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{ "count": 39506, "next": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=5400", "previous": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=5200", "results": [ { "pk": 39597, "title": "Challenges and Hurdles in Establishing a Green Library: Strategies for Overcoming Them", "subtitle": null, "abstract": "A green library, or a sustainable library, enables us to collaborate with nature to fulfill some of our fundamental needs. This concept fosters a harmonious relationship between our community and the environment; green libraries, in essence, serve as examples for reconnecting with the beauty of the natural world. The purpose of this article is to delve into the practical challenges associated with transitioning a conventional library into a green one, as well as strategies for improvements. It explores topics such as the green library's historical background, its significance in environmental conservation, the librarian's role within it, ongoing green library projects, and initiatives promoting eco-friendly libraries, particularly focusing on India's efforts in this regard. Managing a green library poses several challenges. Firstly, the transformation process involves architectural redesign, incurring construction costs if an existing library is to be converted. Establishing a green library from scratch entails substantial initial expenses. Moreover, daily maintenance is crucial, necessitating proper employee training and ongoing efforts. Maintenance costs and the allocation of manpower are also essential considerations. Furthermore, this article examines the roles of key initiatives such as the United Nations Development Program (UNDP), Sustainable Development Goals (UNESCO), the IFLA Green Library Award, the Green Building Council of India, and LEED (Leadership in Energy and Environmental Design) in advancing sustainable practices within library settings.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Green Library, Sustainable Library, Green Library Movement, Green building, Green Earth, Green librarian, Green Library Practice, LEED (Leadership in Energy and Environmental Design), IGBC (Indian G.." } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2xf7304p", "frozenauthors": [ { "first_name": "P.", "middle_name": "", "last_name": "Sivaprasad", "name_suffix": "", "institution": "Alagappa University, Karaikudi", "department": "None" }, { "first_name": "S.", "middle_name": "", "last_name": "Thanuskodi", "name_suffix": "", "institution": "Alagappa University, Karaikudi.", "department": "None" }, { "first_name": "M.", "middle_name": "", "last_name": "Nagaiah", "name_suffix": "", "institution": "Alagappa University, Karaikudi.", "department": "None" } ], "date_submitted": "2022-12-22T17:47:40+11:00", "date_accepted": "2022-12-22T17:47:40+11:00", "date_published": "2024-02-14T17:29:52+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/egj/article/39597/galley/29887/download/" } ] }, { "pk": 38032, "title": "Mester 52 - Digital Version (PDF)", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "MESTER 52 - PDF (DIGITAL VERSION)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1dk268wf", "frozenauthors": [ { "first_name": "Cristina", "middle_name": "G.", "last_name": "Vázquez", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-14T14:06:18+11:00", "date_accepted": "2024-02-14T14:06:18+11:00", "date_published": "2024-02-14T14:08:01+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38032/galley/28624/download/" } ] }, { "pk": 38031, "title": "Back Cover", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "BACK COVER", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4ss716j7", "frozenauthors": [ { "first_name": "Cristina", "middle_name": "G.", "last_name": "Vázquez", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-14T13:25:15+11:00", "date_accepted": "2024-02-14T13:25:15+11:00", "date_published": "2024-02-14T13:27:03+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38031/galley/28623/download/" } ] }, { "pk": 38030, "title": "Notes on Editors and Contributors", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "NOTES ON EDITORS AND CONTRIBUTORS", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/83s668pm", "frozenauthors": [ { "first_name": "Cristina", "middle_name": "G.", "last_name": "Vázquez", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-14T13:22:02+11:00", "date_accepted": "2024-02-14T13:22:02+11:00", "date_published": "2024-02-14T13:23:04+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38030/galley/28622/download/" } ] }, { "pk": 38029, "title": "Table of Contents", "subtitle": null, "abstract": "Mester\n LII (contents)", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "CONTENTS", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6c3083jc", "frozenauthors": [ { "first_name": "Cristina", "middle_name": "G.", "last_name": "Vázquez", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-14T12:43:40+11:00", "date_accepted": "2024-02-14T12:43:40+11:00", "date_published": "2024-02-14T12:50:59+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38029/galley/28621/download/" } ] }, { "pk": 38028, "title": "Introduction", "subtitle": null, "abstract": "On behalf of the Editorial Board of \nMester\n, the academic journal of the graduate students of the Department of Spanish and Portuguese at the University of California (Los Angeles), I am honored to introduce its fifty-second issue. \nMester\n LII welcomed submissions for articles, essays, and interviews written in Spanish, Portuguese, and English from transdisciplinary and interdisciplinary approaches related to Identity and Borders. \nMester\n LII also encouraged submissions focused on – but not limited to – the representation of Identity(ies) through Migrations, Language, Belonging, and Borders in the 21st Century. We invited submissions that explore the relationship between (re)formulating and (re)imagining the complexities of identity and its representation in contemporary times, where mobilizations and migrations challenge the dominant identity discourse in space and time.", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "INTRODUCTION", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8w11v9rn", "frozenauthors": [ { "first_name": "Cristina", "middle_name": "G.", "last_name": "Vázquez", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-14T12:36:04+11:00", "date_accepted": "2024-02-14T12:36:04+11:00", "date_published": "2024-02-14T12:37:42+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38028/galley/28620/download/" } ] }, { "pk": 46049, "title": "Rapid-Onset Drug Induced Liver Injury in a Patient Receiving Intravenous Acetaminophen", "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/7d2213gg", "frozenauthors": [ { "first_name": "Derek", "middle_name": "", "last_name": "Zhang", "name_suffix": "", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Faysal", "middle_name": "", "last_name": "Saab", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-14T03:34:24+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46049/galley/34781/download/" } ] }, { "pk": 1394, "title": "Acute Abdominal Pain and a Whirlpool Sign on Computerized Tomography: A Case Report", "subtitle": null, "abstract": "<b>Introduction:</b> Mesenteric volvulus is a rare cause of abdominal pain and bowel obstruction in elderly patients. When a mesenteric volvulus occurs in adult patients, the symptoms are often non-specific, which contributes to delays in diagnosis.<p></p><p><b><b>Case Report:</b></b> We present a case of a 75-year-old female who presented with non-specific abdominal pain. The rare whirlpool sign on computed tomography identified a mesenteric volvulus as the cause of small bowel obstruction. She was taken to the operating room and, after successful resection of the small bowel, she recovered and ultimately was discharged home.</p><p></p><p><b><b><b>Conclusion:</b></b></b> Early identification of a whirlpool sign and early surgical consultation are key to providing the best chance for salvage of ischemic small bowel due to mesenteric volvulus and to prevent a fatal outcome.</p>", "language": "eng", "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": "Mesenteric volvulus" }, { "word": "malrotation" }, { "word": "midgut volvulus" }, { "word": "whirlpool sign" }, { "word": "acute abdominal pain" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4467q0xg", "frozenauthors": [ { "first_name": "Christopher", "middle_name": "", "last_name": "Libby", "name_suffix": "", "institution": "Cedars Sinai Health System, Department of Emergency Medicine, Los Angeles, California", "department": "" }, { "first_name": "Evan", "middle_name": "", "last_name": "Stern", "name_suffix": "", "institution": "HCA Florida North Florida Hospital, Department of Graduate Medical Education, Gainesville, Florida; University of Central Florida/HCA Florida Healthcare, Gainesville, Florida", "department": "Emergency Medicine" }, { "first_name": "Robyn", "middle_name": "", "last_name": "Hoelle", "name_suffix": "", "institution": "HCA Florida North Florida Hospital, Department of Graduate Medical Education, Gainesville, Florida; University of Central Florida/HCA Florida Healthcare, Gainesville, Florida", "department": "Emergency Medicine" } ], "date_submitted": "2023-05-24T03:29:23.835000+10:00", "date_accepted": "2023-10-24T22:11:26.665000+11:00", "date_published": "2024-02-14T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1394/galley/9611/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1394/galley/3854/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1394/galley/9611/download/" } ] }, { "pk": 1389, "title": "Diabetic Ketoalkalosis: A Case Report", "subtitle": null, "abstract": "<b>Introduction:</b> Diabetic ketoacidosis (DKA) is a common diagnosis in the emergency department (ED). However, one must consider other causes for acid-base disturbances when the pattern is not consistent with typical presentation.<p></p><p><b><b>Case Report:</b></b> A 52-year-old female with a history of insulin-dependent diabetes mellitus type 2 presented to the ED with abdominal pain, nausea, and vomiting for three days. Her diagnostic workup revealed diabetic ketoacidosis but with concurrent metabolic alkalosis. Standard treatment for DKA was initiated, and there was improvement of her mentation and resolution of metabolic derangements.</p><p></p><p><b><b><b>Conclusion:</b></b></b> Overlooking a diagnosis of DKA because of alkalosis on venous blood gas testing could lead to inappropriate treatment and, therefore, increased risk of morbidity and mortality in the affected patient.</p>", "language": "eng", "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": "DKA" }, { "word": "Diabetic ketoalkalosis" }, { "word": "baking soda ingestion" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/99w4n9sm", "frozenauthors": [ { "first_name": "April", "middle_name": "", "last_name": "Brill", "name_suffix": "", "institution": "Franciscan Health Olympia Fields, Emergency Department, Olympia Fields, Illinois", "department": "Emergency Medicine" }, { "first_name": "Nirav", "middle_name": "", "last_name": "Chheda", "name_suffix": "", "institution": "Franciscan Health Olympia Fields, Emergency Department, Olympia Fields, Illinois", "department": "" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Strama", "name_suffix": "", "institution": "Midwestern University Chicago College of Osteopathic Medicine, Downers Grove, Illinois", "department": "" }, { "first_name": "Ramesh", "middle_name": "", "last_name": "Soundarajan", "name_suffix": "", "institution": "Franciscan Health Olympia Fields, Emergency Department, Olympia Fields, Illinois", "department": "" } ], "date_submitted": "2023-05-20T07:20:41.825000+10:00", "date_accepted": "2023-11-10T10:35:32.595000+11:00", "date_published": "2024-02-14T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1389/galley/9614/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1389/galley/3858/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1389/galley/9614/download/" } ] }, { "pk": 18422, "title": "Space Ultrasound: A Proposal for Competency-based Ultrasound Training for In-flight Space Medicine", "subtitle": null, "abstract": "Space travel has transformed in the past several years. Given the burgeoning market for space tourism, in-flight medical emergencies are likely to be expected. Ultrasound is one of the few diagnostic and therapeutic modalities available for astronauts in space. However, while point-of-care ultrasound (POCUS) is available, there is no current standard of training for astronaut preparation. We suggest an organized and structured methodology by which astronauts should best prepare for space with the medical equipment available on board. As technology continues to evolve, the assistance of other artificial intelligence and augmented reality systems are likely to facilitate training and dynamic real-time needs during space emergencies.<p></p><p><b><b>Summary: </b></b>As space tourism continues to evolve, an organized methodology for POCUS use is advised to best prepare astronauts for space.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Point of Care Ultrasound" }, { "word": "Emergency Medicine" }, { "word": "space medicine" } ], "section": "Ultrasound", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2jf9r8qq", "frozenauthors": [ { "first_name": "Chanel", "middle_name": "", "last_name": "Fischetti", "name_suffix": "", "institution": "Brigham and Women’s Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts", "department": "" }, { "first_name": "Emily", "middle_name": "", "last_name": "Frisch", "name_suffix": "", "institution": "Cleveland Clinic, Department of Obstetrics and Gynecology, Cleveland, Ohio", "department": "None" }, { "first_name": "Michael", "middle_name": "", "last_name": "Loesche", "name_suffix": "", "institution": "Brigham and Women’s Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Goldsmith", "name_suffix": "", "institution": "Brigham and Women’s Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Ben", "middle_name": "", "last_name": "Mormann", "name_suffix": "", "institution": "Brigham and Women’s Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Joseph", "middle_name": "S.", "last_name": "Savage", "name_suffix": "", "institution": "Yale Bridgeport Hospital, Department of Emergency Medicine, Bridgeport, Connecticut", "department": "None" }, { "first_name": "Roger", "middle_name": "", "last_name": "Dias", "name_suffix": "", "institution": "Brigham and Women’s Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Nicole", "middle_name": "", "last_name": "Duggan", "name_suffix": "", "institution": "Brigham and Women’s Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" } ], "date_submitted": "2023-08-09T14:37:26+10:00", "date_accepted": "2023-08-09T14:37:26+10:00", "date_published": "2024-02-14T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18422/galley/9610/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18422/galley/9610/download/" } ] }, { "pk": 1399, "title": "Transcatheter Arterial Embolization for Atraumatic Splenic Rupture in TEE-negative Endocarditis: A Case Report", "subtitle": null, "abstract": "<b>Introduction: </b>Spontaneous splenic rupture is an extremely rare complication of infective endocarditis.<p></p><p><b>Case Report:</b> We present a case of a 56-year-old immunocompetent female with porcine bioprosthetic mitral valve replacement, automated implanted cardioverter-defibrillator, and atrial fibrillation on apixaban who was found to have in-hospital atraumatic splenic rupture complicating infective endocarditis with Haemophilus parainfluenza. The rupture was treated successfully by endovascular embolization. Usual treatment with six weeks of antibiotics provided durable cure without further complication, and no surgical intervention was needed for either the valve or spleen.</p><p></p><p><b>Conclusion: </b>Transcatheter arterial embolization should be considered early in atraumatic splenic rupture. Relevant abdominal and cerebral imaging should be considered in all cases of suspected or confirmed infective endocarditis where unexplained symptoms are present.</p>", "language": "eng", "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": "atraumatic splenic rupture" }, { "word": "splenic artery embolization" }, { "word": "endocarditis" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/38w7j8tc", "frozenauthors": [ { "first_name": "Daniel", "middle_name": "P.", "last_name": "High", "name_suffix": "", "institution": "HCA Florida Aventura Hospital, Department of Pulmonary and Critical Care Medicine, Aventura, Florida", "department": "Pulmonary and Critical Care Medicine" }, { "first_name": "Jose", "middle_name": "M.", "last_name": "Acosta-Rullán", "name_suffix": "", "institution": "HCA Florida Aventura Hospital, Department of Internal Medicine, Aventura, Florida", "department": "Internal Medicine" }, { "first_name": "Danay", "middle_name": "", "last_name": "Herrera", "name_suffix": "", "institution": "HCA Florida Aventura Hospital, Department of Internal Medicine, Aventura, Florida", "department": "Internal Medicine" }, { "first_name": "Mauricio", "middle_name": "", "last_name": "Danckers", "name_suffix": "", "institution": "HCA Florida Aventura Hospital, Department of Pulmonary and Critical Care Medicine, Aventura, Florida", "department": "Pulmonary and Critical Care Medicine" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Heller", "name_suffix": "", "institution": "HCA Florida Aventura Hospital, Department of Pulmonary and Critical Care Medicine, Aventura, Florida", "department": "Pulmonary and Critical Care Medicine" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Zapata", "name_suffix": "", "institution": "HCA Florida Kendall Hospital, Department of Pulmonary and Critical Care Medicine, Miami, Florida", "department": "Pulmonary and Critical Care Medicine" } ], "date_submitted": "2023-05-25T03:57:44.018000+10:00", "date_accepted": "2023-10-26T07:11:41.122000+11:00", "date_published": "2024-02-14T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1399/galley/9613/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1399/galley/3855/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1399/galley/9613/download/" } ] }, { "pk": 1919, "title": "Using Point-of-care Ultrasonography to Diagnose Traumatic Arthrotomy of the Knee: A Case Series", "subtitle": null, "abstract": "<b>Introduction: </b>Accurate diagnosis of traumatic arthrotomy of the knee (TAK) is critical for patients presenting to the emergency department (ED) to ensure timely treatment. Current diagnostic modalities including plain radiography, computed tomography (CT), and the saline load test (SLT) have advantages and disadvantages. Point-of-care-ultrasonography (POCUS) offers a possible timely, low-cost, and efficient alternative method of diagnosing TAK. In this case series we present three cases where POCUS was used to diagnose TAK in the ED.<p></p><p><b>Case Series:</b> Three patients in their early 20s presented to the ED complaining of knee trauma with wounds in proximity to the joint. Mechanisms of injury included a gunshot wound in one case and blunt trauma (motor vehicle collision and bicycle crash) in two cases. In all three cases TAK was suggested on POCUS examinations by the presence of intra-articular hyperechoic foci consistent with air artifact. All three cases had TAK confirmed by orthopedic evaluation.</p><p></p><p><b>Discussion: </b>Ultrasound may have utility in the evaluation of patients presenting with knee trauma where TAK is a concern. The SLT is generally considered the gold standard test for diagnosis of TAK, but it is invasive and has a wide range of diagnostic accuracy. Intra-articular air has been found to be a sensitive marker for TAK in CT studies. Thus, additional investigations into the diagnostic accuracy of POCUS for this finding should be undertaken.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "case report" }, { "word": "POCUS" }, { "word": "Traumatic arthrotomy" }, { "word": "Intra-articular air" }, { "word": "musculoskeletal ultrasound" } ], "section": "Case Series", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2fs0z5sf", "frozenauthors": [ { "first_name": "Jordan", "middle_name": "", "last_name": "Mullings", "name_suffix": "", "institution": "Alameda Health System, Department of Emergency Medicine, Highland Hospital, Oakland, California", "department": "Emergency Medicine" }, { "first_name": "Henry", "middle_name": "", "last_name": "Ashworth", "name_suffix": "", "institution": "Alameda Health System, Department of Emergency Medicine, Highland Hospital, Oakland, California", "department": "Emergency Medicine" }, { "first_name": "Matthew", "middle_name": "", "last_name": "Kongkatong", "name_suffix": "", "institution": "University of Virginia Health System, Department of Emergency Medicine, Charlottesville, Virginia", "department": "Emergency Medicine" }, { "first_name": "Daniel", "middle_name": "", "last_name": "Mantuani", "name_suffix": "", "institution": "Alameda Health System, Department of Emergency Medicine, Highland Hospital, Oakland, California", "department": "Emergency Medicine" } ], "date_submitted": "2023-10-04T02:29:17.507000+11:00", "date_accepted": "2023-10-26T04:30:18.763000+11:00", "date_published": "2024-02-14T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1919/galley/9612/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1919/galley/3851/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1919/galley/9612/download/" } ] }, { "pk": 38027, "title": "Mester 52 - Cover", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "COVER", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/10m9j825", "frozenauthors": [ { "first_name": "Cristina", "middle_name": "G.", "last_name": "Vázquez", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-13T19:30:40+11:00", "date_accepted": "2024-02-13T19:30:40+11:00", "date_published": "2024-02-13T19:32:07+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38027/galley/28619/download/" } ] }, { "pk": 38026, "title": "Front Matter", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "FRONT MATTER", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8579v24w", "frozenauthors": [ { "first_name": "Cristina", "middle_name": "G.", "last_name": "Vázquez", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-13T19:14:49+11:00", "date_accepted": "2024-02-13T19:14:49+11:00", "date_published": "2024-02-13T19:16:38+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38026/galley/28618/download/" } ] }, { "pk": 38025, "title": "Tánger multiplicada en los espejos: La otra orilla de Rocío Rojas Marcos", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "INTERVIEWS", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/42n8s6c6", "frozenauthors": [ { "first_name": "Verónica", "middle_name": "", "last_name": "García Moreno", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-13T19:02:41+11:00", "date_accepted": "2024-02-13T19:02:41+11:00", "date_published": "2024-02-13T19:04:34+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38025/galley/28617/download/" } ] }, { "pk": 38024, "title": "The visual poetics of the border: A conversation with Salvador de La Torre", "subtitle": null, "abstract": "Salvador de la Torre is a Mexican-born Texas-raised artist, educator, and storyteller based in Southern California.", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "INTERVIEWS", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8nc3z9wx", "frozenauthors": [ { "first_name": "Verónica", "middle_name": "", "last_name": "García Moreno", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-13T18:56:45+11:00", "date_accepted": "2024-02-13T18:56:45+11:00", "date_published": "2024-02-13T19:00:30+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38024/galley/28616/download/" } ] }, { "pk": 38005, "title": "Using Nearpod for Pronunciation Training in Elementary Spanish Courses", "subtitle": null, "abstract": "Teaching pronunciation using computer and mobile-assisted technology has steadily increased over the past two decades (Olson, 2014; Galazci, 2016, Kochem, 2022; Tseng et al., 2002, Lan, 2022). Furthering our understanding of the impact that teaching pronunciation using technology has on students is vital to continue developing tools to support student-oriented pronunciation goals, especially since prior research elucidates the critical role that pronunciation has in maintaining the flow of interactions in communication, increasing student’s confidence, and even in the process of identity-construction in a second language (Jenkins, 2004; Chapelle, 2003; Foot et al., 2017; Almusharraf, 2022). While several studies have investigated the efficacy of pronunciation training remotely or via distance CALL (Engwall et al., 2004; Rogerson-Revell, 2021), little is known about how students feel about using these tools to practice pronunciation training during class time. Since pronunciation instruction is slowly becoming a staple in foreign/second language curricula (Derwin et al., 2017), research evaluating students’ attitudes and reactions to in-class pronunciation activities has the potential to provide valuable insights into students’ willingness to participate in pronunciation training and the overall efficacy of pronunciation interventions in the classroom which harness technological advances for teaching.", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "Pronunciation, Computer assisted language learning" } ], "section": "IDENTITY AND LANGUAGE", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/99r724rg", "frozenauthors": [ { "first_name": "César", "middle_name": "", "last_name": "Hoyos Álvarez", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2023-02-02T11:57:14+11:00", "date_accepted": "2023-02-02T11:57:14+11:00", "date_published": "2024-02-13T18:53:41+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38005/galley/28608/download/" } ] }, { "pk": 38000, "title": "Identity through Gaming in the L2 Classroom: Contextualization and Narrative", "subtitle": null, "abstract": "This articles discusses the impact that video games can have on student identification in the L2 classroom through contextualization and narration. It also presents a few examples of various forms of identification through students' creation of avatars in the video game \nThe Sims\n. The discussion hopes to inspire future studies and discussions on video games and identity in the language classsroom.", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "IDENTITY AND LANGUAGE", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/63h5n431", "frozenauthors": [ { "first_name": "Kyle", "middle_name": "", "last_name": "Patterson", "name_suffix": "", "institution": "UC Santa Barbara", "department": "None" } ], "date_submitted": "2023-01-21T16:30:57+11:00", "date_accepted": "2023-01-21T16:30:57+11:00", "date_published": "2024-02-13T18:43:36+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38000/galley/28606/download/" } ] }, { "pk": 37997, "title": "Botiflers and Betrayal: Heraldic Semiotics and Linguistic Landscape on Catalonia's National Day", "subtitle": null, "abstract": "The aim of the present research is to analyze the linguistic landscape (LL) and Catalan heraldic imagery of the 2022\n Diada\n, Catalonia’s National Day. The theme and language(s) of all \nDiada\n signage were systematically coded, along with other semiotic elements such as colors and heraldic emblems. A qualitative content analysis complemented this quantitative coding scheme and reveals that \nIndependence\n was the dominant theme in signage, followed by \nBetrayal\n, \nSolidarity\n, and \nCatalan Cultural Identity\n. The targets of \nBetrayal\n messages were pro-independence Catalan politicians who, in the eyes of those partial to secession, have failed to make good on their promises in the five years following the contentious Catalan independence referendum. The quantitative analysis points to an overwhelming preference for the pro-independence \nestelada\n over the less politically-charged \nsenyera\n. Heraldry-theme relationships show the \nsenyera\n to be most represented in signage pertaining to \nCatalan Cultural Identity. \nThis adumbrates that it is still an appropriate symbol for claiming ethnocultural group membership, though \nLa Diada\n semiotics overall emphasized political rather than cultural statements. The LL and heraldic data from the 2022 \nDiada\n shed light on the evolution of secessionist sentiment and the role of traditional Catalan symbols in the tense socio-political climate of post-referendum Catalonia.", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "Linguistic Landscape" }, { "word": "geosemiotics" }, { "word": "Catalonia" }, { "word": "heraldic imagery" }, { "word": "identity" }, { "word": "Catalan" } ], "section": "IDENTITY AND LANGUAGE", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/70s5d9h1", "frozenauthors": [ { "first_name": "Marguerite", "middle_name": "Judith", "last_name": "Morlan", "name_suffix": "", "institution": "UC Berkeley", "department": "None" } ], "date_submitted": "2023-01-21T11:19:54+11:00", "date_accepted": "2023-01-21T11:19:54+11:00", "date_published": "2024-02-13T18:35:54+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/37997/galley/28605/download/" } ] }, { "pk": 38022, "title": "A Linguistic Perspective", "subtitle": null, "abstract": "Undoubtedly, the study of language and identity holds tremendous value as it enables us to gain a better understanding of the mechanisms underlying identity construction and address the current issues faced by multilingual and historically marginalized communities in Latin America and the United States.", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "IDENTITY AND LANGUAGE", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3hn3w04q", "frozenauthors": [ { "first_name": "César", "middle_name": "", "last_name": "Hoyos Álvarez", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-13T18:27:02+11:00", "date_accepted": "2024-02-13T18:27:02+11:00", "date_published": "2024-02-13T18:30:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38022/galley/28615/download/" } ] }, { "pk": 38021, "title": "Percepción y narrativa: inmigración, adopción del dolor y agentes circulantes en Biutiful (2010) y La Promesse (1996)", "subtitle": null, "abstract": "Biutiful\n da entrada a una gama de interpretaciones con relación a la inmigración y a la memoria histórica en la España contemporánea. Mediante una serie de técnicas fílmicas, Alejandro González Iñárritu entrelaza la vida de los inmigrantes senegaleses y chinos con la de los ciudadanos españoles en una Barcelona oscura, fuera de la imagen turística e icónica de la ciudad, pero dentro de los parámetros de la realidad sin perder el sentido de los elementos ficticios. El propósito de este trabajo es analizar cómo Uxbal, el personaje principal y alter ego de González Iñárritu, se convierte en la conexión entre los distintos ‘espectros’ de la sociedad española: los inmigrantes y los ‘fantasmas’ no tan lejanos de la Guerra Civil que aún marcan el presente en España. \nBiutiful\n tiene como premisa plantear una secuencia de denuncias que ha prevalecido en el imaginario hacia la recepción de estos espectros como el otro invisibilizado, sin embargo, ¿se requiere acaso de una mirada extranjera para lograr establecer esta tan necesitada visibilización?", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [], "section": "IDENTITY AND BORDERS", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/47c438kq", "frozenauthors": [ { "first_name": "Cristina", "middle_name": "G.", "last_name": "Vázquez", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-13T18:16:43+11:00", "date_accepted": "2024-02-13T18:16:43+11:00", "date_published": "2024-02-13T18:19:59+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38021/galley/28614/download/" } ] }, { "pk": 38011, "title": "Entornos hostiles, deserción escolar y migraciones", "subtitle": null, "abstract": "Se propone un análisis de los entornos hostiles que enfrenta actualmente la juventud, en su núcleo familiar, en el ámbito escolar y en su lugar de origen que provocan la deserción escolar, el desarraigo familiar y la migración. Una reflexión que surge a partir del contacto con las personas estudiantes de educación básica y media superior en México y desde el contacto con poblaciones de alta marginación en zonas urbanas e indígenas del país, se plantea un análisis desde la experiencia docente y formativa, se propone observar con una mirada respetuosa y compasiva hacia la población juvenil que desde un discurso adultocéntrico se desacredita su papel en nuestra sociedad, se propone abrir las puertas a una nueva perspectiva de juventudes con identidad propia, como agentes del cambio en sus comunidades de origen, papel que legítimamente les pertenece como personas y como ciudadanos.", "language": "en Spanish", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "entornos hostiles" }, { "word": "deserción escolar, migración, educación de calidad, violencia" } ], "section": "IDENTITY AND BORDERS", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/26m5n1jw", "frozenauthors": [ { "first_name": "María del Consuelo", "middle_name": "", "last_name": "Martínez Berber", "name_suffix": "", "institution": "Instituto Politécnico Nacional", "department": "None" } ], "date_submitted": "2023-03-03T17:17:28+11:00", "date_accepted": "2023-03-03T17:17:28+11:00", "date_published": "2024-02-13T18:06:36+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38011/galley/28610/download/" } ] }, { "pk": 38014, "title": "Urban Numbness toward Mexican Domestic Workers from the 1970s to Present Day: A Spiral of Instability in Roma, Hilda, and “Esperanza número equivocado”", "subtitle": null, "abstract": "In March of 2020, the World Health Organization (WHO) declared a global pandemic, provoking uncertainty around the world. In particular, the pandemic produced instability in domestic workers’ employment in Mexico. During the surge of COVID-19, such instability revealed the marginal importance that Mexican society has placed on the lives of domestic workers, especially on their health, independence, and labor rights. This uncaring attitude and impassivity triggered a spiral of instability where the domestic worker’s emotional and socioeconomic state fluctuates in the face of historical events. Through literature and film, the domestic worker’s spiral of instability phenomenon is confirmed in the unfavorable situations that occurred in The Corpus Christi Massacre in 1971, evidenced in Alfonso Cuaron’s \nRoma \n(2018), returning the domestic worker to everyday life, revealed in Elena Poniatowska’s “Esperanza número equivocado” (1979) and Andres Clariond Rangel’s \nHilda\n (2014) and, again, placing the domestic worker in a state of instability during the COVID-19 pandemic in 2020 explained through press report interviews. I will compare the aforementioned works to the domestic workers’ situation in Mexico during the COVID-19 pandemic to identify the oppressive conditions described in literature and film and to highlight the urban numbness that has lessened solidarity.", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "Domestic Workers, Mexican Literature and Film, Instability, Urban Numbness, COVID-19" } ], "section": "IDENTITY AND BORDERS", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/70g0g069", "frozenauthors": [ { "first_name": "Estefanía", "middle_name": "Rocio", "last_name": "Morales", "name_suffix": "", "institution": "UCLA", "department": "None" } ], "date_submitted": "2023-04-28T18:21:06+10:00", "date_accepted": "2023-04-28T18:21:06+10:00", "date_published": "2024-02-13T17:54:33+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38014/galley/28613/download/" } ] }, { "pk": 37996, "title": "Los restos del camino: el territorio trasnacional en el Libro centroamericano de los muertos de Balam Rodrigo", "subtitle": null, "abstract": "El \nLibro centroamericano de los muertos \nes el segundo de una trilogía con la que Balam Rodrigo, poeta chiapaneco, reconstruye el tránsito de migrantes centroamericanos en su paso por México. El poemario está emparentado con la crónica de viajes no solamente por la inclusión de Las Casas como coautor del texto sino en la misma organización de los capítulos, que organizan los poemas a manera de recorrido por los ‘reinos’ de Centroamérica. En este ensayo me propongo investigar ¿qué funciones cumplen las referencias intertextuales con las que dialoga el poemario?, ¿cómo se configura el espacio en el texto? Y finalmente, ¿qué relación tienen estos dos elementos con la propuesta política de Rodrigo? Propongo que el \nLibro centroamericano de los muertos\n produce discursivamente el territorio extendiendo los límites geográficos, lingüísticos y literarios para (re)configurar una imagen de Centroamérica, que trasciende las fronteras políticas a través de la figura del migrante. Para el análisis parto del planteamiento de Deleuze y Guattari y de Edouard Glissant.", "language": "es", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "migración, territorio, Centroamérica" } ], "section": "IDENTITY AND BORDERS", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5zh0c5jb", "frozenauthors": [ { "first_name": "Zyanya", "middle_name": "", "last_name": "Dóniz Ibáñez", "name_suffix": "", "institution": "Georgetown University", "department": "None" } ], "date_submitted": "2023-01-18T11:48:10+11:00", "date_accepted": "2023-01-18T11:48:10+11:00", "date_published": "2024-02-13T17:50:39+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/37996/galley/28604/download/" } ] }, { "pk": 38009, "title": "Irrupciones de la memoria en el cine documental sobre el conflicto armado interno peruano: Tarea Pendiente (2003) y Lucanamarca (2008)", "subtitle": null, "abstract": "El 3 de abril de 1983, Sendero Luminoso asesinó brutalmente a 69 personas en Santiago de Lucanamarca y pueblos aledaños. Este ensayo analiza dos documentales que tratan sobre la consecuencias de esta masacre: \nTarea pendiente \n(2003), de Carlos Cárdenas, y \nLucanamarca\n (2008), de Carlos Cárdenas y Héctor Gálvez. En la primera parte, se muestra cómo estos documentales se producen en dos momentos \nirruptores\n de la memoria del Perú posconflicto y son representativos de su género. En la segunda parte, centrándose en \nLucanamarca\n, se muesta cómo, a pesar de compartir cierto espíritu de responsabilidad social con otros documentales sobre el conflicto armado interno que se produjeron y estrenaron en la década del dos mil, \nLucanamarca\n presenta una narrativa contrahegemónica pues se aleja de la narrativa de una “memoria cívica”.", "language": "es", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "memoria" }, { "word": "justicia transicional" }, { "word": "lucanamarca" }, { "word": "conflicto armado interno peruano" }, { "word": "cine documental" } ], "section": "IDENTITY AND BORDERS", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5010r7f9", "frozenauthors": [ { "first_name": "Maria Claudia", "middle_name": "", "last_name": "Huerta Vera", "name_suffix": "", "institution": "University of California, Davis", "department": "None" } ], "date_submitted": "2023-02-21T19:39:49+11:00", "date_accepted": "2023-02-21T19:39:49+11:00", "date_published": "2024-02-13T17:47:05+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38009/galley/28609/download/" } ] }, { "pk": 38012, "title": "“A chuva nunca foi o problema”: Memory, Indigeneity, and Decoloniality through Uýra", "subtitle": null, "abstract": "This article considers the video-performance “Manaus: Uma cidade na aldeia” by Uýra Sodoma. Divided into four acts, each part of the video-performance exemplifies a rupture with an anthropocentric model of modernity that privileges the human as the sole locus of experience, and it shows how indigenous healing through remembering renounces the naturalization of oppositions such as nature/culture, human/nonhuman. In my analysis, I present Uyra as an alter-political and decolonial figure, meaning that she both presents a path forward that is not necessarily predicated on adversarial schemas, and that she prefers to “contar outras histórias” by physically becoming something else, her body serving as the immanent/imminent site of perspectival differentiation. The video-performance points to the messiness of memory, history, colonial violence, and other forms of being and achieves a different outcome for the rivers, the frogs, and the trees, as well as for indigenous communities within and beyond Brazil.", "language": "en", "license": { "name": "Copyright", "short_name": "Copyright", "text": "", "url": "https://escholarship.org/terms" }, "keywords": [ { "word": "Uýra Sodoma" }, { "word": "Alter-politics" }, { "word": "memory" }, { "word": "Other-than-human" }, { "word": "Decoloniality." } ], "section": "IDENTITY AND BORDERS", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/55v3c44k", "frozenauthors": [ { "first_name": "Logan", "middle_name": "", "last_name": "Krishka", "name_suffix": "", "institution": "University of Wisconsin - Madison", "department": "None" } ], "date_submitted": "2023-03-18T10:01:07+11:00", "date_accepted": "2023-03-18T10:01:07+11:00", "date_published": "2024-02-13T17:41:21+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/mester/article/38012/galley/28611/download/" } ] }, { "pk": 16435, "title": "A Structural Competency Framework for Emergency Medicine Research: Results from a Scoping Review & Consensus Conference", "subtitle": null, "abstract": "Introduction:\n The application of structural competency and structural vulnerability to emergency medicine (EM) research has not been previously described despite EM researchers routinely engaging structurally vulnerable populations. The purpose of this study was to conduct a scoping review and consensus-building process to develop a structurally competent research approach and operational framework relevant to EM research.\nMethods:\n We conducted a scoping review focused on structural competency and structural vulnerability. Results of the review informed the development of a structural competency research framework that was presented throughout a multi-step consensus process culminating in the 2021 Society for Academic Emergency Medicine Consensus Conference. Feedback to the framework was incorporated throughout the conference.\nResults:\n The scoping review produced 291 articles with 123 articles relevant to EM research. All 123 articles underwent full-text review and data extraction following a standardized data extraction form. Most of the articles acknowledged or described structures that lead to inequities with a variety of methodological approaches used to operationalize structural competency and/or structural vulnerability. The framework developed aligned with components of the research process, drawing upon methodologies from studies included in the scoping review. \nConclusion:\n The framework developed provides a starting point for EM researchers seeking to understand, acknowledge, and incorporate structural competency into EM research. By incorporating components of the framework, researchers may enhance their ability to address social, historical, political, and economic forces that lead to health inequities, reframing drivers of inequities away from individual factors and focusing on structural factors.", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "structural competency" }, { "word": "Structural Vulnerability" }, { "word": "research" }, { "word": "social emergency medicine" } ], "section": "Health Equity", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0gg0c1r8", "frozenauthors": [ { "first_name": "Amy", "middle_name": "", "last_name": "Zeidan", "name_suffix": "", "institution": "Emory University School of Medicine", "department": "None" }, { "first_name": "Bisan", "middle_name": "", "last_name": "Salhi", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Anika", "middle_name": "", "last_name": "Backster", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Erica", "middle_name": "", "last_name": "Shelton", "name_suffix": "", "institution": "Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, Maryland", "department": "None" }, { "first_name": "Alycia", "middle_name": "", "last_name": "Valente", "name_suffix": "", "institution": "University of Massachusetts, Department of Emergency Medicine, Worcester, Massachusetts", "department": "None" }, { "first_name": "Basmah", "middle_name": "", "last_name": "Safdar", "name_suffix": "", "institution": "Yale University, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Ambrose", "middle_name": "", "last_name": "Wong", "name_suffix": "", "institution": "Yale University, Department of Emergency Medicine, New Haven, Connecticut", "department": "None" }, { "first_name": "Alessandra", "middle_name": "", "last_name": "Della Porta", "name_suffix": "", "institution": "University of Cincinnati, Department of Emergency Medicine, Cincinnati, Ohio", "department": "None" }, { "first_name": "Sangil", "middle_name": "", "last_name": "Lee", "name_suffix": "", "institution": "The University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Todd", "middle_name": "", "last_name": "Schneberk", "name_suffix": "", "institution": "Los Angeles + University of Southern California, Department of Emergency Medicine, Los Angeles, California", "department": "None" }, { "first_name": "Jason", "middle_name": "", "last_name": "Wilson", "name_suffix": "", "institution": "Morsani College of Medicine, Division of Emergency Medicine, Department of Internal Medicine, Tampa, Florida", "department": "None" }, { "first_name": "Bjorn", "middle_name": "", "last_name": "Westgard", "name_suffix": "", "institution": "University of Minnesota Medical School, Department of Emergency Medicine, Minneapolis, Minnesota", "department": "None" }, { "first_name": "Margaret", "middle_name": "", "last_name": "Samuels-Kalow", "name_suffix": "", "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" } ], "date_submitted": "2022-01-11T12:15:37+11:00", "date_accepted": "2022-01-11T12:15:37+11:00", "date_published": "2024-02-13T03:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/16435/galley/8316/download/" } ] }, { "pk": 19434, "title": "CPC-EM Full-Text Issue", "subtitle": null, "abstract": "", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "CPC-EM Full-Text Issue", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4x97p7vk", "frozenauthors": [ { "first_name": "Nicole", "middle_name": "", "last_name": "Valenzi", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2024-02-13T07:33:12.120000+11:00", "date_accepted": "2024-02-13T07:35:14.896000+11:00", "date_published": "2024-02-13T01:00:00+11:00", "render_galley": { "label": "Full Issue Text", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/19434/galley/9609/download/" }, "galleys": [ { "label": "Full Issue Text", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/19434/galley/9609/download/" } ] }, { "pk": 18085, "title": "Bridging the Gap: Evaluation of an Electrocardiogram Curriculum for Advanced Practice Clinicians", "subtitle": null, "abstract": "<b>Background:</b> Training programs for advanced practice providers (APP) often have significant variability in their curriculum, including electrocardiogram (ECG) education. Despite limitations in formal ECG training, APPs in the emergency department (ED) may be the first practitioner to interpret an ECG. Foundations of Emergency Medicine (FoEM) offers free, open-access curricula that are widely used for resident education. We sought to improve APP ECG interpretation skills by implementing the FoEM ECG I course.<p></p><p><b><b>Methods:</b></b> This was a single-site, pre- and post-intervention study of 23 APPs at our high-acuity, urban ED. In the fall of 2020, APP learners enrolled in a FoEM ECG I course led by faculty and senior resident instructors. The course consisted of six virtual, small-group, active-learning ECG workshops. Participants completed a 15-question multiple-choice test before, immediately after, and six months post-intervention to quantify knowledge acquisition. Additionally, a pre- and post-intervention knowledge, attitudes, and practices survey was administered on ECG interpretation skills and to evaluate the course. We evaluated change in ECG knowledge scores using a Wilcoxon signed-rank test. Changes in self-assessed knowledge were evaluated using an ordinal logistic mixed-effects regression.</p><p></p><p><b><b><b>Results: </b></b></b>A total of 23 APPs enrolled in the course. Knowledge assessments showed APPs improved from the pre-test (median 9/15, interquartile range [IQR] 7–11) to the post-test (median 12/15, IQR 10–13; P = 0.001). Test scores did not significantly change from the post-test to the delayed post-test (median 12/15, IQR 12–13; P = 0.30). Respondents’ subjective rating of their skill did not significantly change (P = 0.06). Respondents reported no change in their likelihood of approaching an attending when uncertain of the correct interpretation of an ECG (P = 0.16). Overall, 91% were satisfied with the course and 96% agreed that the course difficulty was appropriate.</p><p></p><p><b><b><b><b>Conclusion: </b></b></b></b>The FoEM ECG course provided a standardized curriculum that improved APP knowledge for interpreting ECGs. Despite this, the course did not alter APPs’ willingness to approach physicians for guidance with interpretation of abnormal ECGs. These findings may inform expansion of this concept for other programs who desire formalized APP ECG education.