Article List
API Endpoint for journals.
GET /api/articles/?format=api&offset=700
{ "count": 39228, "next": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=800", "previous": "https://eartharxiv.org/api/articles/?format=api&limit=100&offset=600", "results": [ { "pk": 52975, "title": "Giving Voice to the Silenced: Teolinda Gersão on Martha Freud and the Power of Fiction ", "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": "Interview; Teolinda Gersão" }, { "word": "Autobiografia Não Escrita de Martha Freud" }, { "word": "gender" } ], "section": "Interviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1gg949s6", "frozenauthors": [ { "first_name": "Sandra", "middle_name": "", "last_name": "Sousa", "name_suffix": "", "institution": "Other", "department": "" } ], "date_submitted": "2025-09-29T17:19:47.267000Z", "date_accepted": "2025-10-01T01:57:45.480000Z", "date_published": "2026-01-08T16:34:08.990000Z", "render_galley": null, "galleys": [ { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/52975/galley/47877/download/" } ] }, { "pk": 20136, "title": "Pequeñas maniobras contra la censura: Religión y Revolución en la plástica cubana de los años 80 y 90.", "subtitle": null, "abstract": "<p>En 1961, dos años después del triunfo de la Revolución, Fidel Castro pronunció sus célebres palabras a los intelectuales en la Biblioteca Nacional de Cuba José Martí. En ese discurso, estableció la línea rectora que regiría la esfera pública cubana, donde el Estado controlaría todos los medios de difusión y permitiría únicamente expresiones y puntos de vista alineados con los revolucionarios. La frase de Castro, “Dentro la revolución todo, contra la revolución nada”, sin embargo, no fue suficiente y a lo largo del proceso de institucionalización de la Revolución otros dirigentes e intelectuales cubanos, partidarios del régimen, propusieron conceptos que respaldaban esta política y llevaron a cabo purgas contra aquellos que no las respetaban. Dos ejemplos son la declaración del Primer Congreso Nacional de Educación y Cultura celebrado en 1971 y el concepto de “diversionismo ideológico”, expresado primero por Raúl Castro en el juicio contra Aníbal Escalante (1909-1977) en 1968[1] y desarrollado después por el intelectual marxista José Antonio Portuondo (1911-1996). En este ensayo exploraré el desarrollo de este concepto en una ponencia de Raúl Castro y en otra de José Antonio Portuondo así como en las obras artísticas realizadas en Cuba entre mediados de 1980 y 1990 que hablan de la política y la religión. Me interesa subrayar no solo las directrices fundamentales de esta etiqueta ideológica, sino también las formas en que los escritores y artistas la subvirtieron. Para ello recurriré a las ideas de Bronislaw Baczko sobre el imaginario social, y la imposición (y distorsión) de los discursos del poder en cualquier sociedad y en las ideas de Michel Foucault sobre la biopolítica o el control que ejerce el Estado sobre los cuerpos con el objetivo de defender la sociedad. ¿Qué es el imaginario social? y ¿Cómo se desarrollan las prácticas simbólicas en esta generación?</p>\n<p> </p>", "language": "spa", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes 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": "Cuba" }, { "word": "Revolucion" }, { "word": "Martí" }, { "word": "Diversionismo" }, { "word": "Pintura" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/09n73342", "frozenauthors": [ { "first_name": "Jorge", "middle_name": "L", "last_name": "Camacho", "name_suffix": "", "institution": "University of South Carolina-Columbia", "department": "" } ], "date_submitted": "2024-11-02T18:22:36.244000Z", "date_accepted": "2025-07-14T08:25:26.491000Z", "date_published": "2026-01-08T16:21:44.880000Z", "render_galley": null, "galleys": [ { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/20136/galley/47876/download/" } ] }, { "pk": 38397, "title": "Ambivalent Identities in US-Mexico Border Literature: A Short Survey", "subtitle": null, "abstract": "<p>The essay introduces some of the main themes of Mexican American literature and suggests a connection with the phenomenology of the alien (Bernhard Waldenfels) and such resultant values as ambivalence and hybridity. This frame of reference allows a brief exploration of specific topics present in several US-Mexico border authors, including Rubén Martínez and the “zigzagging” consciousness of border life, Gloria Anzaldúa and the values of hybridity and indigenous ancestry, Tomás Rivera and intra-cultural conflict, Lucha Corpi and the clash between ideology and history, and Richard Rodriguez’ problems of assimilation and familial contradictions.</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": "US-Mexico Border" }, { "word": "Mexican American Literature" }, { "word": "Gloria Anzaldúa" }, { "word": "Phenomenology of the Alien" }, { "word": "Intra-Cultural Conflict" }, { "word": "assimilation" }, { "word": "Rubén Martínez" }, { "word": "Richard Rodriguez" }, { "word": "Tomás Rivera" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6d12m2gv", "frozenauthors": [ { "first_name": "Eduardo", "middle_name": "", "last_name": "Ruiz", "name_suffix": "", "institution": "Other", "department": "" } ], "date_submitted": "2024-10-23T01:09:44.879000Z", "date_accepted": "2025-05-31T02:54:57.552000Z", "date_published": "2026-01-08T16:20:08.841000Z", "render_galley": null, "galleys": [ { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/38397/galley/47875/download/" } ] }, { "pk": 48515, "title": "Against Extinction: Space Nomads and Ancestral Futures in <em>Ximan Poteh: contos dos futuros puri</em> (2021)", "subtitle": null, "abstract": "<p>Indigenous futurisms is a growing genre throughout Abiayala, from short fiction, novels, and film to visual art, music, and comics. This essay focuses on a 44-page collection of short stories by Puri author André da Silva Muniz. <em>Ximan Poteh: contos dos futuros puri </em>(2021) imagines a future universe where First Nations like the Puri engage in space exploration, planetary worldbuilding, and interstellar diplomacy based on traditional communal practices. Placing Muniz<!-- x-tinymce/html -->’s approach in dialogue with the broader context of ancestral futures in Brazil and Indigenous futurisms throughout the hemisphere, I consider how he subverts the myth of the vanishing Indian by projecting his people into the distant future as a radical affirmation of presence.</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": "Indigenous futurisms" }, { "word": "ancestral futures" }, { "word": "extinction" }, { "word": "ethnogenesis" }, { "word": "Science Fiction" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7tv1883m", "frozenauthors": [ { "first_name": "Hannah", "middle_name": "", "last_name": "Burdette", "name_suffix": "", "institution": "California State University, Chico", "department": "Languages and Cultures" } ], "date_submitted": "2025-06-10T23:18:37.716000Z", "date_accepted": "2025-10-16T03:21:49.156000Z", "date_published": "2026-01-08T16:18:22.584000Z", "render_galley": null, "galleys": [ { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/48515/galley/47874/download/" } ] }, { "pk": 47031, "title": "\n\nProteger el cuerpo de la nación: Discursos sobre la salud en los textos de viajeros chilenos a la República Popular China\n", "subtitle": null, "abstract": "<p>Este artículo examina las narrativas de viajeros chilenos que visitaron la República Popular China en las décadas de 1950 y 1960, animados por su compromiso social y el deseo de presenciar de cerca la transformación del “enfermo de Asia” en una nueva nación socialista. Específicamente, sostengo que este diverso corpus narrativo ancla su interpretación de la \"Nueva China\" en un lenguaje de salud y medicina, tanto literal como metafórico, en ciertos casos para celebrar los logros del Estado en la creación de un cuerpo social sano y feliz, y en otros, para plantear dudas e inquietudes sobre su naturaleza vigilante e inmunológica. Este artículo sostiene que una lectura biopolítica de las obras de Olga Poblete, Alfonso González Dagnino, Francisco Coloane y Mercedes Valdivieso sobre su tiempo en la República Popular permite conceptualizar el impacto que China tuvo para ellos en la formulación, y las limitaciones, de futuros políticos alternativos durante la guerra fría global.</p>", "language": "spa", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes 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": "Guerra fría global" }, { "word": " Chile" }, { "word": " República Popular China" }, { "word": " narrativa de viaje" }, { "word": " biopolítica" }, { "word": "Chile" }, { "word": "República Popular China" }, { "word": "narrativa de viaje" }, { "word": "Biopolítica" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6b25v407", "frozenauthors": [ { "first_name": "José", "middle_name": "", "last_name": "Chávarry", "name_suffix": "", "institution": "College of Charleston", "department": "Hispanic Studies" } ], "date_submitted": "2025-03-15T23:11:41.636000Z", "date_accepted": "2025-07-20T07:20:59.881000Z", "date_published": "2026-01-08T16:16:20.644000Z", "render_galley": null, "galleys": [ { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/47031/galley/47873/download/" } ] }, { "pk": 46576, "title": "Infraestructuras de imperio: La integración mexicana-estadounidense y el (anti)liberalismo en las crónicas de viajes mexicanas, 1876-1898", "subtitle": null, "abstract": "<p>(English) This article considers late 19th-century U.S.-Mexican integration through the travel chronicles of two writers of Mexico’s political elite, <em>Viaje a los Estados Unidos</em> (1877) by Guillermo Prieto and <em>En Tierra Yankee</em> (1898) by Justo Sierra, with attention to their analysis of the infrastructures and built environment that sustained US imperial expansion. Critics have conventionally analyzed Latin American travel literature in relation to discourses of national identity, nation-building, the European colonial gaze, or the autobiographical “I” (el “yo autobiográfico”). By contrast, this study follows the “infrastructural turn” in cultural studies and Raymond William’s concept of “structures of feeling” to focus on the writers’ attention to ports, ships, railroads, telegraphs, newspapers, and cityscapes as instruments of colonial and racial administration of the conquered Native and Mexican populations. These writers examined the material roots of the continental transition from the Hispanic Empire’s northern frontier to the American West, in part to offer an alternative to racialized narratives of Anglo-Saxon superiority. While Prieto grounds his critique of U.S. imperial expansion in his fading vision of republican nationalism, Sierra fervently denounces U.S.-style capitalism and imperial expansion in the Caribbean through an emerging discourse of pan-Hispanism. </p>", "language": "spa", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes 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": "travel literature" }, { "word": "19th-century Mexican literature" }, { "word": "Infrastructure" }, { "word": "U.S. Empire" }, { "word": "Race/racism" }, { "word": "Mexican liberalism" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9x06c579", "frozenauthors": [ { "first_name": "Jason", "middle_name": "", "last_name": "Ahlenius", "name_suffix": "", "institution": "Vanderbilt University", "department": "Center for Latin American, Caribbean, and Latinx Studies" } ], "date_submitted": "2025-03-10T19:25:54.022000Z", "date_accepted": "2025-09-11T02:22:36.476000Z", "date_published": "2026-01-08T16:12:17.698000Z", "render_galley": null, "galleys": [ { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/46576/galley/47872/download/" } ] }, { "pk": 41520, "title": "Conflictos en la traducción y accesibilidad de dos lenguas indígenas: el quechua de Perú y el náhuatl de México", "subtitle": null, "abstract": "<p>En el marco de la inclusión del náhuatl al traductor de Google, el presente trabajo analiza comparativamente los desafíos de la traducción que enfrentan el náhuatl en México y el quechua en Perú. A tal fin se evalúan los siguientes factores que conforman el paradigma sociolingüístico de dichas lenguas: su estatus social, el papel de los traductores, las limitaciones de las ideologías lingüísticas y la accesibilidad a herramientas tecnológicas. Este artículo muestra que el desplazamiento histórico de estas lenguas las sitúa en una posición doblemente vulnerable en la que la tecnología y los derechos lingüísticos juegan un rol fundamental en su preservación y, paralelamente, en la que algunas de sus ideologías culturales en cuanto a las reglas lingüísticas crean una barrera en la traducción que complica el papel de los traductores. Se comprueba, a modo de conclusión que, aunque el papel de la traducción de lenguas indígenas ha evolucionado e impulsado el apoyo del reconocimiento sociolingüístico de estas lenguas, aún existen muchas trabas que impiden su progreso y estudio. Para intentar resolver dichos conflictos, es necesario un compromiso social y político que impulse a la estandarización de estas lenguas respetando las culturas indígenas, para así crear herramientas tecnológicas adecuadas para sus traducciones.