humanistic approach to language teaching" }, { "word": "performance based pedagogy" }, { "word": "teaching the multicultural student" }, { "word": "professional development" }, { "word": "performative literacy" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1jj590zm", "frozenauthors": [ { "first_name": "Annamaria", "middle_name": "", "last_name": "Bellezza", "name_suffix": "", "institution": "UC Berkeley", "department": "None" } ], "date_submitted": "2019-12-04T18:02:46-05:00", "date_accepted": "2019-12-04T18:02:46-05:00", "date_published": "2020-08-14T20:20:59-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/l2/article/2279/galley/1432/download/" } ] }, { "pk": 3808, "title": "Urban Bites and Agrarian Bytes: Digital Agriculture and Extended Urbanization", "subtitle": null, "abstract": "Capitalist agriculture faces a crisis. Plateauing yields and profits are driving up food prices, and the ability to continue the traditional practice of expanding into new, un-commodified territories appears to be waning. This crisis is due in large part to the accelerating biophysical contradictions of industrial agriculture, which systematically undermine the ecological conditions for its own success in pursuit of profit. We investigate how digital technologies are deployed as a potential data fix that does not solve the crisis but merely staves it off. We situate these technologies within the material context of capitalist urbanization, along the way arguing for bringing information back into the neo-Lefebvrian framework of “extended” or “planetary” urbanization. Digital agriculture technologies continue the centralization of economic knowledge and power as they facilitate the transformation of vast territories into “operational landscapes” that provide the material, energy, and labor for a rapidly expanding urban system.", "language": "en", "license": null, "keywords": [ { "word": "Digital Agriculture, Precision Agriculture, Extended Urbanization, Planetary" } ], "section": "Journal Submissions", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/55r1p8g7", "frozenauthors": [ { "first_name": "Timothy", "middle_name": "", "last_name": "Ravis", "name_suffix": "", "institution": "Harvard University, Graduate School of Design", "department": "None" }, { "first_name": "Benjamin", "middle_name": "", "last_name": "Notkin", "name_suffix": "", "institution": "Harvard University, Graduate School of Design", "department": "None" } ], "date_submitted": "2019-06-10T23:02:31-05:00", "date_accepted": "2019-06-10T23:02:31-05:00", "date_published": "2020-08-14T18:21:14-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/ucb_crp_bpj/article/3808/galley/2469/download/" } ] }, { "pk": 3807, "title": "Landscape Entanglements: Toward a Descriptive Project for Planning Research", "subtitle": null, "abstract": "The conceptual dyad of urban/rural has long formed the basis of the planner’s description of space. However, the terms themselves are increasingly insufficient to describe the world in which we live, presenting as overdetermined and reductive signifiers. In this photographic essay, we use Google Earth satellite images to examine a series of locations where descriptors such as ‘urban’ and ‘rural’ falter against manifold, shifting, and unstable landscape forms. We draw on Henri Lefebvre’s concept of the abstract spaces of capitalism, globalization, and urbanization, which he argued are dialectically produced through their interaction with landscape. However, where Lefebvre contended that abstraction instantiates in more or less discrete typological forms, we argue that abstract space only becomes intelligible under conditions of ‘entanglement,’ where qualities such as ‘urban’ and ‘rural’ become momentarily comprehensible at the instant we observe or describe them. In the end, holding the world still long enough to describe it reveals crucial patterns and relations, but always at a cost, always with the risk of reduction, simplification, and overdetermination. Such pitfalls are inevitable in research; however, they become all the more prevalent as the terms we use to describe the world become less and less applicable, and as the accumulation of anomalies compels us to build new models and to tell new stories.", "language": "en", "license": null, "keywords": [ { "word": "Landscape, Entanglement, Observation, Planning Theory, Orbital Photography" } ], "section": "Journal Submissions", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2537z04j", "frozenauthors": [ { "first_name": "Joseph", "middle_name": "", "last_name": "Heathcott", "name_suffix": "", "institution": "The New School\n66 W. 12th St.\nNew York, NY 10011", "department": "None" }, { "first_name": "Kevin", "middle_name": "", "last_name": "Rogan", "name_suffix": "", "institution": "The New School\n66 W. 12th St.