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Cardiology", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/08n912m2", "frozenauthors": [ { "first_name": "Steven", "middle_name": "", "last_name": "Lindsey", "name_suffix": "", "institution": "Emory University, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Tim", "middle_name": "P.", "last_name": "Moran", "name_suffix": "", "institution": "Emory University, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Meredith", "middle_name": "A.", "last_name": "Stauch", "name_suffix": "", "institution": "Emory University School of Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Alexis", "middle_name": "L.", "last_name": "Lynch", "name_suffix": "", "institution": "Emory University, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" }, { "first_name": "Kristen", "middle_name": "Grabow", "last_name": "Moore", "name_suffix": "", "institution": "Emory University, Department of Emergency Medicine, Atlanta, Georgia", "department": "None" } ], "date_submitted": "2023-04-22T05:16:19+10:00", "date_accepted": "2023-04-22T05:16:19+10:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18085/galley/9600/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18085/galley/9600/download/" } ] }, { "pk": 18327, "title": "Characteristics for Low, High and Very High Emergency Department Use for Mental Health Diagnoses from Health Records and Structured Interviews", "subtitle": null, "abstract": "<b>Introduction: </b>Patients with mental health diagnoses (MHD) are among the most frequent emergency department (ED) users, suggesting the importance of identifying additional factors associated with their ED use frequency. In this study we assessed various patient sociodemographic and clinical characteristics, and service use associated with low ED users (1–3 visits/year), compared to high (4–7) and very high (8+) ED users with MHD.<p></p><p><b><b>Methods: </b></b>Our study was conducted in four large Quebec (Canada) ED networks. A total of 299 patients with MHD were randomly recruited from these ED in 2021–2022. Structured interviews complemented data from network health records, providing extensive data on participant profiles and their quality of care. We used multivariable multinomial logistic regression to compare low ED use to high and very high ED use.</p><p></p><p><b><b><b>Results:</b> </b></b>Over a 12-month period, 39% of patients were low ED users, 37% high, and 24% very high ED users. Compared with low ED users, those at greater probability for high or very high ED use exhibited more violent/disturbed behaviors or social problems, chronic physical illnesses, and barriers to unmet needs. Patients previously hospitalized 1–2 times had lower risk of high or very high ED use than those not previously hospitalized. Compared with low ED users, high and very high ED users showed higher prevalence of personality disorders and suicidal behaviors, respectively. Women had greater probability of high ED use than men. Patients living in rental housing had greater probability of being very high ED users than those living in private housing. Using at least 5+ primary care services and being recurrent ED users two years prior to the last year of ED use had increased probability of very high ED use.</p><p></p><p><b><b><b><b>Conclusion: </b></b></b></b>Frequency of ED use was associated with complex issues and higher perceived barriers to unmet needs among patients. Very high ED users had more severe recurrent conditions, such as isolation and suicidal behaviors, despite using more primary care services. Results suggested substantial reduction of barriers to care and improvement on both access and continuity of care for these vulnerable patients, integrating crisis resolution and supported housing services. Limited hospitalizations may sometimes be indicated, protecting against ED use. </p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Emergency Departments" }, { "word": "frequency of emergency department visits" }, { "word": "low service users" }, { "word": "high service users" }, { "word": "very high service users" }, { "word": "Mental Disorders" }, { "word": "Risk factors" }, { "word": "associated variables." } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/77196895", "frozenauthors": [ { "first_name": "Marie-Josée", "middle_name": "", "last_name": "Fleury", "name_suffix": "", "institution": "McGill University, Department of Psychiatry, Montreal, Canada; Douglas Mental Health University Research Centre, Montreal, Canada", "department": "None" }, { "first_name": "Zhirong", "middle_name": "", "last_name": "Cao", "name_suffix": "", "institution": "Douglas Mental Health University Research Centre, Montreal, Canada", "department": "None" }, { "first_name": "Guy", "middle_name": "", "last_name": "Grenier", "name_suffix": "", "institution": "Douglas Mental Health University Research Centre, Montreal, Canada", "department": "None" } ], "date_submitted": "2023-05-25T13:06:49+10:00", "date_accepted": "2023-05-25T13:06:49+10:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18327/galley/9603/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18327/galley/9603/download/" } ] }, { "pk": 17822, "title": "Diagnostic Accuracy of a Handheld Ultrasound vs a Cart-based Model: A Randomized Clinical Trial", "subtitle": null, "abstract": "<b>Introduction:</b> Numerous studies have demonstrated the accuracy of point-of-care ultrasound (POCUS). Portable, handheld devices have expanded the clinical scope of POCUS at a fraction of the cost of traditional, cart-based models. There is a paucity of data assessing the diagnostic accuracy of portable devices. Our objective in this study was to compare the diagnostic accuracy of a portable device with a cart-based model.<p></p><p><b><b>Methods:</b></b> This was an institutional review board-approved, observational, prospective, randomized clinical trial (NCT05196776) of a convenience sample of adult patients who presented to a university-based health system. Patients who required a cardiac, lung, renal, aorta, or biliary POCUS were randomized to a portable device or to a cart-based model. We hypothesized that the cart-based model would have a 90% diagnostic accuracy vs 70% for the handheld device. To detect a 20% difference, the sample size was calculated to be 98, with 49 patients randomized to each arm. We used standard 2x2 tables to calculate test characteristics with 95% confidence intervals (CI).</p><p></p><p><b><b><b>Results:</b> </b></b>A total of 110 patients were enrolled, with 56 patients randomized to the cart-based model and 54 to the handheld device. The sensitivity, specificity, and diagnostic accuracy of the cart-based vs handheld were 77.8% (40–97.2) vs 92.9% (66.1–99.8), 91.5% (79.6–97.6) vs 92.3% (79.1–98.4%), and 89.3% (78.1–96) vs 92.5% (81.8–97.9), respectively.</p><p></p><p><b><b><b>Conclusion:</b> </b></b>The diagnostic accuracy of a portable, handheld device is similar to that of a cart-based model.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "point-of-care ultrasound" }, { "word": "diagnostic accuracy" }, { "word": "Handheld Ultrasound" } ], "section": "Ultrasound", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5rh0101n", "frozenauthors": [ { "first_name": "Ryan", "middle_name": "C.", "last_name": "Gibbons", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Daniel", "middle_name": "J.", "last_name": "Jaeger", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" }, { "first_name": "Matthew", "middle_name": "", "last_name": "Berger", "name_suffix": "", "institution": "Capital Health, Department of Emergency Medicine, Pennington, New Jersey", "department": "" }, { "first_name": "Mark", "middle_name": "", "last_name": "Magee", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Claire", "middle_name": "", "last_name": "Shaffer", "name_suffix": "", "institution": "University of Pittsburgh Medical Center Harrisburg, Department of Emergency Medicine, Harrisburg, Pennsylvania", "department": "None" }, { "first_name": "Thomas", "middle_name": "G.", "last_name": "Costantino", "name_suffix": "", "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" } ], "date_submitted": "2023-01-23T10:28:27+11:00", "date_accepted": "2023-01-23T10:28:27+11:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17822/galley/9599/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17822/galley/9599/download/" } ] }, { "pk": 17834, "title": "National Characteristics of Emergency Care for Children with Neurologic Complex Chronic Conditions", "subtitle": null, "abstract": "<b>Introduction:</b> Most pediatric emergency care occurs in general emergency departments (GED), where less pediatric experience and lower pediatric emergency readiness may compromise care. Medically vulnerable pediatric patients, such as those with chronic, severe, neurologic conditions, are likely to be disproportionately affected by suboptimal care in GEDs; however, little is known about characteristics of their care in either the general or pediatric emergency setting. In this study our objective was to compare the frequency, characteristics, and outcomes of ED visits made by children with chronic neurologic diseases between general and pediatric EDs (PED).<p></p><p><b><b>Methods: </b></b>We conducted a retrospective analysis of the 2011–2014 Nationwide Emergency Department Sample (NEDS) for ED visits made by patients 0–21 years with neurologic complex chronic conditions (neuro CCC). We compared patient, hospital, and ED visits characteristics between GEDs and PEDs using descriptive statistics. We assessed outcomes of admission, transfer, critical procedure performance, and mortality using multivariable logistic regression.</p><p></p><p><b><b><b>Results:</b> </b></b>There were 387,813 neuro CCC ED visits (0.3% of 0–21-year-old ED visits) in our sample. Care occurred predominantly in GEDs, and visits were associated with a high severity of illness (30.1%highest severity classification score). Compared to GED visits, PED neuro CCC visits were comprised of individuals who were younger, more likely to have comorbid conditions (32.9% vs 21%, P < 0.001), and technology assistance (65.4% vs. 45.9%) but underwent fewer procedures and had lower ED charges ($2,200 vs $1,520, P < 0.001). Visits to PEDs had lower adjusted odds of critical procedures (adjusted odds ratio [aOR] 0.74, 95% confidence interval [CI] 0.62–0.87), transfers (aOR 0.14, 95% CI 0.04–0.56), and mortality (aOR 0.38, 95% CI 0.19–0.75) compared to GEDs.</p><p></p><p><b><b><b><b>Conclusion:</b></b></b></b> Care for children with neuro CCCs in a pediatric ED is associated with less resource utilization and lower rates of transfer and mortality. Identifying features of PED care for neuro CCCs could lead to lower costs and mortality for this population.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "health services" }, { "word": "pediatric emergency care" }, { "word": "complex chronic conditions" } ], "section": "Pediatrics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5sf3v54w", "frozenauthors": [ { "first_name": "Kaileen", "middle_name": "", "last_name": "Jafari", "name_suffix": "", "institution": "University of Washington, Department of Pediatrics, Seattle, Washington; Seattle Children’s Research Institute, Center for Clinical and Translational Research, Seattle, Washington", "department": "None" }, { "first_name": "Kristen", "middle_name": "", "last_name": "Carlin", "name_suffix": "", "institution": "Seattle Children’s Research Institute, Center for Clinical and Translational Research, Seattle, Washington", "department": "" }, { "first_name": "Derya", "middle_name": "", "last_name": "Caglar", "name_suffix": "", "institution": "University of Washington, Department of Pediatrics, Seattle, Washington; Seattle Children’s Research Institute, Center for Clinical and Translational Research, Seattle, Washington", "department": "None" }, { "first_name": "Eileen", "middle_name": "J.", "last_name": "Klein", "name_suffix": "", "institution": "University of Washington, Department of Pediatrics, Seattle, Washington; Seattle Children’s Research Institute, Center for Clinical and Translational Research, Seattle, Washington", "department": "None" }, { "first_name": "Tamara", "middle_name": "D.", "last_name": "Simon", "name_suffix": "", "institution": "University of Southern California, Keck School of Medicine, Department of Pediatrics, Los Angeles, California", "department": "None" } ], "date_submitted": "2023-01-26T09:02:50+11:00", "date_accepted": "2023-01-26T09:02:50+11:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17834/galley/9598/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17834/galley/9598/download/" } ] }, { "pk": 18408, "title": "Pediatric Outcomes of Emergency Medical Services Non-Transport Before and During the COVID-19 Pandemic", "subtitle": null, "abstract": "<b>Introduction:</b> Pediatric patients account for 6–10% of emergency medical services (EMS) activations in the United States. Approximately 30% of these children are not transported to an emergency department (ED). Adult data in the literature reports higher hospitalization and complications following non-transport. Few studies discuss epidemiology and characteristics of pediatric non-transport; however, data on outcome is limited. Our primary aim was to determine outcomes of non-transported children within our urban EMS system before and during the COVID-19 pandemic. Our secondary objective was to explore reasons for non-transport.<p></p><p><b><b>Methods: </b></b>This was a prospective, descriptive pilot study. We compared EMS data for September 2019 (pre-COVID-19) to September 2020 (pandemic). Included were children aged 0–17 years who activated EMS and did not receive transport to the primary hospital for the EMS capture area. We defined outcomes as repeat EMS activation, ED visits, and hospital admissions, all within 72 hours. Data was obtained via electronic capture. We used descriptive statistics to analyze our data, chi square for categorical data, stepwise logistic regression, and univariate logistic regression to test for association of covariates with non-transport.</p><p></p><p><b><b><b>Results:</b> </b></b>There were 1,089 pediatric EMS activations in September 2019 and 780 in September 2020. Non-transport occurred in 633 (58%) in September 2019 and 412 (53%) in September 2020. Emergency medical services was reactivated within 72 hours in the following: 9/633 (1.4%) in 2019; and 5/412 (1.2%) in 2020 (P = 0.77). Visits to the ED occurred in 57/633 (9%) in 2019 and 42/412 (10%) in 2020 (P = 0.53). Hospital admissions occurred in 10/633 (1.5%) in 2019 and 4/412 (0.97%) in 2020 (P = 0.19). One non-transported patient was admitted to the intensive care unit in September 2020 (<1%) and survived. Hispanic ethnicity, age >12 years, and fever were associated with repeat EMS activation. The most common reason for non-transport in both study periods was that the parent felt an ambulance</p>was not necessary (47%).<b><b><p><b><b>Conclusion:</b> </b>In our system, non-transport of pediatric patients occurred in >50% of EMS activations with no significant adverse outcome. Age >12 years, fever, and Hispanic ethnicity were more common in repeated EMS activations. The most common reason for non-transport was parents feeling it was not necessary. Future studies are needed to develop reliable EMS guidelines for pediatric non-transport.</p></b></b>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "pediatric" }, { "word": "EMS" }, { "word": "Non-transport" }, { "word": "COVID" } ], "section": "Pediatrics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1t5945bc", "frozenauthors": [ { "first_name": "Lori", "middle_name": "", "last_name": "Pandya", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center, Department of Pediatrics, Division of Emergency Medicine, Dallas, Texas", "department": "None" }, { "first_name": "Brandon", "middle_name": "", "last_name": "Morshedi", "name_suffix": "", "institution": "University of Arkansas for Medical Sciences, Deprtment of Emergency Medicine, Little Rock, Arkansas", "department": "None" }, { "first_name": "Brian", "middle_name": "", "last_name": "Miller", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, Texas", "department": "None" }, { "first_name": "Halim", "middle_name": "", "last_name": "Hennes", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center, Department of Pediatrics, Division of Emergency Medicine, Dallas, Texas", "department": "None" }, { "first_name": "Mohamed", "middle_name": "", "last_name": "Badawy", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center, Department of Pediatrics, Division of Emergency Medicine, Dallas, Texas", "department": "None" } ], "date_submitted": "2023-07-25T03:21:36+10:00", "date_accepted": "2023-07-25T03:21:36+10:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18408/galley/9606/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18408/galley/9606/download/" } ] }, { "pk": 18440, "title": "Performance of Intra-arrest Echocardiography: A Systematic Review", "subtitle": null, "abstract": "<b>Introduction:</b> Intra-arrest transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) have been introduced in adult patients with cardiac arrest (CA). Whether the diagnostic performance of TTE or TEE is superior during resuscitation is unclear. We conducted a systematic review following PRISMA guidelines.<p></p><p><b>Methods:</b> We searched databases from PubMed, Embase, and Google Scholar and evaluated articles with intra-arrest TTE and TEE in adult patients with non-traumatic CA. Two authors independently screened and selected articles for inclusion; they then dual-extracted study characteristics and target conditions (pericardial effusion, aortic dissection, pulmonary embolism, myocardial infarction, hypovolemia, left ventricular dysfunction, and sonographic cardiac activity). We performed quality assessment using the Quality Assessment of Diagnostic Accuracy Studies Version 2 criteria.</p><p></p><p><b>Results: </b>A total of 27 studies were included: 14 studies with 2,145 patients assessed TTE; and 16 with 556 patients assessed TEE. A high risk of bias or applicability concerns in at least one domain was present in 20 studies (74%). Both TTE and TEE found positive findings in nearly one-half of the patients. The etiology of CA was identified in 13% (271/2,145), and intervention was performed in 38% (102/271) of patients in the TTE group. In patients who received TEE, the etiology was identified in 43% (239/556), and intervention was performed in 28% (68/239). In the TEE group, a higher incidence regarding the etiology of CA was observed, particularly for those with aortic dissection. However, the outcome of those with aortic dissection in the TEE group was poor.</p><p></p><p><b>Conclusion:</b> While TEE could identify more causes of CA than TTE, sonographic cardiac activity was reported much more in the TTE group. The impact of TTE and TEE on the return of spontaneous circulation and further survival was still inconclusive in the current dataset.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "cardiac arrest" }, { "word": "resuscitation" }, { "word": "transthoracic echocardiography" }, { "word": "Transesophageal echocardiography." } ], "section": "Cardiology", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/775094ks", "frozenauthors": [ { "first_name": "Yi-Ju", "middle_name": "", "last_name": "Ho", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Chih-Wei", "middle_name": "", "last_name": "Sung", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University Hsin-Chu Hospital, Department of Emergency Medicine, Hsinchu, Taiwan", "department": "None" }, { "first_name": "Yi-Chu", "middle_name": "", "last_name": "Chen", "name_suffix": "", "institution": "National Taiwan University, Institute of Epidemiology and Preventive Medicine, College of Public Health, Taipei, Taiwan", "department": "None" }, { "first_name": "Wan-Ching", "middle_name": "", "last_name": "Lien", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Wei-Tien", "middle_name": "", "last_name": "Chang", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" }, { "first_name": "Chien-Hua", "middle_name": "", "last_name": "Huang", "name_suffix": "", "institution": "National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan", "department": "None" } ], "date_submitted": "2023-08-22T13:22:46+10:00", "date_accepted": "2023-08-22T13:22:46+10:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18440/galley/9601/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18440/galley/9601/download/" } ] }, { "pk": 17923, "title": "Rapid Cycle Deliberate Practice Training for Simulated Cardiopulmonary Resuscitation in Resident Education", "subtitle": null, "abstract": "<b>Background:</b> Simulation-based medical education has been used in medical training for decades. Rapid cycle deliberate practice (RCDP) is a novel simulation strategy that uses iterative practice and feedback to achieve skill mastery. To date, there has been minimal evaluation of RCDP vs standard immersive simulation (IS) for the teaching of cardiopulmonary resuscitation to graduate medical education (GME) learners. Our primary objective was to compare the time to performance of Advanced Cardiac Life Support (ACLS) actions between trainees who completed RCDP vs IS.<p></p><p><b><b>Methods:</b> </b>This study was a prospective, randomized, controlled curriculum evaluation. A total of 55 postgraduate year-1 internal medicine and emergency medicine residents participated in the study. Residents were randomized to instruction by RCDP (28) or IS (27). Stress and ability were self-assessed before and after training using an anonymous survey that incorporated five-point Likert-type questions. We measured and compared times to initiate critical ACLS actions between the two groups during a subsequent IS.</p><p></p><p><b><b><b>Results:</b> </b></b>Prior learner experience between RCDP and IS groups was similar. Times to completion of the first pulse check, chest compression initiation, backboard placement, pad placement, initial rhythm analysis, first defibrillation, epinephrine administration, and antiarrhythmic administration were similar between RCDP and IS groups. However, RCDP groups took less time to complete the pulse check between compression cycles (6.2 vs 14.2 seconds, P = 0.01). Following training, learners in the RCDP and IS groups scored their ability to lead and their levels of anticipated stress similarly (3.43 vs 3.30,(P = 0.77), 2.43 vs. 2.41, P = 0.98, respectively). However, RCDP groups rated their ability to participate in resuscitation more highly (4.50 vs 3.96, P = 0.01). The RCDP groups also reported their realized stress of participating in the event as lower than that of the IS groups (2.36 vs 2.85, P = 0.01).</p><p></p><p><b><b><b><b>Conclusion: </b></b></b></b>Rapid cycle deliberate practice learners demonstrated a shorter pulse check duration, reported lower stress levels associated with their experience, and rated their ability to participate in ACLS care more highly than their IS-trained peers. Our results support further investigation of RCDP in other simulation settings.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "RCDP" }, { "word": "Rapid Cycle Deliberate Practice" }, { "word": "Simulation" }, { "word": "Graduate Medical Education" }, { "word": "CPR" }, { "word": "resuscitation" }, { "word": "acls" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3n38p6xd", "frozenauthors": [ { "first_name": "Jaron", "middle_name": "D.", "last_name": "Raper", "name_suffix": "", "institution": "University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama", "department": "None" }, { "first_name": "Charles", "middle_name": "A.", "last_name": "Khoury", "name_suffix": "", "institution": "University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama", "department": "None" }, { "first_name": "Anderson", "middle_name": "", "last_name": "Marshall", "name_suffix": "", "institution": "University of Alabama at Birmingham, Department of Internal Medicine, Birmingham, Alabama", "department": "None" }, { "first_name": "Robert", "middle_name": "", "last_name": "Smola", "name_suffix": "", "institution": "University of Alabama at Birmingham, Department of Internal Medicine, Birmingham, Alabama", "department": "None" }, { "first_name": "Zachary", "middle_name": "", "last_name": "Pacheco", "name_suffix": "", "institution": "University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama", "department": "None" }, { "first_name": "Jason", "middle_name": "", "last_name": "Morris", "name_suffix": "", "institution": "University of Alabama at Birmingham, Department of Internal Medicine, Birmingham, Alabama", "department": "None" }, { "first_name": "Guihua", "middle_name": "", "last_name": "Zhai", "name_suffix": "", "institution": "University of Alabama at Birmingham, Center for Clinical and Translational Science, Birmingham, Alabama", "department": "None" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Berger", "name_suffix": "", "institution": "University of Alabama at Birmingham, Department of Pediatrics, Birmingham, Alabama", "department": "None" }, { "first_name": "Ryan", "middle_name": "", "last_name": "Kraemer", "name_suffix": "", "institution": "University of Alabama at Birmingham, Department of Internal Medicine, Birmingham, Alabama", "department": "None" }, { "first_name": "Andrew", "middle_name": "D.", "last_name": "Bloom", "name_suffix": "", "institution": "University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama", "department": "None" } ], "date_submitted": "2023-03-04T09:23:47+11:00", "date_accepted": "2023-03-04T09:23:47+11:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17923/galley/9604/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17923/galley/9604/download/" } ] }, { "pk": 17831, "title": "Root Cause Analysis of Delayed Emergency Department Computed Tomography Scans", "subtitle": null, "abstract": "<b>Introduction:</b> A solution for emergency department (ED) congestion remains elusive. As reliance on imaging grows, computed tomography (CT) turnaround time has been identified as a major bottleneck. In this study we sought to identify factors associated with significantly delayed CT in the ED.