</p>", "language": "spa", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes 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": "lenguas indígenas" }, { "word": "Quechua" }, { "word": "nahuatl" }, { "word": "Traducción" }, { "word": "intérpretes" }, { "word": "conflictos traducción" }, { "word": "ideologías lingüísticas" }, { "word": "traductor" }, { "word": "preservación de lenguas indígenas" }, { "word": "derechos lingüísticos" }, { "word": "español" }, { "word": "desplazamiento histórico" }, { "word": "Derechos Indigenas" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9v28p799", "frozenauthors": [ { "first_name": "Merci", "middle_name": "", "last_name": "Silva-Acosta", "name_suffix": "", "institution": "University Of Nevada - Las Vegas", "department": "World Languages and Cultures" } ], "date_submitted": "2024-12-20T04:15:00.692000Z", "date_accepted": "2025-10-14T01:23:36.108000Z", "date_published": "2026-01-08T16:06:13.672000Z", "render_galley": null, "galleys": [ { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/41520/galley/47871/download/" } ] }, { "pk": 40014, "title": "Troubled Affinities: Feminist Reading of Intercolonial Relations in Emilio Díaz Valcárcel’s Puerto Rican Narratives of the Korean War ", "subtitle": null, "abstract": "<p>This article examines the representation of intercolonial relations between Puerto Rican soldiers and Koreans during the Korean War in Emilio Díaz Valcárcel’s “Andrés” (1956) and “El soldado Damián Sánchez” (1955) from a feminist perspective. Moving beyond interpretations that frame Puerto Rican military participation in the Korean War solely as a reconfiguration of colonial relations between Puerto Rico and the U.S., it considers the war as an intercolonial space where Puerto Ricans and Koreans, differently colonized peoples under U.S. militarism, encounter each other. Focusing on the militarized sexual dynamics of occupied Korea, the article demonstrates how intercolonial relations in Díaz Valcárcel’s stories emerge as troubled affinities that, despite interpersonal and geopolitical resonances among the colonized under transnational U.S. militarism, ultimately reproduce imperial sexual violence toward women from occupied territories. Through an intercolonial and feminist approach that attends to multiple power dynamics within an imperial enterprise, the article highlights the complex positionality of colonized soldiers within the intersecting racist and patriarchal structures of imperial power.</p>\n<p> </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": "The Korean War" }, { "word": "Emilio Díaz Valcárcel" }, { "word": "Intercolonial" }, { "word": "Puerto Rican Literature" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1xz0v7hk", "frozenauthors": [ { "first_name": "Yeongju", "middle_name": "", "last_name": "Lee", "name_suffix": "", "institution": "Smith College", "department": "Spanish and Portuguese" } ], "date_submitted": "2024-11-26T19:08:21.686000Z", "date_accepted": "2025-10-09T08:49:53.582000Z", "date_published": "2026-01-08T16:04:04.833000Z", "render_galley": null, "galleys": [ { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/40014/galley/47870/download/" } ] }, { "pk": 39686, "title": "La materialización del deseo: biopolítica y transnacionalidad en dos ensayos de Octavio Paz", "subtitle": null, "abstract": "<p>Este estudio se enfoca en dos ensayos de Octavio Paz a través de un acercamiento biopolítico como el que propone Christopher Breu. En “El Pachuco y otros extremos” (1950), y “Posiciones y contraposiciones: México y Estados Unidos” (1983), reflexiono sobre la distancia existente entre la realidad/materialidad biológica del cuerpo humano y la realidad/inmaterialidad del cuerpo político que el Estado neoliberal ejerce para mantener su hegemonía. Aquí propongo analizar la materialización del lenguaje simbólico que Paz articuló para aproximarse a la “identidad mexicana” dentro de un contexto trasnacional y de relaciones históricas y culturales entre México y los Estados Unidos.</p>", "language": "spa", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes 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": "Biopolítica" }, { "word": " Materialidad" }, { "word": " Inmaterialidad" }, { "word": " Neoliberalismo" }, { "word": " Postmexicanidad" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7ps2f4gv", "frozenauthors": [ { "first_name": "José", "middle_name": "Clemente", "last_name": "Carreño Medina", "name_suffix": "", "institution": "Truman State University", "department": "Langauges & Linguistics" } ], "date_submitted": "2024-11-05T03:43:40.970000Z", "date_accepted": "2025-12-03T10:55:30.907000Z", "date_published": "2026-01-08T16:01:13.490000Z", "render_galley": null, "galleys": [ { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/39686/galley/47869/download/" } ] }, { "pk": 35387, "title": "La Marcha Verde en <em>El invierno de los jilgueros </em>(2022) de Mohamed El Morabet: el sigilio de un acontecimiento colectivo con repercusiones individuales", "subtitle": null, "abstract": "<p>El objetivo de esta investigación es examinar la novela El invierno de los jilgueros (2022) de Mohamed El Morabet desde una perspectiva psico- temática inspirada en la filosofía de Heidegger. Nos sumergimos en las páginas de esta Bildungsroman con una metodología que desentraña el concepto heideggeriano del Sorge, que va más allá del simple \"cuidado de sí mismo\", abarcando el \"cuidado de\" y el \"velar por\" otros. A través de un minucioso análisis textual, exploramos cómo este concepto se manifiesta en la caracterización de Brahim, el protagonista, a lo largo de su viaje de formación del héroe, en sintonía con la noción del \"héroe formandí\" de Goethe. Descubrimos cómo este personaje llega a entender su papel en la sociedad a través del prisma del \"cuidado\". Este descubrimiento no solo arroja luz sobre la complejidad de la narrativa, sino que también nos invita a reflexionar sobre la importancia del contexto social, histórico y cultural en la formación de la identidad individual.</p>", "language": "spa", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes 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": "El invierno de los jilgueros- Bildungsroman- cuidado - Marcha Verde" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7ch390jd", "frozenauthors": [ { "first_name": "Sahar", "middle_name": "", "last_name": "Ouafqa", "name_suffix": "", "institution": "University Hassan II of Casablanca", "department": "Department of Spanish" } ], "date_submitted": "2024-09-09T14:45:37.487000Z", "date_accepted": "2025-02-13T00:58:32.967000Z", "date_published": "2026-01-08T15:57:39.005000Z", "render_galley": { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/35387/galley/47868/download/" }, "galleys": [ { "label": "By Cristián", "type": "pdf", "path": "https://journalpub.escholarship.org/transmodernity/article/35387/galley/47868/download/" } ] }, { "pk": 48835, "title": "Racial Disparities in Door-to-Clinician Time for Cardiac Chest Pain in the Emergency Department", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> Timely evaluation in the emergency department (ED) is critical for patients with cardiac chest pain. Although racial disparities in ED wait times have been reported, few studies have focused specifically on cardiac-related presentations. In this study we assessed racial and ethnic disparities in ED door-to-clinician time for cardiac chest pain.</p>\n<p><strong>Methods:</strong> We conducted a retrospective analysis of adult ED visits for cardiac chest pain (2019–2025) at a tertiary-care academic hospital. Patients ≥ 18 years of age were included. Race/ethnicity was categorized as White, Hispanic/Latino, Black, Native American, Asian, or other/unknown. Multivariable generalized linear modeling assessed the association between race/ethnicity and door-to-clinician time, adjusting for demographics and clinical variables. </p>\n<p><strong>Results:</strong> The study included 3,925 patients. The overall median door-to-clinician time was 15.9 minutes (interquartile range 8.0-36.0). In unadjusted bivariate analyses, significant differences were observed across racial and ethnic groups (P < .001). Native American patients experienced the longest delays (23.8 minutes [13.9-49.8]), followed by Asian (18.6 minutes [8.4-36.5]) and Hispanic/Latino patients (17.1 minutes [9.3-43.7]). In contrast, White and Black patients had shorter median wait times of 14.9 minutes [7.1-33.9] and 15.0 minutes [8.8-38.7], respectively. After adjustment for age, sex, triage acuity, clinician type, and initial vital signs, Hispanic/Latino patients waited 18.2 minutes vs 14.9 minutes for White patients (absolute +3.3 minutes; 22% longer; relative risk 1.22, 95% CI, 1.09-1.36, P < .001). Adjusted times were also higher for Black (16.5 minutes), Native American (17.7 minutes), and Asian patients (15.1 minutes), but differences were not statistically significant. </p>\n<p><strong>Conclusion:</strong> Hispanic/Latino patients with cardiac chest pain experienced a 22% longer ED wait time than White patients. Our findings highlight the need for targeted interventions and multisite research to ensure equitable, timely care for all patients with acute cardiac conditions.</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": "racial disparities" }, { "word": "health equity" }, { "word": "emergency department" }, { "word": "chest pain" }, { "word": "wait times" } ], "section": "Health Equity", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4mt5g404", "frozenauthors": [ { "first_name": "Emad", "middle_name": "", "last_name": "Awad", "name_suffix": "", "institution": "University of Utah, School of Medicine, Department of Emergency Medicine, Salt Lake City, Utah", "department": "" }, { "first_name": "Shilpa", "middle_name": "", "last_name": "Raju", "name_suffix": "", "institution": "University of Utah, School of Medicine, Department of Emergency Medicine, Salt Lake City, Utah", "department": "" }, { "first_name": "Hesham", "middle_name": "", "last_name": "Alsayyed", "name_suffix": "", "institution": "Walden University, College of Nursing, Minneapolis, Minnesota", "department": "" }, { "first_name": "Ramsey", "middle_name": "", "last_name": "Issa", "name_suffix": "", "institution": "University of Utah, Department of Materials Science and Engineering, Salt Lake City, Utah", "department": "" }, { "first_name": "Jeffrey", "middle_name": "", "last_name": "Druck", "name_suffix": "", "institution": "University of Utah, School of Medicine, Department of Emergency Medicine, Salt Lake City, Utah", "department": "" } ], "date_submitted": "2025-06-27T17:20:37.895000Z", "date_accepted": "2025-10-04T21:08:49.432000Z", "date_published": "2026-01-07T15:04:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/48835/galley/47900/download/" } ] }, { "pk": 48963, "title": "Mirror, Mirror on the Wall: Preventing Shadow Boxing through Habituation - A Pilot Study", "subtitle": null, "abstract": "<p>Shadow boxing is the aggressive response of an animal to its reflection. When the species is strong enough to break surfaces (e.g., bear, monkey, woodpecker), this behaviour can lead to human-wildlife conflicts. In this pilot study, we assessed whether shadow boxing is subject to habituation (learning to ignore stimuli) in Southern ground-hornbills (Bucorvus leadbeateri). In the Mirror task, birds were repeatedly exposed to unbreakable mirrors (habituation). Subsequently, one mirror was presented at a different location (test). In the Neophobia task, a food reward was placed next to novel objects. Ground-hornbills did not habituate to the mirrors, but they differed in their levels of neophobia. </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": "ground-hornbill" }, { "word": "Habituation" }, { "word": "human-wildlife conflict" }, { "word": "learning-conservation interface" }, { "word": "learning" }, { "word": "Neophobia" }, { "word": "shadow boxing" } ], "section": "Brief Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/68c9q9hq", "frozenauthors": [ { "first_name": "Sharline", "middle_name": "", "last_name": "Cully", "name_suffix": "", "institution": "University of Liege", "department": "" }, { "first_name": "Nancy", "middle_name": "", "last_name": "Rebout", "name_suffix": "", "institution": "", "department": "" }, { "first_name": "Lucy", "middle_name": "", "last_name": "Kemp", "name_suffix": "", "institution": "Mabula Ground Hornbill Project", "department": "" }, { "first_name": "Samara", "middle_name": "", "last_name": "Danel", "name_suffix": "", "institution": "Other", "department": "" } ], "date_submitted": "2025-07-11T08:42:17.198000Z", "date_accepted": "2025-10-16T02:44:39.653000Z", "date_published": "2026-01-06T17:07:00Z", "render_galley": { "label": "Danel_final", "type": "pdf", "path": "https://journalpub.escholarship.org/uclapsych_ijcp/article/48963/galley/47848/download/" }, "galleys": [ { "label": "Danel_final", "type": "pdf", "path": "https://journalpub.escholarship.org/uclapsych_ijcp/article/48963/galley/47848/download/" } ] }, { "pk": 47307, "title": "A Case Report of Acute Lymphoblastic Leukemia Presenting as Bilateral Knee Pain in a Healthy Runner", "subtitle": null, "abstract": "<p><strong>Introduction</strong>: Acute lymphoblastic leukemia (ALL) is typically a childhood disease but may present in older patients in rare occurrences. Due to its significant morbidity and mortality, early diagnosis is crucial. The symptoms of ALL may be non-specific, making the initial diagnosis difficult leading to delayed treatment.</p>\n<p><strong>Case Report: </strong>We present the case of a 34-year-old, healthy male runner presenting to the emergency department with a common complaint of bilateral knee pain, who was ultimately diagnosed with ALL with signs of tumor lysis syndrome leading to premature death.</p>\n<p><strong>Conclusion</strong>: We discuss the presenting symptoms of acute lymphoblastic leukemia, which may include joint or knee pain as well as leukemic arthritis. We further discuss the importance of clinicians maintaining a high level of suspicion for the “bounce-back” patient and avoiding taking cognitive shortcuts.