Article List
API Endpoint for journals.
GET /api/articles/?format=api&offset=19000
{ "count": 38487, "next": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=19100", "previous": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=18900", "results": [ { "pk": 2791, "title": "Listening for What is Being Asked: Understanding LGBT* Students Interactions with Student Affairs Professionals", "subtitle": null, "abstract": "This article explores the findings of a qualitative study conducted to better understand how students who identify as members of the LGBT* community and as people of color describe the ways in which student affairs professionals can meet their needs for persistence through college. This study also sought to assess how the students’ perception of the race, gender identity, and sexual orientation of the student affairs professionals impacted the degree to which the students felt their needs were being met. Using a hypothesis coding structure, the researcher explored whether students would describe their needs being met through practices of transgressive teaching, a style of engaged pedagogy described in the seminal text \nTeaching to Transgress: Education as the Practice of Freedom\n by bell hooks. This article will also make recommendations for future research and for student affairs practice.", "language": "en", "license": null, "keywords": [ { "word": "LGBT*, people of color, college students, student affairs" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9mq0x952", "frozenauthors": [ { "first_name": "Conor", "middle_name": "", "last_name": "McLaughlin", "name_suffix": "", "institution": "University of San Diego", "department": "None" } ], "date_submitted": "2015-11-17T23:09:14Z", "date_accepted": "2015-11-17T23:09:14Z", "date_published": "2017-03-23T19:56:56Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/gseis_interactions/article/2791/galley/1651/download/" } ] }, { "pk": 33566, "title": "The Political Meaning of Hacktivism", "subtitle": null, "abstract": "Philosopher-kings or Fawkes masks? Ashley Gorham explores the truth-telling zeal of WikiLeaks and the lulzy opinions of Anonymous.", "language": null, "license": { "name": "Creative Commons Attribution-ShareAlike 4.0", "short_name": "CC BY-SA 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\nShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.\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-sa/4.0" }, "keywords": [], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5498p51h", "frozenauthors": [ { "first_name": "Ashley", "middle_name": "", "last_name": "Gorham", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-23T17:00:00Z", "render_galley": null, "galleys": [ { "label": "HTML", "type": "pdf", "path": "https://journalpub.escholarship.org/limn/article/33566/galley/24639/download/" } ] }, { "pk": 2817, "title": "Catching a Case: Inequality and Fear in New York City’s Child Welfare System. By Tina Lee. New Jersey: Rutgers University Press, 2016. Pp. v + 245. $25.00 (paperback).", "subtitle": null, "abstract": "", "language": "en", "license": null, "keywords": [], "section": "Book Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/87n096vz", "frozenauthors": [ { "first_name": "Katherine", "middle_name": "", "last_name": "Maldonado", "name_suffix": "", "institution": "UCLA", "department": "None" } ], "date_submitted": "2017-03-23T19:43:16Z", "date_accepted": "2017-03-23T19:43:16Z", "date_published": "2017-03-23T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/gseis_interactions/article/2817/galley/1669/download/" } ] }, { "pk": 44280, "title": "Mindful Music: The Effects of Live Music on Stress at UCLA", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Review" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7p16f2nq", "frozenauthors": [ { "first_name": "Sean", "middle_name": "", "last_name": "Dreyer", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Dalida", "middle_name": "", "last_name": "Arakelian", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": "Robert", "middle_name": "", "last_name": "Bilder", "name_suffix": "PhD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-22T16:12:15Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44280/galley/33079/download/" } ] }, { "pk": 381, "title": "13-year-old Girl with Fevers", "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": "Clinicopathological Cases from the University of Maryland", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3fr5m2gh", "frozenauthors": [ { "first_name": "Megan", "middle_name": "", "last_name": "Cobb", "name_suffix": "", "institution": "University of Maryland Medical Center", "department": "None" }, { "first_name": "Emily", "middle_name": "", "last_name": "Gorman", "name_suffix": "", "institution": "University of Maryland School of Medicine", "department": "None" }, { "first_name": "Laura", "middle_name": "J", "last_name": "Bontempo", "name_suffix": "", "institution": "University of Maryland School of Medicine", "department": "None" }, { "first_name": "Zachary", "middle_name": "DW", "last_name": "Dezman", "name_suffix": "", "institution": "University of Maryland School of Medicine", "department": "None" } ], "date_submitted": "2017-03-21T22:24:58Z", "date_accepted": "2017-03-21T22:24:58Z", "date_published": "2017-03-21T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/381/galley/147/download/" } ] }, { "pk": 63228, "title": "Minority Serving Institutions: A Data-Driven Student Landscape in the Outcomes-Based Funding Universe", "subtitle": null, "abstract": "Minority Serving Institutions (MSIs) emerged in response to a history of racial inequity and social injustice due to racial and ethnic minorities’ lack of access to Predominately White Institutions (PWIs). Enrolling 20% of the nation’s college students, MSIs are an integral part of U.S. higher education. The purpose of this paper is to highlight the contributions that MSIs are making to postsecondary education, specifically contributions related to performance with men of color; teacher education; science, technology, engineering, and mathematics (STEM) education; and outcomes measures within two-year MSIs. We use descriptive statistics from the National Center for Educational Statistics and the National Science Foundation to call for deep consideration of the unique mission MSIs serve, especially with regard to educating low-income students of color within the universe of outcomes and performance-based evaluation. We conclude with recommendations and implications for policy.", "language": "en", "license": null, "keywords": [ { "word": "Minority Serving Institutions" }, { "word": "Outcomes" }, { "word": "Accountability" }, { "word": "Performance" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2s64k4mb", "frozenauthors": [ { "first_name": "Marybeth", "middle_name": "", "last_name": "Gasman", "name_suffix": "", "institution": "University of Pennsylvania", "department": "" }, { "first_name": "Thai-Huy", "middle_name": "", "last_name": "Nguyen", "name_suffix": "", "institution": "Seattle University", "department": "" }, { "first_name": "Andrés", "middle_name": "Castro", "last_name": "Samayoa", "name_suffix": "", "institution": "Boston College", "department": "" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Corral", "name_suffix": "", "institution": "University of Wisconsin-Madison", "department": "" } ], "date_submitted": "2014-12-14T05:06:04Z", "date_accepted": "2014-12-14T05:06:04Z", "date_published": "2017-03-18T05:25:42Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/bre/article/63228/galley/48792/download/" } ] }, { "pk": 63276, "title": "Righting Technologies: How Large-Scale Assessment Can Foster a More Equitable Education System", "subtitle": null, "abstract": "For the last century, the quality of large-scale assessment in the United States has been undermined by narrow educational theory and hindered by limitations in technology. As a result, poor assessment practices have encouraged low-level instructional practices that disparately affect students from the most disadvantaged communities and schools. In this historical and theoretical review, we examine the misalignment between educational theory and large-scale assessment practices that rely upon technology, using writing assessment as a case in point. Drawing upon sociocultural theory and critical software studies as conceptual frameworks, we find that today’s software-powered technologies, although capable of taking progressive educational ideals to scale, have not been used for these purposes. Our proposed solution is to shift from using technologies to assess predetermined samples of evidence of learning to using technologies to facilitate complex and negotiated models of assessment. This solution would require policy shifts that honor the needs of various stakeholders in the assessment process. We offer a power-sharing concept called negotiated control that engages policymakers, educators, researchers, and community members inthe assessment process.", "language": "en", "license": null, "keywords": [ { "word": "Large-scale Assessment" }, { "word": "Education Technology" }, { "word": "Writing Assessment" }, { "word": "Sociocultural Theory" }, { "word": "Software" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9v73q3pf", "frozenauthors": [ { "first_name": "Nadia", "middle_name": "", "last_name": "Behizadeh", "name_suffix": "", "institution": "Georgia State University", "department": "" }, { "first_name": "Tom", "middle_name": "Liam", "last_name": "Lynch", "name_suffix": "", "institution": "Pace University", "department": "" } ], "date_submitted": "2016-05-13T16:34:00Z", "date_accepted": "2016-05-13T16:34:00Z", "date_published": "2017-03-17T01:24:04Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/bre/article/63276/galley/48805/download/" } ] }, { "pk": 376, "title": "Accidental Ingestion of Hearing Aid with Exposed Battery", "subtitle": null, "abstract": "A 59-year-old female presented to the emergency department (ED) three days after accidental ingestion of an intact in-the-ear hearing aid. This is the first report of ingestion of a complete hearing aid traveling past the gastroesophageal junction. Of concern was the exposed battery attached to the hearing aid that had advanced minimally in the three days since last evaluation. This case report discusses her ED testing, including gastroenterology consultation, and ultimately retrieval from her distal stomach. The authors conclude that this removal was not medically necessary.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9256f88h", "frozenauthors": [ { "first_name": "Ethan", "middle_name": "B.", "last_name": "Kunstadt", "name_suffix": "", "institution": "University of California, Irvine", "department": "None" }, { "first_name": "Mark", "middle_name": "I.", "last_name": "Langdorf", "name_suffix": "", "institution": "University of California, Irvine", "department": "None" } ], "date_submitted": "2017-03-16T22:51:27Z", "date_accepted": "2017-03-16T22:51:27Z", "date_published": "2017-03-16T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/376/galley/142/download/" } ] }, { "pk": 378, "title": "Acute ST Segment Elevation Myocardial Infarction and Massive Pericardial Effusion Due to Infective Endocarditis", "subtitle": null, "abstract": "Chest pain is a common complaint evaluated in the emergency department. While chest pain in a 22-year-old patient is typically a complaint of low acuity, high-acuity cases that rival those of the older patient population are well documented. We describe a case of complicated infective endocarditis in which point-of-care ultrasound (POCUS) aided the diagnosis of ST-elevation myocardial infarction secondary to a septic thrombus in a 22-year-old female with a history of intravenous drug use. Emergency physicians should be aware of the rare high-acuity cases as well as the impact of POCUS on rapid clinical assessment and treatment of patients of all ages presenting with chest pain.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6rw835n8", "frozenauthors": [ { "first_name": "Maxwell", "middle_name": "", "last_name": "Thompson", "name_suffix": "", "institution": "The University of Alabama at Birmingham", "department": "None" }, { "first_name": "David", "middle_name": "C.", "last_name": "Pigott", "name_suffix": "", "institution": "The University of Alabama at Birmingham", "department": "None" }, { "first_name": "John", "middle_name": "", "last_name": "Gullett", "name_suffix": "", "institution": "The University of Alabama at Birmingham", "department": "None" }, { "first_name": "Blayke", "middle_name": "", "last_name": "Gibson", "name_suffix": "", "institution": "The University of Alabama at Birmingham", "department": "None" } ], "date_submitted": "2017-03-16T23:34:23Z", "date_accepted": "2017-03-16T23:34:23Z", "date_published": "2017-03-16T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/378/galley/144/download/" } ] }, { "pk": 375, "title": "Indicators of Subarachnoid Hemorrhage as a Cause of Sudden Cardiac Arrest", "subtitle": null, "abstract": "Subarachnoid hemorrhage (SAH) may present with cardiac arrest (SAH-CA). We report a case of SAH-CA to assist providers in distinguishing SAH as an etiology of cardiac arrest despite electrocardiogram findings that may be suggestive of a cardiac etiology. SAH-CA is associated with high rates of return of spontaneous circulation, but overall poor outcome. An initially non-shockable cardiac rhythm and the absence of brain stem reflexes are important clues in indentifying SAH-CA.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2mg297jt", "frozenauthors": [ { "first_name": "Joseph", "middle_name": "", "last_name": "Zachariah", "name_suffix": "", "institution": "Mayo Clinic", "department": "None" }, { "first_name": "Jessica", "middle_name": "A.", "last_name": "Stanich", "name_suffix": "", "institution": "Mayo Clinic", "department": "None" }, { "first_name": "Sherri", "middle_name": "A.", "last_name": "Braksick", "name_suffix": "", "institution": "Mayo Clinic", "department": "None" }, { "first_name": "Eelco", "middle_name": "FM.", "last_name": "Wijdicks", "name_suffix": "", "institution": "Mayo Clinic", "department": "None" }, { "first_name": "Ronna", "middle_name": "L.", "last_name": "Campbell", "name_suffix": "", "institution": "Mayo Clinic", "department": "None" }, { "first_name": "Malcolm", "middle_name": "R.", "last_name": "Bell", "name_suffix": "", "institution": "Mayo Clinic", "department": "None" }, { "first_name": "Roger", "middle_name": "", "last_name": "White", "name_suffix": "", "institution": "Mayo Clinic", "department": "None" } ], "date_submitted": "2017-03-16T21:44:51Z", "date_accepted": "2017-03-16T21:44:51Z", "date_published": "2017-03-16T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/375/galley/141/download/" } ] }, { "pk": 380, "title": "Pediatric Death Due to Myocarditis After Exposure to Cannabis", "subtitle": null, "abstract": "Since marijuana legalization, pediatric exposures to cannabis have increased.1 To date, pediatric deathsfrom cannabis exposure have not been reported. The authors report an 11-month-old male who, followingcannabis exposure, presented with central nervous system depression after seizure, and progressed tocardiac arrest and died. Myocarditis was diagnosed post-mortem and cannabis exposure was confirmed.Given the temporal relationship of these two rare occurrences – cannabis exposure and sudden deathsecondary to myocarditis in an 11-month-old – as well as histological consistency with drug-inducedmyocarditis without confirmed alternate causes, and prior reported cases of cannabis-associatedmyocarditis, a possible relationship exists between cannabis exposure in this child and myocarditisleading to death. In areas where marijuana is commercially available or decriminalized, the authors urgeclinicians to preventively counsel parents and to include cannabis exposure in the differential diagnosis ofpatients presenting with myocarditis.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1n10w5pc", "frozenauthors": [ { "first_name": "Thomas", "middle_name": "M.", "last_name": "Nappe", "name_suffix": "", "institution": "Denver Health and Hospital Authority, Rocky Mountain Poison and Drug Center, Denver, Colorado", "department": "None" }, { "first_name": "Christopher", "middle_name": "O.", "last_name": "Hoyte", "name_suffix": "", "institution": "Denver Health and Hospital Authority, Rocky Mountain Poison and Drug Center, Denver, Colorado\nUniversity of Colorodo School of Medicine at Anschutz Medical Center, Department of Emergency Medicine, Aurora, Colorado", "department": "None" } ], "date_submitted": "2017-03-17T00:01:04Z", "date_accepted": "2017-03-17T00:01:04Z", "date_published": "2017-03-16T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/380/galley/146/download/" } ] }, { "pk": 373, "title": "Phytophotodermatitis", "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": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/12b6d62r", "frozenauthors": [ { "first_name": "Liza", "middle_name": "G.", "last_name": "Smith", "name_suffix": "", "institution": "Baystate Medical Center", "department": "None" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Kabhrel", "name_suffix": "", "institution": "Massachusetts General Hospital", "department": "None" } ], "date_submitted": "2017-03-16T20:59:49Z", "date_accepted": "2017-03-16T20:59:49Z", "date_published": "2017-03-16T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/373/galley/139/download/" } ] }, { "pk": 377, "title": "Spontaneous Hemoperitoneum from Rupture of Massive Leiomyoma", "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": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/21p2g72g", "frozenauthors": [ { "first_name": "Arielle", "middle_name": "", "last_name": "Schwitkis", "name_suffix": "", "institution": "Cedars-Sinai Medical Center", "department": "None" }, { "first_name": "Steven", "middle_name": "", "last_name": "Shen", "name_suffix": "", "institution": "Cedars-Sinai Medical Center", "department": "None" }, { "first_name": "Elaine", "middle_name": "", "last_name": "Vos", "name_suffix": "", "institution": "Western Michigan University Homer Stryker M.D. School of Medicine", "department": "None" }, { "first_name": "Sam", "middle_name": "S.", "last_name": "Torbati", "name_suffix": "", "institution": "Cedars-Sinai Medical Center", "department": "None" } ], "date_submitted": "2017-03-16T23:23:14Z", "date_accepted": "2017-03-16T23:23:14Z", "date_published": "2017-03-16T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/377/galley/143/download/" } ] }, { "pk": 374, "title": "The Aortomesenteric Angle as an Aid in Diagnosing Superior Mesenteric Artery Syndrome", "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": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/64j281zf", "frozenauthors": [ { "first_name": "Kathleen", "middle_name": "E.", "last_name": "Kane", "name_suffix": "", "institution": "University of South Florida Morsani College of Medicine", "department": "None" }, { "first_name": "Andrew", "middle_name": "L.", "last_name": "Koons", "name_suffix": "", "institution": "Lehigh Valley Hospital-Muhlenberg", "department": "None" } ], "date_submitted": "2017-03-16T21:17:35Z", "date_accepted": "2017-03-16T21:17:35Z", "date_published": "2017-03-16T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/374/galley/140/download/" } ] }, { "pk": 379, "title": "Use of Ultrasound to Diagnose Pneumonia", "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": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3kk5260s", "frozenauthors": [ { "first_name": "Derek", "middle_name": "L.", "last_name": "Monette", "name_suffix": "", "institution": "Brigham and Women’s Hospital", "department": "None" }, { "first_name": "Sarah", "middle_name": "E.", "last_name": "Frasure", "name_suffix": "", "institution": "Brigham and Women’s Hospital", "department": "None" } ], "date_submitted": "2017-03-16T23:47:23Z", "date_accepted": "2017-03-16T23:47:23Z", "date_published": "2017-03-16T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/379/galley/145/download/" } ] }, { "pk": 44263, "title": "Human Papilloma Virus and Metastatic 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/7w98d6vp", "frozenauthors": [ { "first_name": "Evangelia", "middle_name": "", "last_name": "Kirimis", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-15T20:31:08Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44263/galley/33062/download/" } ] }, { "pk": 372, "title": "Adult Female with a Headache", "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": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1pq36884", "frozenauthors": [ { "first_name": "Kelley", "middle_name": "A.", "last_name": "Wittbold", "name_suffix": "", "institution": "Brigham and Women’s Hospital", "department": "None" }, { "first_name": "Jacqueline", "middle_name": "", "last_name": "Boehme", "name_suffix": "", "institution": "Massachusetts General Hospital", "department": "None" }, { "first_name": "Heidi", "middle_name": "H.", "last_name": "Kimberly", "name_suffix": "", "institution": "Brigham and Women’s Hospital", "department": "None" }, { "first_name": "Sarah", "middle_name": "E.", "last_name": "Frasure", "name_suffix": "", "institution": "Brigham and Women’s Hospital", "department": "None" } ], "date_submitted": "2017-03-15T23:21:59Z", "date_accepted": "2017-03-15T23:21:59Z", "date_published": "2017-03-15T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/372/galley/138/download/" } ] }, { "pk": 369, "title": "Bilateral Chylothorax Due to Blunt Trauma Without Radiographic Evidence of Traumatic Injury", "subtitle": null, "abstract": "Chylothorax represents an uncommon clinical entity with multiple etiologies. Chylothorax following bluntthoracic trauma is typically associated with posterior rib fractures or thoracic vertebral fractures or dislocations.The occurrence of a traumatic chylothorax in the absence of associated injuries is a rare event. We reporta case of a 51-year-old patient who developed bilateral chylothorax after sustaining blunt trauma withoutradiographic evidence of traumatic injury. A 51-year-old male presented to the emergency departmentcomplaining of progressively worsening shortness of breath and associated chest pain for the prior one weekfollowing a fall down several concrete steps. On evaluation, the patient was found to have bilateral pleuraleffusions with no radiographic evidence of traumatic injury, including posterior rib or thoracic vertebral fractures.Subsequent thoracentesis and pleural fluid analysis were performed confirming the diagnosis of chylothorax.Management included repeated thoracentesis, diet modification and octreotide administration, which resultedin dramatic improvement and eventual resolution of symptoms. Non-iatrogenic traumatic bilateral chylothoraxin the absence of other radiographically demonstrated bony or soft tissue injury is a rare event. Chylothoraxshould be considered in the differential diagnosis of patients presenting with chest pain or shortness of breathfollowing blunt trauma and evidence of pleural effusion, even in the absence of obvious traumatic fracture orinjury on radiographic imaging.