<p></p><p><b><b>Methods:</b> </b>We performed a retrospective analysis of all CT imaging completed at an urban, tertiary care ED from May 1–July 31, 2021. During that period, 5,685 CTs were performed on 4,344 patients, with a median time from CT order to completion of 108 minutes (Quartile 1 [Q1]: 57 minutes, Quartile 3 [Q3]: 182 minutes, interquartile range [IQR]: 125 minutes). Outliers were defined as studies that took longer than 369 minutes to complete (Q3 + 1.5 × IQR). We systematically reviewed outlier charts to determine factors associated with delay and identified five factors: behaviorally non-compliant or medically unstable patients; intravenous (IV) line issues; contrast allergies; glomerular filtration rate (GFR) concerns; and delays related to imaging protocol (eg, need for IV contrast, request for oral and/or rectal contrast). We calculated confidence intervals (CI) using the modified Wald method. Inter-rater reliability was assessed with a kappa analysis.</p><p></p><p><b><b><b>Results:</b> </b></b>We identified a total of 182 outliers (4.2% of total patients). Fifteen (8.2%) cases were excluded for CT time-stamp inconsistencies. Of the 167 outliers analyzed, 38 delays (22.8%, 95% confidence interval [CI] 17.0–29.7) were due to behaviorally non-compliant or medically unstable patients; 30 (18.0%, 95% CI 12.8–24.5) were due to IV issues; 24 (14.4%, 95% CI 9.8–20.6) were due to contrast allergies; 21 (12.6%, 95% CI 8.3–18.5) were due to GFR concerns; and 20 (12.0%, 95% CI 7.8–17.9) were related to imaging study protocols. The cause of the delay was unknown in 55 cases (32.9%, 95%CI 26.3–40.4).</p><p><b>Conclusion:</b> Our review identified both modifiable and non-modifiable factors associated with significantly delayed CT in the ED. Patient factors such as behavior, allergies, and medical acuity cannot be controlled. However, institutional policies regarding difficult IV access, contrast administration in low GFR settings, and study protocols may be modified, capturing up to 42.6% of outliers.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "emergency department" }, { "word": "computed tomography" }, { "word": "CT" }, { "word": "Outlier analysis" }, { "word": "Significant delay" } ], "section": "Emergency Department Operations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/19j7199s", "frozenauthors": [ { "first_name": "Arjun", "middle_name": "", "last_name": "Dhanik", "name_suffix": "", "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Harvard University, Boston, Massachusetts", "department": "None" }, { "first_name": "Bryan", "middle_name": "A.", "last_name": "Stenson", "name_suffix": "", "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Harvard University, Boston, Massachusetts", "department": "None" }, { "first_name": "Robin", "middle_name": "B.", "last_name": "Levenson", "name_suffix": "", "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Harvard University, Boston, Massachusetts", "department": "None" }, { "first_name": "Peter", "middle_name": "S.", "last_name": "Antkowiak", "name_suffix": "", "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Harvard University, Boston, Massachusetts", "department": "None" }, { "first_name": "Leon", "middle_name": "D.", "last_name": "Sanchez", "name_suffix": "", "institution": "Harvard Medical School, Harvard University, Boston, Massachusetts; Brigham and Women’s Faulkner Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "David", "middle_name": "T.", "last_name": "Chiu", "name_suffix": "", "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Harvard University, Boston, Massachusetts", "department": "None" } ], "date_submitted": "2023-01-24T17:39:40+11:00", "date_accepted": "2023-01-24T17:39:40+11:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17831/galley/9608/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17831/galley/9608/download/" } ] }, { "pk": 18449, "title": "Simulation Improves Emergency Medicine Residents’ Clinical Performance of Aorta Point-of-Care Ultrasound", "subtitle": null, "abstract": "<p><b>Purpose:</b> Using point-of-care ultrasound (POCUS) to diagnose abdominal aortic aneurysm (AAA) is an essential skill in emergency medicine (EM). While simulation-based POCUS education is commonly used, the translation to performance in the emergency department (ED) is unknown. We investigated whether adding case-based simulation to an EM residency curriculum was associated with changes in the quantity and quality of aorta POCUS performed by residents in the ED.</p><p><b><b>Methods: </b></b>A case-based simulation was introduced to resident didactics at our academic, Level I trauma center. A case of undifferentiated abdominal pain was presented, which required examination of an ultrasound phantom to diagnose an AAA, with a hands-on didactic. We compared the quantity, quality, and descriptive analyses of aorta POCUS performed in the ED during the four months before and after the simulation.</p><p><b><b><b>Results: </b></b></b>For participating residents (17/32), there was an 86% increase in total studies and an 80%increase in clinical studies. On an opportunity-adjusted, per-resident basis, there was no significant difference in median total scans per 100 shifts (4.4 [interquartile range (IQR) 0–15.8 vs 8.3 [IQR] 3.3–23.6, P = 0.21) or average total quality scores (3.2 ± 0.6 vs 3.2 ± 0.5, P = 0.92). The total number of limited or inadequate studies decreased (43% vs 19%, P = 0.02), and the proportion of scans submitted by interns increased (7% vs 54%, P =<.001).</p><p><b><b><b><b>Conclusion: </b></b></b></b>After simulation training, aorta POCUS was performed more frequently, and ED interns contributed a higher proportion of scans. While there was no improvement in quantity or quality scores on a per-resident basis, there were significantly fewer incomplete or limited scans.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "point-of-care" }, { "word": "ultrasonography" }, { "word": "Simulation" }, { "word": "Abdominal aortic aneurysm" }, { "word": "POCUS" }, { "word": "Emergency Medicine" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/73d398gn", "frozenauthors": [ { "first_name": "Brandon", "middle_name": "M.", "last_name": "Wubben", "name_suffix": "", "institution": "University of Iowa Hospitals and Clinics, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Cory", "middle_name": "", "last_name": "Wittrock", "name_suffix": "", "institution": "University of Iowa Hospitals and Clinics, Department of Emergency Medicine, Iowa City, Iowa", "department": "" } ], "date_submitted": "2023-08-31T03:47:55+10:00", "date_accepted": "2023-08-31T03:47:55+10:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18449/galley/9607/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18449/galley/9607/download/" } ] }, { "pk": 17990, "title": "Stage B Heart Failure Is Ubiquitous in Emergency Patients with Asymptomatic Hypertension", "subtitle": null, "abstract": "<b>Introduction: </b>Hypertension is the leading risk factor for morbidity and mortality throughout the world and is pervasive in United States emergency departments (ED). This study documents the point prevalence of subclinical heart disease in emergency patients with asymptomatic hypertension.<p></p><p><b><b>Method: </b>T</b>his was a prospective observational study of ED patients with asymptomatic hypertension conducted at two urban academic EDs that belong to an eight-hospital healthcare organization in New York. Adult (≥18 years of age) English- or Spanish-speaking patients who had an initial blood pressure (BP) ≥160/100 millimeters of mercury (mmHg) and second BP ≥140/90 mm Hg, and pending discharge, were invited to participate in the study. We excluded patients with congestive heart failure, renal insufficiency, and atrial fibrillation, or who were pregnant, a prisoner, cognitively unable to provide informed consent, or experiencing symptoms of hypertension. We assessed echocardiographic evidence of subclinical heart disease (left ventricular hypertrophy, and diastolic and systolic dysfunction).</p><p></p><p><b><b><b>Results:</b></b></b> A total of 53 patients were included in the study; a majority were young (mean 49.5 years old,[SD 14–52]), self-identified as Black or Other (n = 39; 73.5%), and female (n = 30; 56.6%). Mean initial blood pressure was 172/100 mm Hg, and 24 patients (45.3%) self-reported a history of hypertension. Fifty patients completed an echocardiogram. All (100%) had evidence of subclinical heart disease, with 41 (77.4%) displaying left ventricular hypertrophy and 31 (58.5%) diastolic dysfunction. There was a significant relationship between diastolic dysfunction and female gender [x2 (1, n = 53) = 3.98; P = 0.046]; Black or other race [x2 (3, n = 53) = 9.138; P = 0.03] and Hispanic or other ethnicity [x2 (2, n = 53) = 8.03; P = 0.02]. Less than one third of patients demonstrated systolic dysfunction on echocardiogram, and this was more likely to occur in patients with diabetes mellitus [x2 (1, n = 51) = 4.84; P = 0.02].</p><p></p><p><b><b><b><b>Conclusion:</b> </b></b></b>There is a high probability that Black, Hispanic, and female patients with asymptomatic hypertension are on the continuum for developing overt heart failure. Emergency clinicians should provide individualized care that considers their unique health needs, cultural backgrounds, and social determinants of health.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "hypertension" }, { "word": "Heart Failure" }, { "word": "Subclinical heart disease" }, { "word": "emergency department" }, { "word": "health disparities" } ], "section": "Cardiology", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0t02p5ch", "frozenauthors": [ { "first_name": "Kimberly", "middle_name": "", "last_name": "Souffront", "name_suffix": "", "institution": "Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York; Center for Nursing Research and Innovation, Mount Sinai Health System, New York; Ichan School of Medicine at Mount Sinai, Institute for Health Equity Research, New York", "department": "None" }, { "first_name": "Bret", "middle_name": "P.", "last_name": "Nelson", "name_suffix": "", "institution": "Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York", "department": "None" }, { "first_name": "Megan", "middle_name": "", "last_name": "Lukas", "name_suffix": "", "institution": "Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York", "department": "None" }, { "first_name": "Hans", "middle_name": "Reyes", "last_name": "Garay", "name_suffix": "", "institution": "Mount Sinai Morningside, Department of Cardiology, New York", "department": "None" }, { "first_name": "Lauren", "middle_name": "", "last_name": "Gordon", "name_suffix": "", "institution": "Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York; Ichan School of Medicine at Mount Sinai, Institute for Health Equity Research, New York; Icahn School of Medicine at Mount Sinai, Department of Population Health Science and Policy, New York", "department": "None" }, { "first_name": "Thalia", "middle_name": "", "last_name": "Matos", "name_suffix": "", "institution": "Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York", "department": "None" }, { "first_name": "Isabella", "middle_name": "", "last_name": "Hanesworth", "name_suffix": "", "institution": "Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York", "department": "None" }, { "first_name": "Rebecca", "middle_name": "", "last_name": "Mantel", "name_suffix": "", "institution": "Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York", "department": "None" }, { "first_name": "Claire", "middle_name": "", "last_name": "Shubeck", "name_suffix": "", "institution": "Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York", "department": "None" }, { "first_name": "Cassidy", "middle_name": "", "last_name": "Bernstein", "name_suffix": "", "institution": "Center for Nursing Research and Innovation, Mount Sinai Health System, New York", "department": "None" }, { "first_name": "George", "middle_name": "T.", "last_name": "Loo", "name_suffix": "", "institution": "Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York; Icahn School of Medicine at Mount Sinai, Department of Population Health Science and Policy, New York", "department": "None" }, { "first_name": "Lynne", "middle_name": "D.", "last_name": "Richardson", "name_suffix": "", "institution": "Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York; Ichan School of Medicine at Mount Sinai, Institute for Health Equity Research, New York; Icahn School of Medicine at Mount Sinai, Department of Population Health Science and Policy, New York", "department": "None" } ], "date_submitted": "2023-03-24T12:45:17+11:00", "date_accepted": "2023-03-24T12:45:17+11:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17990/galley/9602/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17990/galley/9602/download/" } ] }, { "pk": 18125, "title": "Ultrasound Performed by Emergency Physicians for Deep Vein Thrombosis: A Systematic Review", "subtitle": null, "abstract": "<b>Introduction:</b> Point-of-care ultrasound (POCUS) performed by emergency physicians (EP) has emerged as an effective alternative to radiology department ultrasounds for the diagnosis of lower extremity deep vein thrombosis (DVT). Systematic reviews suggested good sensitivity and specificity overall for EP-performed POCUS for DVT diagnosis, yet high levels of heterogeneity were reported.<p></p><p><b><b>Methods:</b> </b>In this systematic review and meta-analysis, we aimed to provide the most up-to-date estimates of the accuracy of EP-performed POCUS for diagnosis of DVT and to explore potential correlations with test performance. We performed systematic searches in MEDLINE and Embase for original, primary data articles from January 2012–June 2021 comparing the efficacy of POCUS performed by EPs to the local standard. Quality Assessment of Diagnostic Accuracy Studies-2 for individual articles are reported. We obtained summary measures of sensitivity, specificity, and their corresponding 95% confidence intervals (CI) using bivariate mixed-effects regression models. We performed meta-regression, subgroup, and sensitivity analyses as planned in the protocol CRD42021268799 submitted to PROSPERO.</p><p></p><p><b><b><b>Results:</b></b></b> Fifteen publications fit the inclusion criteria, totaling 2,511 examinations. Pooled sensitivity and specificity were 90% (95% CI 82%–95%) and 95% (CI 91%–97%), respectively. Subgroup analyses by EP experience found significantly better accuracy for exams performed by EP specialists (93%, CI 88%–97%) vs trainees (77%, CI 60%–94%). Specificity for EP specialists (97%, CI 94%–99%) was higher than for trainees (87%, CI 76%–99%, P = 0.01). Three-point compression ultrasound (CUS) was more sensitive than two-point CUS but was only statistically significant when limited to EP specialists (92% vs 88%, P = 0.07, and 95% vs 88%, P = 0.02, respectively).</p><p></p><p><b><b><b><b>Conclusion: </b></b></b></b>Point-of-care ultrasound performed by emergency physicians is sensitive and specific for the diagnosis of suspected DVT when performed by trained attending EPs. Three-point compression ultrasound examination may be more sensitive than two-point CUS.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "DVT" }, { "word": "POCUS" }, { "word": "VTE" }, { "word": "Deep Vein Thrombosis" }, { "word": "point-of-care ultrasound" }, { "word": "Sonography" }, { "word": "ultrasound" }, { "word": "venous thromboembolism" }, { "word": "emergency department" } ], "section": "Ultrasound", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0zq46173", "frozenauthors": [ { "first_name": "Daniel", "middle_name": "", "last_name": "Hercz", "name_suffix": "", "institution": "Jackson Memorial Hospital, Department of Emergency Medicine, Miami, Florida; University of Miami, Department of Surgery, Miami, Florida", "department": "None" }, { "first_name": "Oren", "middle_name": "J.", "last_name": "Mechanic", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida; Florida International University, Herbert Wertheim College of Medicine, Department of Medical Education, Miami, Florida", "department": "None" }, { "first_name": "Marcia", "middle_name": "", "last_name": "Varella", "name_suffix": "", "institution": "Florida International University, Herbert Wertheim College of Medicine, Department of Medical Education, Miami, Florida", "department": "None" }, { "first_name": "Francisco", "middle_name": "", "last_name": "Fajardo", "name_suffix": "", "institution": "Florida International University, Herbert Wertheim College of Medicine, Department of Medical Education, Miami, Florida", "department": "None" }, { "first_name": "Robert", "middle_name": "L.", "last_name": "Levine", "name_suffix": "", "institution": "Florida International University, Herbert Wertheim College of Medicine, Department of Emergency Medicine and Critical Care, Miami, Florida", "department": "None" } ], "date_submitted": "2023-05-18T00:34:49+10:00", "date_accepted": "2023-05-18T00:34:49+10:00", "date_published": "2024-02-10T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18125/galley/9605/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18125/galley/9605/download/" } ] }, { "pk": 39617, "title": "Review: Climate Change isn't Everything: Liberating Climate Politics from Alarmism", "subtitle": null, "abstract": "Book Review", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/06k58648", "frozenauthors": [ { "first_name": "Yves", "middle_name": "", "last_name": "Laberge", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2023-11-04T05:59:26+11:00", "date_accepted": "2023-11-04T05:59:26+11:00", "date_published": "2024-02-09T11:36:52+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/egj/article/39617/galley/29899/download/" } ] }, { "pk": 46048, "title": "Allopurinol: Risk Stratification and Safe Prescription", "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/0sq2j2db", "frozenauthors": [ { "first_name": "Charmi", "middle_name": "", "last_name": "Shah", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Chris", "middle_name": "", "last_name": "Gornes", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-08T04:02:41+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46048/galley/34780/download/" } ] }, { "pk": 39608, "title": "Review: Nature and Bureaucracy: The Wildness of Managed Landscapes", "subtitle": null, "abstract": "Book Review", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3ck1t9t5", "frozenauthors": [ { "first_name": "Bishnuprasad", "middle_name": "", "last_name": "Mohapatra", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2023-06-28T07:36:17+10:00", "date_accepted": "2023-06-28T07:36:17+10:00", "date_published": "2024-02-07T17:30:17+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/egj/article/39608/galley/29895/download/" } ] }, { "pk": 39616, "title": "Review: Profit: An Environmental History", "subtitle": null, "abstract": "Book Review", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9717z650", "frozenauthors": [ { "first_name": "Yves", "middle_name": "", "last_name": "Laberge", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2023-11-04T05:44:41+11:00", "date_accepted": "2023-11-04T05:44:41+11:00", "date_published": "2024-02-07T17:27:49+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/egj/article/39616/galley/29898/download/" } ] }, { "pk": 39607, "title": "Review: Live Sustainably Now: A Low-Carbon Vision of the Good Life", "subtitle": null, "abstract": "Book Review", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6dp0z473", "frozenauthors": [ { "first_name": "Amitabh", "middle_name": "Vikram", "last_name": "Dwivedi", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2023-06-28T07:15:35+10:00", "date_accepted": "2023-06-28T07:15:35+10:00", "date_published": "2024-02-07T16:38:28+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/egj/article/39607/galley/29894/download/" } ] }, { "pk": 19410, "title": "NUBE Abstract Issue", "subtitle": null, "abstract": "n/a", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "WestJEM Full-Text Issue", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3md524b0", "frozenauthors": [ { "first_name": "Cassandra", "middle_name": "", "last_name": "Saucedo", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2024-02-07T14:39:44.140000+11:00", "date_accepted": "2024-02-07T15:03:08.178000+11:00", "date_published": "2024-02-07T04:00:00+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/19410/galley/9592/download/" } ] }, { "pk": 46047, "title": "Using IVUS to Discriminate Between SCAD and Atherosclerotic Stenosis", "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/7jd1x11h", "frozenauthors": [ { "first_name": "Michael", "middle_name": "", "last_name": "Mazar", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Shipra", "middle_name": "", "last_name": "Hingorany", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-07T03:09:24+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46047/galley/34779/download/" } ] }, { "pk": 46046, "title": "Small Intestinal Bacterial Overgrowth (SIBO): Is it an Increasingly Common 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/64b8f03k", "frozenauthors": [ { "first_name": "Scott", "middle_name": "", "last_name": "Hahm", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-07T03:02:46+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46046/galley/34778/download/" } ] }, { "pk": 46045, "title": "A 50-Year-Old Male with Inherited and Acquired Pseudocholinesterase Deficiency", "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/2q7084md", "frozenauthors": [ { "first_name": "David", "middle_name": "", "last_name": "Khandabi", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Sachin", "middle_name": "", "last_name": "Gupta", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-07T03:01:12+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46045/galley/34777/download/" } ] }, { "pk": 46044, "title": "EBV-Positive Diffuse Large B-Cell Lymphoma Presenting as Knee Pain", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9mc1057f", "frozenauthors": [ { "first_name": "Alina", "middle_name": "", "last_name": "Katsman", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-07T02:59:39+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46044/galley/34776/download/" } ] }, { "pk": 46043, "title": "Venous Stent Embolized to the Right Ventricle", "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/6h44k8jd", "frozenauthors": [ { "first_name": "William", "middle_name": "", "last_name": "Finch", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Nidhi", "middle_name": "", "last_name": "Thareja", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Jonathan", "middle_name": "", "last_name": "Gordin", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-07T02:57:23+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46043/galley/34775/download/" } ] }, { "pk": 46042, "title": "Metastatic Glioblastoma Multiforme: A Case Report and Review of the Literature", "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/56s194d0", "frozenauthors": [ { "first_name": "Joshua", "middle_name": "", "last_name": "Rosenberg", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Mahshid", "middle_name": "", "last_name": "Mosallaei-Benjamin", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-07T02:56:09+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46042/galley/34774/download/" } ] }, { "pk": 46041, "title": "An Integrative Approach in the Management of Long COVID Fatigue", "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/52n672q7", "frozenauthors": [ { "first_name": "Payam", "middle_name": "", "last_name": "Bokhoor", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-07T02:54:08+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46041/galley/34773/download/" } ] }, { "pk": 46006, "title": "Treatment of Iatrogenic Essential Fatty Acid Deficiency with a Lipid-Rich Matrix in a Child with Intestinal Failure-Associated Liver Disease: Case Report", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8m37z59w", "frozenauthors": [ { "first_name": "Christina", "middle_name": "", "last_name": "Yuen", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Danielle", "middle_name": "", "last_name": "Mein", "name_suffix": "RD", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Joanna", "middle_name": "", "last_name": "Yeh", "name_suffix": "MD", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-07T02:52:53+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46006/galley/34738/download/" } ] }, { "pk": 46040, "title": "Aortopulmonary Fistula in a Patient Presenting with Hemoptysis, Fevers, and Dyspnea after a Chest Deceleration Injury", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Clinical Vignette" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3hh4j4xw", "frozenauthors": [ { "first_name": "Louise", "middle_name": "F.", "last_name": "Curland", "name_suffix": "NP", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "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": "2024-02-07T02:51:02+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46040/galley/34772/download/" } ] }, { "pk": 17973, "title": "Analysis of Anonymous Student Narratives About Experiences with Emergency Medicine Residency Programs", "subtitle": null, "abstract": "<b>Background: </b>Academic emergency medicine (EM) communities have viewed anonymous online communities (AOC) such as Reddit or specialty-specific “applicant spreadsheets” as poor advising resources. Despite this, robust EM AOCs exist, with large user bases and heavy readership. Insights about applicants’ authentic experiences can be critical for applicants and program leadership decision-making. To date, there are no EM studies to qualitatively assess EM AOC narratives during the application cycle. Our goal was to perform a qualitative analysis of students’ EM program experiences through a publicly available AOC.