</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": "knee pain" }, { "word": "acute lymphocytic leukemia" }, { "word": "tumor lysis syndrome" }, { "word": "spontaneous intracranial hemorrhage" }, { "word": "Critical care" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7jx7d00h", "frozenauthors": [ { "first_name": "Michael", "middle_name": "", "last_name": "Rosselli", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida", "department": "" }, { "first_name": "Alejandro", "middle_name": "Jesus", "last_name": "Sanoja", "name_suffix": "", "institution": "University of Florida, Department of Emergency Medicine, Gainesville, Florida", "department": "" }, { "first_name": "Matthew", "middle_name": "", "last_name": "Apicella", "name_suffix": "", "institution": "Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida", "department": "" } ], "date_submitted": "2025-04-26T14:01:58.312000Z", "date_accepted": "2025-08-27T19:56:35.229000Z", "date_published": "2026-01-06T07:38:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/47307/galley/48085/download/" } ] }, { "pk": 49096, "title": "Acute Aortic Dissection Masquerading as Testicular Torsion: A Case Report", "subtitle": null, "abstract": "<p><strong>Introduction</strong>: Aortic dissection is a rare but life-threatening condition with a high mortality rate if diagnosis is delayed. Aortic dissection classically presents with sudden-onset, sharp pain in the chest or back. However, atypical presentations can also occur, which could lead to a delay in diagnosis.</p>\n<p><strong>Case Report: </strong>A patient initially presented to the emergency department (ED) with left testicular pain ongoing for several hours. On examination, he had tenderness in the left lower quadrant abdomen and left testicle. A testicular ultrasound revealed decreased blood flow to the left testicle, raising concern for testicular torsion. The patient was taken to the operating room, where no torsion was found, and he was subsequently discharged home. Several days later, the patient returned to the ED with worsening pain radiating to the back. A computed tomography revealed an acute type A aortic dissection extending to the iliac arteries. He was transferred for surgical repair and discharged 12 days later.</p>\n<p><strong>Conclusion</strong>: While acute aortic dissection (AAD) typically presents with chest or back pain, atypical presentations can occur. When initial findings do not fully explain a patient’s symptoms, AAD should remain on the differential. This case highlights an uncommon presentation of AAD initially mimicking a testicular torsion.</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": "Aortic Dissection" }, { "word": "Testicular torsion" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/12q6f8hs", "frozenauthors": [ { "first_name": "Bruce", "middle_name": "M", "last_name": "Lo", "name_suffix": "", "institution": "Sentara Norfolk General Hospital/Eastern Virginia Medical School at Old Dominion University, Department of Emergency Medicine, Norfolk, Virginia", "department": "" }, { "first_name": "Megyn", "middle_name": "K", "last_name": "Christensen", "name_suffix": "", "institution": "Eastern Virginia Medical School at Old Dominion University, Department of Emergency Medicine, Norfolk, Virginia", "department": "" }, { "first_name": "Coral", "middle_name": "E", "last_name": "Byrns", "name_suffix": "", "institution": "Eastern Virginia Medical School at Old Dominion University, Department of Emergency Medicine, Norfolk, Virginia", "department": "" }, { "first_name": "Benjamin", "middle_name": "", "last_name": "Chidester", "name_suffix": "", "institution": "Sentara Norfolk General Hospital/Eastern Virginia Medical School at Old Dominion University, Department of Emergency Medicine, Norfolk, Virginia", "department": "" } ], "date_submitted": "2025-07-23T04:01:14.369000Z", "date_accepted": "2025-09-16T00:20:17.372000Z", "date_published": "2026-01-06T07:31:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/49096/galley/48087/download/" } ] }, { "pk": 40087, "title": "Diagnosis of Bilateral Quadriceps Tendon Rupture using Point-of-Care Ultrasound", "subtitle": null, "abstract": "<p><strong>Case Presentation: </strong>A healthy 32-year-old man presented to the emergency department with bilateral knee pain after landing from a jump. He was unable to extend his knees and had pain to palpation superior to the patella. Bilateral quadriceps tendon rupture was confirmed using point-of-care ultrasound, and the patient underwent operative repair the next day.</p>\n<p><strong>Discussion</strong>: Bilateral quadriceps tendon rupture is exceedingly rare, which often leads to misdiagnosis. Magnetic resonance imaging is the gold standard diagnostic imaging study but has multiple disadvantages, especially in emergency settings. Point-of-care ultrasound is an excellent tool to screen for this injury and prevent morbidity from delay in surgical repair.</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": "bilateral quadriceps tendon rupture" }, { "word": "case report" }, { "word": "point-of-care ultrasound" } ], "section": "Images in Emergency Medicine", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/10r9605c", "frozenauthors": [ { "first_name": "Edward", "middle_name": "", "last_name": "Guo", "name_suffix": "", "institution": "Jefferson Health Northeast, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Akaysha", "middle_name": "", "last_name": "Duran", "name_suffix": "", "institution": "University of Pittsburgh Medical Center (UPMC) Memorial, Department of Emergency Medicine, York, Pennsylvania", "department": "" }, { "first_name": "Alexander", "middle_name": "", "last_name": "Kuc", "name_suffix": "", "institution": "Cooper University Health Care, Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey", "department": "Cooper University Health Care, Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey" }, { "first_name": "Alfred", "middle_name": "", "last_name": "Cheng", "name_suffix": "", "institution": "Cooper University Health Care, Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey", "department": "" } ], "date_submitted": "2025-06-07T14:38:55.569000Z", "date_accepted": "2025-09-10T20:21:23.791000Z", "date_published": "2026-01-06T07:20:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/40087/galley/48098/download/" } ] }, { "pk": 48651, "title": "Simulation Curriculum Improves Emergency Medicine Resident Preparedness for the New American Board of Emergency Medicine Certifying Exam", "subtitle": null, "abstract": "<p><strong>Introduction: </strong>In 2024, the American Board of Emergency Medicine (ABEM) announced the launch of a new certifying exam that emergency medicine (EM) residency graduates must pass to achieve specialty certification. To date, there are no comprehensive curricula published in the available literature to aid residents in exam preparation.</p>\n<p><strong>Methods: </strong>In this pre-post pilot study, 44% (24/55) of postgraduate year 1 (PGY-1) through PGY-4 EM residents at a single site participated in a four-hour simulated certifying exam curriculum. Learners were asked to complete a four-point Likert scale survey rating self-reported preparedness (very unlikely – very likely) to take the ABEM Certifying Exam, as well as comfort with the ABEM tested competencies, preceding and following the simulation session.</p>\n<p><strong>Results: </strong>Survey respondents (n = 21; 87.5%) reported an improvement in overall preparedness to take the ABEM Certifying Exam, yielding a pre-post mean difference score of +1.2 (1.9 [unlikely] pre to 3.1 [likely] post, P < .001). Additionally, there was an improvement in all ABEM-tested competencies; pre-post mean difference score ranged from +0.5 (3.0 pre to 3.5 post) for patient-centered communication to +1.1 (2.2 pre to 3.3 post) for clinical decision-making (P < .001 for all competencies).</p>\n<p><strong>Conclusion:</strong> Given the critical need, and self-reported improvement in preparedness, EM training programs nationwide could consider incorporating a similar simulation curriculum into their didactic experience to help better prepare their learners for the new ABEM Certifying Exam. </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": "Simulation" }, { "word": "Exam Preparation" }, { "word": "emergency medicine boards" }, { "word": "ABEM" }, { "word": "Certifying Exam" }, { "word": "Peer Roleplay" }, { "word": "Medical Simulation" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3gd2g1c7", "frozenauthors": [ { "first_name": "Ian", "middle_name": "", "last_name": "Batson", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Chinezimuzo", "middle_name": "", "last_name": "Ihenatu", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Frances", "middle_name": "", "last_name": "Shofer", "name_suffix": "", "institution": "University of Pennsylvania, Department of Epidemiology and Biostatistics, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Matthew", "middle_name": "", "last_name": "Magda", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Michael", "middle_name": "E", "last_name": "Abboud", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Lauren", "middle_name": "", "last_name": "Conlon", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Suzana", "middle_name": "", "last_name": "Tsao", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Mira", "middle_name": "", "last_name": "Mamtani", "name_suffix": "", "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" } ], "date_submitted": "2025-06-17T01:16:59.430000Z", "date_accepted": "2025-10-01T01:56:53.941000Z", "date_published": "2026-01-04T02:23:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/48651/galley/47903/download/" } ] }, { "pk": 48788, "title": "Impact of Alcohol Intoxication on Mortality and Emergency Department Resource Use in Suicidal Patients", "subtitle": null, "abstract": "<p><strong>Introduction: </strong>In North America, suicide ranks among the top causes of death in individuals 15-60 years of age. In this study we aimed to determine whether an emergency department (ED) presentation for suicidal behaviors accompanied by acute alcohol intoxication was associated with increased six-month suicide or all-cause mortality compared to non-intoxicated presentations of suicidal behaviors.</p>\n<p><strong>Methods:</strong> We performed a retrospective cohort study of adults (≥ 18 years) presenting to 16 EDs in Alberta, Canada, between April 2011–March 2021. Suicidal attempt or self-harm was identified via International Classification of Diseases codes, 10th Rev, Canadian Enhancement (ICD-10-CA). Patients were classified as acutely intoxicated if they had relevant ICD-10-CA codes or a blood alcohol concentration ≥ 2 millimoles per liter (9.2 milligrams per deciliter). We excluded patients who died on arrival, were transferred, or were non-residents. The primary outcome was suicide-specific mortality at six months; secondary outcomes included all-cause mortality, use of involuntary holds, psychiatric consultations, admissions, and ED return visits. Median differences with 95% confidence intervals and unadjusted odds ratio (OR) with 95% CI were reported for continuous and categorical variables, respectively. </p>\n<p><strong>Results:</strong> Among 58,051 suicidal or self-harm patients, 17,488 (30%) were classified as intoxicated. Six-month suicide mortality was similar between intoxicated and non-intoxicated groups (0.3% each; adjusted sub-distribution hazard ratio = 0.98 [95% CI, 0.73-1.38]), indicating no significant association between alcohol intoxication and suicide-specific death. Intoxicated patients were more often male (58% vs 52%; OR 1.26 [1.22-1.31]), arrived by ambulance (70% vs 50%; OR 2.32 [2.23-2.41]), and were more frequently placed on involuntary holds (26% vs 16%; OR 1.92 [1.83-2.00]). They had fewer hospital admissions (10.8% vs 15.4%; OR 0.63 [0.60-0.67]), longer ED stays (411 vs 277 minutes; median difference = 134 minutes [127.7-140.3]), and higher ED return rates at 30 days (19.8% vs 18.3%; OR 1.10 [1.05-1.15]) and six months (45.8% vs 42.1%; OR 1.16 [1.12-1.20]).</p>\n<p><strong>Conclusion:</strong> Acute alcohol intoxication among ED patients presenting with suicidal behaviors was not independently associated with higher six-month suicide mortality. Patients with acute alcohol intoxication had increased use of involuntary holds, longer lengths of stay, and more frequent ED return visits. Future work should explore other psychosocial and clinical factors, including substance use and psychiatric comorbidities, that may influence outcomes beyond the acute setting. </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": "suicidality" }, { "word": "Alcohol intoxication" }, { "word": "suicide mortality" } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5v13297m", "frozenauthors": [ { "first_name": "Kevin", "middle_name": "", "last_name": "Skoblenick", "name_suffix": "", "institution": "University of Alberta, Department of Emergency Medicine, Edmonton, Alberta, Canada; University of Alberta, Department of Psychiatry, Edmonton, Alberta, Canada; University of Alberta, Neuroscience and Mental Health Institute, Edmonton, Alberta, Canada", "department": "" }, { "first_name": "Esther", "middle_name": "", "last_name": "Yang", "name_suffix": "", "institution": "University of Alberta, Department of Emergency Medicine, Edmonton, Alberta, Canada; Alberta SPOR SUPPORT Unit, Data and Research Services, Edmonton, Alberta, Canada; Alberta Health Services, Provincial Research Data Services, Edmonton, Alberta, Canada", "department": "" }, { "first_name": "Michael", "middle_name": "P.", "last_name": "Wilson", "name_suffix": "", "institution": "Virginia Tech Carilion School of Medicine, Department of Emergency Medicine, Roanoke, Virginia; Virginia Tech Carilion School of Medicine, Department of Psychiatry, Roanoke, Virginia", "department": "" }, { "first_name": "Erik", "middle_name": "", "last_name": "Youngson", "name_suffix": "", "institution": "Alberta SPOR SUPPORT Unit, Data and Research Services, Edmonton, Alberta, Canada; Alberta Health Services, Provincial Research Data Services, Edmonton, Alberta, Canada", "department": "" }, { "first_name": "Brian", "middle_name": "H.", "last_name": "Rowe", "name_suffix": "", "institution": "University of Alberta, Department of Emergency Medicine, Edmonton, Alberta, Canada; University of Alberta, Neuroscience and Mental Health Institute, Edmonton, Alberta, Canada; University of Alberta, School of Public Health, Edmonton, Alberta, Canada", "department": "" } ], "date_submitted": "2025-06-24T20:07:55.236000Z", "date_accepted": "2025-10-28T15:23:49.775000Z", "date_published": "2026-01-04T02:06:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/48788/galley/47911/download/" } ] }, { "pk": 48847, "title": "Improving Standardization and Access to Care via Seizure Pathways in the Emergency Department", "subtitle": null, "abstract": "<p><strong>Introduction: </strong>Seizures are one of the most common neurological presentations to an emergency department (ED), often as a first seizure of life or a breakthrough seizure. There is practice variation regarding the diagnostic workup and management for these patient populations. A standardized pathway for emergent evaluation of first seizure of life or breakthrough seizure currently does not exist, resulting in variability in evaluation and timing of outpatient care.