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2n64w22z", "frozenauthors": [ { "first_name": "Mohamed", "middle_name": "", "last_name": "Mohamed", "name_suffix": "", "institution": "Sparrow Hospital", "department": "None" }, { "first_name": "Weaam", "middle_name": "", "last_name": "Alshenawy", "name_suffix": "", "institution": "Sparrow Hospital", "department": "None" }, { "first_name": "Christen", "middle_name": "", "last_name": "Kegarise", "name_suffix": "", "institution": "Sparrow Hospital", "department": "None" }, { "first_name": "David", "middle_name": "", "last_name": "Betten", "name_suffix": "", "institution": "Sparrow Hospital", "department": "None" } ], "date_submitted": "2017-03-14T21:26:09Z", "date_accepted": "2017-03-14T21:26:09Z", "date_published": "2017-03-15T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/369/galley/135/download/" } ] }, { "pk": 365, "title": "Intercostal Lung Herniation", "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": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0cf3n1xx", "frozenauthors": [ { "first_name": "David", "middle_name": "", "last_name": "Manthey", "name_suffix": "", "institution": "Wake Forest School of Medicine", "department": "None" }, { "first_name": "Alexander", "middle_name": "W.", "last_name": "Nickle", "name_suffix": "", "institution": "Wake Forest School of Medicine", "department": "None" } ], "date_submitted": "2017-03-14T20:31:36Z", "date_accepted": "2017-03-14T20:31:36Z", "date_published": "2017-03-15T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/365/galley/131/download/" } ] }, { "pk": 370, "title": "Intermittent Ovarian Torsion in Pregnancy", "subtitle": null, "abstract": "Ovarian torsion during pregnancy is a fairly uncommon complication with a high patient morbidity and fetal mortality if not immediately treated. Ovarian torsion should be considered a clinical diagnosis, and a high level of clinical suspicion is needed by the practitioner to ensure that this diagnosis is not missed. We present an unusual case of intermittent ovarian torsion discussing both the presentation and the operative and post-operative management.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8kc7h25f", "frozenauthors": [ { "first_name": "Randall", "middle_name": "", "last_name": "Young", "name_suffix": "", "institution": "Kaiser Permanente San Diego Medical Center", "department": "None" }, { "first_name": "Kelly", "middle_name": "", "last_name": "Cork", "name_suffix": "", "institution": "Kaiser Permanente San Diego Medical Center", "department": "None" } ], "date_submitted": "2017-03-15T22:39:26Z", "date_accepted": "2017-03-15T22:39:26Z", "date_published": "2017-03-15T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/370/galley/136/download/" } ] }, { "pk": 371, "title": "Normokalemic Thyrotoxic Periodic Paralysis with Acute Resolution in the Emergency Department", "subtitle": null, "abstract": "Thyrotoxic periodic paralysis is a rare cause of acute paralysis in the emergency department (ED). The disorder is generally thought to be due to acute hypokalemia leading to paralysis. Treatment is generally targeted at correcting the thyrotoxic state with careful potassium repletion. We present a rare case of normokalemic, thyrotoxic periodic paralysis with acute resolution while 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": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7975v5wf", "frozenauthors": [ { "first_name": "James", "middle_name": "I.", "last_name": "Gragg", "name_suffix": "", "institution": "Carl R. Darnall Army Medical Center", "department": "None" }, { "first_name": "Massimo", "middle_name": "", "last_name": "Federico", "name_suffix": "", "institution": "Carl R. Darnall Army Medical Center", "department": "None" }, { "first_name": "Larry", "middle_name": "B.", "last_name": "Mellick", "name_suffix": "", "institution": "Augusta University Medical Center", "department": "None" } ], "date_submitted": "2017-03-15T23:06:18Z", "date_accepted": "2017-03-15T23:06:18Z", "date_published": "2017-03-15T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/371/galley/137/download/" } ] }, { "pk": 366, "title": "Quality Initiatives May Affect Diagnostic Accuracy: STEMI Mimics in an Age of Decreasing Door to Balloon Time", "subtitle": null, "abstract": "A 53-year-old male with several cardiac risk factors presented to the emergency department with backpain and an electrocardiogram concerning for an anterior ST-elevation myocardial infarction. The patientdecompensated hemodynamically and a point-of-care ultrasound revealed a small pericardial effusion.An aortic dissection was ruled out by computed tomography angiography and coronary catheterization didnot reveal a culprit lesion. The diagnosis of tamponade was made in the catheterization laboratory aftermeasurement of intra-cardiac diastolic pressures and the patient’s symptoms resolved after drainage of 100mL of pericardial fluid.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7qb497w3", "frozenauthors": [ { "first_name": "Jose", "middle_name": "L.", "last_name": "Villa-Uribe", "name_suffix": "", "institution": "University of Massachusetts Medical School- Baystate", "department": "None" }, { "first_name": "Elizabeth", "middle_name": "M.", "last_name": "Schoenfeld", "name_suffix": "", "institution": "University of Massachusetts Medical School- Baystate", "department": "None" } ], "date_submitted": "2017-03-14T20:51:26Z", "date_accepted": "2017-03-14T20:51:26Z", "date_published": "2017-03-15T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/366/galley/132/download/" } ] }, { "pk": 367, "title": "Should Pharmacies Be Included in Medication Reconciliation? A Report of Recurrent Valproic Acid Toxicity", "subtitle": null, "abstract": "Including outpatient pharmacies in the medication reconciliation process upon hospital discharge isnot commonly performed. This case highlights the consequences of a patient refilling a discontinuedprescription for valproic acid (VPA). We present a 32-year old male found unresponsive after ingestingdelayed release divalproex sodium. Cerebral edema was visualized on magnetic resonance imaging.Hemodialysis and levo-carnitine treatment led to improved mental status, and VPA was discontinued.The same patient presented with VPA overdose eight months later after he continued to fill an outda tedprescription. This case highlights consequences of VPA toxicity; it also demonstrates an opportunity toimprove patient safety and high-value care by collaborating with outpatient pharmacies in the medicationreconciliation process upon hospital discharge.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4z99356h", "frozenauthors": [ { "first_name": "B.", "middle_name": "Tate", "last_name": "Cutshall", "name_suffix": "", "institution": "Houston Methodist Hospital", "department": "None" }, { "first_name": "Samarth", "middle_name": "P.", "last_name": "Shah", "name_suffix": "", "institution": "Methodist LeBonheur Healthcare-University Hospital", "department": "None" }, { "first_name": "Megan", "middle_name": "A.", "last_name": "Van Berkel", "name_suffix": "", "institution": "Methodist LeBonheur Healthcare-University Hospital", "department": "None" }, { "first_name": "Shanise", "middle_name": "", "last_name": "Patterson", "name_suffix": "", "institution": "Methodist LeBonheur Healthcare-South Hospital", "department": "None" }, { "first_name": "L.", "middle_name": "Jeff", "last_name": "Harris", "name_suffix": "", "institution": "University of Tennessee Health Science Center", "department": "None" }, { "first_name": "Jessica", "middle_name": "V.", "last_name": "Rivera", "name_suffix": "", "institution": "Methodist LeBonheur Healthcare-University Hospital", "department": "None" } ], "date_submitted": "2017-03-14T21:05:39Z", "date_accepted": "2017-03-14T21:05:39Z", "date_published": "2017-03-15T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/367/galley/133/download/" } ] }, { "pk": 368, "title": "Spinal Epidural Abscess Complicated by Meningitis, Sepsis and Thrombocytopenia in a Patient Lacking Traditional Risk Factors", "subtitle": null, "abstract": "Spinal epidural abscess is a rare diagnosis with a classic triad of fever, spinal pain and neurologicdeficits. Only a small proportion of patients have all three findings, making the diagnosis challenging.Here we present a case of cervical and thoracic spinal epidural abscess complicated by meningitis,sepsis and thrombocytopenia in a patient lacking traditional risk factors. The patient was initiallytreated non-operatively secondary to thrombocytopenia but subsequently required transfer to atertiary care facility for surgical drainage after clinical deterioration. This case report highlights theneed for a high index of suspicion and low threshold for imaging when considering this rare butpotentially deadly condition.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0b50c7ms", "frozenauthors": [ { "first_name": "Christian", "middle_name": "", "last_name": "Spano", "name_suffix": "", "institution": "Orange Regional Medical Center", "department": "None" }, { "first_name": "Michael", "middle_name": "", "last_name": "Ward", "name_suffix": "", "institution": "Touro College of Osteopathic Medicine", "department": "None" }, { "first_name": "Nicole", "middle_name": "", "last_name": "Zagelbaum", "name_suffix": "", "institution": "Touro College of Osteopathic Medicine", "department": "None" } ], "date_submitted": "2017-03-14T21:17:55Z", "date_accepted": "2017-03-14T21:17:55Z", "date_published": "2017-03-15T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/368/galley/134/download/" } ] }, { "pk": 10464, "title": "Blog and Podcast Watch: Orthopedic Emergencies", "subtitle": null, "abstract": "Introduction:\n The \nWestJEM\n Blog and Podcast Watch presents high quality open access educational blogs and podcasts in emergency medicine (EM) based on the ongoing ALiEM Approved Instructional Resources (AIR) and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of orthopedic emergencies from the AIR series.\n \n \n \nMethods:\n The AIR series is a continuously building curriculum which follows the Council of Emergency Medicine Residency Director’s (CORD) annual testing schedule. For each module, relevant content is collected from the top 50 Social Media Index sites published within the previous 12 months, and scored by 8 board members using 5 equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM) score, accuracy, educational utility, evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIR label. Resources scoring 27-29 receive an Honorable Mention label, if the executive board agrees that the post is accurate and educationally valuable.\n \n \n \nResults:\n A total of 87 blog posts and podcasts were evaluated. Key educational pearls from the 3 AIR posts and the 14 Honorable Mentions are summarized.\n \nConclusion: \nThe \nWestJEM \nBlog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. This series provides an expert-based, post-publication curation of educational social media content for EM clinicians with this installment focusing on orthopedic emergencies.", "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": "FOAM, orthopedics" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0pd8868q", "frozenauthors": [ { "first_name": "Andrew", "middle_name": "", "last_name": "Grock", "name_suffix": "", "institution": "Department of Emergency Medicine, UCLA Olive View and Department of Emergency Medicine, Department of Emergency Medicine, University of Southern California, Los Angeles, CA.", "department": "None" }, { "first_name": "Salim", "middle_name": "", "last_name": "Rezaie", "name_suffix": "", "institution": "Greater San Antonio Emergency Physicians (GSEP)", "department": "None" }, { "first_name": "Anand", "middle_name": "", "last_name": "Swaminathan", "name_suffix": "", "institution": "Ronald O Perelman department of emergency medicine. NYU/Bellevue hospital", "department": "None" }, { "first_name": "Alice", "middle_name": "", "last_name": "Min", "name_suffix": "", "institution": "University of Arizona, College of Medicine, Department of Emergency Medicine", "department": "None" }, { "first_name": "Kaushal", "middle_name": "", "last_name": "Shah", "name_suffix": "", "institution": "Icahn School of Medicine, Mount Sinai Hospital", "department": "None" }, { "first_name": "Michelle", "middle_name": "", "last_name": "Lin", "name_suffix": "", "institution": "University of California San Francisco", "department": "None" } ], "date_submitted": "2016-11-19T21:53:35Z", "date_accepted": "2016-11-19T21:53:35Z", "date_published": "2017-03-14T19:42:33Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10464/galley/5752/download/" } ] }, { "pk": 364, "title": "A Novel Source of Chest Pain in the Emergency Department", "subtitle": null, "abstract": "This is a case report of a patient with an unusual presentation of an inferior vena cava (IVC) filter migrationwith a delayed presentation, and without electrical or valvular abnormalities. We discuss considerations andpotential complications from IVC filter placement from the emergency physician perspective.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/75k7h5nb", "frozenauthors": [ { "first_name": "Ibrahim", "middle_name": "", "last_name": "Isa", "name_suffix": "", "institution": "Medical University of South Carolina", "department": "None" }, { "first_name": "Jeffrey", "middle_name": "S.", "last_name": "Bush", "name_suffix": "", "institution": "Medical University of South Carolina", "department": "None" }, { "first_name": "Simon", "middle_name": "", "last_name": "Watson", "name_suffix": "", "institution": "Medical University of South Carolina", "department": "None" }, { "first_name": "Joseph", "middle_name": "", "last_name": "Schoepf", "name_suffix": "", "institution": "Medical University of South Carolina", "department": "None" } ], "date_submitted": "2017-03-14T20:23:01Z", "date_accepted": "2017-03-14T20:23:01Z", "date_published": "2017-03-14T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/364/galley/130/download/" } ] }, { "pk": 363, "title": "Burn-induced Myxedema Crisis", "subtitle": null, "abstract": "Myxedema crisis (MC) is a rare but life-threatening illness characterized by multi-system organ impairmentfrom thyroid hormone deficiency that is often brought on by an eliciting event. We present the case of MCwith a rapid progression of hypothermia, altered mental status, and respiratory failure that was instigatedby a flash burn to the face. The patient’s condition was refractory to rewarming and supportive efforts untilthyroid hormone was replaced. This case illustrates the need for a high index of suspicion for patients with arapid onset of metabolic encephalopathy immediately after an injury or burn.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1p6194rq", "frozenauthors": [ { "first_name": "Ann", "middle_name": "S.", "last_name": "Batista", "name_suffix": "", "institution": "Wake Forest School of Medicine", "department": "None" }, { "first_name": "Laura", "middle_name": "L.", "last_name": "Zane", "name_suffix": "", "institution": "Wake Forest School of Medicine", "department": "None" }, { "first_name": "Lane", "middle_name": "M.", "last_name": "Smith", "name_suffix": "", "institution": "Wake Forest School of Medicine", "department": "None" } ], "date_submitted": "2017-03-14T19:58:54Z", "date_accepted": "2017-03-14T19:58:54Z", "date_published": "2017-03-14T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/363/galley/129/download/" } ] }, { "pk": 361, "title": "Emphysematous Pyelonephritis: Bedside Ultrasound Diagnosis in the Emergency Department", "subtitle": null, "abstract": "Emphysematous pyelonephritis (EPN) is a rare, life-threatening infection, and misdiagnosis asuncomplicated pyelonephritis is potentially fatal. Point-of-care ultrasound (POCUS) is a valuable toolfor evaluation of the kidneys in patients with septic shock and pyelonephritis. While used primarilyto assess for the complication of obstruction and hydronephrosis, POCUS may also detect signs ofEPN and prompt surgical consultation for nephrectomy. We present a case in which the emergencyphysician diagnosed EPN by POCUS in a patient with septic shock and pyelonephritis.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6r46g5j8", "frozenauthors": [ { "first_name": "Gillian", "middle_name": "", "last_name": "McCafferty", "name_suffix": "", "institution": "Lahey Hospital and Medical Center", "department": "None" }, { "first_name": "Amanda", "middle_name": "", "last_name": "Shorette", "name_suffix": "", "institution": "Baystate Medical Center", "department": "None" }, { "first_name": "Sukhdeep", "middle_name": "", "last_name": "Singh", "name_suffix": "", "institution": "Baystate Medical Center", "department": "None" }, { "first_name": "Gavin", "middle_name": "", "last_name": "Budhram", "name_suffix": "", "institution": "Baystate Medical Center", "department": "None" } ], "date_submitted": "2017-03-14T19:25:11Z", "date_accepted": "2017-03-14T19:25:11Z", "date_published": "2017-03-14T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/361/galley/127/download/" } ] }, { "pk": 10322, "title": "The Efficacy of LUCAS in Prehospital Cardiac Arrest Scenarios: A Crossover Mannequin Study", "subtitle": null, "abstract": "Introduction:\n High quality CPR is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS Chest Compression System to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high quality CPR guidelines.\n \nMethods:\n We performed a crossover controlled study in which a recording mannequin was placed on the second floor of a building. An EMS crew responded, defibrillated, and provided either manual or LUCAS CPR. The team transported the mannequin through hallways and down stairs to an ambulance and drove to the hospital with CPR in progress. Critical events were manually timed while the mannequin recorded data on compressions.\n \nResults:\n Twenty-three EMS providers participated. Median time to defibrillation was not different for LUCAS compared to manual CPR (p=0.97). LUCAS had a lower median number of compressions per minute (p<0.002), which was more consistent with current American Heart Association CPR guidelines, and percent adequate compression rate (p<0.002). In addition, LUCAS had a higher percent adequate depth (p<0.007) lower percent total hands off time (p<0.005). LUCAS performed no differently than manual CPR in median compression release depth, percent fully released compressions, median time hands off, or percent correct hand position.\n \nConclusion:\n In our simulation, LUCAS had a higher rate of adequate compressions and decreased total hands off time as compared to manual CPR. Chest compression quality may be better when using a mechanical device during patient movement in prehospital cardiac arrest 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": "mechanical CPR, resuscitation, cardiac arrest prehospital" } ], "section": "Prehospital Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0p1813xh", "frozenauthors": [ { "first_name": "Robert", "middle_name": "Aaron", "last_name": "Gyory", "name_suffix": "", "institution": "Penn State College of Medicine\nPenn State Health Milton S. Hershey Medical Center", "department": "None" }, { "first_name": "Scott", "middle_name": "Edward", "last_name": "Buchle", "name_suffix": "", "institution": "Penn State Health Milton S. Hershey Medical Center", "department": "None" }, { "first_name": "David", "middle_name": "", "last_name": "Rodgers", "name_suffix": "", "institution": "Penn State College of Medicine", "department": "None" }, { "first_name": "Jeffrey", "middle_name": "Scott", "last_name": "Lubin", "name_suffix": "", "institution": "Penn State College of Medicine\nPenn State Health Milton S. Hershey Medical Center", "department": "None" } ], "date_submitted": "2016-09-17T16:06:05Z", "date_accepted": "2016-09-17T16:06:05Z", "date_published": "2017-03-14T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10322/galley/5676/download/" } ] }, { "pk": 362, "title": "Wernicke’s Encephalopathy in a Patient Without Chronic Alcohol Abuse", "subtitle": null, "abstract": "Wernicke’s encephalopathy (WE) is traditionally seen in the emergency department in patients with chronicalcohol abuse. WE can result in significant morbidity and mortality if untreated, making early diagnosis andintervention paramount. We discuss a case of WE in a 63-year-old female with no history of chronic alcoholabuse, who presented with bilateral opthalmoplegia that resolved after intravenous thiamine administration.This case report highlights the varied clinical settings other than chronic alcohol abuse in which thediagnosis of WE should be considered.