<p></p><p><b>Methods: </b>This was a qualitative analysis of a publicly available, time-stamped, user-locked AOC dataset: “Official 2020–2021 Emergency Medicine Applicant Spreadsheet.” We extracted and then de-identified all data from selected sub-sheets entitled “Virtual Interview Impressions” and “Rotation Impressions.” Four investigators used constant comparative method to analyze the data inductively, and they subsequently met to generate common themes discussed by students. Preliminary thematic analysis was conducted on a random sample of 37/183 (20%) independent narratives to create the initial codebook. This was used and updated iteratively to analyze the entire narrative set consisting of 841 discrete statements. Finally, two unique codes were created to distinguish whether the identified sub-themes, or program attributes, were likely “modifiable” or “non-modifiable.”</p><p></p><p><b>Results:</b> We identified six major themes: living and working conditions; interpersonal relationships; learning experiences, postgraduate readiness, and online/virtual supplements. Common sub-themes included patient population (13%); resident personality (7%); program leadership personality (7%); relationship with faculty/leadership (6%); geography (4%); practice setting (4%); program reputation (4%), and postgraduate year-3 experiences (4%). Modifiable sub-themes outnumbered non-modifiable sub-themes, 60.7% to 39.3%.</p><p></p><p><b>Conclusion:</b> In this analysis of selected medical students’ narratives in an AOC, the majority of identified themes represented topics that may serve as external feedback for EM residency programs and their clerkships. Selective use of AOCs may set a precedent for future program assessments by applicants and inform program leadership of important programmatic elements in the eyes of applicants. It elucidates important themes in their interactions or learning experiences with programs and creates opportunities for learner-centric program improvement.</p>", "language": null, "license": { "name": "Creative Commons Attribution-NonCommercial 4.0", "short_name": "CC BY-NC 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc/4.0" }, "keywords": [ { "word": "anonymous online community" }, { "word": "trainee feedback" }, { "word": "Residency Program" }, { "word": "social media" }, { "word": "clerkship rotation" }, { "word": "Emergency Medicine" }, { "word": "Residency Recruitment" }, { "word": "program development" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8j70q89w", "frozenauthors": [ { "first_name": "Molly", "middle_name": "", "last_name": "Estes", "name_suffix": "", "institution": "Loma Linda University, Department of Emergency Medicine, Loma Linda, California", "department": "" }, { "first_name": "Jacob", "middle_name": "", "last_name": "Garcia", "name_suffix": "", "institution": "Mount Sinai Morningside/West, Department of Emergency Medicine, New York, New York", "department": "" }, { "first_name": "Ronnie", "middle_name": "", "last_name": "Ren", "name_suffix": "", "institution": "University of Massachusetts, Department of Emergency Medicine, Boston, Massachusetts; University of Florida Health Shands Hospital, Department of Emergency Medicine, Gainesville, Florida", "department": "None" }, { "first_name": "Mark", "middle_name": "", "last_name": "Olaf", "name_suffix": "", "institution": "Geisinger Commonwealth School of Medicine, Department of Emergency Medicine, Scranton, Pennsylvania", "department": "" }, { "first_name": "Shannon", "middle_name": "", "last_name": "Moffett", "name_suffix": "", "institution": "Rutgers New Jersey Medical School, Department of Emergency Medicine, Newark, New Jersey", "department": "" }, { "first_name": "Michael", "middle_name": "", "last_name": "Galuska", "name_suffix": "", "institution": "Conemaugh Memorial Medical Center, Department of Emergency Medicine, Johnstown, Pennsylvania", "department": "" }, { "first_name": "Xiao Chi", "middle_name": "", "last_name": "Zhang", "name_suffix": "", "institution": "Thomas Jefferson University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "None" } ], "date_submitted": "2023-03-16T03:11:58+11:00", "date_accepted": "2023-03-16T03:11:58+11:00", "date_published": "2024-02-06T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17973/galley/9586/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/17973/galley/9586/download/" } ] }, { "pk": 21116, "title": "Cover, Contributors and Contents", "subtitle": null, "abstract": "Cover, Contrubutors and Contents", "language": "en", "license": { "name": "Creative Commons Attribution-NonCommercial 4.0", "short_name": "CC BY-NC 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc/4.0" }, "keywords": [ { "word": "Urban planning" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1z80n15x", "frozenauthors": [ { "first_name": "CPJ", "middle_name": "", "last_name": "Volume 27", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-02-02T06:10:14+11:00", "date_accepted": "2024-02-02T06:10:14+11:00", "date_published": "2024-02-02T19:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/criticalplanning/article/21116/galley/10767/download/" } ] }, { "pk": 63529, "title": "From Youth Activism to Youth-Powered Curriculum", "subtitle": null, "abstract": "How do youth move in an uprising? Members of YoUthROC, a BIPOC-centered, youth-led research group with young people from both the university and the community, reflect on creating a youth-powered curriculum that processes years of activism and inspires young people to use teaching as a way to create change in their communities. To ensure the relevance of their curriculum to the current needs, strengths, and curiosities of young people, the YoUthROC team wrote and collected autoethnographies, cataloged historical artifacts, analyzed social media, and conducted public focus groups and Instagram spotlight interviews during a year of uprising and unrest in Minneapolis, Minnesota. Results from this research include the following themes: the centrality of collectivism, internal and collective self-determination, and young people’s already-existing commitment to analysis and change. Educators, adult activists, and youth need to see that young people are central to social movements and are already contributing profoundly to anti-racist, anti-oppression work. This reflection and YoUthROC’s ongoing work is for young people eager to engage in activism, teachers looking to create authentic student-centered classrooms, and adult researchers ready to learn from and create with youth researchers.", "language": "en", "license": null, "keywords": [ { "word": "Student organizing, collectivism, social movements, YPAR, student-centered lessons" } ], "section": "Call for Conversations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5n60q5ss", "frozenauthors": [ { "first_name": "YoUthROC", "middle_name": "", "last_name": "With contributions from Amina Smaller, Shaunassey Johnson, Eva García, Savannah McCullough", "name_suffix": "", "institution": "University of Minnesota", "department": "" }, { "first_name": "Abigail", "middle_name": "", "last_name": "Rombalski", "name_suffix": "", "institution": "University of Minnesota", "department": "" } ], "date_submitted": "2023-10-18T04:31:36+11:00", "date_accepted": "2023-10-18T04:31:36+11:00", "date_published": "2024-02-02T19:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/bre/article/63529/galley/48889/download/" } ] }, { "pk": 35551, "title": "Extracranial Internal Carotid Artery Fenestration: A Case Report", "subtitle": null, "abstract": "Fenestration of the internal carotid artery (ICA) is an extremely rare congenital abnormality thought to be secondary to incomplete segmental fusion of vessels at the early stages of their development. Fenestration is usually asymptomatic and often misdiagnosed as arterial dissection. Distinction between the two can be challenging on both magnetic resonance angiography and computed tomography angiography, and digital subtraction angiography must often be utilized for precise characterization of the abnormalities. Certain imaging features, namely the length of the involved arterial segment, the regularity of luminal contour, the symmetry of arterial limbs, and the absence/presence of fusiform dilatation of either limb, produced by noninvasive angiography have the potential to help distinguish between an ICA fenestration and dissection. We report a case of an asymptomatic, true fenestration of a short segment of ICA and discuss its imaging characteristics.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "internal carotid artery (ICA) fenestration" }, { "word": "arterial fenestration" }, { "word": "Arterial Dissection" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3qg5750g", "frozenauthors": [ { "first_name": "Zachary", "middle_name": "", "last_name": "Winchester", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Zhang", "name_suffix": "", "institution": "Greater Los Angeles VA Medical Center", "department": "None" }, { "first_name": "Gasser", "middle_name": "", "last_name": "Hathout", "name_suffix": "", "institution": "Greater Los Angeles VA Medical Center; Olive View-UCLA Medical Center", "department": "None" } ], "date_submitted": "2022-08-24T14:57:43+10:00", "date_accepted": "2022-08-24T14:57:43+10:00", "date_published": "2024-02-01T11:59:52+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucla_rsp/article/35551/galley/26454/download/" } ] }, { "pk": 35559, "title": "Scapulothoracic Bursitis Appearing as Fluorodeoxyglucose-Avid Subscapular Mass: A Case Report", "subtitle": null, "abstract": "Overuse or structural bony abnormalities of the scapulothoracic “articulation” make it susceptible to chronic friction, which can lead to bursitis and soft tissue changes. Clinically, scapulothoracic bursitis is associated with pain, crepitus, and scapular snapping. On physical examination, a firm, large subscapular mass may be present, sometimes with rapid growth. Asymptomatic cases without scapular snapping can be clinically indistinguishable from soft tissue tumors of the chest wall. Characteristic imaging findings of scapulothoracic bursitis include a well-circumscribed cystic mass, internal debris, and intralesional hemorrhage. Recognition of these characteristic findings is essential to avoid misinterpretation and unnecessary treatments. Here, we describe a case of an incidentally discovered, asymptomatic, fluorodeoxyglucose (FDG)-avid subscapular mass with typical imaging features of scapulothoracic bursitis. Additional imaging and histopathologic examination of sampled tissue confirmed the diagnosis. To our knowledge, this incidental finding is the first documented case of FDG-avid scapulothoracic bursitis.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "scapulothoracic bursitis" }, { "word": "subscapular mass" }, { "word": "FDG-avid cystic mass" }, { "word": "snapping scapula syndrome" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2qs117rm", "frozenauthors": [ { "first_name": "Annie", "middle_name": "", "last_name": "Huang", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" }, { "first_name": "Jeremy", "middle_name": "J", "last_name": "Middleton", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" }, { "first_name": "Kambiz", "middle_name": "", "last_name": "Motamedi", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" } ], "date_submitted": "2023-07-31T03:37:45+10:00", "date_accepted": "2023-07-31T03:37:45+10:00", "date_published": "2024-02-01T11:49:22+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucla_rsp/article/35559/galley/26461/download/" } ] }, { "pk": 35534, "title": "Primary Synovial Chondromatosis of the Knee in a 12-Year-Old Boy: A Case Report", "subtitle": null, "abstract": "Primary synovial chondromatosis is an uncommon, benign synovial proliferative disorder rarely seen in children. The most commonly affected joint is the knee, followed by the hip. The symptoms of this condition are progressive and insidious and may include pain, joint stiffness, and swelling. Radiography is an appropriate first imaging modality that typically shows multiple calcified loose bodies within the affected joint space. Magnetic resonance imaging should then be performed to evaluate for the presence of noncalcified cartilaginous loose bodies and soft tissue involvement prior to surgical treatment that is necessary to prevent permanent joint damage. The recurrence of primary synovial chondromatosis is common, especially in cases of incomplete surgical excision. We report a case of primary synovial chondromatosis in a child. The diagnostic and the treatment considerations of the case are briefly discussed.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "synovial chondromatosis" }, { "word": "loose bodies" }, { "word": "chondrosarcoma" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7t90x4vv", "frozenauthors": [ { "first_name": "Catherine", "middle_name": "A", "last_name": "McNulty", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" }, { "first_name": "Tara", "middle_name": "", "last_name": "Narasimhalu", "name_suffix": "", "institution": "Department of Pathology and Laboratory Medicine", "department": "None" }, { "first_name": "Shahnaz", "middle_name": "", "last_name": "Ghahremani Koureh", "name_suffix": "", "institution": "David Geffen School of Medicine at UCLA", "department": "None" } ], "date_submitted": "2021-06-25T12:35:12+10:00", "date_accepted": "2021-06-25T12:35:12+10:00", "date_published": "2024-02-01T11:41:31+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/ucla_rsp/article/35534/galley/26446/download/" } ] }, { "pk": 46039, "title": "Blunted Safety Paracentesis Catheters vs. Traditional Paracentesis Catheters on a Teaching Service", "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/4x2586v6", "frozenauthors": [ { "first_name": "Jason", "middle_name": "", "last_name": "Bahk", "name_suffix": "MD, FACP", "institution": "University of California, Los Angeles", "department": "Medicine" }, { "first_name": "Patrick", "middle_name": "", "last_name": "Poquiz", "name_suffix": "MD, FACP", "institution": "University of California, Los Angeles", "department": "Medicine" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-02-01T08:08:30+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/ucladom_proceedings/article/46039/galley/34771/download/" } ] }, { "pk": 35666, "title": "Revisiting Compadrazgo: Issues Concerning ‘What Kinship Is’", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Kinship" }, { "word": "caste" }, { "word": "compadrazgo" }, { "word": "spirit kinship" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/22t0c7xj", "frozenauthors": [ { "first_name": "Fadwa", "middle_name": "", "last_name": "El Guindi", "name_suffix": "", "institution": "UCLA Retiree", "department": "None" } ], "date_submitted": "2024-02-01T00:43:20+11:00", "date_accepted": "2024-02-01T00:43:20+11:00", "date_published": "2024-02-01T00:49:42+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/kinship/article/35666/galley/26535/download/" } ] }, { "pk": 35665, "title": "Caste and Jāti", "subtitle": null, "abstract": "Abstract\n: \nTraditional Indian social organization developed under very specific historical circumstances. The Brahmanic ideology of Dharma dominated the social and even economic life of the Hindus and cre-ated a system capable of maintaining stability through the unique structure of \"caste order\". However, caste as described in many Western scholarly publications bears only a faint resemblance to this institution of Hindu society.\nIndian social structure is composed of a great diversity of elements with kinship categories being its essence. Specific characteristics of caste - such as endogamy, profession, a particular kind of religious worship and marriage rules - manifest themselves at the level of kin groups and \nbirādarī\ns, of which the broadest and dominant of these being \njāti\n. The institution of \njāti \nis rooted in prehistoric tribal concepts and usages. In Hindu society, \njāti \nacts as a real agent that manages all the tasks and aims inherent in, and regarded as important by, Hindu society. Thus, \njāti \nis a basic \"structural unit\" of Hindu society.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Kinship" }, { "word": "caste" }, { "word": "jāti" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5tv9212m", "frozenauthors": [ { "first_name": "Elena", "middle_name": "N", "last_name": "Uspenskaya", "name_suffix": "", "institution": "St. Petersberg University", "department": "None" } ], "date_submitted": "2024-02-01T00:36:14+11:00", "date_accepted": "2024-02-01T00:36:14+11:00", "date_published": "2024-02-01T00:37:08+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/kinship/article/35665/galley/26534/download/" } ] }, { "pk": 35664, "title": "Introduction", "subtitle": null, "abstract": "", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Kinship" }, { "word": "social systems" }, { "word": "caste" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9r06p2mh", "frozenauthors": [ { "first_name": "Dwight", "middle_name": "W", "last_name": "Read", "name_suffix": "", "institution": "UCLA", "department": "None" } ], "date_submitted": "2024-02-01T00:22:08+11:00", "date_accepted": "2024-02-01T00:22:08+11:00", "date_published": "2024-02-01T00:24:25+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/kinship/article/35664/galley/26533/download/" } ] }, { "pk": 52092, "title": "A Guide to the Medical School Curriculum Vitae", "subtitle": null, "abstract": "Audience: Although this lecture is aimed at medical students, it can also be utilized for residents, fellows, and junior faculty.\nBackground: The topic of teaching medical students about the fundamentals of creating a curriculum vitae (CV) is important because a CV serves as a record of scholastic and professional experiences.1 Thus, their CV will undoubtedly play a vital role in residency applications.2,3 Intentional instruction about the elements to incorporate in a CV are especially important for first-generation and underrepresented students in the medical field because they may not have had as much exposure to both the requirements of a residency application nor qualities of an effective CV.\nEducational Objectives: After this lecture, learners should be able to: 1) elaborate on the significance of a CV for medical students and discuss its purpose, 2) outline the elements that should and should not be included on a CV, 3) integrate knowledge gleaned from basic principles with provided examples to establish the foundation of their own CV.\nEducational Methods: A PowerPoint lecture was used to explain the purpose of a CV and the elements to include in a personal CV for medical students. The lecture took place via Zoom and was provided at no cost to all UCISOM medical students.\nResearch Methods: Students were given a short survey after the session to assess their understanding of why it is important to create and maintain a CV, including an evaluation of their overall satisfaction with the lecture presentation.\nResults: All the respondents (n=10) found the workshop to be useful and enjoyed the ability to see student examples while 80% of the respondents (n=8) found their knowledge of CVs increased because of the session.\nOn a Likert scale from 1-5, with a 1 indicating “very unconfident” and 5 indicating “very confident,” 90% of respondents (n=9) indicated they are now confident or very confident in building or updating their CV after this session.\nDiscussion: Overall, the educational content was found to be effective. Although the sample size from the survey was modest at best, we feel the survey data and comments from attendees during and after the session indicate the effectiveness of the content. From its initial implementation, we learned that this lecture can be given by any level of medical education professional (student, administrator, etc) due to the comprehensiveness of the presentation. We also learned that using video conferencing such as Zoom was an effective administration method but could also be replaced by in-person learning without much difficulty. Overall, we deem this presentation to be easy to administer, thorough, full of examples, and educationally effective.\nTopics: Curriculum vitae, CV, medical student, residency application, electronic residency application service, ERAS.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Lectures/Podcasts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5bw0r01v", "frozenauthors": [ { "first_name": "Konnor", "middle_name": "", "last_name": "Davis, BS", "name_suffix": "", "institution": "University of California, Irvine, School of Medicine, Irvine, CA", "department": "" }, { "first_name": "Megan", "middle_name": "", "last_name": "Boysen-Osborn, MD, MHPE", "name_suffix": "", "institution": "University of California, Irvine, School of Medicine, Irvine, CA; University of California, Irvine, Department of Emergency Medicine, Orange, CA", "department": "" }, { "first_name": "Alisa", "middle_name": "", "last_name": "Wray, MD, MAEd", "name_suffix": "", "institution": "University of California, Irvine, School of Medicine, Irvine, CA; University of California, Irvine, Department of Emergency Medicine, Orange, CA", "department": "" }, { "first_name": "Lauren", "middle_name": "", "last_name": "Stokes, EdD, MS", "name_suffix": "", "institution": "University of California, Irvine, School of Medicine, Irvine, CA", "department": "" } ], "date_submitted": "2024-02-05T10:54:42+11:00", "date_accepted": "2024-02-05T10:54:42+11:00", "date_published": "2024-01-31T19:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52092/galley/39397/download/" } ] }, { "pk": 52094, "title": "An Appy That Needs Epi: An Atypical Presentation of Anaphylaxis", "subtitle": null, "abstract": "Audience: This simulation is intended for 4th year medical students.\nBackground: Shock is the result of inadequate circulation and failure to perfuse tissues, leading to cellular and organ dysfunction.1 Anaphylactic shock specifically is a type of distributive shock secondary to an IgE (immunoglobulin E) dependent reaction, which can result in respiratory compromise and cardiovascular collapse. The National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network (NIAID/FAAN) laid out three diagnostic criteria for the diagnosis of anaphylaxis. Fulfillment of any one of the three following criteria likely indicates anaphylaxis: 1) acute onset of illness with skin findings and either respiratory compromise or reduced blood pressure, 2) involvement of two or more organ systems after exposure to a likely allergen, 3) reduced blood pressure after exposure to a known allergen.2 While not a required component of the pathology, hives and cutaneous findings often prompt clinicians to consider anaphylaxis in their differential diagnosis. However, skin findings are absent in 10-20% of cases of anaphylaxis.3 It is therefore important for physicians to quickly recognize anaphylactic shock and begin appropriate management in a timely manner even in the absence of skin findings. A previous study of fatal anaphylactic reactions showed a median time to respiratory or cardiac arrest as 30 minutes for foods, 15 minutes for envenomations, and five minutes for iatrogenic reactions.4 Drugs are the most common reported cause of fatal anaphylaxis in the United States,5 and penicillin allergy is the most common drug allergy reported by patients.6 This simulation will help learners recognize an atypical presentation of anaphylactic shock, encourage them to consider anaphylaxis in their differential diagnosis for decompensated patients, and reinforce the correct management of anaphylaxis.