</p>\n<p><strong>Methods: </strong>We created standardized pathways for evaluation and management of patients presenting to the ED with a first seizure of life or breakthrough seizure. These pathways, implemented at a large, quaternary-care hospital system, were utilized on 130 patients presenting with a seizure and compared with all patients with seizure on whom the pathway was not used, between May 2022–October 2023. Outcomes of interest included ED length of stay (LOS), proportion of patients admitted, time to outpatient follow-up, and difference in resource utilization. We compared categorical variables using chi-square test and continuous variables using the Wilcoxon rank-sum test. Equality of variance between the two cohorts was tested using the Levene test.</p>\n<p><strong>Results:</strong> There was no statistically significant difference between the percentage of male and female patients evaluated via standard-of-care model (45.6% and 49.5%) and those on the pathway (56.9% and 43.1%). The average age of patients was similar between standard-of-care and pathway groups (41 and 39 years, respectively). Median ED LOS was 5.0 (Interquartile range [IQR] 2.9-9.4) hours for standard of care and 4.8 (IQR 3.1-7.0) hours for pathway (P = .34), with a significant difference in variability in time for pathway group (P < .001). Fewer patients were admitted or observed with pathway use (P < .02). Median time to outpatient follow-up was 41.0 days (IQR 17.0-93.0) with standard of care and 23.5 days (IQR 8.0-57.0) with pathway use (P < .001). More urinalyses (P < .001), drug screens (P < .001), alcohol levels (P < .001) and computed tomography for first seizures (P < .001) were ordered for the pathway group. Fewer magnetic resonance imaging studies were ordered for patients in the breakthrough seizures group using the pathway (P < .001).</p>\n<p><strong>Conclusion:</strong> Standardized pathways to approach seizure presentation in the ED can reduce variability in care, improve time to outpatient neurologic care, and standardize seizure-safety counseling. </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": [], "section": "Neurology", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9q58t2nq", "frozenauthors": [ { "first_name": "Brian", "middle_name": "E.", "last_name": "Emmert", "name_suffix": "", "institution": "Columbia University, Vagelos College of Physicians and Surgeons, Department of Neurology, Division of Epilepsy, New York, New York", "department": "" }, { "first_name": "Cody", "middle_name": "L.", "last_name": "Nathan", "name_suffix": "", "institution": "Northwestern Memorial Hospital, Department of Neurology, Division of Epilepsy, Chicago, Illinois", "department": "" }, { "first_name": "James", "middle_name": "J.", "last_name": "Gugger", "name_suffix": "", "institution": "University of Rochester, Department of Neurology, Rochester, New York", "department": "" }, { "first_name": "Kathryn", "middle_name": "A", "last_name": "Davis", "name_suffix": "", "institution": "Perelman School of Medicine at the University of Pennsylvania, Department of Neurology, Division of Epilepsy, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Margaret", "middle_name": "", "last_name": "Provencher", "name_suffix": "", "institution": "Perelman School of Medicine at the University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Laura", "middle_name": "A.", "last_name": "Stein", "name_suffix": "", "institution": "Perelman School of Medicine at the University of Pennsylvania, Department of Neurology, Neurohospitalist Division, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Keith", "middle_name": "C.", "last_name": "Hemmert", "name_suffix": "", "institution": "Perelman School of Medicine at the University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" } ], "date_submitted": "2025-06-30T16:28:23.041000Z", "date_accepted": "2025-10-19T17:35:49.143000Z", "date_published": "2026-01-04T01:54:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/48847/galley/47906/download/" } ] }, { "pk": 54016, "title": "We Are Not Okay", "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": [], "section": "Humanism", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/18j4t4zg", "frozenauthors": [ { "first_name": "Deena", "middle_name": "D", "last_name": "Wasserman", "name_suffix": "", "institution": "Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania", "department": "" } ], "date_submitted": "2025-11-19T19:19:43.829000Z", "date_accepted": "2025-11-19T22:50:35.472000Z", "date_published": "2026-01-04T01:03:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/54016/galley/47918/download/" } ] }, { "pk": 47910, "title": "Impact of Primary Spoken Language as a Social Determinant of Health on Cardiopulmonary Education and Use: Pilot Study", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> Over 350,000 out-of-hospital cardiac arrests occur annually in the United States, with neurologically intact survival below 10%. Recent literature demonstrates that survival is lower in communities of color and non-English speakers. Social determinants of health, such as healthcare access, language, and literacy, may serve as barriers to receiving cardiopulmonary resuscitation (CPR) education and using the skills learned. Current research is sparse on identifying barriers contributing to the lack of CPR education and use in non-English speaking communities. We hypothesized that barriers to CPR education and use differ between English- and Spanish-speaking learners. This study provides insights into how classes could be tailored to address disparities in CPR education and use.</p>\n<p><strong>Methods: </strong>In this cross-sectional study we used survey-based research to assess the knowledge, comfort, and perceived barriers to activating the 9-1-1 system and performing bystander CPR. Participants were recruited using convenience sampling at community-based events in Roanoke, Virginia. We directly compared responses between language groups using Fisher tests within R, adjusting for various demographic factors.</p>\n<p><strong>Results: </strong>We collected 367 surveys from the 550 participants (estimated 50 attendees each for 11 events) for a response rate of 66.7%. Of the surveys collected, 231 (63%) were in English and 136 (37%) in Spanish. Spanish-speakers were more concerned with immigration status (7% vs 1%), doing something wrong (14% vs 7%), and language barrier (31% vs 1%) compared to English-speakers when asked why they may not call 9-1-1. We found that 72% of English-speakers would have no problem calling 9-1-1, compared to only 16% of Spanish-speakers. Regardless of language, the most prevalent barrier to initiating CPR was the “fear of doing something wrong” with 49% of Spanish-speakers and 28% of English-speakers endorsing this as a barrier. Only 10% of Spanish speakers would have no concerns starting CPR, compared to 54% of English-speakers. Language was reported by 21% of Spanish-speakers vs 2% of English-speakers as a barrier to administering CPR.</p>\n<p><strong>Conclusion: </strong>Results of this pilot study highlight that Spanish-speaking respondents were less comfortable calling 9-1-1 and initiating CPR compared to English-speaking respondents. While there were some shared barriers between the groups, Spanish-speaking respondents were more likely to identify a barrier overall. These results suggest that marginalized communities would benefit from tailored educational models that address their unique challenges. Further research is necessary to better understand how social determinants of health serve as barriers to CPR education/use in specific communities.</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": "Out-of-hospital Cardiac Arrest" }, { "word": "language disparities" }, { "word": "chain of survival" }, { "word": "cardiopulmonary resuscitation" }, { "word": "social determinants of health" } ], "section": "Health Equity", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/96z004v2", "frozenauthors": [ { "first_name": "Charles", "middle_name": "", "last_name": "LeNeave", "name_suffix": "", "institution": "Virginia Tech Carilion School of Medicine, Roanoke, Virgina", "department": "" }, { "first_name": "Brian", "middle_name": "", "last_name": "Meier", "name_suffix": "", "institution": "Virginia Tech Carilion School of Medicine, Department of Emergency Medicine, Roanoke, Virgina; Carilion Clinic, Roanoke, Virginia", "department": "" }, { "first_name": "Heather", "middle_name": "", "last_name": "Liffert", "name_suffix": "", "institution": "Compress and Shock Foundation, Roanoke, Virginia", "department": "" }, { "first_name": "Jack", "middle_name": "C.", "last_name": "Perkins", "name_suffix": "", "institution": "Virginia Tech Carilion School of Medicine, Department of Emergency Medicine, Roanoke, Virgina; Carilion Clinic, Roanoke, Virginia; Compress and Shock Foundation, Roanoke, Virginia", "department": "" } ], "date_submitted": "2025-05-22T16:52:22.399000Z", "date_accepted": "2025-10-25T20:10:15.841000Z", "date_published": "2026-01-04T00:53:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/47910/galley/47897/download/" } ] }, { "pk": 52941, "title": "Retention Challenges in Opioid Use Disorder Treatment: The Role of Comorbid Psychological Conditions", "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": "Letters to the Editor", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/75x589kg", "frozenauthors": [ { "first_name": "David", "middle_name": "C", "last_name": "Seaberg", "name_suffix": "", "institution": "US Acute Care Solutions, Canton, Ohio", "department": "" } ], "date_submitted": "2025-09-24T18:20:19.489000Z", "date_accepted": "2025-09-24T18:25:03.373000Z", "date_published": "2026-01-04T00:32:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/52941/galley/47931/download/" } ] }, { "pk": 50773, "title": "Retention Challenges in Opioid Use Disorder Treatment: The Role of Comorbid Psychological Conditions", "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": [], "section": "Letters to the Editor", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6xk1n2kc", "frozenauthors": [ { "first_name": "Shu", "middle_name": "", "last_name": "Yuan", "name_suffix": "", "institution": "Sichuan Agricultural University, College of Resources, Chengdu, China", "department": "" }, { "first_name": "Zi-Lin", "middle_name": "", "last_name": "Li", "name_suffix": "", "institution": "Medical University of the Air Force, College of Cardiovascular Medicine, Xi’an, China", "department": "" }, { "first_name": "Jing", "middle_name": "", "last_name": "Hu", "name_suffix": "", "institution": "Northwest University, School of Medicine, Xi’an, China", "department": "" } ], "date_submitted": "2025-08-28T05:18:20.345000Z", "date_accepted": "2025-09-10T16:09:00.594000Z", "date_published": "2026-01-04T00:26:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/50773/galley/47930/download/" } ] }, { "pk": 48354, "title": "A Case Report of Milk-Alkali Syndrome Secondary to Excessive Antacid Use", "subtitle": null, "abstract": "<p><strong>Introduction</strong>: Milk-alkali syndrome is characterized by the triad of hypercalcemia, metabolic alkalosis, and acute kidney injury resulting from excessive intake of calcium and absorbable alkali. Despite falling out of prominence with the advent of modern ulcer treatments, milk-alkali syndrome has experienced a resurgence with the widespread availability of over-the-counter calcium preparations, which now account for up to 10% of hypercalcemia cases.</p>\n<p><strong>Case Report: </strong>A 60-year-old man with multiple comorbidities presented to the emergency department with altered mental status after his scheduled kyphoplasty was canceled due to concerning neurological findings. Laboratory evaluation revealed severe hypercalcemia, marked metabolic alkalosis, and acute kidney injury. Further history revealed excessive antacid consumption for heartburn. The patient was diagnosed with milk-alkali syndrome, treated with intravenous fluids and calcitonin, and discharged home after 48 hours with complete resolution of signs and symptoms.