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7rp820gn", "frozenauthors": [ { "first_name": "Darshan", "middle_name": "", "last_name": "Thota", "name_suffix": "", "institution": "Naval Medical Center San Diego", "department": "None" }, { "first_name": "Sherri", "middle_name": "", "last_name": "Rudinsky", "name_suffix": "", "institution": "Naval Medical Center San Diego", "department": "None" } ], "date_submitted": "2017-03-14T19:54:20Z", "date_accepted": "2017-03-14T19:54:20Z", "date_published": "2017-03-14T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/362/galley/128/download/" } ] }, { "pk": 44262, "title": "Recurrent Pneumonia as a Complication of Coil Endobronchial Lung Volume Reduction for Treatment of Advanced Homogenous Emphysema", "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/7331g8tc", "frozenauthors": [ { "first_name": "Corinne", "middle_name": "T.", "last_name": "Sheth", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Elinor", "middle_name": "", "last_name": "Lee", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": "Malcolm", "middle_name": "I.", "last_name": "Smith", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": "Scott", "middle_name": "", "last_name": "Oh", "name_suffix": "DO", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-13T20:30:02Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44262/galley/33061/download/" } ] }, { "pk": 10065, "title": "Impact of Health Policy Changes on Emergency Medicine in Maryland Stratified by Socioeconomic Status", "subtitle": null, "abstract": "Introduction\n On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD’s Medicare Waiver ushered in global budget revenue (GBR) structure for hospital reimbursement. Our objective is to analyze the impact of these policy changes on Emergency Department (ED) utilization, admission practices, insurance profiles, and professional revenue. We stratified our analysis by the socioeconomic status (SES) of the ED patient population.\n \nMethods\n Monthly mean data including patient volume, admission and observation percentages, payer mix, and professional revenue were collected from January 2013 through December 2015 from a convenience sample of 11 EDs in Maryland. Using regression models, we compared each of the variables 18 months after the policy changes and a six-month washout period to the year prior to ACA/GBR implementation. We included the median income of each ED’s patient population as an explanatory variable and stratified our results by SES.\n \n \n \nResults\n Our 11 EDs saw an annualized volume of 399,310 patient visits during the study period. This ranged from a mean of 41 daily visits in the lowest volume rural ED to 171 in the highest volume suburban ED. After ACA/GBR, ED volumes were unchanged (95% Confidence Interval (CI): (-1.58, 1.24), p=.817). Admission plus observation percentages decreased significantly by 1.9% from 17.2% to 15.3% (95% CI: (-2.47%, - 1.38%), p<.001). The percentage of uninsured patients decreased from 20.4% to 11.9%. This 8.5% change was significant (95% CI: (-9.20%, -7.80%), p<.001). The professional revenue per relative value unit increased significantly by $3.97 (95% CI: (3.20, 4.74), p<.001). When stratified by the median patient income of each ED, changes in each outcome were significantly more pronounced in EDs of lower SES.\n \nConclusion\n Health policy changes at the federal and state levels have resulted in significant changes to emergency medicine practice and finances in MD. Admission and observation percentages have been reduced, fewer patients are uninsured, and professional revenue has increased. All changes are significantly more pronounced in EDs with patients of lower SES.", "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, emergency medicine, affordable care act" } ], "section": "Societal Impact on Emergency Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8g35v95z", "frozenauthors": [ { "first_name": "Laura", "middle_name": "", "last_name": "Pimentel", "name_suffix": "", "institution": "University of MD School of Medicine", "department": "None" } ], "date_submitted": "2016-07-24T00:59:08Z", "date_accepted": "2016-07-24T00:59:08Z", "date_published": "2017-03-13T17:40:01Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10065/galley/5488/download/" } ] }, { "pk": 9733, "title": "Agreement Between Serum Assays Performed in ED Point-of-Care and Hospital Central Laboratories", "subtitle": null, "abstract": "Background:\n Point-of-care (POC) testing allows for more time-sensitive diagnosis and treatment in the ED than sending blood samples to the hospital central laboratory (CL). However, many ED patients have blood sent to both, either out of clinical custom, or because clinicians do not trust the POC values.\n \nObjective:\n To examine the level of agreement between POC and CL values in a large cohort of ED patients.\n \nMethods:\n In an urban, Level One ED that sees approximately 120,000 patients/year, all patients seen between March 1st, 2013 and October 1st, 2014 who had blood sent to POC and CL labs had levels of agreement measured between serum sodium, potassium, BUN, creatinine, and hematocrit. Data were extracted from the hospital's clinical information system. Agreement was analyzed with the use of Bland-Altman plots, defining both 95% confidence intervals (CIs) and more conservative CIs based on clinical judgment.\n \nResults:\n Out of 163,661 patients seen during the study period, 14,567 had blood samples sent both for POC and CL analysis. Using clinical criteria, the levels of agreement for sodium were 98.6% (within 5mg/dL), for potassium 90.7% (0.5 mmol/L), for BUN 89.0% (within 5 mg/dL), for creatinine 94.5% (within 0.3 mg/dL), for hematocrit 96.5% (within 5 g/dL).\n \nConclusion:\n Agreement between POC and CL values is excellent. Restricting the analysis to clinically important levels of agreement continues to show excellent agreement. The data suggest that sending a serum sample to the hospital CL for duplicate assays is unnecessary. This may result in substantial savings and shorter ED lengths of stay.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Point-of-care, laboratory testing, healthcare costs, duplication, utilization" } ], "section": "Emergency Department Operations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1ps2f83f", "frozenauthors": [ { "first_name": "Meir", "middle_name": "", "last_name": "Dashevsky", "name_suffix": "", "institution": "Yale University School of Medicine", "department": "None" }, { "first_name": "Carol", "middle_name": "L", "last_name": "Barsky", "name_suffix": "", "institution": "Yale University School of Medicine", "department": "None" }, { "first_name": "Richard", "middle_name": "Andrew", "last_name": "Taylor", "name_suffix": "", "institution": "Yale University School of Medicine", "department": "None" }, { "first_name": "Steven", "middle_name": "L.", "last_name": "Berstein", "name_suffix": "", "institution": "Yale University School of Medicine", "department": "None" } ], "date_submitted": "2016-04-04T16:42:01Z", "date_accepted": "2016-04-04T16:42:01Z", "date_published": "2017-03-13T17:37:11Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/9733/galley/5389/download/" } ] }, { "pk": 10328, "title": "Outcomes by Mode of Transport of ST Elevation MI Patients in the United Arab Emirates", "subtitle": null, "abstract": "Introduction. \nThe purpose of this multicenter, prospective study was to assess differences in demographics, medical history, treatment times, and follow-up status among patients with ST-elevation myocardial infarction (STEMI), who were transported to the hospital by emergency medical services (EMS), privately, or transferred from other medical facilities.\n \nMethods. \nOur sample consisted of 455 patients admitted to 4 hospitals in “blinded for peer review.” We collected electronic medical records from EMS and hospitals, and conducted interviews with patients in-person or via telephone. Chi-square tests and Kruskal–Wallis tests were used to examine differences in variables by mode of transportation.\n \nResults. \nResults indicated significant differences in modes of transportation when considering symptom-onset-to-balloon-time (\np\n < 0.001), door-to-balloon time (\np\n < 0.001), and health status at 6-month and 1-year follow-up (\np\n < 0.001). In all cases, EMS transportation was associated with a shorter time to treatment than other modes of transportation. However, the EMS group experienced greater rates of in-hospital events, including cardiac arrest and mortality, than the private transport group.\n \nConclusion. \nOur results contribute data supporting EMS transportation for patients with acute coronary syndrome. Although a lack of follow-up data made it difficult to draw conclusions about long-term outcomes, our findings clearly indicate that EMS transportation can speed time to treatment, including time to balloon inflation, potentially reducing readmission and adverse events. We conclude that future efforts should focus on encouraging the use of EMS and improving transfer practices. Such efforts could improve outcomes for patients presenting with STEMI.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "acute coronary syndrome" }, { "word": "emergency medical services" }, { "word": "door-to-balloon time" }, { "word": "modes of transportation" }, { "word": "ST-elevation myocardial infarction" } ], "section": "Disaster Medicine/ Emergency Medical Services", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7dv9g4js", "frozenauthors": [ { "first_name": "Edward", "middle_name": "Lance", "last_name": "Callachan", "name_suffix": "", "institution": "Division of Emergency Medicine\nUniversity of Cape Town Faculty of Health Sciences\nP.O. Box 53507, Abu Dhabi, United Arab Emirates", "department": "None" }, { "first_name": "Alawi", "middle_name": "A.", "last_name": "Alsheikh-Ali", "name_suffix": "", "institution": "Institute of Cardiac Sciences, Sheikh Khalifa Medical City \nP.O. Box 59100, Abu Dhabi, United Arab Emirates \n\nCollege of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates", "department": "None" }, { "first_name": "Satish", "middle_name": "", "last_name": "Chandrasekhar Nair", "name_suffix": "", "institution": "Director Clinical Research, Tawam Hospital- Johns Hopkins Medicine Affiliate, Box 15258, Al Ain UAE", "department": "None" }, { "first_name": "Stevan", "middle_name": "", "last_name": "Bruijns", "name_suffix": "", "institution": "University of Cape Town, Division of Emergency Medicine Private Bag X24, Bellville, 7535, South Africa", "department": "None" }, { "first_name": "Lee", "middle_name": "A", "last_name": "Wallis", "name_suffix": "", "institution": "University of Cape Town, Division of Emergency Medicine \nPrivate Bag X24, Bellville, 7535, South Africa", "department": "None" } ], "date_submitted": "2016-09-20T07:23:22Z", "date_accepted": "2016-09-20T07:23:22Z", "date_published": "2017-03-13T17:34:38Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10328/galley/5679/download/" } ] }, { "pk": 10418, "title": "Areas of Potential Impact of the Patient Protection and Affordable Care Act on EMS: A Synthesis of the Literature", "subtitle": null, "abstract": "This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act’s (ACA) as it relates to Emergency Medical Services (EMS) in order to provide guidance for navigating current and future healthcare changes. Patient usage and access to care, healthcare quality assessments, reimbursement changes, new EMS innovations, and changes to emergency preparedness are the major areas impacted by the ACA. Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems. New Medicaid enrollees and changes to existing coverage plans may alter EMS transport volumes. Reimbursement changes such as adjustments to the Ambulance Inflation Factor (AIF) alter the yearly increases in EMS reimbursement by incorporating the multifactor productivity value into yearly reimbursement adjustments. New initiatives, funded by the Center for Medicare & Medicaid Innovation (CMMI) are exploring novel and cost effective prehospital care delivery opportunities while EMS agencies individually explore partnerships with healthcare systems.", "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": "EMS, Patient Protection and Accountable Care Act, Prehospital Medicine, Paramedicine" } ], "section": "Prehospital Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3bk4f30f", "frozenauthors": [ { "first_name": "Daniel", "middle_name": "G.", "last_name": "Ostermayer", "name_suffix": "", "institution": "University of Texas Houston Health Science Center\nMcGovern Medical School\nHouston Fire Department", "department": "None" }, { "first_name": "Charles", "middle_name": "A.", "last_name": "Brown", "name_suffix": "", "institution": "McGovern Medical School\nHouston, Texas", "department": "None" }, { "first_name": "William", "middle_name": "G.", "last_name": "Fernandez", "name_suffix": "", "institution": "University of Texas Houston Health Science Center\nMcGovern Medical School", "department": "None" }, { "first_name": "Emily", "middle_name": "", "last_name": "Couvillon", "name_suffix": "", "institution": "Texas Medical Center Library", "department": "None" } ], "date_submitted": "2016-10-27T21:42:06Z", "date_accepted": "2016-10-27T21:42:06Z", "date_published": "2017-03-13T17:29:30Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10418/galley/5727/download/" } ] }, { "pk": 360, "title": "Avulsion of the Lesser Trochanter Following a Shot Put Sport Session", "subtitle": null, "abstract": "Avulsion of the lesser trochanter is an uncommon injury. In children and adolescents it usually occursas a sports injury via traumatic avulsion of the psoas major tendon. In adults, isolated fractures of thelesser trochanter are most commonly pathological due to metastatic tumor invasion of the proximalfemur. This case report documents how a 14-year-old boy, who presented with an avulsion of thelesser trochanter of the proximal femur following a seemingly atraumatic shot put session at a trackand field event, was diagnosed and successfully treated with a conservative approach.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8t6699np", "frozenauthors": [ { "first_name": "Mohamed", "middle_name": "Habib", "last_name": "Grissa", "name_suffix": "", "institution": "Fattouma Bourguiba University Hospital", "department": "None" }, { "first_name": "Nasri", "middle_name": "", "last_name": "Bzeouich", "name_suffix": "", "institution": "Fattouma Bourguiba University Hospital", "department": "None" }, { "first_name": "Makram", "middle_name": "", "last_name": "Zrig", "name_suffix": "", "institution": "Fattouma Bourguiba University Hospital", "department": "None" }, { "first_name": "Hamdi", "middle_name": "", "last_name": "Boubaker", "name_suffix": "", "institution": "Fattouma Bourguiba University Hospital", "department": "None" }, { "first_name": "Mohamed", "middle_name": "Amine", "last_name": "Msolli", "name_suffix": "", "institution": "Fattouma Bourguiba University Hospital", "department": "None" }, { "first_name": "Abderrazak", "middle_name": "", "last_name": "Abid", "name_suffix": "", "institution": "Fattouma Bourguiba University Hospital", "department": "None" }, { "first_name": "Semir", "middle_name": "", "last_name": "Nouira", "name_suffix": "", "institution": "Fattouma Bourguiba University Hospital", "department": "None" }, { "first_name": "Amanda", "middle_name": "", "last_name": "Montgomery", "name_suffix": "", "institution": "Kern Medical", "department": "None" } ], "date_submitted": "2017-03-13T23:51:17Z", "date_accepted": "2017-03-13T23:51:17Z", "date_published": "2017-03-13T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/360/galley/126/download/" } ] }, { "pk": 10244, "title": "Cross-Sectional Study of Risky Substance Use of Injured Emergency Department Patients", "subtitle": null, "abstract": "Introduction\n. Survey data regarding the prevalence of risky substance use in the emergency department (ED) is not consistent. The objective of this study is to identify the prevalence of risky substance use among injured ED patients based on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST v3.0). A secondary objective was to report on the feasibility of administering the ASSIST to this population, based on the time to conduct screening. \nMethods.\n This cross-sectional study used screening data from a randomized controlled trial. Injured ED patients completed the ASSIST on a tablet computer, and an ASSIST score was computed that indicated the need for a brief or intensive treatment intervention (risky use) for alcohol and other substances. For a subsample, data to complete each step of screening was recorded. \nResults.\n Between July 2010 and March 2013, 5,695 patients completed the ASSIST. Most (92%) reported lifetime use of at least one substance and 51% reported current risky use of at least one substance. Mean time to complete the ASSIST was 5.4 minutes and screening was feasible even when paused for clinical care to proceed. \nConclusion.\n Estimates of risky substance use based on the ASSIST in our large sample of injured ED patients are higher than previously reported in other studies of ED patients, possibly due to the current focus on an injured population. In addition, it was feasible to administer the ASSIST to patients in the course of their clinical 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": "Substance use" }, { "word": "injured patients" }, { "word": "screening" } ], "section": "Injury Prevention and Population Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9vs44513", "frozenauthors": [ { "first_name": "Valerie", "middle_name": "", "last_name": "Strezsak", "name_suffix": "", "institution": "Brown University", "department": "None" }, { "first_name": "Janette", "middle_name": "", "last_name": "Baird", "name_suffix": "", "institution": "Brown University", "department": "None" }, { "first_name": "Christina", "middle_name": "S", "last_name": "Lee", "name_suffix": "", "institution": "Northeastern University", "department": "None" }, { "first_name": "Michael", "middle_name": "J", "last_name": "Mello", "name_suffix": "", "institution": "Brown University", "department": "None" } ], "date_submitted": "2016-08-19T18:27:42Z", "date_accepted": "2016-08-19T18:27:42Z", "date_published": "2017-03-13T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10244/galley/5634/download/" } ] }, { "pk": 359, "title": "No Room for Error: Empiric Treatment for Fulminant Pneumonia", "subtitle": null, "abstract": "Early antibiotic administration is critical in cases of sepsis and severe community-acquired pneumonia, which is frequently due to \nStreptococcus pneumoniae\n, \nStaphylococcus aureus\n, \nLegionella\n species, or influenza. We describe the case of a 29-year-old previously healthy man who presented to an urban emergency department (ED) in the North Central U.S. with fever, hip pain, severe hypoxemia, and diffuse pulmonary infiltrates. He was intubated and received piperacillin/tazobactam, levofloxacin, vancomycin, and oseltamivir; given his fulminant presentation and predicted high mortality, doxycycline, methylprednisolone, and amphotericin B were also administered empirically in the ED. A respiratory culture eventually grew \nBlastomyces dermatitidis\n, and the patient survived. Severe acute respiratory distress syndrome due to fulminant pneumonitis carries a high mortality. Faced with this scenario and no room for error, it is important that the emergency physician cover for all possible pathogens, including zoonotic bacteria and endemic fungi.