\nEducational Objectives: At the conclusion of the simulation, learners will be able to: 1) demonstrate ability to efficiently review patient records to optimize patient care and identify relevant details to current presentation, 2) rapidly assess a patient when there is a change in clinical status, 3) recognize the need to start resuscitative fluids for undifferentiated hypotension, 4) identify anaphylaxis, 5) demonstrate the medical management of anaphylaxis, 6) utilize the I-PASS framework to communicate with the inpatient team during the transition of care.\nEducational Methods: This summative simulation was designed to assess competence in two of the core Entrustable Professional Activities (EPAs), as defined by the Association of American Medical Colleges (AAMC). These include EPA 8 (Give or Receive a Patient Handover to Transition Care Responsibility) and EPA 10 (Recognize a Patient Requiring Urgent or Emergent Care and Initiate Evaluation and Management). It was performed with 4th year medical students at the conclusion of their month-long emergency medicine (EM) clerkship. This scenario joined seven other scenarios in our pool of potential cases. These sessions are conducted using a high-fidelity manikin as the patient and a confederate/actor in the nursing role. After each scenario concludes, there is a post-simulation debriefing session on the presentation, differential diagnosis, physical exam findings, and management of the target pathology. A Gather-Analyze-Summarize technique was used for the debriefing session.7\nResearch Methods: Facilitators provided informal feedback to the scenario developers after the case was introduced into the assessment rotation. Learners completed a standard evaluation issued by the College of Medicine for the entire session, rather than for individual scenarios. These evaluations were reviewed in aggregate for the first year of implementation. Over this time frame, approximately half the students were run through this scenario.\nResults: Overall, our facilitators felt the case fit well into our pool of simulation cases. They felt they were adequately able to assess the students’ ability to respond to a decompensating patient and thought the difficulty level was appropriate for 4th year medical students. The simulation assessment exercise as a whole was highly rated by the students. Of the 198 students who completed an evaluation, 93% rated the overall quality of the session as Very Good or Excellent.\nDiscussion: Our department has run formative simulations during the 4th year EM clerkship for over ten years. Our primary objective is to assess 4th year students’ competence in EPA 10 (Recognize a Patient Requiring Urgent or Emergent Care and Initiate Evaluation and Management). This case was developed to replace another scenario of anaphylaxis which was felt to be too straightforward and easier than other scenarios in our repertoire. By making the scenario more difficult and the presentation of anaphylaxis a bit atypical, we were able to reinforce the need to include anaphylaxis in the differential diagnosis for any patient who rapidly decompensates. We are also able to review the diagnostic criteria for anaphylaxis and the appropriate treatment, including stopping the exposure to the antigen. This simulation proved to be highly engaging for 4th year medical students, and students seemed to perform at a similar level as previous summative simulations. Overall, we felt this simulation successfully achieved the objectives of the simulation session as a whole, and it was integrated into our 4th year EM clerkship simulation curriculum.\nTopics: Medical simulation, emergency medicine, anaphylaxis, anaphylactic shock, allergic reaction, penicillin allergy.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Simulation", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3vc1g8f4", "frozenauthors": [ { "first_name": "Ryan", "middle_name": "", "last_name": "O’Neill, MD", "name_suffix": "", "institution": "The Ohio State University, Department of Emergency Medicine, Columbus, OH", "department": "" }, { "first_name": "Cyrus", "middle_name": "", "last_name": "Adeli, BA, CHSE", "name_suffix": "", "institution": "The Ohio State University College of Medicine, Clinical Skill Education and Assessment Center, Columbus, OH", "department": "" }, { "first_name": "Christopher", "middle_name": "E.", "last_name": "San Miguel, MD, MEd", "name_suffix": "", "institution": "The Ohio State University, Department of Emergency Medicine, Columbus, OH", "department": "" } ], "date_submitted": "2024-02-05T11:24:11+11:00", "date_accepted": "2024-02-05T11:24:11+11:00", "date_published": "2024-01-31T19:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52094/galley/39399/download/" } ] }, { "pk": 52087, "title": "A Novel Leadership Curriculum for Emergency Medicine Residents", "subtitle": null, "abstract": "Audience and Type of Curriculum: This longitudinal leadership curriculum is designed for emergency medicine residents at all levels, with individual sessions designed for each residency year.\nLength of Curriculum: This curriculum runs once annually over three to four years of emergency medicine residency.\nIntroduction: Leadership is a vital skill for emergency physicians but is often passively taught during residency training. Strong leadership skills can lead to improved patient outcomes, but very few residency programs in any specialty and no emergency medicine residency programs have published comprehensive leadership training curricula.\nEducational Goals: The goals of this curriculum are to expose Emergency Medicine residents to the basics of leadership, to provide a graduated series of interactive, psychologically safe environments to explore individual leadership styles, to review interesting relevant literature, and to discuss leadership principles and experiences with senior leaders in our Emergency Department.\nEducational Methods: The educational strategies used in this curriculum include: brief lecture-style seminars, small group discussion and reflection, and a panel-style discussion.\nResearch Methods: The educational content of this curriculum was evaluated by learners via feedback surveys after each session.\nResults: Course evaluations conducted in both 2017 and 2020 showed that more than 89% of resident participants found these sessions “useful” or “very useful.” All residents surveyed agreed that leadership is an important topic for emergency medicine residency, and 76% felt that the inclusion of leadership content strengthened the residency’s curriculum. Suggestions for future topics included handling personal conflict and discussing transitions in leadership during yearly residency promotions.\nDiscussion: The curriculum has been successfully implemented for seven years. It has proven to be sustainable and requires minimal resources. The residents report high satisfaction with the curriculum and agree that formal instruction on the topic of leadership is important to their on-shift performance and careers.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Curriculum", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/75k4558m", "frozenauthors": [ { "first_name": "Michael", "middle_name": "J", "last_name": "Zdradzinski, MD", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, GA", "department": "" }, { "first_name": "Stephen", "middle_name": "", "last_name": "Sanders, MD", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, GA", "department": "" }, { "first_name": "Qasim", "middle_name": "", "last_name": "Kazmi, MD", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, GA", "department": "" }, { "first_name": "Vanessa", "middle_name": "", "last_name": "Fields, MD", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, GA", "department": "" }, { "first_name": "James", "middle_name": "", "last_name": "James O’Shea, MBBS", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, GA", "department": "" }, { "first_name": "Sar", "middle_name": "", "last_name": "Medoff, MD, MPP", "name_suffix": "", "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, GA", "department": "" } ], "date_submitted": "2024-02-03T15:47:43+11:00", "date_accepted": "2024-02-03T15:47:43+11:00", "date_published": "2024-01-31T19:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52087/galley/39392/download/" } ] }, { "pk": 52093, "title": "Calcium Channel Blocker Overdose", "subtitle": null, "abstract": "Audience: Emergency medicine residents and medical students on emergency medicine rotation.\nBackground: Calcium channel blocker (CCB) overdoses can be severe with potentially serious adverse outcomes. CCBs work by blocking the calcium channels on smooth and cardiac muscle tissue. At low dose ranges, dihydropyridine CCBs (such as nifedipine, amlodipine, and nicardipine) block the L-type calcium receptors in the peripheral vasculature, whereas non-dihydropyridine CCBs (such as: verapamil and diltiazem) affect the L-type calcium receptors in the myocardium.1 Because of this distinction, dihydropyridine CCB toxicity manifests as arterial vasodilation and non-dihydropyridine CCB toxicity is associated with cardiac manifestations such as bradycardia and negative inotropy.2 It is important to note that in high concentrations (such as in overdoses), CCBs lose specificity for their specific receptors and can show all the manifestations of toxicity such as bradycardia, peripheral vasodilation, and hypotension. Patients can develop both vasoplegic shock from peripheral vasodilation and cardiogenic shock. This is a high acuity low occurrence case with infrequently used but specific treatments, and thus this case provides educational value.\nEducational Objectives: At the end of this oral board session, examinees will: (1) demonstrate ability to evaluate a patient with undifferentiated shock with bradycardia and discuss the differential diagnosis, (2) recognize the signs and symptoms of calcium channel blocker overdose, (3) demonstrate ability to manage treatment of a patient with calcium channel overdose.\nEducational Methods: This oral board case followed the standard American Board of Emergency Medicine- style case in a tertiary care hospital with access to all specialists and resources needed. This case was tested using 12 resident volunteers ranging from PGY 1-2 in an ACGME (Accreditation Council for Graduate Medical Education) accredited emergency medicine residency program.\nResearch Methods: Immediate feedback was solicited both from the learners and from the evaluators following the debriefing session. Residents were asked to evaluate the educational value of the case using a 1-5 Likert scale (5 being excellent). Evaluators were asked to score the residents using the ACGME core competencies with a scale of 1-8, 1-4 being unacceptable and 5-8 being acceptable.\nResults: Seven PGY1 residents and five PGY2 residents, thus twelve residents in total, completed the case. The average score was 5.10/8. Three residents missed zero critical actions. The most common critical action missed was consulting cardiology or cardiothoracic surgery for circulatory support options. Many residents failed to recognize that the patient did not have a perfusing blood pressure at the beginning of the case and did not start CPR. Although most residents recognized the patient’s hemodynamic collapse was from a calcium channel blocker overdose, most did not know the treatment for this beyond atropine and intravenous fluids.\nThe learners rated the educational value of the case as 4.9/5. Seven residents reported that the case definitely increased their medical knowledge; five residents reported that it somewhat increased their medical knowledge. All residents rated the case as helpful in preparing to manage this medical condition.\nDiscussion: The educational content from this case was effective. This is a high acuity low occurrence case that has unique treatments that are not commonly used. This makes this case excellent for practice and discussion. We learned during implementation that this case has a high degree of difficulty compared to other cases, and junior learners will need more prompting. It is also important for the proctor to keep the case moving because there is a lot to cover in the allotted amount of time.\nTopics: Calcium channel blocker overdose, toxicology.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Oral Boards", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/08p5g7zn", "frozenauthors": [ { "first_name": "Jessica", "middle_name": "G.", "last_name": "Andrusaitis, MD, MS", "name_suffix": "", "institution": "Sutter Roseville Medical Center, Department of Emergency Medicine, Roseville, CA", "department": "" }, { "first_name": "Alan", "middle_name": "", "last_name": "Givertz, MD", "name_suffix": "", "institution": "St Agnes Medical Center, Department of Emergency Medicine, Fresno, CA", "department": "" } ], "date_submitted": "2024-02-05T11:13:25+11:00", "date_accepted": "2024-02-05T11:13:25+11:00", "date_published": "2024-01-31T19:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52093/galley/39398/download/" } ] }, { "pk": 52090, "title": "E-FAST Ultrasound Training Curriculum for Prehospital Emergency Medical Service (EMS) Clinicians", "subtitle": null, "abstract": "Audience and Type of Curriculum: Audience and type of curriculum: This hybrid, asynchronous curriculum is designed for prehospital clinician colleagues, including but not limited to emergency medical technicians (EMT), advanced EMTs (AEMT), EMT-paramedics (EMT-P), critical care EMT-Ps (CCEMTP), critical care transport nurses (CCTN), and certified flight registered nurses (CFRN) to learn and practice ultrasound fundamentals in the setting of a standardized extended focused assessment with sonography in trauma (E- FAST) exam.\nLength of Curriculum: Over a five-month curriculum, learners will perform a pre-test, review online module lectures, attend an ultrasound scanning workshop, and perform post-test examinations.\nIntroduction: The extended-focused assessment with sonography in trauma (E-FAST) exam can identify intrathoracic and intraabdominal free fluid, as well as pneumothoraces. The E-FAST ultrasound exam has previously been taught to clinicians of various backgrounds in healthcare including emergency medical service (EMS). However, an open-access, systemized curriculum for teaching E-FAST exams to EMS clinicians has not been published.\nEducational Goals: By the end of these training activities, prehospital EMS learners will be able to demonstrate foundational ultrasound skills in scanning, interpretation, and artifact recognition by identifying pertinent organs and anatomically relevant structures for an E-FAST examination. Learners will differentiate between normal and pathologic E-FAST ultrasound images by identifying the presence of free fluid and lung sliding. Learners will also explain the clinical significance and application of detecting free fluid during an E- FAST scan.\nEducational Methods: The educational strategies used in this curriculum include a hybrid, asynchronous curriculum encompassing 2.5 hours of lectures derived from online learning modules and in-person review. In addition, learners will attend 2 hours of hands-on proctored ultrasound scanning practicing E-FAST examinations.\nResearch Methods: An online 13-question pre-test was administered prior to the study. An online post-test and in-person scanning OSCEs were administered at least eight weeks after their scheduled workshop consisting of an online 13-question multiple-choice post-test, a confidence survey, and a hands-on E-FAST Objectively Structured Clinical Exam (OSCE) session. A non-parametric Wilcoxon signed-rank test was performed between each pre-test and post-test metric to examine the statistical differences of paired data.\nResults: Post-test scores demonstrated statistically significant improvement in both image interpretation exams and ultrasound self-efficacy from the pre-test. The mean pre-test and post-test scores were 55.46% (7.21 ± 1.99) and 84.23% (10.89 ± 1.59) correct out of 13 questions, respectively (p < 0.0001). Participants surveyed an increase in self-efficacy reflected by a Likert scale for ultrasound usage and image interpretation (p < 0.005). The average post-test OSCE E-FAST exam score was 37.89 ± 2.76 out of 42 points (90.21%).\nDiscussion: This 4.5-hour hybrid asynchronous model demonstrates an effective curriculum for teaching E- FAST ultrasound to prehospital clinicians.\nTopics: Ultrasound, sonography, prehospital clinicians, emergency medical services (EMS), paramedics, critical care transport, extended focused assessment with sonography in trauma (E-FAST), free fluid, sliding lung sign, elective, 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.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Curriculum", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6br3950q", "frozenauthors": [ { "first_name": "Clever", "middle_name": "M.", "last_name": "Nguyen, BS", "name_suffix": "", "institution": "Pennsylvania State University College of Medicine, Hershey, PA", "department": "" }, { "first_name": "Krista", "middle_name": "", "last_name": "Hartmann, BS, EMT-A", "name_suffix": "", "institution": "Pennsylvania State University College of Medicine, Hershey, PA", "department": "" }, { "first_name": "Avram", "middle_name": "", "last_name": "Flamm, DO, EMT-P, FACEP, FAEMS", "name_suffix": "", "institution": "*Pennsylvania State University College of Medicine, Hershey, PA; WellSpan Health, Department of Emergency Medicine, York, PA; WellSpan EMS, York, PA", "department": "" } ], "date_submitted": "2024-02-05T09:58:32+11:00", "date_accepted": "2024-02-05T09:58:32+11:00", "date_published": "2024-01-31T19:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52090/galley/39395/download/" } ] }, { "pk": 52096, "title": "Septic Arthritis of the Acromioclavicular Joint: A Case Report", "subtitle": null, "abstract": "Septic arthritis of native joints is uncommon, but the condition can be threatening to life and limb if left untreated.1 Septic arthritis of the acromioclavicular (AC) joint of the shoulder is particularly rare and has only appeared sparsely in medical literature, mainly through individual case reports. Early recognition and treatment of the condition is vital, but diagnosis of septic AC arthritis can be difficult due to its presentation with vague symptoms and nonspecific laboratory findings. This case report describes the care of a patient with poorly managed diabetes who presented to the emergency department with one month of pain and swelling of the left shoulder and two weeks of pain and swelling in the right ankle. Imaging revealed fluid in the AC joint, and laboratory evaluation showed an elevation in inflammatory markers, including leukocyte count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The patient’s hospital course was complicated by methicillin-sensitive Staphylococcus Aureus bacteremia without evidence of sepsis. The patient underwent open debridement and washout of both the ankle and AC joint without complication. After recovery, the patient was discharged to a rehabilitative center with IV antibiotics and weekly follow up care with infectious disease specialists. This case illustrates the importance of early diagnosis and treatment of septic arthritis, even in less common joint spaces, to prevent progression of this dangerous disease.\nTopics: Septic arthritis, acromioclavicular joint, diabetes, bacteremia.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Visual EM", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9sb06461", "frozenauthors": [ { "first_name": "Serena", "middle_name": "", "last_name": "Tally, BS", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Orange, CA", "department": "" }, { "first_name": "Michael", "middle_name": "", "last_name": "Head, MA", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Orange, CA", "department": "" }, { "first_name": "Kerri", "middle_name": "", "last_name": "Kraft, MD", "name_suffix": "", "institution": "University of California, Irvine, Department of Emergency Medicine, Orange, CA", "department": "" } ], "date_submitted": "2024-02-05T12:11:34+11:00", "date_accepted": "2024-02-05T12:11:34+11:00", "date_published": "2024-01-31T19:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52096/galley/39401/download/" } ] }, { "pk": 52095, "title": "The Clue is in the Eyes. A Case Report of Internuclear Ophthalmoplegia", "subtitle": null, "abstract": "The chief complaint of vertiginous symptoms can be daunting, and the differential is quite long. Approximately 15% of patients presenting to the emergency department (ED) with dizziness have a dangerous underlying cause.1 We present a case of a 40-year-old female with a sudden onset of what she describes as vertigo, in the setting of intermittent diplopia. The patient was found to have a left medial rectus palsy consistent with a left internuclear ophthalmoplegia. Internuclear ophthalmoplegia (INO) is an abnormal gaze that is characterized by the weakness or inability to adduct the affected eye. This occurs secondary to a lesion in the brain affecting the medial longitudinal fasciculus (MLF) most commonly in the pons; however, this pathway can also be affected in the midbrain.2 The diagnosis in our patient was confirmed after an MRI revealed an acute infarct of the left dorsal pons involving the medial longitudinal fasciculus, resulting in the observed left INO. The patient was admitted to the hospitalist service with neurology consultation for further stroke workup. Ultimately, the stroke was deemed cryptogenic in etiology with hyperlipidemia and obesity as the patient’s risk factors. She was discharged home after three days in the hospital on daily aspirin and high-intensity statin. Upon six-month follow up she had near resolution of her symptoms.\nTopics: Internuclear Ophthalmoplegia, INO, Vertigo, Stroke, Neurology", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Visual EM", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/141862qm", "frozenauthors": [ { "first_name": "Cooper", "middle_name": "", "last_name": "Nickels, DO", "name_suffix": "", "institution": "Prisma Health Upstate, Department of Emergency Medicine, Greenville, South Carolina", "department": "" }, { "first_name": "Christy", "middle_name": "", "last_name": "Keyes, MD", "name_suffix": "", "institution": "Prisma Health Upstate, Department of Emergency Medicine, Greenville, South Carolina", "department": "" }, { "first_name": "Caroline", "middle_name": "", "last_name": "Astemborski, MD, MEHP", "name_suffix": "", "institution": "Prisma Health Upstate, Department of Emergency Medicine, Greenville, South Carolina", "department": "" }, { "first_name": "Haley", "middle_name": "", "last_name": "Fulton, BS", "name_suffix": "", "institution": "University of South Carolina School of Medicine Greenville (USCSOMG), Greenville, South Carolina", "department": "" } ], "date_submitted": "2024-02-05T11:37:52+11:00", "date_accepted": "2024-02-05T11:37:52+11:00", "date_published": "2024-01-31T19:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52095/galley/39400/download/" } ] }, { "pk": 52089, "title": "What You Didn’t Learn in Residency: A Collective Curriculum for New Academic EM Faculty and Fellows", "subtitle": null, "abstract": "Audience and Type of Curriculum: This curriculum is designed for emergency medicine fellows and first-year junior faculty. The curriculum covers core topics related to academic and professional success for an early career faculty member.\nLength of Curriculum: The curriculum is designed as quarterly sessions over the course of one academic year.\nIntroduction: An increasing number of emergency medicine graduates are pursuing fellowship after completion of residency.1 Fellowship can be challenging as newly minted graduates begin to explore their academic niche, refine their clinical practice, and define their personal and professional spheres. We propose a structured curriculum to help guide fellows and new faculty to mitigate these challenges.\nEducational Goals: The aim of this curriculum is to develop relevant skills to promote academic success for fellows and first-year faculty at the start of their academic career and which could be completed during a one-year training timeline. We included topics relevant to all fellow and new faculty’s expected personal and professional journey during this first year, including time management, academic productivity, resilience/wellness, and developing a national reputation.\nEducational Methods: The educational strategies used in this curriculum consist primarily of lecture seminars. There is one short individual activity associated with the lectures and one small group discussion.\nResearch Methods: The course was assessed with pre- and post-test surveys following each lecture. Surveys assessed participants’ reaction, learning, and behavior for each session. Evaluations were completed based on a 5-point Likert scale (1=strongly disagree, 5=strongly agree).