</p>\n<p><strong>Conclusion</strong>: Milk-alkali syndrome represents an increasingly recognized cause of severe hypercalcemia in the emergency setting. This case demonstrates the importance of thorough medication history, early recognition of the classic triad, and prompt initiation of conservative management. With the growing use of calcium-based, over-the-counter preparations, emergency physicians must maintain vigilance for this potentially serious but readily treatable condition.</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": "milk alkali syndome" }, { "word": "Hypercalcemia" }, { "word": "antacids" }, { "word": "Metabolic alkalosis" }, { "word": "acute kidney injury" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6wj9x771", "frozenauthors": [ { "first_name": "Layla", "middle_name": "", "last_name": "Abubshait", "name_suffix": "", "institution": "Jefferson Einstein Montgomery Hospital, Department of Emergency Medicine, East Norriton, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania", "department": "" }, { "first_name": "Samir", "middle_name": "", "last_name": "Beso", "name_suffix": "", "institution": "Jefferson Einstein Montgomery Hospital, Department of Emergency Medicine, East Norriton, Pennsylvania", "department": "" } ], "date_submitted": "2025-05-29T14:29:07.832000Z", "date_accepted": "2025-09-10T19:40:16.571000Z", "date_published": "2026-01-02T00:44:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/48354/galley/48088/download/" } ] }, { "pk": 48533, "title": "Case Report: Pediatric Hallucinations and Anti-Neuronal Intermediate Filament Autoimmune Encephalitis", "subtitle": null, "abstract": "<p><strong>Introduction</strong>: Patients with psychiatric concerns often present to an emergency department (ED) for medical evaluation prior to inpatient psychiatry placement. One diagnosis to consider prior to disposition is autoimmune encephalitis (AIE). This report describes a pediatric patient who presented with psychiatric symptoms that required inpatient admission and workup to diagnose a rare form of AIE.</p>\n<p><strong>Case Report: </strong>A 16-year-old female with no known past medical history presented as a transfer from an outside hospital for medical evaluation of two days of auditory and visual hallucinations. Initial labs and imaging were unremarkable. Due to the acuity of her symptoms and abnormal vital signs, she was admitted to the hospital for further medical workup. After almost three weeks inpatient and multiple specialist consultations, she was diagnosed with anti-heavy chain neuronal intermediate filament AIE. The next month of admission included treatment with immunomodulators, antibiotics for associated infections, and malignancy evaluation. Symptoms resolved, and the patient was discharged. The patient remained asymptomatic on immunotherapies, and without psychiatric medications, the following year.</p>\n<p><strong>Conclusion</strong>: During evaluation of psychiatric concerns in the ED, it is essential to consider organic causes of behavioral changes, which can be difficult to discern. Autoimmune encephalitis can be subtle. Features such as autonomic dysregulation, acute or subacute symptom onset, recent infection, autoimmune or malignancy history, cognitive deficits, or focal neurologic findings should raise clinical suspicion. For patients with psychiatric symptoms, the role of an emergency physician is not to diagnose autoimmune encephalitis, but to recognize nuances in patient presentations to best direct proper workup, treatment, and disposition.</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": "Autoimmune encephalitis" }, { "word": "pediatric" }, { "word": "neuronal intermediate filament" }, { "word": "case report" } ], "section": "Case Reports", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5nc3w288", "frozenauthors": [ { "first_name": "Amanda", "middle_name": "", "last_name": "Bjornstad", "name_suffix": "", "institution": "Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California", "department": "" }, { "first_name": "Natalie", "middle_name": "", "last_name": "Oberhauser-Lim", "name_suffix": "", "institution": "Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California", "department": "" }, { "first_name": "Tammy", "middle_name": "", "last_name": "Phan", "name_suffix": "", "institution": "Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California", "department": "" }, { "first_name": "Emmelyn", "middle_name": "", "last_name": "Samones", "name_suffix": "", "institution": "Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California", "department": "" }, { "first_name": "Tim", "middle_name": "", "last_name": "Young", "name_suffix": "", "institution": "Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California", "department": "" } ], "date_submitted": "2025-06-11T15:22:45.538000Z", "date_accepted": "2025-09-10T20:31:18.873000Z", "date_published": "2026-01-02T00:30:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_cpcem/article/48533/galley/48090/download/" } ] }, { "pk": 52346, "title": "Prioritization: Intracranial Hemorrhage, Testicular Torsion, and Tricyclic Antidepressant Department", "subtitle": null, "abstract": "<p>Audience: This case is designed for emergency medicine residents preparing for the American Board of Emergency Medicine Certifying Exam (ABEM). While we tested the case with third year emergency medicine residents, it could also be used with first- and second-year residents to develop complex decision-making and prioritization skills in a simulated environment.</p>\n<p>Introduction: Emergency medicine requires physicians to rapidly prioritize care, stabilize critically ill patients, adapt to changing clinical circumstances, and delegate tasks and resources. Traditional oral board cases emphasize single-patient encounters rather than multitasking or task-switching. This prioritization case better aligns with the clinical workflow of a shift in the emergency department, including triage, teamwork, and flexibility. This case forces learners to make timely decisions with incomplete information, giving examiners insight into how the examinee performs in the clinical environment.</p>\n<p>Educational Objectives: By the end of this case learners should: 1) Become familiar with the format of a prioritization case (a component of the ABEM Certifying Exam), 2) demonstrate their ability to prioritize multiple patients and provide stabilizing care, 3) consider changes in status/patient acuity/new cases as presented, 4) understand how to utilize team resources appropriately.</p>\n<p>Educational Methods: A group of five emergency medicine faculty with experience in simulation and oral board case design created a 15-minute practice prioritization case. This case is based on information provided by ABEM on the prioritization case format from the ABEM Certifying Exam. Learners are presented with evolving patient scenarios via tracking boards and prompted to prioritize, stabilize, task switch, and delegate as they manage multiple patients. The case is intended to be administered with two examiners and one examinee at a time. We used a group debrief structure, but this case can also be debriefed with each individual learner.</p>\n<p>Research Methods: This case was tested on 18 third-year emergency medicine residents. Following the case, each resident completed an anonymous two-item evaluation. The first item, “This case increased my understanding of the certifying exam format,” was scored on a 5-point Likert scale from “strongly disagree” to “strongly agree.” The second item, “How would you rate the overall quality of this case?” was scored on a 5-point Likert scale from “poor” to “excellent.” </p>\n<p>Results: Sixteen of eighteen (89%) examinees completed the post-case evaluation. All respondents (100%) “agreed” or “strongly agreed” that the case improved their understanding of the ABEM Certifying Exam format. Overall case quality was rated 4.88/5, and all learners rated the case “very good” or “excellent.”</p>\n<p>Discussion: This case was effective in simulating the competing demands of the clinical environment while also preparing learners for a new exam format. During the group debrief session, learners appreciated the pace, needing to stabilize multiple patients, and reacting to new information as it was presented. This case significantly improved residents’ understanding of the prioritization case type that will be tested on the ABEM Certifying Exam. It also provides a controlled environment for program faculty to observe how residents perform managing multiple sick patients simultaneously.</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.\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": "Prioritization" }, { "word": "resource utilization" }, { "word": "triage and stabilization" }, { "word": "task-switching" }, { "word": "cognitive load" } ], "section": "Certifying Exam Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5b69d06w", "frozenauthors": [ { "first_name": "Brian", "middle_name": "", "last_name": "Milman", "name_suffix": "", "institution": "UT Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Marshall", "middle_name": "", "last_name": "Howell", "name_suffix": "", "institution": "UT Southwestern Medical Center", "department": "" }, { "first_name": "Joshua", "middle_name": "", "last_name": "Ginsburg", "name_suffix": "", "institution": "UT Southwestern Medical Center", "department": "" }, { "first_name": "Samuel", "middle_name": "", "last_name": "Parnell", "name_suffix": "", "institution": "UT Southwestern Medical Center", "department": "" } ], "date_submitted": "2025-07-01T22:20:08Z", "date_accepted": "2025-12-04T23:02:14.695000Z", "date_published": "2026-01-01T03:15:00Z", "render_galley": { "label": "Milman B, et al. Prioritization Intracranial Hemorrhage, Testicular Torsion, and Tricyclic Antidepressant Department. JETem 2025. 10(5)CE370-396", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52346/galley/47812/download/" }, "galleys": [ { "label": "Milman B, et al. Prioritization Intracranial Hemorrhage, Testicular Torsion, and Tricyclic Antidepressant Department. JETem 2025. 10(5)CE370-396", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52346/galley/47812/download/" } ] }, { "pk": 52355, "title": "Prioritization: Run This Board: Septic Shock, Acute Coronary Syndrome, Small Bowel Obstruction, and Penetrating Chest Trauma", "subtitle": null, "abstract": "<p>Audience: This case was specifically designed for senior emergency medicine (EM) resident physicians as a preparatory tool for the American Board of Emergency Medicine (ABEM) Certifying Exam. However, it is applicable for EM residents at all levels of training.</p>\n<p>Introduction: “A hallmark of emergency medicine is the ability to triage or prioritize care. This case will require the physician to evaluate and treat multiple patients while ensuring those who require immediate care receive it quickly. The physician may face the arrival of additional patients, the deterioration of existing patients, and realistic workflow interruptions during the case. A successful candidate will identify and stabilize high acuity patients.”1 With the introduction of the new Certifying Exam by ABEM and the current lack of resources to practice prioritization in an assessment setting, resident physicians will need practice material in order to adequately prepare for their board examination.</p>\n<p>Educational Objectives: By the end of this case learners will be able to: 1) Become familiar with format of a prioritization case (a component of the ABEM Certifying Exam), 2) Practice their ability to prioritize multiple patients and provide stabilizing care, 3) Consider changes in status/patient acuity/new cases as presented, 4) Understand how to utilize team resources appropriately.</p>\n<p>Educational Methods: This encounter is a structured, oral simulation case designed as a prioritization exercise for emergency medicine resident trainees. It follows an interview-based format in which an examiner presents evolving patient information in a time-limited scenario, and the examinee responds in real time with clinical reasoning, prioritization of care, and management decisions. The case mimics the structure of the Prioritization Case in the ABEM Certifying Exam, allowing the examinee to verbalize thought processes while receiving updated clinical data from the examiner. This format emphasizes critical thinking, triage under pressure, and the delegation of tasks within a simulated emergency department environment.</p>\n<p>Research Methods: We first alpha-tested the case with board-certified emergency medicine physicians, who evaluated both the facilitator and learner aspects of the simulation. Their feedback was used to refine the structure, flow, and clinical realism of the case. Following these edits, the revised case was implemented with emergency medicine residents across varying levels of training. This staged approach allowed us to ensure educational fidelity and enhance realism, while also confirming that the case structure aligned with ABEM exam standards and expectations.</p>\n<p>Results: We conducted multi-site alpha and beta testing of a novel ABEM-style prioritization case with a total of 18 emergency medicine residents (eight individual residents and two 5-person PGY2 teams) and three facilitators. Surveys were completed by two facilitators (Simulation Scenario Evaluation Tool, SSET) and eight resident participants or teams (modified usability survey). Facilitators rated the case highly, with an average global score of 87.5/100, and learners reported strong overall quality (4.4/5) and exceptional educational value (4.9/5), though clarity of instructions was rated lower (3.6/5). Participants were predominantly senior residents (62.5% PGY-3, 25.0% PGY-2, and 12.5% PGY-4). Qualitative comments emphasized the usefulness of practicing the new case format and highlighted a need for clearer explanations of structure and rules. </p>\n<p>These results suggest the case was well-received across training levels, with iterative revisions improving clarity and usability. Based on preliminary beta testing, a Total Score of 70-75% indicates passing for this case.