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3w4336k1", "frozenauthors": [ { "first_name": "Matthew", "middle_name": "E", "last_name": "Prekker", "name_suffix": "", "institution": "Hennepin County Medical Center, University of Minnesota Medical School", "department": "None" }, { "first_name": "Stephen", "middle_name": "W", "last_name": "Smith", "name_suffix": "", "institution": "Hennepin County Medical Center, University of Minnesota Medical School", "department": "None" } ], "date_submitted": "2017-03-13T21:00:01Z", "date_accepted": "2017-03-13T21:00:01Z", "date_published": "2017-03-13T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/359/galley/125/download/" } ] }, { "pk": 358, "title": "Phelgmasia Cerulea Dolens Diagnosed by Point-of- Care Ultrasound", "subtitle": null, "abstract": "Phlegmasia cerulea dolens (PCD) is a rare entity that is associated with significant morbidity and mortality, including limb ischemia and pulmonary embolism. Point-of-care ultrasound (POCUS) can expedite the diagnosis, leading to earlier life- and limb-saving treatment. Although primarily used for assessing for the presence of deep venous thrombosis, in the appropriate clinical setting POCUS can also be used to diagnosis PCD as well as to distinguish between venous and arterial occlusion, which can lead to a difference in management. We present a case of phlegmasia cerulea dolens after mild trauma in a patient with an underlying hypercoagulability disorder diagnosed by an emergency physician using POCUS, which expedited treatment with catheter-directed thrombolytic therapy.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8tc6n5rm", "frozenauthors": [ { "first_name": "Michele", "middle_name": "", "last_name": "Schroeder", "name_suffix": "", "institution": "University of Massachusetts Medical School-Baystate Health Springfield Campus, Baystate Medical Center", "department": "None" }, { "first_name": "Amanda", "middle_name": "", "last_name": "Shorette", "name_suffix": "", "institution": "University of Massachusetts Medical School-Baystate Health Springfield Campus, Baystate Medical Center", "department": "None" }, { "first_name": "Sukhdeep", "middle_name": "", "last_name": "Singh", "name_suffix": "", "institution": "University of Massachusetts Medical School-Baystate Health Springfield Campus, Baystate Medical Center", "department": "None" }, { "first_name": "Gavin", "middle_name": "", "last_name": "Budhram", "name_suffix": "", "institution": "University of Massachusetts Medical School-Baystate Health Springfield Campus, Baystate Medical Center", "department": "None" } ], "date_submitted": "2017-03-10T23:32:07Z", "date_accepted": "2017-03-10T23:32:07Z", "date_published": "2017-03-13T07:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/358/galley/124/download/" } ] }, { "pk": 33567, "title": "I am Not a Hacker", "subtitle": null, "abstract": "The term \"hacker\" is notoriously slippery. Paula Bialski dives into the practices and micropolitics of self-proclaimed non-hackers.", "language": null, "license": { "name": "Creative Commons Attribution-ShareAlike 4.0", "short_name": "CC BY-SA 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\nShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.\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-sa/4.0" }, "keywords": [], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5xq0v7rb", "frozenauthors": [ { "first_name": "Paula", "middle_name": "", "last_name": "Bialski", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-10T18:00:00Z", "render_galley": null, "galleys": [ { "label": "HTML", "type": "pdf", "path": "https://journalpub.escholarship.org/limn/article/33567/galley/24640/download/" } ] }, { "pk": 357, "title": "Pyogenic Flexor Tenosynovitis in an Infant", "subtitle": null, "abstract": "Pyogenic flexor tenosynovitis is a rare though well known infectious process of the flexor tendon sheath of the hand. This condition is generally diagnosed in adults by the observance of the four Kanavel signs. Application of the Kanavel signs to diagnosis in the pediatric population, however, is of unknown utility. We present the case of a 13-month-old male with pyogenic flexor tenosynovitis who presented with all four of the Kanavel signs.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8fp2d70g", "frozenauthors": [ { "first_name": "James", "middle_name": "Insco", "last_name": "Gragg", "name_suffix": "", "institution": "Carl R. Darnall Army Medical Center", "department": "None" }, { "first_name": "Ryder", "middle_name": "", "last_name": "Olsen", "name_suffix": "", "institution": "Carl R. Darnall Army Medical Center", "department": "None" }, { "first_name": "S. Briant", "middle_name": "", "last_name": "Stringham", "name_suffix": "", "institution": "Carl R. Darnall Army Medical Center", "department": "None" } ], "date_submitted": "2017-03-10T21:23:38Z", "date_accepted": "2017-03-10T21:23:38Z", "date_published": "2017-03-10T08:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/357/galley/123/download/" } ] }, { "pk": 44261, "title": "A Case of Lichen Nitidus Mimicking Papular Sarcoidosis", "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/77w43849", "frozenauthors": [ { "first_name": "Sina", "middle_name": "", "last_name": "Rabi", "name_suffix": "BA", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Delila", "middle_name": "", "last_name": "Pouldar", "name_suffix": "BS", "institution": "", "department": "" }, { "first_name": " Lisa", "middle_name": "", "last_name": "Hisaw", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": " Daniel", "middle_name": "", "last_name": "Neill", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": "Lorraine", "middle_name": "", "last_name": "Young", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-09T20:28:41Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44261/galley/33060/download/" } ] }, { "pk": 10348, "title": "Choosing Wisely Imaging Recommendations: Initial Implementation in New England Emergency Departments", "subtitle": null, "abstract": "Introduction\n \nIn June 2016, the American College of Emergency Physicians (ACEP) Emergency Quality Network began its \nReduce Avoidable Imaging Initiative\n, designed to “reduce testing and imaging with low risk patients through the implementation of \nChoosing Wisely r\necommendations”. However, it is unknown whether New England Emergency Departments (EDs) have already implemented evidence-based interventions to improve adherence to ACEP\n Choosing Wisely\n recommendations related to imaging after their initial release in 2013. Our objective was to determine this, as well as whether provider-specific audit-and-feedback for imaging had been implemented in these EDs.\n \n \nMethods\n \nThis survey study was exempt from Institutional Review Board review. In 2015, we mailed surveys to 195 hospital-affiliated EDs in all six New England states to determine whether they had implemented \nChoosing Wisely\n-focused interventions in 2014. Initial mailings included cover letters denoting the endorsement of each state’s ACEP chapter, and were followed-up twice with repeat mailings to non-responders. Data analysis included descriptive statistics and a comparison of state differences using Fisher’s exact test.\n \n \n \nResults\n \nA total of 169/195 (87%) of New England EDs responded, with all individual state response rates >80%. Overall, 101 (60%) of responding EDs had implemented an intervention for at least one \nChoosing Wisely\n imaging scenario; 57% reported implementing a specific guideline/policy/clinical pathway, 40% had implemented provider-specific audit-and-feedback, and 28% reported implementing a computerized decision support system. The most common interventions were for chest CT in patients at low-risk of pulmonary embolism (47% of EDs) and head CT in patients with minor trauma (45% of EDs). In addition, 40% of EDs had implemented provider-specific audit-and-feedback, without significant interstate variation (range: 29-55%).\n \n \n \nConclusion\n \nOne year after release of the ACEP \nChoosing \nWisely recommendations, most New England EDs had a guideline/policy/clinical pathway related to at least one of the recommendations. However, only a minority were using provider-specific audit-and-feedback or computerized decision support. Few EDs have embraced the opportunity to implement the multiple evidence-based interventions likely to advance the national goals of improving patient-centered and resource-efficient 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": "Emergency Medicine" }, { "word": "Emergency Radiology" }, { "word": "Quality Improvement" } ], "section": "Patient Safety", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/70977873", "frozenauthors": [ { "first_name": "Ali", "middle_name": "S.", "last_name": "Raja", "name_suffix": "", "institution": "Department of Emergency Medicine\nMassachusetts General Hospital\nHarvard Medical School", "department": "None" }, { "first_name": "Arjun", "middle_name": "K.", "last_name": "Venkatesh", "name_suffix": "", "institution": "Department of Emergency Medicine and \nCenter for Outcomes Research and Evaluation\nYale University School of Medicine", "department": "None" }, { "first_name": "Nathan", "middle_name": "", "last_name": "Mick", "name_suffix": "", "institution": "Department of Emergency Medicine, Maine Medical Center\nTufts University School of Medicine", "department": "None" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Zabbo", "name_suffix": "", "institution": "Department of Emergency Medicine\nKent Hospital, Warwick, RI", "department": "None" }, { "first_name": "Kohei", "middle_name": "", "last_name": "Hasegawa", "name_suffix": "", "institution": "Department of Emergency Medicine\nMassachusetts General Hospital\nHarvard Medical School", "department": "None" }, { "first_name": "Janice", "middle_name": "", "last_name": "Espinola", "name_suffix": "", "institution": "Department of Emergency Medicine\nMassachusetts General Hospital", "department": "None" }, { "first_name": "Jane", "middle_name": "", "last_name": "Bittner", "name_suffix": "", "institution": "Department of Emergency Medicine\nMassachusetts General Hospital", "department": "None" }, { "first_name": "Carlos", "middle_name": "A", "last_name": "Camargo", "name_suffix": "", "institution": "Department of Emergency Medicine\nMassachusetts General Hospital\nHarvard Medical School", "department": "None" } ], "date_submitted": "2016-09-28T15:40:55Z", "date_accepted": "2016-09-28T15:40:55Z", "date_published": "2017-03-08T18:26:27Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10348/galley/5689/download/" } ] }, { "pk": 10308, "title": "Gender Differences in CDC Guideline Compliance for STIs in Emergency Departments", "subtitle": null, "abstract": "Introduction: Sexually transmitted infections (STIs) are a common reason for Emergency Department (ED) visits. The objective of this study was to see if there were gender differences in CDC diagnosis and treatment guidelines as documented by emergency physicians.\nMethods: A retrospective chart review was performed to idenitfy patients treate for urethritis, cervicitis, and PID in the EDs of three hospitals in a PA network during a calendar year. Cases were reviewed to assess for compliance in documentation with CDC guidelines. Descriptive statistics were used to assess the distributions of study variables by patient sex. Student t-tess, chi-square tests, and logistic regression were used in the analysis. Statistical significance was set at p less than or equal to 0.05.\nResults: 286 patient records were identified, of these 39 were excluded due to incorrect disease coding, the patient was admitted and treated as an inpatient for their disease, or the patient left the emergency department after refusing care. Of the 247 participangs, 159 (64.4%) were female. Females were significantly younger (26.6 years, SD=8.0) than males (31.2, SD=11.5%), (95%CI:2.0-7.0, p=0.0003). All of the males (n=88) in the cohort presented with urethritis;25.8% of females presented with cervicitis and 75.2% with PID. Compliance with documentation for the 5 CDC criteria ranged from 68.8% for patient history to 93.5% for patient diagnostic testing including urine pregnancy, and gonorrhea/chlamydia cultures. Significant differences were obesrved by patient sex. 54% of the charts had symptoms recorded for female patients that were consistent with CDC characteristics for diagnostic critera compared to over 95% for males , (OR=16.9, 95% CI 5.9-48.4, p less than 0.001). Similar results were observed for patient discharge instructions, with physicians completely documenting deliver of discharge instructions to 51.6% females compared to 97.7% of complet documentation in males OR=42.3;95%CI;10.0-178.6, p <0.001). No significant sex differences in documentaion were observed for exam or fo therapeutic antibiotic treatment. Conclusion: This retrospective study found patient gender differences in documentaiton compliance with CDC guidelines for the diagnosis and treatment of urethritis, cervicitis and PID", "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": "STI treatment, CDC compliance" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/79p7x009", "frozenauthors": [ { "first_name": "Bryan", "middle_name": "G", "last_name": "Kane", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Alexander", "middle_name": "WD", "last_name": "Guillaume", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Elizabeth", "middle_name": "M", "last_name": "Evans", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Terrence", "middle_name": "E", "last_name": "Goyke", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Jessica", "middle_name": "K", "last_name": "Eygnor", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Lauren", "middle_name": "", "last_name": "Semler", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Stephen", "middle_name": "W", "last_name": "Dusza", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Marna", "middle_name": "Rayl", "last_name": "Greenberg", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network, Department of Emergency Medicine Research, Allentown, Pennsylvania", "department": "None" } ], "date_submitted": "2016-09-11T13:56:08Z", "date_accepted": "2016-09-11T13:56:08Z", "date_published": "2017-03-08T18:12:49Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10308/galley/5667/download/" } ] }, { "pk": 10152, "title": "Inter-rater Agreement of End-of-shift Evaluations Based on a Single Encounter", "subtitle": null, "abstract": "Introduction\n End-of-shift evaluation (ESE) forms, also known as daily encounter cards, represent a subset of encounter-based assessment forms. Encounter cards have become prevalent for formative evaluation, with some suggesting a potential for summative evaluation. Our objective was to evaluate the inter-rater agreement of ESE forms using a single scripted encounter at a conference of emergency medicine (EM) educators.\n \n \n \nMethods\n Following institutional review board exemption a scripted video simulating an encounter between an intern and a patient with an ankle injury was created. That video was shown during a lecture at the Council of EM Residency Director’s Academic Assembly with attendees asked to evaluate the “resident” using 1 of 8 possible ESE forms randomly distributed. Descriptive statistics were used to analyze the results with Fleiss’ Kappa to evaluate inter-rater agreement.\n \n \n \nResults\n Most of the 324 respondents were leadership in residency programs (66%). Despite that, few individuals (5%) felt they were experts in assessing residents based on EM milestones. Fleiss’ Kappa ranged from 0.157 - 0.308 and did not perform much better in two post-hoc subgroup analyses.\n \n \n \nConclusion \n \nThe kappa ranges found show only slight to fair inter-rater agreement and raise concerns about the use of ESE forms in assessment of EM residents. Despite limitations present in this study, these results and a lack of other studies on inter-rater agreement of encounter cards should prompt further studies of such methods of assessment. Additionally, EM educators should focus research on methods to improve inter-rater agreement of ESE forms or other evaluating other methods of assessment of EM residents.", "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": "Encounter Cards" }, { "word": "Interrater agreement" }, { "word": "Emergency Medicine Milestones" }, { "word": "Assessment" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/64v6d72b", "frozenauthors": [ { "first_name": "Steven", "middle_name": "Jay", "last_name": "Warrington", "name_suffix": "", "institution": "Kaweah Delta Medical Center", "department": "None" }, { "first_name": "Michael", "middle_name": "S", "last_name": "Beeson", "name_suffix": "", "institution": "Akron General Medical Center; Northeast Ohio Medical University", "department": "None" }, { "first_name": "Amber", "middle_name": "", "last_name": "Bradford-Saffles", "name_suffix": "", "institution": "Akron General Medical Center; Northeast Ohio Medical University", "department": "None" } ], "date_submitted": "2016-08-09T02:29:55Z", "date_accepted": "2016-08-09T02:29:55Z", "date_published": "2017-03-08T01:08:38Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10152/galley/5556/download/" } ] }, { "pk": 9802, "title": "State Emergency Department Opioid Guidelines: Current Status", "subtitle": null, "abstract": "Study Objective: The purpose of this study was to evaluate and categorize current state-sponsored opioid guidelines which affect Emergency Medicine practice. \nMethods: We conducted a comprehensive search of emergency medicine-specific opioid prescribing guidelines and/or policies in each state to determine current state involvement in emergency medicine opioid prescribing, as well as to evaluate some of the specifics of each guideline or policy. The search was conducted using an online query and a follow-up email request to each state chapter of ACEP.\nResults: We found that eighteen states had emergency department-specific guidelines. We further organized these into four categories; Limiting Prescriptions for Opioids with 67 total recommendations, Preventing/Diverting Abuse with 56 total recommendations, Addiction related guidelines with 29 total recommendations, and a Community Resources section with 24 total recommendations. Our results showed that current state guidelines focus on providers limiting opioid pain prescriptions and vetting patients for possible abuse/diversion.. \nConclusion: This study highlights the 18 states that have addressed opioid prescribing guidelines and categorizes their efforts to date. It is hoped that this work will provide the basis for similar efforts in other states.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Opioids, Prescribing Practices," } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7qq5d4qz", "frozenauthors": [ { "first_name": "Andrew", "middle_name": "", "last_name": "Little, DO", "name_suffix": "", "institution": "Doctors Hospital Emergency Department", "department": "None" }, { "first_name": "Robert", "middle_name": "I", "last_name": "Broida, MD FACEP", "name_suffix": "", "institution": "Chief Operating Officer of PSLRRG, Director of Risk Management EMP. Canton, Ohio", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Kalnow, DO", "name_suffix": "", "institution": "Doctors Hospital Emergency Department", "department": "None" }, { "first_name": "Tanner", "middle_name": "", "last_name": "Gronowski, DO", "name_suffix": "", "institution": "Doctors Hospital Emergency Department", "department": "None" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Lloyd, DO", "name_suffix": "", "institution": "Doctors Hospital Emergency Department", "department": "None" } ], "date_submitted": "2016-05-11T01:48:18Z", "date_accepted": "2016-05-11T01:48:18Z", "date_published": "2017-03-08T01:03:04Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/9802/galley/5407/download/" } ] }, { "pk": 10432, "title": "Impact of clinical decision support on radiography for acute ankle injuries: a randomized trial", "subtitle": null, "abstract": "INTRODUCTION \n \nWhile only 15-20% of patients with foot and ankle injuries presenting to urgent care centers have clinically significant fractures, most undergo radiography. We examined the impact of electronic point-of-care clinical decision support (CDS) on adherence to the Ottawa Ankle Rules (OAR) as well as use and yield of foot and ankle radiographs in patients with acute ankle injury. \n \nMETHODS\n \nInstitutional Review Board approval was obtained for this randomized controlled study performed April 18, 2012 through December 15, 2013. All ordering providers credentialed at an urgent care affiliated with a quaternary care academic hospital were randomized to either receive or not receive CDS, based on the OAR and integrated into the physician order entry system, with feedback at the time of imaging order. If the patient met OAR low-risk criteria, providers were advised against imaging and could either cancel the order or ignore the alert. Patients with foot and ankle complaints were identified via ICD-9 billing codes and electronic health records and radiology reports reviewed for those who were eligible. Chi-square was used to compare adherence to the OAR (primary outcome), radiography utilization rate and radiography yield of foot and ankle imaging (secondary outcomes) between the intervention and control groups.\n \nRESULTS\n \nOf 14,642 patients seen at urgent care during the study period, 613 (4.2%, representing 632 visits) presented with acute ankle injury and were eligible for application of the OAR; 374 (59.2%) of these were seen by control group providers. In the intervention group, CDS adherence was higher for both ankle (239/258=92.6% vs. 231/374=61.8%, p=0.02) and foot radiography (209/258=81.0% vs. 238/374=63.6%; p<0.01). However, ankle radiography use was higher in the intervention group (166/258=64.3% vs. 183/374=48.9%; p<0.01) while foot radiography use (141/258=54.6% vs. 202/374=54.0%; p=0.95) was not. Radiography yield was also higher in the intervention group (26/307=8.5% vs. 18/385=4.7%; p=0.04).