\nResults: Fifteen participants attended the seminar series encompassing fellows and first-year faculty/post- fellows from ten different fellowship subspecialities. Average pre-assessment scores were low for many of the self-reported skills and confidence throughout the seminar series. Overall, participants reported increased confidence on the post-test for each of the seminar topics. In addition, participants reported that they learned new skills and planned to use the new ideas presented. All participants reported they would recommend these seminars to someone else on their same career path.\nDiscussion: Overall, participants reported increased confidence, new skills, and plans to use the ideas presented in the seminar series. The content appears applicable to this learner set since all reported they would recommend the series to others on their career path.In conclusion, we believe our seminar series will build skills for fellows and first-year faculty which will promote academic success.\nTopics: Academic success, professional development, early career development.", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Curriculum", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/23q173b2", "frozenauthors": [ { "first_name": "Jessica", "middle_name": "", "last_name": "Schmidt MD, MPH", "name_suffix": "", "institution": "University of Wisconsin Madison, Department of Emergency Medicine, Madison, WI", "department": "" }, { "first_name": "Benjamin", "middle_name": "", "last_name": "Schnapp, MD, MEd", "name_suffix": "", "institution": "University of Wisconsin Madison, Department of Emergency Medicine, Madison, WI", "department": "" }, { "first_name": "Sara", "middle_name": "", "last_name": "Damewood, MD", "name_suffix": "", "institution": "University of Wisconsin Madison, Department of Emergency Medicine, Madison, WI", "department": "" }, { "first_name": "Mary", "middle_name": "", "last_name": "Westergaard, MD", "name_suffix": "", "institution": "University of Wisconsin Madison, Department of Emergency Medicine, Madison, WI", "department": "" } ], "date_submitted": "2024-02-05T09:22:25+11:00", "date_accepted": "2024-02-05T09:22:25+11:00", "date_published": "2024-01-31T19:00:00+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52089/galley/39394/download/" } ] }, { "pk": 65621, "title": "11.1 Table of Contents and Editors' Note (January 30, 2024)", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/63c3c702", "frozenauthors": [ { "first_name": "AGS", "middle_name": "", "last_name": "Editors", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-01-30T20:00:00+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/analoggamestudies/article/65621/galley/50387/download/" } ] }, { "pk": 65624, "title": "\"Murders on the Stage, Tortures, Woundings, and the Like\": Dungeons & Dragons Adventures as Tragedy", "subtitle": null, "abstract": "This article examines Dungeons & Dragons (D&D) adventures as a genre to address game content, player agency, and reception. Specifically, Aristotle's Poetics serves as a starting point for the analysis of D&D adventures in order to think about the similarities between theatre and TTRPGs but also the nature and experience of tragedy and D&D adventures.", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "Dungeons & Dragons" }, { "word": "D&D" }, { "word": "tragedy" }, { "word": "theater" }, { "word": "player agency" }, { "word": "reception" }, { "word": "Aristotle" }, { "word": "Poetics" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1nz7z32b", "frozenauthors": [ { "first_name": "Brian", "middle_name": "", "last_name": "McKenzie", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-01-30T20:00:00+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/analoggamestudies/article/65624/galley/50390/download/" } ] }, { "pk": 65622, "title": "The Board Game as a Narrative Medium", "subtitle": null, "abstract": "Drawing on analyses of a range of German board games, this essay offers an overview of the development and definition of board games and an exploration of why board games are a legitimate medium for storytelling.", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "board games" }, { "word": "narrative" }, { "word": "metagame" }, { "word": "media" }, { "word": "storytelling" }, { "word": "German analog games" }, { "word": "history" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9f6679cd", "frozenauthors": [ { "first_name": "Pawel", "middle_name": "", "last_name": "Bornstedt", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-01-30T20:00:00+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/analoggamestudies/article/65622/galley/50388/download/" } ] }, { "pk": 65623, "title": "The Scientification of Games: Analyzing Ghost Blitz through the Lens of Cognitive Psychology", "subtitle": null, "abstract": "This article provides a proof-of-concept for the complementary route of the scientification of games. We argue that the tasks and rules developed within commercially available games can exactly represent the same kinds of tasks studied in Cognitive Psychology. Consequently, analyzing games as though they were scientific paradigms a) allows for unique teachable moments in Cognitive Psychology using games as the vehicle of delivery, and b) feeds back principles of randomization and counterbalancing into the design and development of commercial games. Using the popular card game Ghost Blitz, we identify how players might resolve the game on a round-by-round basis in terms of both bottom-up (stimulus-driven) and top-down (expectation-driven) processes. We identify statistical biases within the card deck favoring one rule over the other, and a second bias where specific color/shape conjunctions are both under- and over-represented. These detailed analyses provided the insights necessary to present a re-designed and balanced version of the game and allow for teachable moments with respect to Cognitive Psychology including feature versus conjunction processing, visual search asymmetries, and task switching.", "language": "eng", "license": { "name": "", "short_name": "", "text": null, "url": "" }, "keywords": [ { "word": "card games" }, { "word": "Ghost Blitz" }, { "word": "cognitive psychology" }, { "word": "player psychology" }, { "word": "game statistics" }, { "word": "scientification" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6h43b14j", "frozenauthors": [ { "first_name": "Benjamin", "middle_name": "James", "last_name": "Dyson", "name_suffix": "", "institution": "", "department": "" }, { "first_name": "Leo", "middle_name": "", "last_name": "Baik", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2024-01-30T20:00:00+11:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/analoggamestudies/article/65623/galley/50389/download/" } ] }, { "pk": 18088, "title": "Usability of the 4Ms Worksheet in the Emergency Department for Older Patients: A Qualitative Study", "subtitle": null, "abstract": "Introduction:\n Older adults often have multiple comorbidities; therefore, they are at high risk for adverse events after discharge. The 4Ms framework—what matters, medications, mentation, mobility—has been used in acute and ambulatory care settings to identify risk factors for adverse events in older adults, although it has not been used in the emergency department (ED).Weaimed to determine whether 1) use of the 4Ms worksheet would help emergency clinicians understand older adult patients’ goals of care and 2) use of the worksheet was feasible in the ED.\nMethods: \nWe conducted a qualitative, descriptive study among patients aged ≥60 years and emergency clinicians from January–June 2022. Patients were asked to fill out a 4Ms worksheet; following this, semi-structured interviews were conducted with patients and clinicians separately. We analysed data to create codes, which were divided into categories and sub-categories.\nResults:\n A total of 20 older patients and 19 emergency clinicians were interviewed. We identified two categories based on our aims: understanding patient goals of care (sub-categories: clinician/ patient concordance; understanding underlying goals of care; underlying goals of care discrepancy) and use of 4Ms Worksheet (sub-categories: worksheet to discussion discrepancy; challenges using worksheet; challenge completing worksheet before discharge). Rates of concordance between patient and clinician on main concern/goal of care and underlying goals of care were 82.4% and 15.4%, respectively.\nConclusion: \nWe found that most patients and emergency clinicians agreed on the main goal of care, although clinicians often failed to elicit patients’ underlying goal(s) of care. Additionally, many patients preferred to have the interviewer fill out the worksheet for them. There was often discrepancy between what was written and what was discussed with the interviewer. More research is needed to determine the best way to integrate the 4Ms framework within emergency care.", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Geriatrics" }, { "word": "goals of care" }, { "word": "Age-friendly health system" } ], "section": "Geriatrics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4nd2734n", "frozenauthors": [ { "first_name": "McKenzie", "middle_name": "A.", "last_name": "McKnight", "name_suffix": "", "institution": "University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Melissa", "middle_name": "K.", "last_name": "Sheber", "name_suffix": "", "institution": "University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Daniel", "middle_name": "J.", "last_name": "Liebzeit", "name_suffix": "", "institution": "University of Iowa, College of Nursing, Iowa City, Iowa", "department": "None" }, { "first_name": "Aaron", "middle_name": "T.", "last_name": "Seaman", "name_suffix": "", "institution": "University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Department of Internal Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Erica", "middle_name": "K.", "last_name": "Husser", "name_suffix": "", "institution": "Penn State University, Ross and Carol Nese College of Nursing, University Park, Pennsylvania", "department": "None" }, { "first_name": "Harleah", "middle_name": "G.", "last_name": "Buck", "name_suffix": "", "institution": "University of Iowa, College of Nursing, Iowa City, Iowa", "department": "None" }, { "first_name": "Heather", "middle_name": "S.", "last_name": "Reisinger", "name_suffix": "", "institution": "University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Department of Internal Medicine, Iowa City, Iowa", "department": "None" }, { "first_name": "Sangil", "middle_name": "", "last_name": "Lee", "name_suffix": "", "institution": "University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Department of Internal Medicine, Iowa City, Iowa; Department of Epidemiology, University of Iowa College of Public Health, Department of Emergency Medicine, Iowa City, Iowa", "department": "None" } ], "date_submitted": "2023-04-22T11:23:02+10:00", "date_accepted": null, "date_published": "2024-01-26T02:37:00+11:00", "render_galley": { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18088/galley/9220/download/" }, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18088/galley/9220/download/" } ] }, { "pk": 4914, "title": "Buprenorphine for High-dose Tramadol Dependence: A Case Report of Successful Outpatient Treatment", "subtitle": null, "abstract": "", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "buprenorphine" }, { "word": "letter to the editor" }, { "word": "reply" } ], "section": "Letters to the Editor", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/08t1b2hj", "frozenauthors": [ { "first_name": "Leslie", "middle_name": "", "last_name": "Mukau", "name_suffix": "", "institution": "University of California San Diego, Department of Emergency Medicine, San Diego, California; El Centro Regional Medical Center, Department of Emergency Medicine, El Centro, California", "department": "" }, { "first_name": "Kadia", "middle_name": "", "last_name": "Wormley", "name_suffix": "", "institution": "Highland Hospital-Alameda Health System, Department of Emergency Medicine, Oakland, California", "department": "" }, { "first_name": "Christian", "middle_name": "", "last_name": "Tomaszewski", "name_suffix": "", "institution": "University of California San Diego, Department of Emergency Medicine, San Diego, California; El Centro Regional Medical Center, Department of Emergency Medicine, El Centro, California", "department": "" }, { "first_name": "Bushra", "middle_name": "", "last_name": "Ahmad", "name_suffix": "", "institution": "Imperial County Behavioral Health Services, Division of Substance Use Disorder Treatment Program, El Centro, California", "department": "" }, { "first_name": "Rais", "middle_name": "", "last_name": "Vohra", "name_suffix": "", "institution": "University of California San Francisco-Fresno, Department of Emergency Medicine, Fresno, California", "department": "" }, { "first_name": "Andrew", "middle_name": "A.", "last_name": "Herring", "name_suffix": "", "institution": "Highland Hospital-Alameda Health System, Department of Emergency Medicine, Oakland, California; University of California San Francisco, Department of Emergency Medicine, San Francisco, California", "department": "" } ], "date_submitted": "2023-11-07T03:55:03.379000+11:00", "date_accepted": "2023-11-17T04:26:17.143000+11:00", "date_published": "2024-01-26T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/4914/galley/4330/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/4914/galley/3862/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/4914/galley/4330/download/" } ] }, { "pk": 2589, "title": "Caution Regarding Self-reported Tramadol Dependence", "subtitle": null, "abstract": "", "language": "eng", "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": "tramadol" }, { "word": "buprenorphine" }, { "word": "opioid dependence" }, { "word": "letter to the editor" } ], "section": "Letters to the Editor", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4bx3f86j", "frozenauthors": [ { "first_name": "James", "middle_name": "", "last_name": "Dunford", "name_suffix": "", "institution": "University of California San Diego, School of Medicine, San Diego, California; McAlister Institute for Treatment and Education, El Cajon, California", "department": "Emergency Medicine" }, { "first_name": "Aaron", "middle_name": "", "last_name": "Schneir", "name_suffix": "", "institution": "University of California San Diego Health System, Department of Emergency Medicine, Division of Medical Toxicology, San Diego, California", "department": "Emergency Medicine" } ], "date_submitted": "2023-10-14T09:44:06.901000+11:00", "date_accepted": "2023-10-19T04:22:52.495000+11:00", "date_published": "2024-01-26T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/2589/galley/4329/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/2589/galley/3861/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/2589/galley/4329/download/" } ] }, { "pk": 1594, "title": "Complications of Bacterial Keratitis Impacted by Social Determinants of Health: A Case Report", "subtitle": null, "abstract": "<b>Introduction: </b>The emergency department commonly evaluates eye pain and vision loss. Typically, these conditions can be managed outpatient; however, delays can lead to advanced pathology.<p></p><p><b>Case Report: </b>A 48-year-old homeless male presented with left-eye vision loss and pain. His exam revealed monocular decreased visual acuity, corneal ulcer, and hypopyon. The patient was diagnosed with bacterial keratitis and admitted for treatment but left against medical advice. He returned and was admitted for further treatment but was lost to follow-up thereafter.</p><p></p><p><b>Conclusion:</b> Our case features complicated bacterial keratitis with several treatment interruptions, demonstrating how healthcare disparities contribute to potentially preventable advanced pathology.</p>", "language": "eng", "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": "keratitis" }, { "word": "vision loss" }, { "word": "hypopyon" }, { "word": "corneal ulcer" }, { "word": "Pain" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1th9n8v1", "frozenauthors": [ { "first_name": "Taylor", "middle_name": "", "last_name": "Diederich", "name_suffix": "", "institution": "Department of Emergency Medicine, University of Kansas Medical Center, University of Kansas Health System, Kansas City, Kansas", "department": "" }, { "first_name": "Hope", "middle_name": "", "last_name": "Ring", "name_suffix": "", "institution": "Department of Emergency Medicine, University of Kansas Medical Center, University of Kansas Health System, Kansas City, Kansas", "department": "" }, { "first_name": "Mary", "middle_name": "", "last_name": "Velagapudi", "name_suffix": "", "institution": "Department of Emergency Medicine, University of Kansas Medical Center, University of Kansas Health System, Kansas City, Kansas", "department": "" } ], "date_submitted": "2023-08-08T03:25:40.417000+10:00", "date_accepted": "2023-11-10T10:49:36.333000+11:00", "date_published": "2024-01-26T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1594/galley/4327/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1594/galley/3860/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1594/galley/4327/download/" } ] }, { "pk": 1563, "title": "Septic Arthritis of the Sternoclavicular Joint", "subtitle": null, "abstract": "<b>Introduction: </b>Sternoclavicular joint (SCJ) septic arthritis is a rare but rapidly fatal joint infection. Without proper medical or surgical management, it can progress to osteomyelitis, chest wall abscess, mediastinitis, or myositis.<p></p><p><b><b>Case Report:</b> </b>A 57-year-old male with a past history of intravenous drug use presented to the emergency department (ED) with chest tenderness of one week duration. Vital signs were unremarkable, and exam was notable for tender, raised right SCJ without any fluctuance. On point-of-care ultrasound we noted fluid collection and capsular distention along the SCJ, which aided in rapidly diagnosing septic arthritis. The patient was immediately started on antibiotics and taken to the operating room for excision and debridement.</p><p></p><p><b><b><b>Conclusion:</b> </b></b>While computed tomography is routinely used in the emergency department for diagnosing septic arthritis, ultrasound offers a rapid and safe alternative for diagnosis. </p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "septic arthritis" }, { "word": "sternoclavicular joint" }, { "word": "ultrasound" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0ph174q3", "frozenauthors": [ { "first_name": "George", "middle_name": "V.", "last_name": "Koshy", "name_suffix": "", "institution": "Department of Emergency Medicine, Geisinger Medical Center, Danville, Pennsylvania", "department": "Emergency Medicine" }, { "first_name": "Richard", "middle_name": "", "last_name": "Davis", "name_suffix": "", "institution": "Department of Emergency Medicine, Geisinger Medical Center, Danville, Pennsylvania", "department": "" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Wilson", "name_suffix": "", "institution": "Department of Emergency Medicine, Geisinger Medical Center, Danville, Pennsylvania", "department": "" } ], "date_submitted": "2023-07-29T01:12:39.573000+10:00", "date_accepted": "2023-11-10T11:03:40.033000+11:00", "date_published": "2024-01-26T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1563/galley/4328/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1563/galley/3859/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1563/galley/4328/download/" } ] }, { "pk": 7225, "title": "Aortic Thrombus with Bilateral Renal Infarcts: A Case Report", "subtitle": null, "abstract": "<b>Introduction: </b>The presence of a hypercoagulable state predisposes to venous and arterial thrombi. While the relationship between protein C and S deficiencies with venous thrombus formation is clear, the relationship to arterial thrombi formation is less common. Thromboembolic disease of the renal arteries may result in renal infarction. The development of simultaneous bilateral renal infarction is rare and can lead to significant morbidity and mortality.<p></p><p><b><b>Case Report: </b></b>This is a case of a 48-year-old male with known protein C deficiency who presented to the emergency department with sudden onset abdominal pain. A computed tomography angiogram of the abdomen showed bilateral renal infarctions. The patient required significant analgesia and developed acute kidney injury. He was treated conservatively, and dialysis was not required.</p><p></p><p><b><b><b>Conclusion:</b> </b></b>There are no reports in the emergency medicine literature of bilateral renal infarction secondary to protein C and S deficiency. Prompt evaluation with definitive imaging is necessary for patients who are at high risk for arterial thrombi and present with symptoms suggestive of the diagnosis.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "thrombophilias" }, { "word": "protein C deficiency" }, { "word": "protein S deficiency" }, { "word": "renal infarction" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5xg8196t", "frozenauthors": [ { "first_name": "Lev", "middle_name": "", "last_name": "Libet", "name_suffix": "", "institution": "Kern Medical, Department of Emergency Medicine, Bakersfield, California", "department": "" } ], "date_submitted": "2024-01-24T07:01:37.233000+11:00", "date_accepted": "2024-01-24T07:03:55.691000+11:00", "date_published": "2024-01-24T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/7225/galley/4325/download/" }, "galleys": [ { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/7225/galley/4325/download/" } ] }, { "pk": 1359, "title": "Case Report: Pediatric Thyroid Storm Presenting to the Emergency Department with Afebrile Seizure", "subtitle": null, "abstract": "<p><b>Introduction: </b>Seizures are a common presenting complaint and account for approximately 1% of total emergency department (ED) visits. Seizures are especially common in children less than five years old as they have a lower seizure threshold as compared to adults. One potentially dangerous etiology that is far less common, especially in children, is thyroid storm, the extreme manifestationof hyperthyroidism.</p><p><b>Case Report: </b>We describe the case of a 3-year-old girl who presented to the ED with an afebrile seizure but was found to be in thyroid storm. This case should serve as a reminder for emergency physicians to consider thyroid disease when evaluating patients presenting with seizures.</p><p><b><b>Conclusion: </b></b>Although most pediatric seizures are self-limited and frequently benign, it is imperative that the emergency physician evaluate for and rule out any potentially associated dangerous conditions such as thyroid storm. </p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Thyroid storm" }, { "word": "pediatric afebrile seizure" }, { "word": "thyrotoxicosis" }, { "word": "Emergency Medicine" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9500t8m2", "frozenauthors": [ { "first_name": "Daniel", "middle_name": "J.", "last_name": "Klein", "name_suffix": "", "institution": "Los Angeles General Medical Center, Keck School of Medicine of the University of Southern California, Department of Emergency Medicine, Los Angeles, California", "department": "" }, { "first_name": "Emily", "middle_name": "", "last_name": "Rose", "name_suffix": "", "institution": "Los Angeles General Medical Center, Keck School of Medicine of the University of Southern California, Department of Emergency Medicine, Los Angeles, California", "department": "" } ], "date_submitted": "2023-05-16T03:56:32.825000+10:00", "date_accepted": "2023-10-20T02:42:30.348000+11:00", "date_published": "2024-01-24T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1359/galley/4324/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1359/galley/3829/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1359/galley/4324/download/" } ] }, { "pk": 1565, "title": "Isolated Laryngeal Angioedema in a Patient with Long-term ACE Inhibitor Use: A Case Report", "subtitle": null, "abstract": "<b>Introduction:</b> Angiotensin converting enzyme (ACE) inhibitor-associated angioedema is the most common cause of angioedema seen in the emergency department (ED) and can be associated with a high morbidity. Most cases occur within months of initiation of an ACE inhibitor and are associated with facial and/or oropharyngeal swelling. We present a case of isolated laryngeal edema requiring intubation following 10 years of ACE inhibitor therapy.<p></p><p><b><b>Case Report:</b> </b>An 82-year-old female, who was on lisinopril therapy for 10 years, presented to the ED with shortness of breath and a sensation that her throat was swelling. She appeared to be in mild respiratory distress and could only speak in one-word sentences. On the physical exam, there was no swelling in the tongue, lips, or face, and the uvula was midline. There was mild posterior pharyngeal edema and swelling noted, but the airway was not visibly obstructed. She was tachypneic and stridor was present. After no improvement with medications, anesthesia successfully intubated her in the operating room. It was deemed a difficult airway secondary to posterior pharyngeal erythema and edema. She was diagnosed with ACE inhibitor-associated angioedema and was extubated four days later. Her lisinopril was discontinued, and she has not had a recurrence of angioedema.