\nNew York, NY 10011", "department": "None" } ], "date_submitted": "2019-05-27T08:33:28-05:00", "date_accepted": "2019-05-27T08:33:28-05:00", "date_published": "2020-08-14T18:19:38-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/ucb_crp_bpj/article/3807/galley/2468/download/" } ] }, { "pk": 3803, "title": "Transformative Practices within Mechanisms of Control: “Recognizing” Unrecognized Arab-Bedouin Villages in Israel", "subtitle": null, "abstract": "“Seeing from the South” (Watson 2008) and “Re-engaging Planning Theory with South-Eastern Perspectives” (Yiftachel 2006) are essential calls for the development of planning theories and empirical research from the Global South. Such scholarship has interpreted the rationalities at play as informal settlements develop on the peripheries of rapidly globalizing cities and explored how they reflect the nature of state interventions. This article examines the utility of planning theories issued from the Global South and North in explaining a case of state planning for an indigenous, ethnic minority in Israel: the Negev/Naqab Arab-Bedouins. The researchers conducted 90 interviews with planners, engineers, Bedouin residents, government officials, academics, and employees of non-governmental organizations. Their aim was to understand how stakeholders comprehended, engaged with, and approached planning for the Abu-Basma Regional Council, a state initiative to plan and provide services to informal Bedouin villages in Israel’s south, as well as the program’s outcomes. The findings indicate that planning theories from the Global South, which are focused on space, resource distribution, and resident-driven spatial change, are essential to understanding the outcomes of planning. They provide a necessary context for the North’s normative/prescriptive planning theories, which highlight tangible “episodes” (Healey 2007, 78) of planning practice but risk misattributing popular resistance to a program’s communication challenges, rather than to residents’ fundamental objections.", "language": "en", "license": null, "keywords": [ { "word": "Participatory planning, Bedouin, Territorial control, Indigenous, Global South" } ], "section": "Journal Submissions", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1hd972s2", "frozenauthors": [ { "first_name": "Abra", "middle_name": "Sharkey", "last_name": "Berkowitz", "name_suffix": "", "institution": "Ben-Gurion University", "department": "None" }, { "first_name": "Sarab", "middle_name": "", "last_name": "Abu-Rabia-Queder", "name_suffix": "", "institution": "Ben-Gurion University", "department": "None" }, { "first_name": "Daniel", "middle_name": "E.", "last_name": "Orenstein", "name_suffix": "", "institution": "Technion: Israel Institute of Technology", "department": "None" } ], "date_submitted": "2019-03-01T00:30:49-05:00", "date_accepted": "2019-03-01T00:30:49-05:00", "date_published": "2020-08-14T18:15:20-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/ucb_crp_bpj/article/3803/galley/2467/download/" } ] }, { "pk": 3799, "title": "Feudalism in the Age of Neoliberalism: A Century of Urban and Rural Co-dependency in Lebanon", "subtitle": null, "abstract": "The urban and rural co-dependency in Lebanon has been drastically transformed and further heightened since the joining of both territories with the Declaration of Greater Lebanon on September 1st, 1920. The lack of any formal planning during the past century has driven socio-political and economic forces to shape or disfigure the built environment. Historians, geographers, and urban planners have addressed Lebanon’s urban-rural divide by highlighting unequal development. Even still, a comprehensive overview of key historical moments that investigates migrations and the economic system is needed to understand the current co-dependent and conflicted relationship between both territories. Accordingly, this paper explores the urban and rural dynamics starting from the early nineteenth century to modern- day Lebanon, by juxtaposing the flow of migrations between Mount Lebanon and Beirut with the country’s neoliberal economic policies. This analysis is derived from historical books, articles, and theses on the region and aims to highlight the integration of the rural feudalist- sectarian structure with the hyper-financialized urban neoliberal system.", "language": "en", "license": null, "keywords": [ { "word": "Beirut, Mount Lebanon, Migrations, Neoliberalism, Feudalism" } ], "section": "Journal Submissions", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/69p7w3jm", "frozenauthors": [ { "first_name": "Anahid", "middle_name": "Zarig", "last_name": "Simitian", "name_suffix": "", "institution": "Lebanese American University", "department": "None" } ], "date_submitted": "2019-02-23T14:38:54-05:00", "date_accepted": "2019-02-23T14:38:54-05:00", "date_published": "2020-08-14T18:04:12-05:00", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/ucb_crp_bpj/article/3799/galley/2465/download/" } ] }, { "pk": 44995, "title": "Aortic Dissection in a 40-Year-Old with Bicuspid Aortic Valve", "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/4sf2477s", "frozenauthors": [ { "first_name": "Benjamin", "middle_name": "", "last_name": "Noor", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Roman", "middle_name": "", "last_name": "Leibzon", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Ramin", "middle_name": "", "last_name": "Tabibiazar", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-13T12:57:55-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44995/galley/33788/download/" } ] }, { "pk": 44994, "title": "Adverse Oral Effects of Statins", "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/9hz0s7pg", "frozenauthors": [ { "first_name": "Laurel", "middle_name": "B.", "last_name": "Yates", "name_suffix": "MD, MPH", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-13T12:55:42-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44994/galley/33787/download/" } ] }, { "pk": 44993, "title": "The Diagnosis and Clinical Manifestations of IgG4-Related 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/0279h979", "frozenauthors": [ { "first_name": "Kristal", "middle_name": "", "last_name": "Choi", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2020-08-13T12:53:43-05:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44993/galley/33786/download/" } ] } ] }