\n \nCONCLUSION\n \nClinical Decision Support, previously demonstrated to improve guideline adherence for high-cost imaging, can also improve guideline adherence for radiography – as demonstrated by increased OAR adherence and increase imaging yield.", "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": "evidence-based imaging, appropriate utilization of imaging, Ottawa Ankle Rules, clinical decision support, urgent care" } ], "section": "Technology in Emergency Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6gb6t75d", "frozenauthors": [ { "first_name": "Shahein", "middle_name": "", "last_name": "Tajmir", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Ali", "middle_name": "S.", "last_name": "Raja", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Ivan", "middle_name": "K", "last_name": "Ip", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "James", "middle_name": "", "last_name": "Andruchow", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Patricia", "middle_name": "", "last_name": "Silveira", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Stacy", "middle_name": "", "last_name": "Smith", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Ramin", "middle_name": "", "last_name": "Khorasani", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2016-11-02T17:23:52Z", "date_accepted": "2016-11-02T17:23:52Z", "date_published": "2017-03-08T00:59:46Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10432/galley/5737/download/" } ] }, { "pk": 10433, "title": "Prevalence of Homelessness in the Emergency Department Setting", "subtitle": null, "abstract": "Background/Objective: To determine the prevalence of homelessness or at-risk for homelessness in the ED setting.\nMethods: Using a 5 question screening tool derived from teh US department of Housing and Urband Development (HUD), Health and Human Services (HHS) and the Beterans Administration (VA) definition for homelessness, we surveyed all patients meeting inclusion criteria on scheudled shifts in one of three EDs in Northeastern Pennsylvania Two survey periods were selected to represent seasonal variations.\nResults: 4395 subjects were included in the analysis. The mean age of participants was 50.8 (SD 20.5) and 2,557(58.2%) were women. The mean age of those who screened positive for homelessness or at-risk for homelessness was 43.1 (SD16.6). Overall, 136 (3.1%) participants screened positive for at-risk for homelessness and 309 (7.0%) screened positive for homelessness. 103 (9.8%) subjects screened positive for homelessness or at-risk for homelessness on weekends and 312 (10.3%) on weekedays (p=-.64). The proportion of those screening positive for homelessness or at-risk for homelessness varied by site: 145 (7.5%) at hte trauma cetner, 151 (9.1%) at the suburban site and 149 (18.7%) at the center city site, p<0.001. There was no statistical significance to the difference between the trauma center and the suburban site (p=.088), but there was statistical significance between both the suburban and the trauma cneter when compared to the center city site (both p<0.0001). The proportion of those screening positive for homelessness in the summer months (156,7.5%) was similar to those in the winter months (153, 6.6%), p=-.23, but it did favor summer months if those who were at-risk for homelessness were included (230, 11.1%, summer versus 215, 9.2% winter; p=0.045).\nConclusions: In our study, the overall prevalence of homelessness or at-risk for homelessness was 10.1%. This prevalence did not seem to vary between weekdays and weekends. Additionally summer months had a prevalence that was was concerning as winter months. The prevalence does, however, seem to vary by institutional characteristics even in the same geographic region. Understanding the patterns of prevalence of homelessness is a step toward considering possible interventions to assist this vulnerable population", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "homelessness" }, { "word": "prevalence" } ], "section": "Emergency Department Access", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/67r8k225", "frozenauthors": [ { "first_name": "Brett", "middle_name": "J", "last_name": "Feldman", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network", "department": "None" }, { "first_name": "Cristina", "middle_name": "G", "last_name": "Calogero", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network", "department": "None" }, { "first_name": "Kareem", "middle_name": "S", "last_name": "Elsayed", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network", "department": "None" }, { "first_name": "Osman", "middle_name": "Z", "last_name": "Abbasi", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network", "department": "None" }, { "first_name": "Joshua", "middle_name": "", "last_name": "Enyart", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network", "department": "None" }, { "first_name": "Timothy", "middle_name": "J", "last_name": "Friel", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network", "department": "None" }, { "first_name": "Yasir", "middle_name": "H", "last_name": "Abunamous", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network", "department": "None" }, { "first_name": "Stephen", "middle_name": "W", "last_name": "Dusza", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network", "department": "None" }, { "first_name": "Marna", "middle_name": "Rayl", "last_name": "Greenberg", "name_suffix": "", "institution": "Lehigh Valley Hospital and Health Network, Department of Emergency Medicine Research, Allentown, Pennsylvania", "department": "None" } ], "date_submitted": "2016-11-02T18:11:18Z", "date_accepted": "2016-11-02T18:11:18Z", "date_published": "2017-03-08T00:26:55Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10433/galley/5738/download/" } ] }, { "pk": 44274, "title": "The Undiagnosed Exudate: Pleuroscopy and Pleural Effusions", "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/2pg5082m", "frozenauthors": [ { "first_name": "Andrew", "middle_name": "", "last_name": "Sumarsono", "name_suffix": "BS", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Cynthia", "middle_name": "", "last_name": "Kim", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": "Irawan", "middle_name": "", "last_name": "Susanto", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": "Scott", "middle_name": "", "last_name": "Oh", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-06T23:06:35Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44274/galley/33073/download/" } ] }, { "pk": 356, "title": "Nonspecific Headache Diagnosed as a Brain Colloid Cyst with Hydrocephalus", "subtitle": null, "abstract": "A 29-year-old male presented to our emergency department with complaints of a left frontal headache, similar to his prior headaches. He also reported about 30 minutes of facial and tongue numbness, left arm weakness, slurred speech and changes in hearing that had resolved prior to his arrival. Despite the short duration of the other neurologic symptoms, he also endorsed persistent “dizziness.” Despite his history of recurrent headaches, he had never had any neuroimaging. This, as well as his reports of new neurological symptoms, prompted his care team to obtain a non-contrast brain computed tomography. The findings were consistent with a mass with mild hydrocephalus. Patient underwent neurosurgical resection of the mass at a tertiary center. He did well after surgery and was discharged on postop day 6 with a diagnosis of colloid cyst.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0wg9t5dk", "frozenauthors": [ { "first_name": "Christine", "middle_name": "", "last_name": "Carroll", "name_suffix": "", "institution": "Carl R. Darnall Army Medical Center", "department": "None" }, { "first_name": "Mark", "middle_name": "", "last_name": "Riddle", "name_suffix": "", "institution": "Carl R. Darnall Army Medical Center", "department": "None" } ], "date_submitted": "2017-03-06T21:03:23Z", "date_accepted": "2017-03-06T21:03:23Z", "date_published": "2017-03-06T08:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/356/galley/122/download/" } ] }, { "pk": 10164, "title": "Prehospital Care for the Adult and Pediatric Seizure Patient: Current Evidence Based Recommendations", "subtitle": null, "abstract": "Introduction: We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of adult and pediatric patients with a seizure and to compare these recommendations against the current protocol utilized by the 33 EMS agencies in California.\nMethods: We performed a review of the evidence in the prehospital treatment of a patients with a seizure. We compared the seizure protocols of each of the 33 EMS agencies for consistency with these recommendations. We analyzed the type and route of medication administered, number of additional rescue doses permitted, and requirements for glucose testing prior to medication. The treatment for eclampsia and seizures in pediatric patients were analyzed separately.\nResults: Protocols across EMS Agencies in California varied widely. Multiple drugs, dosages, routes of administration, re-dosing instructions, and requirement for blood glucose testing prior to medication delivery were identified. Blood glucose testing prior to benzodiazepine administratin is required by 61% (20/33) of agencies for adult patients and 76% (25/33) for pediatric patients. All agencies have protocols for giving intramuscular benzodiazepines and 76% (25/33) have protocols for intranasal benzodiazepines. Intramuscular midazolam dosages ranged from 2 to 10 mg per single adult dose, 2 to 8 mg per single pediatric dose, and 0.1 to 0.2 mg/kg as a weight-based dose. Intranasal midazolam dosages ranged from 2 to 10 mg pr single adult or pediatric dose, and 0.1 to 0.2 mg/kg as a weight-based dose. Intravenous/intrasosseous midazolam dosages ranged from 1 to 6 mg per single adult dose, 1 to 5 mg per single pediatric dose, and 0.05 to 0.1 mg/kg as a weight-based dose. Eclampsia is specifically addressed by 85% (28/33) of agencies. Forty-two percent (14/33) have a protocol for adminstering magnesium sulfate, with intravenous dosages ranging from 2 to 6 mg, and 58% (19/33) allow benzodiazepines to be administered.\nConclusion: Protocols for a patient with a seizure, including eclampsia, and febrile seizures, vary widely across California. These recommendations for the prehospital diagnosis and treatment of seizures may be useful for EMS Medical Directors tasked with creating and revising these protocols.", "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": "Seizure, Febrile seizure, Eclampsia, Status Epilepticus, Emergency Medical Services, Prehospital, Evidence-based Guideline" } ], "section": "Prehospital Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3qn9w8fs", "frozenauthors": [ { "first_name": "Eric", "middle_name": "C", "last_name": "Silverman", "name_suffix": "", "institution": "UCSF, School of Medicne", "department": "None" }, { "first_name": "Karl", "middle_name": "A", "last_name": "Sporer", "name_suffix": "", "institution": "UC San Francisco", "department": "None" }, { "first_name": "Justin", "middle_name": "M.", "last_name": "Lemieux", "name_suffix": "", "institution": "Stanford, School of Medicine", "department": "None" }, { "first_name": "John", "middle_name": "F", "last_name": "Brown", "name_suffix": "", "institution": "UCSF, School of Medicine", "department": "None" }, { "first_name": "Kristi", "middle_name": "L", "last_name": "Koenig", "name_suffix": "", "institution": "UC Irvine, School of Medicine", "department": "None" }, { "first_name": "Marianne", "middle_name": "", "last_name": "Gausche-Hill", "name_suffix": "", "institution": "David Geffen School of Medicine\nHarbor-UCLA Medical Center", "department": "None" }, { "first_name": "Eric", "middle_name": "M", "last_name": "Rudnick", "name_suffix": "", "institution": "EMS Medical Directors Association of California", "department": "None" }, { "first_name": "Angelo", "middle_name": "A", "last_name": "Salvucci", "name_suffix": "", "institution": "EMS Medical Directors Association of California", "department": "None" }, { "first_name": "Greg", "middle_name": "H", "last_name": "Gilbert", "name_suffix": "", "institution": "Stanford University, School of Medicine", "department": "None" } ], "date_submitted": "2016-08-15T22:44:44Z", "date_accepted": "2016-08-15T22:44:44Z", "date_published": "2017-03-03T23:34:47Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10164/galley/5562/download/" } ] }, { "pk": 10397, "title": "Audience Response System Facilitates Prediction of Scores on In-Training Examination", "subtitle": null, "abstract": "Objectives\n: To determine if scores on review quizzes delivered by an audience response system (ARS) correlate with in-training exam (ITE) scores.\nMethods\n: Prospective observational study of EM residents at 6 accredited EM residency programs. Subjects included residents who had taken previous in-training examinations. Subjects participated in bimonthly review sessions using an audience response system. Twelve review quizzes were administered, each consisting of 10 multiple choice questions. After the in-training exam, subjects completed an attitudinal survey consisting of six Likert scale items and one “yes/no” item. A mixed linear model was used to analyze the data accounting for prior 2012 in-training exam scores and nesting due to institution. \nResults\n: Among 192 participants, data from 135 (70.3%) participants were analyzed. Results from the mixed linear model indicate that the total mean score on the review quizzes was a significant [t(127) = 6.68; p < 0.001] predictor of the 2013 in-training exam score after controlling for the 2012 in-training exam score. 146 participants completed the attitudinal survey. 96% of respondents stated that they would like ARS to be used more often in resident education. Respondents felt the sessions aided in learning (mean 7.7/10), assisted in preparation for the in-training exam (mean 6.7/10), and helped identify content areas of weakness (mean 7.6/10). \nConclusion\n: Our results suggest that scores from review quizzes delivered by an audience response system correlate with in-training exam scores and is viewed positively by residents.", "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": "medical education, graduate medical education, audience response system, test preparation" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1w0261s3", "frozenauthors": [ { "first_name": "Kaushal", "middle_name": "", "last_name": "Shah", "name_suffix": "", "institution": "Icahn School of Medicine at Mt. Sinai", "department": "None" }, { "first_name": "Jaime", "middle_name": "", "last_name": "Jordan", "name_suffix": "", "institution": "Harbor-UCLA Medical Center", "department": "None" }, { "first_name": "Katherine", "middle_name": "", "last_name": "Jahnes", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "David", "middle_name": "", "last_name": "Lisbon", "name_suffix": "", "institution": "University of Kansas Hospital", "department": "None" }, { "first_name": "Lucienne", "middle_name": "", "last_name": "Lutfy-Clayton", "name_suffix": "", "institution": "Tufts University Medical School", "department": "None" }, { "first_name": "Grant", "middle_name": "", "last_name": "Wei", "name_suffix": "", "institution": "Robert Wood Johnson University Hospital", "department": "None" }, { "first_name": "Gary", "middle_name": "", "last_name": "Winkel", "name_suffix": "", "institution": "Icahn School of Medicine at Mt. Sinai", "department": "None" }, { "first_name": "Sally", "middle_name": "", "last_name": "Santen", "name_suffix": "", "institution": "University of Michigan", "department": "None" } ], "date_submitted": "2016-10-15T18:16:59Z", "date_accepted": "2016-10-15T18:16:59Z", "date_published": "2017-03-03T23:26:43Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10397/galley/5717/download/" } ] }, { "pk": 44273, "title": "Late Presentation of Fibromuscular Dysplasia in an Elderly Female with Branch Retinal Artery Occlusion", "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/5ch0h0wx", "frozenauthors": [ { "first_name": "Erin", "middle_name": "A.", "last_name": "Cook", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Grace", "middle_name": "I.", "last_name": "Chen", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-03T23:05:33Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44273/galley/33072/download/" } ] }, { "pk": 9673, "title": "Security, Violent Events, and Anticipated Surge Capabilities of Emergency Departments in Washington State", "subtitle": null, "abstract": "Background\n: Over the past 15 years, violent threats and acts against hospital patients, staff, and providers have increased and escalated. The leading area for violence is the emergency department given its 24/7 operations, its role in patient care, admissions gateway, and the center for influxes during acute surge events.\n \nObjectives\n: This investigation had three objectives: to assess the current security of Washington State EDs, to estimate the prevalence of and response to threats and violence in Washington State EDs, and to appraise the Washington State ED security capability to respond to acute influxes of patients, bystanders, and media during acute surge events.\n \nMethods\n: A voluntary, blinded, 28-question web-based survey developed by ED physicians was electronically delivered to all 87 Washington State ED Directors in January 2013. Responses were evaluated by descriptive statistical analyses.\n \nResults\n: Analyses occurred after 90% (78/87) of ED Directors responded. Annual censes of the EDs ranged from < 20,000 to 100,000 patients and represented the entire spectrum of practice environments, including critical access hospitals to a regional quaternary referral medical center. Thirty-four of 75 (45%) reported the current level of security was inadequate based on the general consensus of their ED staff. Nearly two-thirds (63%) of EDs had 24-hour security personnel coverage, 28% reported no assigned security personnel. Security personnel training was provided by 45% of hospitals or health care systems. Sixty-nine of 78 (88%) respondents witnessed or heard violent threats or acts occurring in their ED. Of these, 93% were directed towards nursing staff, 90% towards physicians, 74% towards security personnel, and 51% towards administrative personnel. Nearly half (48%) noted incidents directed towards another patient, and 50% towards a patient’s family or friend. These events were variably reported to the hospital administration. After an acute surge event, 35% believed the initial additional security response would not be adequate and 26% reporting no additional security would be available within 15 minutes.\n \nConclusion\n: Our study reveals the variability of ED security staffing and a heterogeneity of capabilities throughout Washington State. These deficiencies and vulnerabilities are likely shared by and relevant for other EDs and regional emergency preparedness planners.", "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": "Violence, Security Measures, Mass Casualty Incidents, Emergency Preparedness" } ], "section": "Patient Safety", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/45b129db", "frozenauthors": [ { "first_name": "Jonathan", "middle_name": "S", "last_name": "Weyand", "name_suffix": "", "institution": "212th Combat Support Hospital\nLandstuhl Regional Medical Center", "department": "None" }, { "first_name": "Emily", "middle_name": "", "last_name": "Junck", "name_suffix": "", "institution": "University of Washington, Division of Emergency Medicine", "department": "None" }, { "first_name": "Christopher", "middle_name": "S", "last_name": "Kang", "name_suffix": "", "institution": "Madigan Army Medical Center, Department of Emergency Medicine", "department": "None" }, { "first_name": "Jason", "middle_name": "D", "last_name": "Heiner", "name_suffix": "", "institution": "Division of Emergency Medicine, University of Washington\nDepartment of Emergency Medicine, PeaceHealth Peace Island Medical Center", "department": "None" } ], "date_submitted": "2016-03-06T13:29:23Z", "date_accepted": "2016-03-06T13:29:23Z", "date_published": "2017-03-03T19:20:57Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/9673/galley/5367/download/" } ] }, { "pk": 10072, "title": "Differentiating Urgent and Emergent Causes of Acute Red Eye for the Emergency Physician", "subtitle": null, "abstract": "Patients commonly present with an acute red eye to the emergency department. It is important to distinguish between benign and sight-threatening diagnoses. Here we provide a comprehensive overview on the acute red eye in the emergency department.