</p><p></p><p><b><b><b>Conclusion:</b> </b></b>ACE inhibitor-induced angioedema commonly presents with facial and oropharyngeal swelling. Its recognition, even years after starting an ACE inhibitor, is necessary to ensure swift and appropriate treatment of potentially life-threatening posterior pharyngeal edema.</p>", "language": "eng", "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": "laryngeal edema" }, { "word": "ACE Inhibitor" }, { "word": "case report" }, { "word": "angioedema" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/09r8z5d9", "frozenauthors": [ { "first_name": "Carney", "middle_name": "", "last_name": "Flinn", "name_suffix": "", "institution": "Virginia Tech Carilion School of Medicine, Roanoke, Virginia", "department": "" }, { "first_name": "Inna", "middle_name": "", "last_name": "Massaro", "name_suffix": "", "institution": "Roanoke Memorial Hospital, Department of Emergency Medicine, Carilion Health System, Roanoke, Virginia", "department": "Emergency Medicine" } ], "date_submitted": "2023-07-30T02:47:26.026000+10:00", "date_accepted": "2023-10-22T18:36:33.362000+11:00", "date_published": "2024-01-24T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1565/galley/4323/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1565/galley/3828/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1565/galley/4323/download/" } ] }, { "pk": 1442, "title": "Lithium Toxicity: A Case Report of Toxicity Resulting in a Third-degree Heart Block", "subtitle": null, "abstract": "<b>Introduction: </b>Lithium is a medication used to treat bipolar disorder. It has a narrow therapeutic index, which frequently causes toxicity in patients.<p></p><p><b><b>Case Report: </b></b>We present an unusual case of a 66-year-old female with a history of bipolar disorder on chronic lithium, who developed a third-degree heart block, encephalopathy, and acute renal failure because of lithium toxicity.</p><p></p><p><b><b><b>Conclusion:</b> </b></b>This case highlights a rare but life-threatening case of complete heart block in the setting of lithium toxicity. The patient was treated with hemodialysis and pacemaker placement.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "case report" }, { "word": "lithium toxicity" }, { "word": "heart block" }, { "word": "therapeutic index" }, { "word": "hemodialysis" }, { "word": "pacemaker replacement" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7zm5g01c", "frozenauthors": [ { "first_name": "Samantha", "middle_name": "L.", "last_name": "Gaetani", "name_suffix": "", "institution": "Lehigh Valley Health Network/University of South Florida Morsani College of Medicine, Department of Emergency and Hospital Medicine, Allentown, Pennsylvania", "department": "Department of Emergency and Hospital Medicine" }, { "first_name": "Alexandra", "middle_name": "M.", "last_name": "Amaducci", "name_suffix": "", "institution": "Lehigh Valley Health Network/University of South Florida Morsani College of Medicine, Department of Emergency and Hospital Medicine, Division of Medical Toxicology, Allentown, Pennsylvania", "department": "Department of Emergency and Hospital Medicine" }, { "first_name": "Derek", "middle_name": "", "last_name": "Fikse", "name_suffix": "", "institution": "Lehigh Valley Health Network/University of South Florida Morsani College of Medicine, Department of Emergency and Hospital Medicine, Division of Medical Toxicology, Allentown, Pennsylvania", "department": "Department of Emergency and Hospital Medicine" }, { "first_name": "Andrew", "middle_name": "L.", "last_name": "Koons", "name_suffix": "", "institution": "Lehigh Valley Health Network/University of South Florida Morsani College of Medicine, Department of Emergency and Hospital Medicine, Division of Medical Toxicology, Allentown, Pennsylvania", "department": "Department of Emergency and Hospital Medicine" } ], "date_submitted": "2023-06-17T00:05:12.727000+10:00", "date_accepted": "2023-09-30T06:31:01.089000+10:00", "date_published": "2024-01-24T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1442/galley/4320/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1442/galley/3818/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1442/galley/4320/download/" } ] }, { "pk": 1510, "title": "Median Arcuate Ligament Syndrome in 17-year-old Male with Abdominal Pain: Case Report", "subtitle": null, "abstract": "<p><b>Introduction:</b> Median arcuate ligament syndrome (MALS) is an uncommon cause of chronic abdominal pain resulting from the compression of the celiac artery. It shares symptoms with chronic functional abdominal pain, a more common cause of pediatric chronic abdominal pain. Typically found in middle-aged females, MALS is a diagnosis of exclusion.</p><p><b><b>Case Report:</b> </b>A 17-year-old male who presented to the emergency department with periumbilical pain for two months was subsequently diagnosed with MALS through computed tomography angiography. Further vascular and gastroenterology evaluations confirmed the diagnosis, ruling out other common causes of chronic abdominal pain. The patient received non-operative treatment in the form of endoscopic ultrasound celiac plexus block, with the possibility of surgical management if necessary.</p><p><b><b>Conclusion:</b></b> Median arcuate ligament syndrome is an uncommon cause of chronic abdominal pain that is difficult to differentiate from other causes, especially in pediatric patients. It should be considered in the patient whose previous workup was not conclusive and symptom management had failed. Management is multidisciplinary with non-operative management preferred initially. If there is no improvement, surgical management should be considered.</p>", "language": "eng", "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": "Median Arcuate Ligament Syndrome" }, { "word": "Angiogram" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6dg3v4js", "frozenauthors": [ { "first_name": "Jessica", "middle_name": "", "last_name": "Doctor", "name_suffix": "", "institution": "San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX", "department": "Emergency Medicine" }, { "first_name": "Jonathan", "middle_name": "", "last_name": "Henderson", "name_suffix": "", "institution": "San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX", "department": "" } ], "date_submitted": "2023-07-08T04:48:54.721000+10:00", "date_accepted": "2023-10-19T04:45:29.415000+11:00", "date_published": "2024-01-24T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1510/galley/4321/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1510/galley/3820/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1510/galley/4321/download/" } ] }, { "pk": 1372, "title": "Spontaneous Coronary Artery Dissection Presenting as Electrical Storm: A Case Report", "subtitle": null, "abstract": "<b>Introduction: </b>Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction in patients of younger age without typical atherosclerotic risk factors and can present with ventricular arrhythmia such as ventricular tachycardia (VT) or ventricular fibrillation (VF). Electrical storm (ES) is defined as greater than or equal to 3 episodes of VT or VF occurring within 24 hours.<p></p><p><b><b>Case Report:</b> </b>A healthy 38-year-old-male developed chest pain while exercising at the gym and presented to the emergency department unresponsive in a ventricular arrhythmia defined as ES. The patient’s cardiac arrest was initially refractory to standard defibrillation and Advanced Cardiac Life Support medications. He was ultimately diagnosed with SCAD of the left anterior descending artery, which was stented. The patient survived neurologically intact after a 13-day hospital stay.</p><p></p><p><b><b><b>Conclusion: </b></b></b>Spontaneous coronary artery dissection is a significant cause of acute coronary syndrome and occurs in healthier patients without cardiac risk factors. Electrical storm represents a unique manifestation of SCAD. Emergency physicians should maintain a heightened suspicion for SCAD for accurate diagnosis and treatment.</p>", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "spontaneous coronary artery dissection" }, { "word": "electrical storm" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4bx6v0rr", "frozenauthors": [ { "first_name": "Nathan", "middle_name": "", "last_name": "Escorial", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California", "department": "" }, { "first_name": "Coleman", "middle_name": "", "last_name": "Cowart", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California", "department": "" }, { "first_name": "Matthew", "middle_name": "", "last_name": "Paparian", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California", "department": "" }, { "first_name": "Joel", "middle_name": "", "last_name": "Stillings", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California", "department": "" } ], "date_submitted": "2023-05-16T03:54:42.838000+10:00", "date_accepted": "2023-09-13T07:07:55.044000+10:00", "date_published": "2024-01-24T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1372/galley/4318/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1372/galley/2706/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1372/galley/4318/download/" } ] }, { "pk": 1671, "title": "Spontaneously Conceived Ruptured Heterotopic Pregnancy Presenting with Chest Pain and Dyspnea: A Case Report", "subtitle": null, "abstract": "<b>Introduction: </b>Heterotopic pregnancy, defined as simultaneous intrauterine and ectopic pregnancy, is a rare and potentially life-threatening condition. The incidence of heterotopic pregnancy has significantly increased in the modern era, primarily due to use of assisted reproductive technology. Heterotopic pregnancy in the absence of risk factors is uncommon. The symptoms of heterotopic pregnancy are similar to those of ectopic pregnancy, primarily abdominal pain and vaginal bleeding.<p></p><p><b>Case Report: </b>We report a case of heterotopic pregnancy occurring in the absence of risk factors and presenting with primary symptoms of chest pain and shortness of breath.</p><p></p><p><b>Conclusion:</b> While uncommon, heterotopic pregnancy may occur in patients without risk factors and may present with atypical symptoms such as chest pain and shortness of breath.</p>", "language": "eng", "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": "heterotopic pregnancy" }, { "word": "ectopic pregnancy" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8xf6c9rw", "frozenauthors": [ { "first_name": "Farrah", "middle_name": "", "last_name": "Nasrollahi", "name_suffix": "", "institution": "University of Illinois, College of Medicine, Department of Emergency Medicine, Chicago, Illinois", "department": "Emergency Medicine" }, { "first_name": "Kevin", "middle_name": "", "last_name": "Cao", "name_suffix": "", "institution": "University of Illinois, College of Medicine, Chicago, Illinois", "department": "" }, { "first_name": "Janae", "middle_name": "", "last_name": "Hohbein", "name_suffix": "", "institution": "University of Illinois, College of Medicine, Department of Emergency Medicine, Chicago, Illinois", "department": "Emergency medicine" }, { "first_name": "Wesley", "middle_name": "", "last_name": "Eilbert", "name_suffix": "", "institution": "University of Illinois, College of Medicine, Department of Emergency Medicine, Chicago, Illinois", "department": "" } ], "date_submitted": "2023-09-15T10:42:01.993000+10:00", "date_accepted": "2023-10-18T09:42:35.115000+11:00", "date_published": "2024-01-24T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1671/galley/4322/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1671/galley/3822/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1671/galley/4322/download/" } ] }, { "pk": 1265, "title": "Ultrasound-Guided, Mid-Forearm Median Nerve Block for Relief of Carpal Tunnel Syndrome Pain in the Emergency Department: A Case Report", "subtitle": null, "abstract": "<b>Introduction:</b> Carpal tunnel syndrome (CTS) is a common complaint in the emergency department (ED) and accounts for approximately 90% of all peripheral neuropathies.6 Pain control from injection with corticosteroids into the carpal tunnel space is associated with multiple possible complications including atrophy, iatrogenic median nerve injury, and skin changes. Ultrasound (US)-guided mid-forearm median nerve block is an ED procedure that can be used to avoid direct injection into the carpal tunnel space. Here we present a case report proposing the use of US-guided mid-forearm block as a safe and effective adjunct to the management of acute pain caused by CTS.<p></p><p><b><b>Case Report:</b></b> A previously healthy 44-year-old, right-hand dominant female presented to the ED with left wrist pain. Her clinical exam and US findings were consistent with CTS. Given her allergy to non-steroidal anti-inflammatory drugs, she was offered a median nerve block, which was performed in the ED. The patient reported continued pain relief 24 hours after discharge from the ED.</p><p></p><p><b><b><b>Conclusion: </b></b></b>There is limited data on the use of US-guided mid-forearm median nerve block as an acute pain management tool for CTS in the ED. The US-guided median nerve block done in the mid-forearm location can provide pain control for those with CTS while reducing the risk of complications associated with direct carpal tunnel injection.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "ultrasound" }, { "word": "Median Nerve block" }, { "word": "Carpal Tunnel Syndrome" }, { "word": "regional anesthesia" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8s24b9s7", "frozenauthors": [ { "first_name": "Daniel", "middle_name": "L.", "last_name": "Puebla", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, Miami, Florida", "department": "Emergency Medicine" }, { "first_name": "Ilya", "middle_name": "", "last_name": "Luchitsky", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, Miami, Florida", "department": "Emergency Medicine" }, { "first_name": "Roman", "middle_name": "", "last_name": "Montes De Oca", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, Miami, Florida", "department": "Emergency Medicine" }, { "first_name": "Michael", "middle_name": "", "last_name": "Shalaby", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, Miami, Florida; Florida International University, Herbert Wertheim College of Medicine, Department of Emergency Medicine, Miami, Florida", "department": "Advanced Emergency Ultrasound" }, { "first_name": "Robert", "middle_name": "A.", "last_name": "Farrow II", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, Miami, Florida", "department": "Emergency Medicine" } ], "date_submitted": "2023-04-01T02:20:45.167000+11:00", "date_accepted": "2023-09-30T05:04:41.546000+10:00", "date_published": "2024-01-24T01:00:00+11:00", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1265/galley/4319/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1265/galley/2709/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1265/galley/4319/download/" } ] }, { "pk": 18739, "title": "(O-D2) Needs Assessment Tool for Global Emergency Medicine Residency Curriculum Modification", "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": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4gj5166m", "frozenauthors": [ { "first_name": "Sean", "middle_name": "M.", "last_name": "Boaglio", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Zelda", "middle_name": "", "last_name": "Luke-Blyden", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Kristen", "middle_name": "", "last_name": "Dettorre", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Charles", "middle_name": "", "last_name": "Lei", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T08:13:13+11:00", "date_accepted": "2024-01-20T08:13:13+11:00", "date_published": "2024-01-20T08:14:02+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18739/galley/9465/download/" } ] }, { "pk": 18738, "title": "(O-D6) CP-”R” You Ready for Residency", "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": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2m1498jt", "frozenauthors": [ { "first_name": "Amritpal", "middle_name": "", "last_name": "Saini", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Nora", "middle_name": "", "last_name": "McNulty", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Nora", "middle_name": "", "last_name": "McNulty", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Noah", "middle_name": "", "last_name": "Trump", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Noah", "middle_name": "", "last_name": "Trump", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Sandeep", "middle_name": "K.", "last_name": "Dhillon", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Sandeep", "middle_name": "K.", "last_name": "Dhillon", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Maninder", "middle_name": "", "last_name": "Singh", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Maninder", "middle_name": "", "last_name": "Singh", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Restivo", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Restivo", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T08:10:31+11:00", "date_accepted": "2024-01-20T08:10:31+11:00", "date_published": "2024-01-20T08:11:13+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18738/galley/9464/download/" } ] }, { "pk": 18737, "title": "(O-E6) Active Threat: Evaluating a Borderland’s Emergency Department Staff’s Preparedness", "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": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2kb9b972", "frozenauthors": [ { "first_name": "Neha", "middle_name": "", "last_name": "Sehgal", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Jessica", "middle_name": "", "last_name": "Vanschuyver", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Erica", "middle_name": "", "last_name": "Guerrero", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T08:07:23+11:00", "date_accepted": "2024-01-20T08:07:23+11:00", "date_published": "2024-01-20T08:08:01+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18737/galley/9463/download/" } ] }, { "pk": 18736, "title": "(O-B1) A Retrospective Cohort Study to Determine the Injury Prevalence of Cervical Spine Injuries in Elderly Patients Undergoing Full Trauma CT", "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": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8885k7kk", "frozenauthors": [ { "first_name": "John", "middle_name": "S.", "last_name": "Batchelor", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Pedro", "middle_name": "", "last_name": "Simoes", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Khalid", "middle_name": "", "last_name": "Abdelsadig", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T08:03:41+11:00", "date_accepted": "2024-01-20T08:03:41+11:00", "date_published": "2024-01-20T08:04:50+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18736/galley/9462/download/" } ] }, { "pk": 18735, "title": "(O-C7) De-escalating Techniques to Reduce Tension in the Emergency Department Among Staff", "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": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2db279nw", "frozenauthors": [ { "first_name": "Mohamad", "middle_name": "", "last_name": "Moussa", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T08:01:20+11:00", "date_accepted": "2024-01-20T08:01:20+11:00", "date_published": "2024-01-20T08:02:14+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18735/galley/9461/download/" } ] }, { "pk": 18734, "title": "(P82) Predictors of Prolonged Hospital Length of Stay After Traumatic Brain Injury", "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": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6hh20816", "frozenauthors": [ { "first_name": "Shameeke", "middle_name": "", "last_name": "Taylor", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "George", "middle_name": "", "last_name": "Loo", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Eric", "middle_name": "", "last_name": "Legome", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T07:59:31+11:00", "date_accepted": "2024-01-20T07:59:31+11:00", "date_published": "2024-01-20T08:00:05+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18734/galley/9460/download/" } ] }, { "pk": 18733, "title": "(O-D1) Simulation-based Assessment for the Emergency Medicine Milestones", "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": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5x48g821", "frozenauthors": [ { "first_name": "Afrah", "middle_name": "A.", "last_name": "Ali", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Ashley", "middle_name": "", "last_name": "Crimmins", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Danya", "middle_name": "", "last_name": "Khoujah", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T07:55:36+11:00", "date_accepted": "2024-01-20T07:55:36+11:00", "date_published": "2024-01-20T07:57:08+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18733/galley/9459/download/" } ] }, { "pk": 18731, "title": "(O-E2) Buprenorphine Initiation for Opioid Use Disorder in the Emergency Department: Impact on Patient Outcomes in at a Community Hospital", "subtitle": null, "abstract": "n/a", "language": null, "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [], "section": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/26b85920", "frozenauthors": [ { "first_name": "Darien", "middle_name": "", "last_name": "Lee", "name_suffix": "", "institution": "", "department": "" }, { "first_name": "Nileena", "middle_name": "", "last_name": "Johnkutty", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Nikitha", "middle_name": "", "last_name": "Ashok", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Jibril", "middle_name": "Ahiru", "last_name": "Balogun", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Greg", "middle_name": "", "last_name": "Neyman", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Nicole", "middle_name": "", "last_name": "Maguire", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Vasallo", "name_suffix": "", "institution": "", "department": "" }, { "first_name": "Danielle", "middle_name": "", "last_name": "Biggs", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Hrant", "middle_name": "", "last_name": "Gevorgian", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T07:49:50+11:00", "date_accepted": "2024-01-20T07:49:50+11:00", "date_published": "2024-01-20T07:51:30+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18731/galley/9458/download/" } ] }, { "pk": 18730, "title": "(O-F7) Augmented Reality for Empathy Training: Stepping into the Patient’s Shoes", "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": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/36m5v8mh", "frozenauthors": [ { "first_name": "Alisa", "middle_name": "", "last_name": "Wray", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Aaron", "middle_name": "", "last_name": "Frank", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Melissa", "middle_name": "", "last_name": "Allison", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Clara", "middle_name": "", "last_name": "Riggle", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Ronnie", "middle_name": "", "last_name": "Rivera", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Ariana", "middle_name": "", "last_name": "Nelson", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T07:45:52+11:00", "date_accepted": "2024-01-20T07:45:52+11:00", "date_published": "2024-01-20T07:46:32+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18730/galley/9457/download/" } ] }, { "pk": 18729, "title": "(O-D4) Impact of an Electronic Format on the Completion of Evaluations of Medical Students in the Emergency Department", "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": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/84z0g8tp", "frozenauthors": [ { "first_name": "Joshua", "middle_name": "", "last_name": "Easter", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T07:42:42+11:00", "date_accepted": "2024-01-20T07:42:42+11:00", "date_published": "2024-01-20T07:43:16+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18729/galley/9456/download/" } ] }, { "pk": 18728, "title": "(O-G2) Laboratory Testing Is Indicated for Older but Not Younger Emergency Department Psychiatric Patients", "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": "Abstracts", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/95d5j67w", "frozenauthors": [ { "first_name": "Barnet", "middle_name": "", "last_name": "Eskin", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "John", "middle_name": "R.", "last_name": "Allegra", "name_suffix": "", "institution": "", "department": "None" }, { "first_name": "Marielle", "middle_name": "", "last_name": "Daclan", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2024-01-20T07:39:55+11:00", "date_accepted": "2024-01-20T07:39:55+11:00", "date_published": "2024-01-20T07:40:47+11:00", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/18728/galley/9455/download/" } ] } ] }