</p>\n<p>Discussion: This oral board-style prioritization case offers learners the opportunity to practice essential but often underemphasized skills, including rapid prioritization, task switching, and real-time decision-making. The case format reinforces critical concepts such as situational awareness and resource management within the dynamic environment of the emergency department. During initial implementation, participants reported strong engagement and found the exercise particularly valuable in preparing for the ABEM Certifying Exam. Many noted that the structure and expectations closely mirrored those of the actual prioritization station based on the example video provided by ABEM.</p>\n<p>From the instructor perspective, the standardized format promotes consistent delivery and assessment. To minimize examiner cognitive load during this high-complexity simulation, we developed a modular toolkit including a structured script, stimuli slides, and an automated scoring sheet, modeled in part after ABEM’s dual-examiner approach. A suite of Appendices supports both digital and paper-based use, allowing flexibility across educational settings.</p>\n<p>To further support formative practice, we created a scoring rubric to guide examiner feedback and learner self-assessment. However, as ABEM has not released its internal scoring criteria, this rubric is unofficial and should be interpreted with caution. It is intended for educational use only and is not designed to predict performance on the actual certification exam.</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.\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": "Prioritization" }, { "word": "triage" }, { "word": "stabilization" }, { "word": "delegation" }, { "word": "task switching" }, { "word": "vaginal bleeding" }, { "word": "pediatric injury" }, { "word": "altered mental status" }, { "word": "septic shock" }, { "word": "acute coronary syndrome" }, { "word": "headache" }, { "word": "abdominal pain" }, { "word": "small bowel obstruction" }, { "word": "penetrating chest trauma" }, { "word": "Urinary Tract Infection" } ], "section": "Certifying Exam Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8sw547sf", "frozenauthors": [ { "first_name": "Colleen", "middle_name": "", "last_name": "Donovan", "name_suffix": "", "institution": "Rutgers Robert Wood Johnson Medical School", "department": "" }, { "first_name": "Nicole", "middle_name": "", "last_name": "Novotny", "name_suffix": "", "institution": "Ochnser Health System", "department": "" }, { "first_name": "Charles", "middle_name": "", "last_name": "Lei", "name_suffix": "", "institution": "Hennepin County Medical Center", "department": "" }, { "first_name": "Alaa", "middle_name": "", "last_name": "Aldalati", "name_suffix": "", "institution": "University of Kansas School of Medicine-Wichita", "department": "Wesley Medical Center Emergency Department" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Melendez", "name_suffix": "", "institution": "Yale University", "department": "" }, { "first_name": "Neil", "middle_name": "", "last_name": "Wallace", "name_suffix": "", "institution": "University of Arizona/Banner Medical Center", "department": "" }, { "first_name": "Tiffany", "middle_name": "", "last_name": "Moadel", "name_suffix": "", "institution": "Zucker School of Medicine at Hofstra/Northwell Health", "department": "" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Stapleton", "name_suffix": "", "institution": "Boston University/Boston Medical Center", "department": "" }, { "first_name": "Shagun", "middle_name": "", "last_name": "Berry", "name_suffix": "", "institution": "Rush University Medical Center", "department": "" } ], "date_submitted": "2025-07-18T18:17:09Z", "date_accepted": "2025-12-13T21:14:27.927000Z", "date_published": "2026-01-01T02:59:00Z", "render_galley": { "label": "Donovan C, et al. Prioritization Run This Board Septic Shock, Acute Coronary Syndrome, Small Bowel Obstruction, and Penetrating Chest Trauma. JETem 2025. 10(5)CE312-369", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52355/galley/47811/download/" }, "galleys": [ { "label": "Donovan C, et al. Prioritization Run This Board Septic Shock, Acute Coronary Syndrome, Small Bowel Obstruction, and Penetrating Chest Trauma. JETem 2025. 10(5)CE312-369", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52355/galley/47811/download/" } ] }, { "pk": 53233, "title": "Clinical Decision-Making Case: Non-Accidental Trauma", "subtitle": null, "abstract": "<p>Audience: This clinical decision-making (CDM) case is intended for emergency medicine (EM) residents of all levels.</p>\n<p>Introduction: Non-accidental trauma (NAT) is a leading cause of morbidity and mortality in pediatrics. Every year in the United States, more than 656,000 children are found to be victims of NAT, causing over 1,800 deaths annually.<sup>1</sup> Subtle abusive injuries are frequently missed in medical settings,<sup>1-3</sup> and children may subsequently experience escalating or life-threatening abuse if interventions do not occur.<sup>2</sup> Timely identification of abusive injuries in acute care settings is crucial to provide appropriate and potentially life-saving care.</p>\n<p>Educational Objectives: By the end of this clinical decision-making case, learners will be able to: 1) demonstrate familiarity with the CDM case format and case play, 2) describe important historical information to obtain when suspecting non-accidental trauma, 3) recognize potential physical exam findings in non-accidental trauma, 4) justify appropriate diagnostic studies based on clinical findings and current evidence on occult injury in suspected pediatric abuse, and 5) propose an appropriate disposition plan for patients with non-accidental trauma.</p>\n<p>Educational Methods: This is a clinical decision-making boards case as outlined by the American Board of Emergency Medicine (ABEM). Each learner was paired with one instructor for the case, a scoring checklist by the instructor was used, and learners were given the opportunity to provide feedback after the case.</p>\n<p>Research Methods: Each CDM case session lasted approximately 20 minutes, with 15 minutes for the case and 5 minutes for debriefing and feedback. A 25-point critical action checklist was developed to evaluate each learner’s performance. Learners then provided verbal feedback on the cases to the examiners at the conclusion of their assessments. </p>\n<p>Results: Thirty-nine emergency medicine residents participated as learners for this clinical decision-making session, including 10 third-year residents, 12 second-year residents, and 17 first-year residents. Scoring checklists had a possible score of 25 points, with each point reflecting an equally weighted item. The average overall score was 16.85 of 25 possible points. Performance with respect to post-graduate year (PGY) is as follows: 18.0 for PGY-3s, 18.9 for PGY-2s, and 14.7 for PGY-1s. One resident had a perfect score of 25/25. There was no threshold passing score; therefore, no one resident “failed” this mock structured interview.</p>\n<p>Discussion: Performance of our learners varied and unexpectedly, our second-year residents outperformed our third-year residents. We believe this is due to our PGY-2 learners being responsible for the primary care of stroke patients in our department, which makes their identification of head bleed likely more recently retrievable. We reviewed outlier items (where residents all scored very high or if the score was lower compared to other items) to determine if this is an appropriately written item, and if so, we will use lower-scoring items as learning opportunities to emphasize within future didactics sessions. One of these items involved asking who the patients’ caregivers were, which may be attributed to being unaware of the relevance of this question to NAT, or, more likely, that NAT was not a top differential diagnosis in the early aspects of the case.</p>\n<p>Verbal feedback from our learners primarily focused on widening our accepted differential diagnoses for future iterations. We believe that this case is appropriate for all levels of learning, particularly when a formative approach (assessment for learning) is used. Given the feedback learners and instructors provided, we believe this case has high value impact in reviewing high-risk or high-acuity pediatric pathology. </p>\n<p>Topics: Emergency medicine, pediatrics, non-accidental trauma, pediatric head trauma, head bleed.</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.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Emergency Medicine" }, { "word": "pediatrics" }, { "word": "non-accidental trauma" }, { "word": "Pediatric head trauma" }, { "word": "head bleed" } ], "section": "Certifying Exam Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/35s7b4xb", "frozenauthors": [ { "first_name": "H", "middle_name": "Michelle", "last_name": "Greene", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "Department of Pediatrics" }, { "first_name": "Anne", "middle_name": "", "last_name": "Runkle", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "Department of Pediatrics and Department of Emergency Medicine" }, { "first_name": "Jennifer", "middle_name": "", "last_name": "Mitzman", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "Department of Pediatrics and Department of Emergency Medicine" }, { "first_name": "Christopher", "middle_name": "", "last_name": "San Miguel", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "Department of Emergency Medicine" }, { "first_name": "Krystin", "middle_name": "N", "last_name": "Miller", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "Department of Emergency Medicine" }, { "first_name": "Simiao", "middle_name": "", "last_name": "Li-Sauerwine", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "Department of Emergency Medicine" }, { "first_name": "Geremiha", "middle_name": "", "last_name": "Emerson", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "Department of Emergency Medicine" }, { "first_name": "Sorabh", "middle_name": "", "last_name": "Khandelwal", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "" }, { "first_name": "Kelsey", "middle_name": "", "last_name": "Jordan", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "Department of Emergency Medicine" }, { "first_name": "Jennifer", "middle_name": "", "last_name": "Yee", "name_suffix": "", "institution": "The Ohio State University College of Medicine", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-10-23T17:56:00.351000Z", "date_accepted": "2025-11-30T20:32:43.941000Z", "date_published": "2026-01-01T02:45:00Z", "render_galley": { "label": "Greene H M, et al. Clinical Decision-Making Case Non-Accidental Trauma. JETem 2025. 10(5)CE292-311", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/53233/galley/47810/download/" }, "galleys": [ { "label": "Greene H M, et al. Clinical Decision-Making Case Non-Accidental Trauma. JETem 2025. 10(5)CE292-311", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/53233/galley/47810/download/" } ] }, { "pk": 53003, "title": "Clinical Decision-Making Case: Thyroid Storm", "subtitle": null, "abstract": "<p>Audience: This clinical decision-making case is intended for all emergency physicians (EP) in training.</p>\n<p>Introduction: Thyroid storm (TS) is a rare but life-threatening endocrine emergency that represents the most severe form of thyrotoxicosis. If not promptly recognized and appropriately managed, TS carries a mortality rate of up to 25%.¹ However, with timely and aggressive treatment, mortality can be significantly reduced to 1.2–3.6% in the United States.² Due to its rarity and often nonspecific presentation, early diagnosis and intervention in the emergency department are essential to improving patient outcomes. Recognizing its critical nature, the American Board of Emergency Medicine (ABEM) identifies thyroid storm as a core emergency condition that emergency physicians (EPs) must be trained to manage.³ Additionally, recent updates to the ABEM certifying examination emphasize the importance of clinical decision-making and the ability to verbalize diagnostic reasoning and management plans. This case has been designed to help learners practice and demonstrate these skills in the context of a high-stakes, time-sensitive clinical scenario involving thyroid storm.</p>\n<p>Educational Objectives: By the end of the session, learners will be able to: 1) verbalize key pertinent historical and physical exam findings in a young female patient presenting with altered mental status; 2) formulate a prioritized differential diagnosis based on the history and physical exam; 3) order appropriate diagnostic studies and recognize abnormalities suggesting thyroid storm; 4) describe pathophysiology, management and rationale of sequential pharmacologic therapy in thyroid storm; 5) communicate patient’s medical care and course to family; and 6) review essential disposition actions including consultations and level of care for admission. </p>\n<p>Educational Methods: We implemented a certifying exam board format case aligned with the ABEM’s updated certifying exam board examination. The case was co-developed by experts in simulation-based education and emergency medicine and underwent external peer review, which focused on the accuracy of the clinical context, clarity of scenario instructions, and educational value.