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Acute Red Eye" }, { "word": "eye pain" }, { "word": "Ophthalmologic Emergencies" }, { "word": "acute angle closure glaucoma" }, { "word": "Scleritis" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/818221g2", "frozenauthors": [ { "first_name": "Christopher", "middle_name": "J.", "last_name": "Gilani", "name_suffix": "", "institution": "University of California, Irvine", "department": "None" }, { "first_name": "Allen", "middle_name": "", "last_name": "Yang", "name_suffix": "", "institution": "Western University of Health Sciences, College of Osteopathic Medicine of the Pacific", "department": "None" }, { "first_name": "Marc", "middle_name": "", "last_name": "Yonkers", "name_suffix": "", "institution": "Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, Medical Center", "department": "None" }, { "first_name": "Megan", "middle_name": "", "last_name": "Boysen-Osborn", "name_suffix": "", "institution": "Department of Emergency Medicine, University of California, Irvine, Medical Center", "department": "None" } ], "date_submitted": "2016-07-26T16:06:48Z", "date_accepted": "2016-07-26T16:06:48Z", "date_published": "2017-03-03T19:15:05Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10072/galley/5491/download/" } ] }, { "pk": 44278, "title": "Late Presentation of Fibromuscular Dysplasia in an Elderly Female with Branch Retinal Artery Occlusion", "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/3m51h53t", "frozenauthors": [ { "first_name": "Erin", "middle_name": "A.", "last_name": "Cook", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Grace", "middle_name": "I.", "last_name": "Chen", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-03T16:09:21Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44278/galley/33077/download/" } ] }, { "pk": 44272, "title": "An Interesting Case of Cardiomegaly", "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/3r42281q", "frozenauthors": [ { "first_name": "Shipra", "middle_name": "", "last_name": "Hingorany", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-02T23:04:18Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44272/galley/33071/download/" } ] }, { "pk": 44277, "title": "An Interesting Case of Cardiomegaly", "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/45h468gm", "frozenauthors": [ { "first_name": "Shipra", "middle_name": "", "last_name": "Hingorany", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-02T16:07:59Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44277/galley/33076/download/" } ] }, { "pk": 54921, "title": "Cover", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [], "section": "Forematter", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7xz5x7h6", "frozenauthors": [ { "first_name": "BUJC", "middle_name": "", "last_name": "Admin", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2015-02-24T17:42:03Z", "date_accepted": "2015-02-24T17:42:03Z", "date_published": "2017-03-02T01:39:26Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucbclassics_bujc/article/54921/galley/41430/download/" } ] }, { "pk": 54976, "title": "Letter from the Editors", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [], "section": "Forematter", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/84v5r1zv", "frozenauthors": [ { "first_name": "Olivia", "middle_name": "", "last_name": "Graves", "name_suffix": "", "institution": "", "department": "" }, { "first_name": "Julia", "middle_name": "", "last_name": "Lyter", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2017-03-02T01:25:39Z", "date_accepted": "2017-03-02T01:25:39Z", "date_published": "2017-03-02T01:27:53Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucbclassics_bujc/article/54976/galley/41453/download/" } ] }, { "pk": 33568, "title": "When GhostSec Goes Hunting", "subtitle": null, "abstract": "GhostSec engaged in vigilante counter-terrorism against ISIS. Robert Tynes explores whether this makes them part of the state, part of civil society, or part of empire.", "language": null, "license": { "name": "Creative Commons Attribution-ShareAlike 4.0", "short_name": "CC BY-SA 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\nShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.\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-sa/4.0" }, "keywords": [], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0fk3m0g7", "frozenauthors": [ { "first_name": "Robert", "middle_name": "", "last_name": "Tynes", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-03-01T18:00:00Z", "render_galley": null, "galleys": [ { "label": "HTML", "type": "pdf", "path": "https://journalpub.escholarship.org/limn/article/33568/galley/24641/download/" } ] }, { "pk": 54975, "title": "Bow Designs on Ancient Greek Vases", "subtitle": null, "abstract": "This research looks to investigate the designs of ancient bows depicted on ancient Greek pottery. The goal is to show that the bows most commonly shown are not native to the Greek mainland but rather are from both Scythia and Egypt. This has been done by examining a number of vases, pyramid friezes, and modern bow reconstructions. The common use of the Scythian design for archer characters in scenes of myth implies a familiarity with archery primarily through the Scythian mercenaries. The Egyptian acacia deflex bow design, while rare in vase depictions, directly corresponds to images on pyramids. The Egyptian angular composite bow appears in a rare case on a Greek vase, but its depiction is consistent with modern historical reconstructions. Through showing these non-native bow origins, this paper hopes to further demonstrate the worldly influences to archaic Greece.", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Bow, Greek vases, Archery" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3rh4f9jd", "frozenauthors": [ { "first_name": "Emily", "middle_name": "S", "last_name": "Bowyer", "name_suffix": "", "institution": "UCLA", "department": "" } ], "date_submitted": "2017-01-15T06:48:48Z", "date_accepted": "2017-01-15T06:48:48Z", "date_published": "2017-03-01T10:48:19Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucbclassics_bujc/article/54975/galley/41452/download/" } ] }, { "pk": 54973, "title": "Assimilation or Destruction: The Christianization of Late Antique Statuary", "subtitle": null, "abstract": "Abstract\n \n \n \nThe recent destruction of Palmyra sent shockwaves across the globe, as the days of religious fanaticism and outbursts of iconoclasm had largely been forgotten by the collective memory. Yet, such acts of destruction have long been a point of discussion (and contention) among scholars. In the centuries following the conversion from paganism to Christianity the fate of the pagan statuary was left in the hands of a newly Christian society, and to the processes of Christianization. Processes which acted either to assimilate the statue into the newly Christian cultural milieu or destroy the statue for its pagan nature. This paper will present an overview of the various attitudes, and responses, towards pagan statuary in late antiquity, and the ways in which recent scholarship has interpreted the processes of Christianization with renewed enthusiasm. Using the Hearst Herakles as a case study for the practice of Christianization, this paper will first examine the processes of Christianization as a means of assimilation, in which the pagan statue was deliberately altered in order to remove its pagan character and make certain of its ability to function in Christian society; then examine the processes of Christianization in which the statue was destroyed for its pagan nature.", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Processes of Christianization" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6g73w5ww", "frozenauthors": [ { "first_name": "Christian", "middle_name": "", "last_name": "Hall", "name_suffix": "", "institution": "UC Berkeley", "department": "" } ], "date_submitted": "2017-01-11T20:57:53Z", "date_accepted": "2017-01-11T20:57:53Z", "date_published": "2017-03-01T10:40:20Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucbclassics_bujc/article/54973/galley/41450/download/" } ] }, { "pk": 54974, "title": "The Roots of Morality: From Classical to Christian Eschatology", "subtitle": null, "abstract": "The possibility of life after death has captured the imagination of different cultures and religions around the world, resulting in a wide variety of afterlife myths. Modern Western cultures tend to believe that an individual’s experience in the afterlife relies heavily upon the ethical behavior of an individual during their lifetime. This morality-based eschatology has roots in early Judeo-Christian thought – although Classical authors also placed an emphasis on ethical behavior in their understandings of the afterlife. This paper examines how the writings of Homer, Hesiod, Plato, and Virgil blended together with Biblical teachings from the Old and New Testament over the centuries. Thanks in part to later authors, such as Dante Alighieri, these differing worldviews came together to create the widespread modern belief that the virtuous go to heaven, and the wicked go to hell.", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "eschatology" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/97s627bg", "frozenauthors": [ { "first_name": "Sierra", "middle_name": "", "last_name": "Schiano", "name_suffix": "", "institution": "UC Berkeley", "department": "" } ], "date_submitted": "2017-01-13T03:25:11Z", "date_accepted": "2017-01-13T03:25:11Z", "date_published": "2017-03-01T10:19:13Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucbclassics_bujc/article/54974/galley/41451/download/" } ] }, { "pk": 54972, "title": "Tyrannos, Rhētōr, and Strategos: Herodotus' Athenian Artemisia", "subtitle": null, "abstract": "Portrayed as the charismatic Queen of Halicarnassus, shrewd adviser to the Xerxes, and fearless admiral at the Battle of Salamis, Herodotus' Artemisia boldly transgresses into the traditionally male-dominated spaces of tyrant, orator, and general. While some have interpreted Artemisia’s lack of punctilio as emblematic of a Persia so politically and culturally backwards that even women (viewed by Greeks as the inferior sex) were entrusted with authority, the significance of her narrative may be more complex. In light of recent scholarship about Herodotus’ generally favorable presentation of women, it appears that each of Artemisia’s three appearances - \nHistories\n 7.99, 8.68-69, and 8.87-88 – actually serve to liken the Queen to her Athenian foes. An interpretation of Artemisia as fundamentally Athenian reminds us that the rigid, binary association of a “feminine East” and a “masculine West” in Greek historiography should be called into question.\nPortrayed as the charismatic Queen of Halicarnassus, shrewd adviser to the Xerxes, and fearless admiral at the Battle of Salamis, Herodotus' Artemisia boldly transgresses into the traditionally male dominated spaces of tyrant, orator, and general. While some have interpreted Artemisia’s lack of punctilio as emblematic of a Persia so politically and culturally backwards that even women (viewed by Greeks as the inferior sex) were entrusted with authority, the significance of her narrative may be more complex. In light of recent scholarship about Herodotus’ generally favorable presentation of women, it appears that each of Artemisia’s three appearances - \nHistories\n 7.99, 8.68-69, and 8.87-88 – actually serve to liken the Queen to her Athenian foes. An interpretation of Artemisia as fundamentally Athenian reminds us that the rigid, binary association of a “feminine East” and a “masculine West” in Greek historiography should be called into question.", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Herodotus" }, { "word": "Artemisia" }, { "word": "Women in Ancient Greece" }, { "word": "Greek Historiography" }, { "word": "Thomata" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1205t8rd", "frozenauthors": [ { "first_name": "Nick", "middle_name": "", "last_name": "Ackert", "name_suffix": "", "institution": "Harvard University Department of the Classics", "department": "" } ], "date_submitted": "2017-01-09T18:23:49Z", "date_accepted": "2017-01-09T18:23:49Z", "date_published": "2017-03-01T10:12:08Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucbclassics_bujc/article/54972/galley/41449/download/" } ] }, { "pk": 9454, "title": "Randomized Trial of Adding Parenteral Acetaminophen to Prochlorperazine and Diphenhydramine to Treat Headache in the Emergency Department", "subtitle": null, "abstract": "Abstract\n \n \n \nIntroduction: Headaches represent over 3 million Emergency Department visits per year comprising 2.4 percent of all ED visits. Headaches are thought to be one of the three most common complaints of patient presentations to EDs across the country. There are many proposed methods and clinical guidelines of treating acute headache presentations however data on intravenous acetaminophen usage in these settings are lacking.\n \n \n \nObjectives: The study attempts to determine the efficacy of IV Acetaminophen as an adjunct to a standard therapy for the treatment of patients who present to the emergency department with a chief complaint of “headache” or variants thereof.\n \n \n \nDesign: Randomized, double-blind, placebo-controlled trial. Institutional IRB approval was obtained prior to implementation.\n \n \n \nSetting: Academic Community Hospital.\n \n \n \nPatients: Key elements of eligibility included adults ages 18-65 who had no mental or physical hindrances to pain assessment or to receiving acetaminophen. Exclusion criteria included those who had received total cumulative dose of acetaminophen >2600mg within past 24 hours, documented or suspected pregnancy, dementia, psychosis, liver cirrhosis, hemodynamic instability or other medical conditions prohibiting acetaminophen use. Ability to understand informed consent was necessary.\n \n \n \nInterventions: All patients received prochlorperazine, diphenhydramine, 1000ml 0.9% normal saline IV, and were randomized to receive either parenteral acetaminophen (1000mg/100ml) or 100ml of 0.9% NS as control in the placebo group.\n \n \n \nMain outcome measures: Subjective pain scores rated on a 1-10 Visual Assessment Scale were assessed repeatedly at 30 minute intervals. Length of stay and time to disposition were also noted. The incidence of rescue medications required outside of the initial regimen was also noted, with particular attention to narcotic utilization.\n \n \n \nResults: Of the (n=45) patients who received IV acetaminophen, 36 reported a statistically significant decrease by pain score of 2 or greater from presentation at the 90 minute mark. Of the (n=45) patients who received placebo, 25 reported a statistically significant decrease by pain score reporting from presentation at the 90 minute mark. (p 0.01, >95% CI). For the acetaminophen group the initial mean VAS pain score was 8.7, for the placebo group 8.6. At 90 minutes 2.2 for Acetaminophen, 4.0 for placebo group. (p<0.01, >99% CI). Length of stay was decreased a mean 36.6 minutes in the Acetaminophen group. 17 patients in the IV acetaminophen and 24 patients in the placebo group received rescue medications, with 18% less in the acetaminophen group requiring narcotics (p 0.01, CI >95).\n \n \n \nConclusion: In Emergency Department patients with acute headache, IV Acetaminophen when used as an adjunct to prochlorperazine and diphenhydramine resulted in increased pain reduction, decreased length of stay and less rescue medications utilized including narcotics when compared to treatment with prochlorperazine and diphenhydramine alone.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "intravenous" }, { "word": "Acetaminophen" }, { "word": "headache" }, { "word": "migraine" }, { "word": "cephalgia" }, { "word": "Analgesia" }, { "word": "multi-modal" }, { "word": "Opiate" }, { "word": "opiod" }, { "word": "Narcotic" }, { "word": "sparing" } ], "section": "Health Outcomes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9m49w09p", "frozenauthors": [ { "first_name": "Stefan", "middle_name": "H", "last_name": "Meyering", "name_suffix": "", "institution": "Michigan State University\nLakeland Healthcare Emergency Medicine Residency Program\nClinical Instructor, Department of Emergency Medicine\nSt. Joseph, Michigan", "department": "None" }, { "first_name": "Ryan", "middle_name": "W", "last_name": "Stringer", "name_suffix": "", "institution": "Michigan State University\nLakeland Healthcare Emergency Medicine Residency Program\nClinical Instructor, Department of Emergency Medicine\nSt. Joseph, Michigan", "department": "None" }, { "first_name": "Matthew", "middle_name": "K", "last_name": "Hysell", "name_suffix": "", "institution": "Emergency Physicians Medical Group\nMichigan State University\nLakeland Healthcare Emergency Medicine Residency Program\nCore Faculty, Emergency Medicine Residency Program\nSt. Joseph, Michigan", "department": "None" } ], "date_submitted": "2015-11-11T01:48:26Z", "date_accepted": "2015-11-11T01:48:26Z", "date_published": "2017-02-27T21:25:32Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/9454/galley/5295/download/" } ] }, { "pk": 9804, "title": "Improved Accuracy and Quality of Information During Emergency Department Care Transitions", "subtitle": null, "abstract": "Introduction:\n Suboptimal communication during Emergency Department care transitions has been shown to contribute to medical errors, sometimes resulting in patient injury and litigation. The study objective was to determine whether a standardized checkout process would decrease the number of relevant missed clinical items (MCI).\n \n \n \nMethods\n: In this prospective pre- and post-intervention study conducted in an urban academic ED, data on omitted or inaccurately conveyed medical information was collected before and after the initiation of a standardized checkout process. The intervention included group checkout in an optimal location, review of electronic medical records, case discussion and assigned roles. MCI were considered relevant if they resulted in a delay or alteration in disposition or treatment plan. The primary outcome was the change in the number of MCI. Secondary outcomes were duration of checkout and physician satisfaction with the intervention.\n \n \n \nResults:\n Pre-intervention, there were 94 relevant MCI during 164 care transitions. Post-intervention, there were 36 MCI in 157 transitions. The mean MCI per transition decreased by 58% from 0.57 (95% CI 0.41, 0.73) to 0.23 (95% CI 0.11, 0.35). Instituting the intervention did not lengthen checkout duration, which was 15 minutes (95% CI 13.81, 16.19) pre-intervention and 14 minutes (95% CI 12.99, 15.01) post-intervention. The majority of participants (73.4%) felt that the process decreased MCI, and 89.5% reported that the new process had a positive or neutral effect on their satisfaction with care transitions.\n \n \n \nConclusion:\n The adoption of a standardized care transition process markedly decreased clinically relevant communication errors without lengthening checkout duration.", "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": "Hand-offs, care transitions, checkout, signout, medical quality, quality assurance" } ], "section": "Patient Safety", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0h92s8xx", "frozenauthors": [ { "first_name": "Kimberly", "middle_name": "", "last_name": "Chambers", "name_suffix": "", "institution": "University of Texas Houston Health Science Center- McGovern Medical School", "department": "None" }, { "first_name": "Nnaemeka", "middle_name": "", "last_name": "Okafor", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Justin", "middle_name": "", "last_name": "Mazzillo", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Sara", "middle_name": "", "last_name": "Miller", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Samar", "middle_name": "", "last_name": "Yusuf", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Vanessa", "middle_name": "", "last_name": "Garza-Miranda", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Yashwant", "middle_name": "", "last_name": "Chathampally", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2016-05-11T18:22:56Z", "date_accepted": "2016-05-11T18:22:56Z", "date_published": "2017-02-27T20:44:45Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/9804/galley/5408/download/" } ] }, { "pk": 44260, "title": "Right Ventricular Metastasis of Hepatocellular Carcinoma", "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/9sf287c0", "frozenauthors": [ { "first_name": "Vaughn", "middle_name": "", "last_name": "Eyvazian", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Kamran", "middle_name": "", "last_name": "Shamsa", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-27T20:26:51Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44260/galley/33059/download/" } ] }, { "pk": 10294, "title": "Ultrasound Guided Radial Artery Compression to Assess Blood Pressure", "subtitle": null, "abstract": "Background\n \nWe propose using compression sonography to observe the deformation and collapse of the radial artery as a surrogate for automated cuff blood pressures. We hypothesize that the pressure required to achieve coaptation and complete collapse of the artery will correlate to the diastolic and systolic blood pressure, respectively.\n \n \n \nObjective\n \nOur primary aim was to assess the feasibility of Ultrasound-guided Radial Artery Compression (URAC) for blood pressure measurement. Our secondary aim was to compare patient comfort levels during automated cuff and URAC measurements.\n \n \n \nMethods\n \nThis was a prospective cohort study with a convenience sampling of 25 adult patients at a single urban ED. URAC pressure was measured followed by cuff manometry on the same arm. A 100mL NS bag was connected to the Stryker pressure monitor and placed on the volar wrist. Pressure was applied to the bag with a linear transducer and the radial artery was observed for coaptation of the anterior and posterior walls (diastolic pressure) and complete collapse (systolic pressure). Pressures were subsequently recorded. Patient level of comfort was also documented during the URAC method, with patients reporting either ‘more’, ‘same’ or ‘less’ comfort in comparison to automated cuffs. Data were analyzed using intraclass correlation and paired t-tests.\n \n \n \nResults\n \nThe mean cuff systolic BP was 138.6 ± 22.1 mmHg compared to 126.9 ± 19.8 mmHg for the URAC systolic BP(p=0.02). For diastolic blood pressure, there was no significant difference between the cuff BP and the URAC BP (83.7 ± 13.0 cuff vs. 86.5 ± 19.8 URAC, p=0.46). The intraclass correlation (ICC) for systolic BP was 0.48 (p=0.04) and 0.57 (p=0.02) for diastolic BP. 80% (20/25) of subjects found the URAC method more comfortable than the cuff measurement, and the remainder found it the same (5/20).\n \n \n \nConclusion\n \nThis preliminary study concluded there was a statistically significant moderate correlation between automated cuff and URAC measurements, though stronger for the diastolic measurement. Additionally, most patients found the URAC method more comfortable than traditional cuff measurements. Compression ultrasonography shows promise as a surrogate for BP measurement, though future studies are 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": "Ultrasound, Radial Artery, Compression" } ], "section": "Technology in Emergency Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/762764v3", "frozenauthors": [ { "first_name": "Leonard", "middle_name": "", "last_name": "Bunting", "name_suffix": "", "institution": "St. John Hospital and Medical Center", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Butki", "name_suffix": "", "institution": "St. John Hospital and Medical Center", "department": "None" }, { "first_name": "Ashley", "middle_name": "", "last_name": "Sullivan", "name_suffix": "", "institution": "St. John Hospital and Medical Center", "department": "None" } ], "date_submitted": "2016-09-06T19:13:15Z", "date_accepted": "2016-09-06T19:13:15Z", "date_published": "2017-02-27T20:17:53Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10294/galley/5664/download/" } ] }, { "pk": 10347, "title": "The Fast and the Furious: Low-Risk Chest Pain and the Rapid Rule-Out Protocol", "subtitle": null, "abstract": "Accelerated diagnostic pathways (ADPs) have been designed to identify low risk chest pain patients in the emergency department. This review article discusses the ASPECT score, the ADAPT score, the EDACS score, the HEART score and the HEART pathway. These ADPs have been validated in various studies, and aid the emergency provider with identifying the low risk chest pain patient that is appropriate for discharge home, while at the same time highlighting those patients who would benefit from further in patient work up. These approaches should be pared with patient input and shared decision making strategies.", "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, cardiology, low-risk chest painEmergency medicine, cardiology, low-risk chest pain" } ], "section": "Patient Safety", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3t55r3px", "frozenauthors": [ { "first_name": "Maite", "middle_name": "", "last_name": "Huis in 't Veld", "name_suffix": "", "institution": "Other", "department": "None" } ], "date_submitted": "2016-09-28T15:34:11Z", "date_accepted": "2016-09-28T15:34:11Z", "date_published": "2017-02-27T19:59:50Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10347/galley/5688/download/" } ] }, { "pk": 10391, "title": "Correlation of Physical Exam Findings with Fever in Patients with Skin and Soft Tissue Infections", "subtitle": null, "abstract": "Study Objectives\n \nThe objectives of this study were to determine the prevalence of fever in adult ED patients with skin and soft tissue infections (SSTI) and to determine which, if any, physical exam, x-ray and laboratory test findings were associated with fever.\n \n \n \nMethods\n \nWe conducted a prospective, observational study at an urban county trauma center of adults who presented to the ED for evaluation of suspected SSTI. ED providers measured area of erythema and induration using a tape measure, and completed data sheets indicating comorbid conditions and the presence or absence of physical exam findings. Fever was defined as any recorded temperature > 38\n°\nC during the first 6 hours of ED evaluation.\n \n \n \nResults\n \nOf the 734 patients enrolled, 96 (13.1%) had fever. Physical and laboratory exam findings associated with the presence of a fever in multivariable logistic regression were the area of erythema, particularly the largest quartile of area of erythema, 144 – 5000 cm2, (odd ratio (OR) = 2.9; 95% confidence interval [CI] = 1.6 – 5.2) and leukocytosis (OR = 4.4, 95% CI = 2.7 – 7.0). Bullae, necrosis, streaks, adenopathy, and bone involvement on imaging were not associated with fever.\n \n \n \nConclusions\n \nFever is uncommon in patients presenting to the ED for evaluation of suspected SSTI. Area of erythema and leukocytosis were associated with fever and should be considered in future decision rules for the evaluation and treatment of SSTI.", "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": "fever, skin and soft tissue infection, injection drug use" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9656w9q6", "frozenauthors": [ { "first_name": "Jillian", "middle_name": "", "last_name": "Mongelluzzo", "name_suffix": "", "institution": "UC San Francisco", "department": "None" }, { "first_name": "Brian", "middle_name": "", "last_name": "Tu", "name_suffix": "", "institution": "UC San Francisco", "department": "None" }, { "first_name": "Jersey", "middle_name": "", "last_name": "Neilson", "name_suffix": "", "institution": "UC San Francisco", "department": "None" }, { "first_name": "Barbara", "middle_name": "", "last_name": "Grimes", "name_suffix": "", "institution": "UC San Francisco", "department": "None" }, { "first_name": "Sharvina", "middle_name": "", "last_name": "Ziyeh", "name_suffix": "", "institution": "UC San Francisco", "department": "None" }, { "first_name": "Robert", "middle_name": "", "last_name": "Rodriguez", "name_suffix": "", "institution": "UC San Francisco", "department": "None" } ], "date_submitted": "2016-10-12T22:54:18Z", "date_accepted": "2016-10-12T22:54:18Z", "date_published": "2017-02-27T19:53:17Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10391/galley/5713/download/" } ] }, { "pk": 41651, "title": "Western Association of Vertebrate Paleontology Annual Meeting: Program with Abstracts", "subtitle": null, "abstract": "The Program and Abstracts volume for the 2017 WAVP annual meeting held February 17-19, 2017 at Yavapai College, Prescott, Arizona.", "language": "en", "license": null, "keywords": [ { "word": "WAVP, 2017" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5r04v1fn", "frozenauthors": [ { "first_name": "Jeb", "middle_name": "", "last_name": "Bevers", "name_suffix": "", "institution": "Yavapai College, Prescott, Arizona", "department": "None" }, { "first_name": "Dirilee", "middle_name": "", "last_name": "Curtis", "name_suffix": "", "institution": "Yavapai College, Prescott, Arizona", "department": "None" }, { "first_name": "Ivy", "middle_name": "", "last_name": "Morton", "name_suffix": "", "institution": "Yavapai College, Prescott, Arizona", "department": "None" }, { "first_name": "Beth", "middle_name": "", "last_name": "Boyd", "name_suffix": "", "institution": "Yavapai College, Prescott, Arizona", "department": "None" } ], "date_submitted": "2017-02-28T01:56:10Z", "date_accepted": "2017-02-28T01:56:10Z", "date_published": "2017-02-27T08:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucmp_paleobios/article/41651/galley/31172/download/" } ] }, { "pk": 54971, "title": "Grotesque Forms: ἔρως and σῶμα in the Symposium", "subtitle": null, "abstract": "The purpose of this paper is to examine the conception of the body and its relationship to desire articulated by Aristophanes in Plato's \nSymposium\n. The paper begins by analyzing the progress of Aristophanes creation myth and determining the role of the body as origin, hindrance, and aid of love. Then the paper compares the account of Aristophanes to the experience of Alcibiades. Lastly the paper compares the account to the one put forward by Plato's Socrates via Diotima. Through this multi-step analysis, we reconstruct a unique conception of the body not found in other works by Plato and come to better understand the role of the body in Plato's account of desire as a whole.", "language": "en", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1xs8499d", "frozenauthors": [ { "first_name": "David", "middle_name": "Thomas", "last_name": "Carroll", "name_suffix": "", "institution": "St. John's College", "department": "" } ], "date_submitted": "2016-12-31T10:23:47Z", "date_accepted": "2016-12-31T10:23:47Z", "date_published": "2017-02-25T04:11:45Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucbclassics_bujc/article/54971/galley/41448/download/" } ] }, { "pk": 2116, "title": "The Effects of L2 Proficiency on Pragmatics Instruction: A Web-Based Approach to Teaching Chinese Expressions of Gratitude", "subtitle": null, "abstract": "This study investigated whether the effects of pragmatics instruction delivered via a self-access website in a Chinese as a foreign language learning environment vary according to learners’ language proficiency. The website provided learners with explicit instruction in how to express gratitude appropriately in Chinese and offered them pragmatic consciousness-raising activities for practice. Two groups of learners who differed in Chinese proficiency received the instruction over five weeks. The results showed that all learners produced more appropriate expressions of gratitude and used more varied thanking strategies in the posttest, but higher-level learners benefited more from the instruction in both pragmatic awareness and production. In their reflective e-journals, learners reported the promising possibilities of using websites as a tool for teaching pragmatics in foreign language contexts.", "language": "chi", "license": null, "keywords": [ { "word": "language proficiency" }, { "word": "pragmatics instruction" }, { "word": "web-based technology" }, { "word": "Chinese as a foreign language" }, { "word": "expressions of gratitude" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7n82c0pw", "frozenauthors": [ { "first_name": "Li", "middle_name": "", "last_name": "Yang", "name_suffix": "", "institution": "Kansas State University", "department": "None" } ], "date_submitted": "2016-10-02T20:18:31Z", "date_accepted": "2016-10-02T20:18:31Z", "date_published": "2017-02-24T19:07:17Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/l2/article/2116/galley/1384/download/" } ] }, { "pk": 2109, "title": "The Impact of a Computer-Mediated Shadowing Activity on ESL Speaking Skill Development: A Pilot Study", "subtitle": null, "abstract": "This pilot study explored the instructional value and potential of a computer-mediated shadowing activity for improving English as a Second Language (ESL) learners’ speech intelligibility. Prospective International Teaching Assistants (ITAs), who were enrolled in an ESL classroom communication class at a large public, completed a computer-mediated shadowing activity using two web resources, Go Animate and TED talks. Then, these adult ESL participants were surveyed on their perceptions of the efficacy of this shadowing activity for improving their pronunciation, intonation, rhythm, and fluency. In addition, participants’ speech samples recorded during the shadowing activity were independently rated by certified ESL speaking exam raters. The evaluation results, including holistic proficiency scores and rater comments, were analyzed in terms of pronunciation, prosodic control, and overall intelligibility of the speech samples. Although the study is inconclusive, findings from this case study suggest that the computer-mediated shadowing activity may well be an effective means to raise ESL learners’ awareness of the problems in their prosodic control and help improve their speech intelligibility.", "language": "en", "license": null, "keywords": [ { "word": "SLA, ESL speaking development, CALL" } ], "section": "Teachers' Forum", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/56q742fr", "frozenauthors": [ { "first_name": "Masakazu", "middle_name": "", "last_name": "Mishima", "name_suffix": "", "institution": "Rikkyo University Language Center\nRikkyo University", "department": "None" }, { "first_name": "Lixia", "middle_name": "", "last_name": "Cheng", "name_suffix": "", "institution": "Purdue Language and Cultural Exchange (PLaCE)\nPurdue University", "department": "None" } ], "date_submitted": "2016-09-15T21:18:46Z", "date_accepted": "2016-09-15T21:18:46Z", "date_published": "2017-02-24T19:07:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/l2/article/2109/galley/1382/download/" } ] }, { "pk": 44281, "title": "Stiff-Person Syndrome – A Case for Early Diagnosis", "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/2kq6x8bd", "frozenauthors": [ { "first_name": "Stella", "middle_name": "", "last_name": "Izuchukwu", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Carmen", "middle_name": "K.", "last_name": "Chan", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-22T18:23:10Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44281/galley/33080/download/" } ] }, { "pk": 33569, "title": "Survival of the Cryptic", "subtitle": null, "abstract": "Should we have privacy for the weak and transparency for the powerful? Sarah Myers West reminds us that we've been agonizing over this question since at least the 1990s, when the cypherpunks first started discussing it.", "language": null, "license": { "name": "Creative Commons Attribution-ShareAlike 4.0", "short_name": "CC BY-SA 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\nShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.\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-sa/4.0" }, "keywords": [], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/32v8c5k4", "frozenauthors": [ { "first_name": "Sarah Myers", "middle_name": "", "last_name": "West", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-22T18:00:00Z", "render_galley": null, "galleys": [ { "label": "HTML", "type": "pdf", "path": "https://journalpub.escholarship.org/limn/article/33569/galley/24642/download/" } ] }, { "pk": 10312, "title": "Applying Systems Engineering Reduces Radiology Transport Cycle Times in the Emergency Department", "subtitle": null, "abstract": "INTRODUCTION \n \nEmergency Department (ED) crowding is prevalent and can result in care delays, medical errors, increased costs and mortality. Simultaneously, capacity constraints on EDs are worsening, yet patient arrival rates and inpatient bed capacity are often outside the influence of ED administrators. Therefore systems engineering to improve throughput and reduce waste and waits holds the most readily available promise. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time. We sought to investigate the impact of systems engineering science targeting ED radiology transport delays, and determine the most effective techniques.\n \n \n \nMETHODS \n \nThis prospective, before and after analysis of radiology process flow improvements in a academic hospital ED was exempt from Institutional Review Board review as a quality improvement initiative. We hypothesized that reorganization of radiology transport would improve radiology cycle time and reduce waste. The intervention included systems engineering science-based reorganization of ED radiology transport processes, largely utilizing Lean methodologies, and adding no resources. The primary outcome was average transport time between study order and complete time. All patients presenting between 8/2013-3/2016 and requiring plain film imaging were included. Electronic medical record data were analyzed using Microsoft Excel and SAS version 9.4.\n \n \n \nRESULTS \n \nFollowing the intervention, average transport time decreased significantly and sustainably. Average radiology transport time was 28.1 ± 4.2 minutes during the 3 months pre-intervention. It was reduced by 13% in the first three months (3.8 minutes; to 24.3 ± 3.3 min, P=0.021), 17% in the following six months (4.8 minutes; to 23.3 ± 3.5 min, P=0.003), and 24% one year following the intervention (6.8 minutes; to 21.3 ± 3.1 min, P=0.0001). This result was achieved without any additional resources, and demonstrated a continual trend towards improvement. This innovation demonstrates the value of systems engineering science to increase efficiency in Emergency Department (ED) radiology processes.\n \n \n \nCONCLUSION \n \nIn this study, reorganization of the ED radiology transport process using systems engineering science significantly increased process efficiency without additional resource 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 department" }, { "word": "Systems Engineering" }, { "word": "Operational Improvement" }, { "word": "Lean" } ], "section": "Emergency Department Operations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/93m63284", "frozenauthors": [ { "first_name": "Benjamin", "middle_name": "A", "last_name": "White", "name_suffix": "", "institution": "Massachusetts General Hospital, Harvard Medical School", "department": "None" }, { "first_name": "Brian", "middle_name": "J", "last_name": "Yun", "name_suffix": "", "institution": "Massachusetts General Hospital, Harvard Medical School", "department": "None" }, { "first_name": "Michael", "middle_name": "H", "last_name": "Lev", "name_suffix": "", "institution": "Massachusetts General Hospital, Harvard Medical School", "department": "None" }, { "first_name": "Ali", "middle_name": "S.", "last_name": "Raja", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2016-09-13T19:23:47Z", "date_accepted": "2016-09-13T19:23:47Z", "date_published": "2017-02-21T23:20:23Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10312/galley/5669/download/" } ] }, { "pk": 355, "title": "18-year-old Female with a Change in Mental Status", "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": "Clinicopathological Cases from the University of Maryland", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/39h5x1gm", "frozenauthors": [ { "first_name": "Laura", "middle_name": "J", "last_name": "Bontempo", "name_suffix": "", "institution": "University of Maryland School of Medicine", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Crouter", "name_suffix": "", "institution": "University of Maryland Medical Center", "department": "None" }, { "first_name": "Danya", "middle_name": "", "last_name": "Khoujah", "name_suffix": "", "institution": "University of Maryland School of Medicine", "department": "None" }, { "first_name": "Zachary", "middle_name": "DW", "last_name": "Dezman", "name_suffix": "", "institution": "University of Maryland School of Medicine", "department": "None" } ], "date_submitted": "2017-02-21T21:29:49Z", "date_accepted": "2017-02-21T21:29:49Z", "date_published": "2017-02-21T08:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/355/galley/121/download/" } ] }, { "pk": 39482, "title": "Earth system governance. Ruling climate across society", "subtitle": null, "abstract": "This paper collects notes and reflections emerging from the survey of three volumes published in the \nEarth System Governance\n MIT Press series, dealing with issues of world politics, international institutions, consensus, deliberative democracy, and leadership of global governance in the dawn of the Anthropocene. The gathering arguments of the texts discussing the social, cultural, economic, and practice difficulties actually hindering the transition to a viable society worldwide ruled according to safe conditions for the environmental cycles and living beings. \nProgressively, the series unpacks implications for global-scale governance \nat the epoch of the ever-increasing impact of men. \nAuthors consider Earth governance offering analytical insights and normative perspectives on the possible implementation modalities, including questions on democratic means and the possible role of national and transnational organizations to achieve sustainability, \nbefore the irreversible destruction of the biodiversity wealth constituted on Earth through entire eons.", "language": "en", "license": { "name": "none", "short_name": "none", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "Governance, Anthropocene, Climate Change, Earth System" } ], "section": "Essays", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9ps3g2wh", "frozenauthors": [ { "first_name": "Enzo", "middle_name": "", "last_name": "Ferrara", "name_suffix": "", "institution": "Centro Studi Sereno Regis & Istituto di Ricerche Interdisciplinari sulla Sostenibilità – Torino, Italy\n\nIstituto nazionale di Ricerca Metrologica – INRIM, Torino, Italy\nStrada delle Cacce 91, 10135 – Torino (Italy), voice: + 39(0)113919837", "department": "None" } ], "date_submitted": "2017-01-13T15:42:27Z", "date_accepted": "2017-01-13T15:42:27Z", "date_published": "2017-02-20T14:09:13Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/egj/article/39482/galley/29800/download/" } ] }, { "pk": 39488, "title": "Environnement et développement durable: une approche méta-économique [Environment and Sustainable Development: A Meta-Economical Approach]", "subtitle": null, "abstract": "Book review\nFrench Language