</p>\n<p>Research Methods: The case was iteratively developed and refined through multi-site piloting. Initial design was completed by three faculty with emergency medicine and simulation backgrounds, followed by external review using the Simulation Scenario Evaluation Tool (SSET). Feedback focused on case progression, realism, alignment with objectives, and consistency with assessment standards.</p>\n<p>The case was then piloted at two academic training sites and at the Society for Academic Emergency Medicine (SAEM) Annual Meeting. Participants included faculty facilitators and EM residents. Residents and faculty completed a modified usability survey incorporating Likert-scale items (1 = strongly disagree to 5 = strongly agree) and open-ended comments. Data was collected in Qualtrics® and analyzed in Excel®. Revisions were made after each iteration to improve clarity, usability, and educational impact.</p>\n<p>Results: The simulation scenario evaluation tool (SSET) evaluations were strongly positive. Facilitators (n = 3) consistently rated the case objectives, critical actions, and supporting materials as clear. They agreed or strongly agreed that the case was appropriate for the learner level, that the clinical course adhered to the ABEM format, and that the critical actions supported the stated objectives. Mean ratings ranged from 4 to 5 for ease of use, and facilitators noted that their colleagues would also find the materials accessible. They described the case as well-integrated, expressed confidence in facilitation, and endorsed its utility for ABEM certifying exam preparation.</p>\n<p>Resident feedback was similarly supportive. Three learners unanimously agreed that the case provided helpful practice for the ABEM exam and reported that both the written and verbal instructions were clear.</p>\n<p>Discussion: The thyroid storm clinical decision-making case proved to be an effective educational tool, meeting its intended objectives and offering meaningful preparation for emergency medicine residents facing the new ABEM certifying examination. Facilitators consistently reported that the case objectives, critical actions, and supporting materials were clear and aligned with the targeted level of learner training. Similarly, both facilitators and residents found the case to be a valuable exercise, providing relevant and realistic practice in the style of the certifying exam.</p>\n<p>While early results are encouraging, future challenges and opportunities remain. In particular, the evolving structure and scoring approach of the new ABEM certifying examination introduces areas where additional refinement may be needed. As more information becomes available regarding the exam’s evaluation metrics, this case can be further tailored to enhance alignment and maximize its educational impact. Continued iterative development will ensure the case remains a practical and high-yield resource for residents as they prepare for certification.</p>\n<p>Topics: Hyperthyroidism, communication, clinical decision-making case, certifying exam, thyroid storm, endocrinology.</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.\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": "Hyperthyroidism" }, { "word": "Communication" }, { "word": "Clinical Decision-Making Case" }, { "word": "Certifying Exam" }, { "word": "Thyroid storm" }, { "word": "endocrinology" } ], "section": "Certifying Exam Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1c35h05x", "frozenauthors": [ { "first_name": "Stephanie", "middle_name": "", "last_name": "Cohen", "name_suffix": "", "institution": "University of Central Florida", "department": "Department of Emergency Medicine" }, { "first_name": "Amrita", "middle_name": "", "last_name": "Vempati", "name_suffix": "", "institution": "Creighton School of Medicine Phoenix", "department": "Department of Emergency Medicine" }, { "first_name": "Charles", "middle_name": "", "last_name": "Lei", "name_suffix": "", "institution": "Hennepin County Medical Center", "department": "Emergency Medicine" }, { "first_name": "Hillary", "middle_name": "", "last_name": "Moss", "name_suffix": "", "institution": "Montefiore Medical Center", "department": "Department of Emergency Medicine," }, { "first_name": "Tiffany", "middle_name": "", "last_name": "Moadel", "name_suffix": "", "institution": "Zucker School of Medicine at Hofstra/Northwell", "department": "Department of Emergency Medicine" }, { "first_name": "Suzanne", "middle_name": "", "last_name": "Bentley", "name_suffix": "", "institution": "NYC Health + Hospitals/Elmhurst; Icahn SOM at Mount Sinai", "department": "Department of Emergency Medicine" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Stapleton", "name_suffix": "", "institution": "Boston University/Boston Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Kelly", "middle_name": "N.", "last_name": "Roszczynialski", "name_suffix": "", "institution": "Stanford University", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-10-02T19:02:35.501000Z", "date_accepted": "2025-12-23T04:08:35.341000Z", "date_published": "2026-01-01T02:35:00Z", "render_galley": { "label": "Cohen S, et al. Clinical Decision-Making Case Thyroid Storm. JETem 2025. 10(5)CE260-291", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/53003/galley/47809/download/" }, "galleys": [ { "label": "Cohen S, et al. Clinical Decision-Making Case Thyroid Storm. JETem 2025. 10(5)CE260-291", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/53003/galley/47809/download/" } ] }, { "pk": 52322, "title": "Clinical Decision-Making Case: A Giant Headache", "subtitle": null, "abstract": "<p>Audience: This certifying exam practice case is intended for emergency medicine residents and medical students rotating through emergency medicine.</p>\n<p>Introduction: Giant cell arteritis (also known as GCA, temporal arteritis, cranial arteritis, or Horton’s disease) is the most common systemic vasculitis.<sup>1</sup> Patients commonly present with a new and unique headache, often with tenderness in the temporal region. Patients may present with associated jaw claudication and transient visual loss. Constitutional symptoms such as fever and fatigue are common and proximal muscle weakness may be present with concurrent polymyalgia rheumatica.<sup>1</sup> These symptoms are thought to be a result of an exaggerated immune response to vascular injury with lymphocyte proliferation and giant cell formation which can lead to luminal narrowing and even ischemia.<sup>2 </sup></p>\n<p>The incidence varies among various demographics. It is highest in Scandinavia (21 per 100,000) and lowest in East Asia (less than one per 100,000). Globally, it is estimated to be 10 per 100,000 and in the US roughly 19 per 100,000.<sup>2,3</sup> Recent studies have shown increasing incidence in Hispanic and African American populations while showing it to still be rare in Middle Eastern and Asian populations.<sup>4</sup> It is most common in patients who are 70-79 years old and almost never presents in those under 50.<sup>1</sup></p>\n<p><br>Left untreated, GCA can result in significant morbidity – vision loss.<sup>4</sup> Treatment is not benign – there are adverse effects of long-term glucocorticoid therapy. The cost to the healthcare system in the US is expected to increase dramatically by 2050 due to the aging population and cost of treatment.<sup>3 </sup></p>\n<p>Given its relatively low incidence but high morbidity, giant cell arteritis is a rare diagnosis that Emergency Medicine residents may not encounter in training but is an important differential diagnosis to consider in the appropriate clinical context. </p>\n<p>Educational Objectives: By the end of this clinical decision-making case, learners will be able to: 1) demonstrate increased knowledge pertaining to ABEM’s clinical decision-making case, 2) communicate the differential diagnosis of a new acute onset headache in patients over the age of 50 and the importance of giant cell arteritis in that differential, 3) acquire an appropriate history and physical exam in this clinical setting, 4) verbalize, interpret, and justify the appropriate diagnostic testing for this clinical case (at minimum CT head, complete blood count (CBC), basic metabolic panel (BMP), comprehensive metabolic panel (CMP), erythrocyte sedimentation rate (ESR), and 5) explain the appropriate treatment and disposition of a patient with temporal arteritis.</p>\n<p>Educational Methods: This session was structured after the clinical decision-making case that was introduced by the American Board of Emergency Medicine (ABEM) in the instructional videos on the ABEM Qualifying Exam Part 2 released in December 2024. The materials used were modeled after the samples that were provided in the supplemental material for the clinical decision-making case. Slides were provided to the instructor concerning clinical presentation, differential diagnosis, and management for the debriefing following the session. This case was tested using 18 resident volunteers PGY 1-2 in an ACGME (Accreditation Council for Graduate Medical Education) accredited emergency medicine residency program.</p>\n<p>Research Methods: Using a score sheet, evaluators assessed the residents’ performance in acquiring appropriate clinical information, interpreting diagnostic tests, providing a differential, and justifying their management. Residents were asked to evaluate the educational value of the case. </p>\n<p>Results: Nine PGY1 residents and nine PGY2 residents completed the case, scoring 19.7/25 with four failures and 21.4/25 with three failures, respectively. Reasons for failing included scoring less than 19/25 or missing a critical action. Of the 17 residents that completed the post-survey, the educational value was reported to be 4.7/5 with all residents stating it increased their medical knowledge. Almost all of those residents stated that this experience made them more comfortable with the new ABEM clinical decision-making case.</p>\n<p>Discussion: This educational case focusing on giant cell arteritis (GCA) was effective in enhancing resident knowledge and clinical skills. All participating residents reported increased knowledge following the exercise and rated the case highly in terms of educational value. Performance outcomes further supported the case’s efficacy. All residents successfully completed critical actions related to obtaining an adequate history, performing a focused physical exam, and ordering appropriate diagnostic tests. The only resident who failed the critical action of starting steroids was also the only resident to miss the critical action of diagnosis, which supports the close association of these two critical actions. This positive feedback supports the use of this case to expose learners to a rare but high-risk diagnose which they are unlikely to encounter during clinical training. </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.\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": "giant cell arteritis" }, { "word": "temporal arteritis" }, { "word": "headache" }, { "word": "Vasculitis" }, { "word": "ophthalmologic disorders" } ], "section": "Certifying Exam Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8rp4m7gm", "frozenauthors": [ { "first_name": "Mark", "middle_name": "", "last_name": "Portman", "name_suffix": "", "institution": "Sutter Roseville Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Linda", "middle_name": "", "last_name": "Herman", "name_suffix": "", "institution": "Sutter Roseville Medical Center", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-06-04T18:11:00Z", "date_accepted": "2025-12-12T19:50:26.736000Z", "date_published": "2026-01-01T02:25:00Z", "render_galley": { "label": "Portman M, et al. Clinical Decision-Making Case A Giant Headache. JETem 2025. 10(5)CE239-259", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52322/galley/47808/download/" }, "galleys": [ { "label": "Portman M, et al. Clinical Decision-Making Case A Giant Headache. JETem 2025. 10(5)CE239-259", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52322/galley/47808/download/" } ] }, { "pk": 52339, "title": "Clinical Decision-Making Case: Pulmonary Embolism", "subtitle": null, "abstract": "<p>Audience: Emergency medicine residents and medical students on emergency medicine rotations.</p>\n<p>Introduction: Pulmonary embolism (PE) is a common diagnosis with an annual incidence of approximately one in 1000 persons.1,2,3 There is a wide variety of clinical presentations, ranging from the asymptomatic patient to shock and cardiac arrest. Most patients have chest pain and shortness of breath (SOB), but PE may also present with mild or nonspecific symptoms, such as dizziness, cough, wheezing, syncope and hemoptysis. These patients have risk for clinical decompensation.4,5 It is therefore critical to maintain a high level of suspicion because misdiagnosis is common. There are risks attributable to the diagnostic evaluation and treatment, including radiation exposure, contrast reactions and complications related to anticoagulant therapy. Work up requires an understanding of clinical pretest probability, diagnostic algorithms such as the modified Wells scoring system and the revised Geneva scoring system, the pulmonary embolism rule-out criteria (PERC), and interpretation of D-dimer testing and diagnostic imaging.6,7 Management requires anticoagulation, but for the unstable patient may also require respiratory and hemodynamic support, systemic or catheter-directed thrombolysis, catheter or surgical embolectomy, or extracorporeal membrane oxygenation (ECMO) if available. Understanding the diagnostic evaluation and management of pulmonary embolism is essential for the practicing emergency medicine physician.