Book", "language": "en", "license": { "name": "none", "short_name": "none", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "sustainable development" }, { "word": "Economics" }, { "word": "Environmental Issues" } ], "section": "Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2686316b", "frozenauthors": [ { "first_name": "Yves", "middle_name": "", "last_name": "Laberge", "name_suffix": "", "institution": "University of Ottawa", "department": "None" } ], "date_submitted": "2017-02-17T20:14:40Z", "date_accepted": "2017-02-17T20:14:40Z", "date_published": "2017-02-20T13:18:33Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/egj/article/39488/galley/29804/download/" } ] }, { "pk": 39466, "title": "Review: Bee Time: Lessons from the Hive", "subtitle": null, "abstract": "Book Review", "language": "en", "license": { "name": "none", "short_name": "none", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "Honeybees" } ], "section": "Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2rp2n233", "frozenauthors": [ { "first_name": "Byron", "middle_name": "P.", "last_name": "Anderson", "name_suffix": "", "institution": "Retired/Northern Illinois University", "department": "None" } ], "date_submitted": "2016-11-25T16:07:41Z", "date_accepted": "2016-11-25T16:07:41Z", "date_published": "2017-02-20T13:15:39Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/egj/article/39466/galley/29791/download/" } ] }, { "pk": 39486, "title": "Review: Unearthing Conflict: Corporate Mining, Expertise, and Activism in Peru", "subtitle": null, "abstract": "Book Review", "language": "en", "license": { "name": "none", "short_name": "none", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "Peru" }, { "word": "Mineral industries" }, { "word": "Social Aspects" }, { "word": "Political Aspects" } ], "section": "Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6ks7j33n", "frozenauthors": [ { "first_name": "Lia", "middle_name": "", "last_name": "Vella", "name_suffix": "", "institution": "U.S. National Park Service", "department": "None" } ], "date_submitted": "2017-02-17T19:09:19Z", "date_accepted": "2017-02-17T19:09:19Z", "date_published": "2017-02-20T13:15:14Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/egj/article/39486/galley/29802/download/" } ] }, { "pk": 39487, "title": "Review: State and Environment: The Comparative Study of Environmental Governance", "subtitle": null, "abstract": "Book Review", "language": "en", "license": { "name": "none", "short_name": "none", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8j78z1h0", "frozenauthors": [ { "first_name": "Dale", "middle_name": "A.", "last_name": "Stirling", "name_suffix": "", "institution": "Freelance Consultant", "department": "None" } ], "date_submitted": "2017-02-17T19:20:35Z", "date_accepted": "2017-02-17T19:20:35Z", "date_published": "2017-02-20T13:14:33Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/egj/article/39487/galley/29803/download/" } ] }, { "pk": 44271, "title": "A Rare Hemoglobinopathy: Hemoglobin Titusville", "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/0690z94z", "frozenauthors": [ { "first_name": "Ishan", "middle_name": "", "last_name": "Mehta", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Kavita", "middle_name": "", "last_name": "Patel", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-19T23:03:20Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44271/galley/33070/download/" } ] }, { "pk": 33570, "title": "Half-Lives of Hackers and the Shelf Life of Hacks", "subtitle": null, "abstract": "What is the speed of hacking? Luca Follis and Adam Fish explore the temporality of hacking and leaking in the cases of Snowden, the DNC leaks and the Lauri Love case.", "language": null, "license": { "name": "Creative Commons Attribution-ShareAlike 4.0", "short_name": "CC BY-SA 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\nShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.\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-sa/4.0" }, "keywords": [], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/50k7w92t", "frozenauthors": [ { "first_name": "Luca", "middle_name": "", "last_name": "Follis", "name_suffix": "", "institution": "", "department": "" }, { "first_name": "Adam", "middle_name": "", "last_name": "Fish", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-18T18:00:00Z", "render_galley": null, "galleys": [ { "label": "HTML", "type": "pdf", "path": "https://journalpub.escholarship.org/limn/article/33570/galley/24643/download/" } ] }, { "pk": 44270, "title": "A Commonly Overlooked Cause of Anemia and Thrombocytopenia", "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/0zd718mq", "frozenauthors": [ { "first_name": "Katelyn", "middle_name": "", "last_name": "Stepanyan", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Linda", "middle_name": "", "last_name": "Czypinski", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-17T23:02:14Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44270/galley/33069/download/" } ] }, { "pk": 44269, "title": "Difficulty in Diagnosing and Treating Group 5 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/3mb0x03s", "frozenauthors": [ { "first_name": "Veronica", "middle_name": "", "last_name": "Ramirez", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Digish", "middle_name": "D.", "last_name": "Shah", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": "Janette", "middle_name": "N.", "last_name": "Zara", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-17T23:00:06Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44269/galley/33068/download/" } ] }, { "pk": 44268, "title": "Cryptogenic Pyogenic Liver Abscess due to Prevotella in an Immunocompetent Male", "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/6gs1w86t", "frozenauthors": [ { "first_name": "Evan", "middle_name": "J.", "last_name": "Shih", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-16T22:58:58Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44268/galley/33067/download/" } ] }, { "pk": 44267, "title": "Pelvic Inflammatory Disease in a Male Patient: The Importance of Understanding the Transgender Patient", "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/95m583sx", "frozenauthors": [ { "first_name": "Amy", "middle_name": "K.", "last_name": "Weimer", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-16T22:57:37Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44267/galley/33066/download/" } ] }, { "pk": 33571, "title": "The Extortion Stack", "subtitle": null, "abstract": "Finn Brunton explores the dream of the perfect leak, and what a science fiction story can tell us about the state of truth today.", "language": null, "license": { "name": "Creative Commons Attribution-ShareAlike 4.0", "short_name": "CC BY-SA 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\nShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.\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-sa/4.0" }, "keywords": [], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4214v2cc", "frozenauthors": [ { "first_name": "Finn", "middle_name": "", "last_name": "Brunton", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-16T18:00:00Z", "render_galley": null, "galleys": [ { "label": "HTML", "type": "pdf", "path": "https://journalpub.escholarship.org/limn/article/33571/galley/24644/download/" } ] }, { "pk": 44259, "title": "Hypercalcemia Preceding the Leukemic Transformation of Myelofibrosis", "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/0x82m1zk", "frozenauthors": [ { "first_name": "Albert", "middle_name": "Y", "last_name": "Liu", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Estebes", "middle_name": "A", "last_name": "Hernandez", "name_suffix": "MD", "institution": "", "department": "" }, { "first_name": "Jason", "middle_name": "", "last_name": "Williams", "name_suffix": "MD", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-15T20:25:38Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44259/galley/33058/download/" } ] }, { "pk": 33573, "title": "Can You Secure an Iron Cage?", "subtitle": null, "abstract": "Are bureaucracies defensible? Nils Gilman, Jesse Goldhammer, and Steven Weber explore the Office of Personnel Management hack, and what it tells us about the inherent vulnerabilities of bureaucratic organizations in a digital age.", "language": null, "license": { "name": "Creative Commons Attribution-ShareAlike 4.0", "short_name": "CC BY-SA 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\nShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.\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-sa/4.0" }, "keywords": [], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/58f5441v", "frozenauthors": [ { "first_name": "Nils", "middle_name": "", "last_name": "Gilman", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-14T18:00:00Z", "render_galley": null, "galleys": [ { "label": "HTML", "type": "pdf", "path": "https://journalpub.escholarship.org/limn/article/33573/galley/24646/download/" } ] }, { "pk": 33572, "title": "The Paradoxical Authority of the Certified Ethical Hacker", "subtitle": null, "abstract": "Can hackers be certified? Rebecca Slayton looks at efforts to blend, certify and market the subversive skills of hacking with the ethos of professionalism.", "language": null, "license": { "name": "Creative Commons Attribution-ShareAlike 4.0", "short_name": "CC BY-SA 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\nShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.\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-sa/4.0" }, "keywords": [], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1s68x57c", "frozenauthors": [ { "first_name": "Rebecca", "middle_name": "", "last_name": "Slayton", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-14T18:00:00Z", "render_galley": null, "galleys": [ { "label": "HTML", "type": "pdf", "path": "https://journalpub.escholarship.org/limn/article/33572/galley/24645/download/" } ] }, { "pk": 44276, "title": "Paratesticular Serous Papillary Carcinoma", "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/4210p1x3", "frozenauthors": [ { "first_name": "Evangelia", "middle_name": "", "last_name": "Kirimis", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-14T16:06:46Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44276/galley/33075/download/" } ] }, { "pk": 10317, "title": "Inferior Vena Cava Measurement With Ultrasound: What is The Best View and Best Mode?", "subtitle": null, "abstract": "ABSTRACT\n \nIntroduction\n \nIntravascular volume status is an important clinical consideration in the management of the critically ill. Point of care ultrasonography (POCUS) has gained popularity as a non-invasive means of intravascular volume assessment via examination of the inferior vena cava (IVC). However, there is limited data comparing different acquisition techniques for IVC measurement by POCUS.\n \nThe goal of this evaluation is to determine the reliability of three IVC acquisition techniques for volume assessment: sub-xiphoid transabdominal long axis (LA), transabdominal short axis (SA), and right lateral transabdominal coronal long axis (CLA) (aka “rescue view”).\n \nMethods\n \nVolunteers were evaluated by three experienced emergency physician sonographers (EP). Gray scale (B-mode) and Motion-mode (M-mode) diameters were measured and IVC collapsibility index (IVCCI) calculated for three anatomic views (LA, SA, CLA). For each IVC measurement, descriptive statistics, intra-class correlation coefficients (ICC), and 2-Way Univariate Analyses of Variance (ANOVA) were calculated.\n \nResults\n \nThirty-nine volunteers were evaluated yielding 351 total US measurements. Measurements of the three views had similar means (LA 1.9 ± 0.4cm; SA 1.9 ± 0.4cm; CLA 2.0 ± 0.5cm). For B-Mode, LA had the highest ICC (0.86, 95% CI = 0.76 to 0.92) while CLA had the poorest ICC (0.74, 95% CI = 0.56 to 0.85). ICCs for all M-mode IVCCI were low. Significant interaction effects between anatomical view and EP were observed for B-mode and M-mode measurements. Post-hoc analyses reveal difficulty in consistent view acquisition between EPs.\n \nConclusions \n \nInter rater reliability of the IVC by EPs was highest for B-mode LA and poorest for all M-Mode IVC collapsibility indices (IVCCI). These results suggest that B-mode LA holds the most promise to deliver reliable measures of IVC diameter. Future studies may focus on validation in a clinical setting as well as comparison to a reference standard.", "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": "Inferior Vena Cava" }, { "word": "point-of-care" }, { "word": "ultrasonography" }, { "word": "Variation in inferior vena cava" }, { "word": "Critical illness" }, { "word": "Fluid responsiveness" } ], "section": "Technology in Emergency Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1638r0nf", "frozenauthors": [ { "first_name": "Nathan", "middle_name": "M", "last_name": "Finnerty", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "None" }, { "first_name": "Ashish", "middle_name": "R", "last_name": "Panchal", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "None" }, { "first_name": "Creagh", "middle_name": "", "last_name": "Boulger", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "None" }, { "first_name": "Amar", "middle_name": "", "last_name": "Vira", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "None" }, { "first_name": "Jason", "middle_name": "J", "last_name": "Bischof", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "None" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Amick", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "None" }, { "first_name": "David", "middle_name": "P", "last_name": "Way", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "None" }, { "first_name": "David", "middle_name": "P", "last_name": "Bahner", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "None" } ], "date_submitted": "2016-09-15T08:35:27Z", "date_accepted": "2016-09-15T08:35:27Z", "date_published": "2017-02-13T20:02:29Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10317/galley/5672/download/" } ] }, { "pk": 63255, "title": "Translanguaging: Definitions, Implications, and Further Needs in Burgeoning Inquiry", "subtitle": null, "abstract": "The term \ntranslanguaging\n has appeared with growing frequency in research about the education of linguistic minority students. Amid increasing application of the term, concern emerges regarding the consistency of its definitions and characterizations, specifically with respect to the term’s social justice implications, which risk dilution. Early instances (García, 2007, 2009a) position the term as both a pedagogical strategy for supporting multilingual learners and a critique of existing conceptualizations of language and bilingualism that have historically marginalized particular speech communities. In this review of recent literature, I analyze 53 texts published between 1996 and 2014 for their definitions, exemplifications, and attributed implications of translanguaging, as an ontological perspective on language and as a set of teaching practices. In the review, I find that although the term has largely maintained its sociolinguistic critique, its ties to critical pedagogy appear only sporadically. I close this review by proposing avenues for new research.", "language": "en", "license": null, "keywords": [ { "word": "Translanguaging" }, { "word": "Multilingualism" }, { "word": "Bilingual Education" }, { "word": "Critical Pedagogy" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8k26h2tp", "frozenauthors": [ { "first_name": "Luis", "middle_name": "", "last_name": "Poza", "name_suffix": "", "institution": "University of Colorado Denver", "department": "" } ], "date_submitted": "2015-10-31T01:28:48Z", "date_accepted": "2015-10-31T01:28:48Z", "date_published": "2017-02-11T02:09:35Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/bre/article/63255/galley/48798/download/" } ] }, { "pk": 5385, "title": "Male Mate Choice Among Captive Long-tailed Macaques (Macaca Fascicularis)", "subtitle": null, "abstract": "The purpose of this study was to investigate male preference and to define the aspects of females that affect male preference. We set experimental conditions that enabled us to measure successful mating by gathering sperm from female vaginal washings and observing sexual behavior. The animal subjects in our study were cynomolgus monkeys, all of whom were bred in our primate institute. During the study, one male would be grouped with two females, each of whom lived in a cage adjacent to the male’s cage. This enabled each of the females to be housed with the male in turn; 12 males and 24 females were included in the study. After a male was housed with a female, we observed through a microscope the existence of sperm in the female’s vaginal washing, thus confirming copulation success. In some of the groups, behavioral observation was conducted on both the male and female subjects. According to our findings, in the multiparous females, successful mating was observed on 29% of cohabitation days. Among nulliparous females, the presence of sperm was observed on only 6% of cohabitation periods. Some 66.7% of nulliparous females never mated with a male. Our observations also revealed that sexual behaviors were more frequently observed when a male lived with a multiparous female. “Male-grooming-of-female” activities were seen more frequently between a male and multiparous female; that is, the male approached a multiparous female for copulation by grooming her. Our study suggests that male cynomolgus monkeys prefer multiparous females, as it is important that a male choose a female who more easily and regularly becomes pregnant and gives birth to offspring with a higher survival rate. Thus, male choice is biologically significant with respect to leaving more offspring.", "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": "Mating Strategy" }, { "word": "Male’s Preference" }, { "word": "Cynomolgus Monkeys" }, { "word": "Multiparous Female" }, { "word": "Behavioral Observation" }, { "word": "Sperm" }, { "word": "Sexual Behavior" } ], "section": "Research Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/37v283bn", "frozenauthors": [ { "first_name": "Maiko", "middle_name": "Yoshida", "last_name": "Kobayashi", "name_suffix": "", "institution": "Japan Women’s University", "department": "None" } ], "date_submitted": "2016-07-05T08:52:49Z", "date_accepted": "2016-07-05T08:52:49Z", "date_published": "2017-02-10T08:00:00Z", "render_galley": null, "galleys": [ { "label": "", "type": "", "path": "https://journalpub.escholarship.org/uclapsych_ijcp/article/5385/galley/3239/download/" } ] }, { "pk": 44306, "title": "Duchenne Muscular Dystrophy and Anesthesia", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Commentary" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1s37d288", "frozenauthors": [ { "first_name": "Fei", "middle_name": "", "last_name": "Zheng-Ward", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2017-02-09T19:33:18Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/44306/galley/33104/download/" } ] }, { "pk": 10278, "title": "Skin to Intramuscular Compartment Thigh Measurement by Ultrasound in Pediatric Population", "subtitle": null, "abstract": "Introduction \nPediatric obesity threatens the efficacy of life-saving medications given intramuscularly to anaphylactic patients. Epinephrine auto-injector needle lengths are potentially too short to reach the muscle compartment in patients with elevated body habitus. The objective of the study was to determine needle length requirements for intramuscular injections in pediatric patients.\nMethods \nUltrasound was used to measure the distance from skin to muscle compartment of the thigh in 200 pediatric patients of various weight and body mass index who presented to the Emergency Department.\nResults\n \nPatients with higher body mass index had an increased distance to muscle and bone. If current auto-injector recommendations were followed, 12% of patients weighing less than 30 kilograms and 9% of patients weighing more than 30 kilograms would have potentially used an auto-injector inadequate in needle length.\n \nConclusion \nWith the increase in childhood obesity, auto-injector needle lengths may be too short to effectively deliver medications. Needle length should be evaluated to accommodate pediatric patients with increased skin to muscle distance.", "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": "childhood obesity, auto-injector, needle length" } ], "section": "Technology in Emergency Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6x97k710", "frozenauthors": [ { "first_name": "Myto", "middle_name": "", "last_name": "Duong", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Albert", "middle_name": "", "last_name": "Botchway", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Jonathan", "middle_name": "", "last_name": "dela Cruz", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Richard", "middle_name": "", "last_name": "Austin", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Kevin", "middle_name": "", "last_name": "McDaniel", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Cassie", "middle_name": "", "last_name": "Jaeger", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2016-08-31T18:12:43Z", "date_accepted": "2016-08-31T18:12:43Z", "date_published": "2017-02-07T23:31:01Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/10278/galley/5655/download/" } ] } ] }