</p>\n<p>Educational Objectives: By the end of the clinical decision-making case, the learner will: 1) gain familiarity with clinical decision-making (CDM) case format to be used in the new American Board of Emergency Medicine (ABEM) certification examination starting in 2026, 2) demonstrate the ability to obtain a focused history and physical examination and develop appropriate differential diagnoses for chest pain and dyspnea, 3) demonstrate understanding of clinical decisions rules to estimate the pre-test probability for pulmonary embolism and the application of rules to guide appropriate diagnostic testing, 4) recognize high clinical suspicion for pulmonary embolism and indication for empirical treatment, 5) recognize the unstable patient and provide appropriate hemodynamic and respiratory support, 6) understand indications for thrombolytic therapy or embolectomy in unstable pulmonary embolism, 7) demonstrate communication skills with patients and specialists across the health care spectrum, and 8) arrange appropriate disposition for the unstable patient with a pulmonary embolism.</p>\n<p>Educational Methods: This session is based on the clinical decision-making (CDM) case format introduced by ABEM to be used in the oral certification examination starting in 2026.8 The materials were modeled after the samples provided in the instructional videos on the ABEM Qualifying Exam Part 2 released in December 2024. Slides were provided to the instructor concerning clinical presentation, differential diagnosis, and management for the debrief following the session. This case was tested using 18 resident volunteers ranging from PGY 1-2 in an Accreditation Council for Graduate Medical Education (ACGME) accredited emergency medicine residency program. This was our first mock board session using the CDM format.</p>\n<p>Research Methods: Prior to the session, the learner was asked to complete a pre-survey to see if the learner had previously reviewed the ABEM instructional video demonstrating a CDM case. Immediate feedback was then 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 by designating whether the learner was able to provide the correct responses concerning required appropriate historical information, physical examination findings, diagnostic testing needed, differential diagnoses, interpretation of diagnostic results, reaching the correct diagnosis, management and disposition of the patient and coordinating transition of care. The examiner would mark the evaluation form with either a yes or no for each response.</p>\n<p>Results: Eighteen residents (nine PGY1 residents and nine PGY2 residents) completed the case. We were a new residency program at the time and did not yet have any PGY3 residents. The average score was 28.9 out of 29 points. The pre-survey revealed that only two of the nine EM PGY1 and four of the nine EM PGY2 had reviewed the ABEM video. Eighteen residents completed the post-survey which was done immediately after the simulation. The learners rated the educational value of the case 4.9/5 (5.0/5 for PGY1, 4.9/5 for PGY2). Fifteen residents (8/9 PGY1, 7/9 PGY2) stated that the case increased their understanding of key concepts about the disease process “somewhat,” while three responded that they have had similar patients and did not learn anything new. Thirteen residents (8/9 PGY1, 5/9 PGY2) said that the experience made them more comfortable with the new testing process but that they needed more practice, while only two residents (both PGY2) responded that they were very comfortable with the process.</p>\n<p>Discussion: The objective of this oral boards case was two-fold: to give residents experience with the new CDM case format of the ABEM certifying exam and to reinforce the work-up and management of pulmonary embolism.</p>\n<p>This simulation was an effective educational tool for residents to gain familiarity with the CDM case portion of the ABEM certifying exam. Only a minority (6/18, 33%) of the residents were familiar with the new testing format prior to the case. This session was the first mock oral board session using a CDM case. Post survey results revealed that 72% of the residents (13/18) said that the experience made them more comfortable with the new testing method but that they needed more practice, while only two residents (11%) stated that they were very comfortable with the process.</p>\n<p>This was also a learning opportunity for the examiner in this new CDM case format. The evaluation form used a dichotomous yes/no format which likely contributed to excessive prompting which inflated scoring. This may not accurately reflect the experience at the certifying exam. In response, more specific criteria regarding the degree of prompting and timing of case were added to the script. Repetition of testing in this format should be helpful for residents and educators as preparation for the ABEM certifying exam.</p>\n<p>The initial evaluation of pulmonary embolism is a topic with which most residents are comfortable. Residents scored well on testing, suggesting an understanding of the work-up for chest pain and routine management for pulmonary embolism. They had less familiarity with management of the high-acuity, unstable presentation.</p>\n<p>This case was not tested on medical students, but we anticipate that this would be an appropriate learning experience for the medical student on an emergency medicine rotation, without need for modification.</p>\n<p>This case was designed to introduce residents to the CDM case format. There is limited existing training material for the new oral board exam, and we feel this simulation case is valuable for residents to gain familiarity with the new ABEM certifying exam format through a comfortable topic and a “low pressure” setting.</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.\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": "Clinical Decision-Making Case" }, { "word": "pulmonary embolism" }, { "word": "shortness of breath" }, { "word": "Dyspnea" } ], "section": "Certifying Exam Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2sc8r5xk", "frozenauthors": [ { "first_name": "James", "middle_name": "H", "last_name": "Lee", "name_suffix": "", "institution": "Sutter Roseville Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Linda", "middle_name": "", "last_name": "Herman", "name_suffix": "", "institution": "Sutter Roseville Medical Center", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-06-25T20:24:24Z", "date_accepted": "2025-11-27T22:58:03.445000Z", "date_published": "2026-01-01T02:17:00Z", "render_galley": { "label": "Lee J H, et al. Clinical Decision-Making Case Pulmonary Embolism. JETem 2025. 10(5)CE212-238", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52339/galley/47807/download/" }, "galleys": [ { "label": "Lee J H, et al. Clinical Decision-Making Case Pulmonary Embolism. JETem 2025. 10(5)CE212-238", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52339/galley/47807/download/" } ] }, { "pk": 53814, "title": "Simulation-Based Preparation for the American Board of Emergency Medicine Certifying Exam: A Comprehensive Curriculum for Residents \n<!--EndFragment-->", "subtitle": null, "abstract": "<p>Audience and type of curriculum: This curriculum is designed for junior and senior emergency medicine (EM) residents who are preparing for the new American Board of Emergency Medicine (ABEM) Certifying Exam.</p>\n<p>Length of curriculum: This curriculum can be completed over the course of an EM residency program to prepare junior residents for the individual content areas encountered on the new Certifying Exam. Alternatively, it can be implemented during a single session to simulate the actual exam for senior residents.</p>\n<p>Introduction/Background: With ABEM transitioning to a new format for its Certifying Exam, there is a critical need for targeted preparatory materials that reflect these changes.</p>\n<p>Educational Goals: The goal of this curriculum is to equip residents with the knowledge and skills needed to succeed on the ABEM Certifying Exam. It includes a comprehensive set of case types expected to appear on the Certifying Exam, with a focus on assessing competencies not currently evaluated by the existing written Qualifying Exam and retiring Oral Exam. The curriculum is designed to be delivered to current residents in a single-day exam format to closely replicate the structure and experience of the new Certifying Exam.</p>\n<p>Educational Methods: The educational strategy used in this curriculum consists of a set of eight simulation scenarios written in an Observed Structured Clinical Examination (OSCE) format. Each scenario targets a distinct area of the recently introduced ABEM Certifying Exam. These content areas include clinical decision making, prioritization, reassessment, difficult conversations, managing conflict, ultrasound, procedures, and patient-centered communications. The OSCE structure intentionally reflects that of the ABEM Certifying Exam to enhance realism, ensure consistency, and maintain educational relevance.</p>\n<p>Research Methods: This eight-case simulation curriculum focuses on core EM competencies, including decision making, communication, conflict resolution, prioritization, procedural skills, and ultrasound. Initially developed by experts in simulation and medical education, each case was subsequently refined through a structured peer review process. This process involved written evaluations by external reviewers followed by pilot testing across multiple EM residency programs and at the Society for Academic Emergency Medicine Annual Meeting. Faculty facilitators and resident learners provided targeted feedback using the Simulation Scenario Evaluation Tool and modified usability surveys, assessing factors such as case realism, scenario flow, clarity of learning objectives, alignment of assessment criteria, and practical feasibility for implementation.</p>\n<p>Results: Pilot testing across multiple institutions and at a national academic meeting demonstrated the curriculum’s strong educational value, clarity, and usability. Feedback from both facilitators and residents was overwhelmingly positive, highlighting the simulation scenarios’ realism, clinical relevance, and effectiveness in exam preparation.</p>\n<p>Discussion: This comprehensive simulation-based curriculum, designed to align with the ABEM Certifying Exam, proved to be feasible, effective, and well-received by both learners and facilitators. Key insights from its implementation emphasized the importance of thorough faculty preparation, flexibility in adapting to available resources, and the use of structured debriefing to support learning. Thoughtfully designed simulation experiences can significantly enhance EM resident preparedness for high-stakes assessments.</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.\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": "Certifying Exam" }, { "word": "Simulation" }, { "word": "board certification" }, { "word": "American Board of Emergency Medicine" }, { "word": "Residency" } ], "section": "Curriculum", "is_remote": false, "remote_url": "https://jetem.org/certifying_exam_curr/", "frozenauthors": [ { "first_name": "Kimberly", "middle_name": "", "last_name": "Sokol", "name_suffix": "", "institution": "Kaweah Health Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Alaa", "middle_name": "", "last_name": "Aldalati", "name_suffix": "", "institution": "University of Kansas School of Medicine-Wichita", "department": "Wesley Medical Center Emergency Department" }, { "first_name": "Michelle", "middle_name": "", "last_name": "Hughes", "name_suffix": "", "institution": "University of Wisconsin School of Medicine and Public Health", "department": "Department of Emergency Medicine" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Stapleton", "name_suffix": "", "institution": "Boston University/Boston Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Charles", "middle_name": "", "last_name": "Lei", "name_suffix": "", "institution": "Hennepin County Medical Center", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-10-31T19:36:22.944000Z", "date_accepted": "2025-12-15T19:41:40.256000Z", "date_published": "2026-01-01T01:54:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/53814/galley/47793/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/53814/galley/47793/download/" } ] }, { "pk": 52338, "title": "Clinical Decision-Making Case: Seizing the Diagnosis: Eclampsia", "subtitle": null, "abstract": "<p>Audience: This practice certifying exam case is intended for emergency medicine residents.</p>\n<p>Introduction: The American Board of Emergency Medicine (ABEM) certification process is currently undergoing a significant transformation, with the new ABEM Certifying Exam replacing the long-standing ABEM Oral Exam, which has been in place since 1980. The Certifying Exam will utilize a new exam format to evaluate different competencies compared to the Oral Exam, including high-stakes communication, managing difficult conversations, patient-centered communication, clinical decision-making, team management, leadership, procedural skills, ultrasound skills, reassessment, troubleshooting, task switching, and prioritization. This shift has understandably generated a degree of apprehension among Emergency Medicine (EM) residents preparing for their board exams. The new exam emphasizes several new cases and scenarios, including Clinical Decision-Making (CDM) cases. These structured discussions require residents to articulate their thought processes and justify their clinical choices while navigating simulated Emergency Department (ED) encounters with undifferentiated patients.</p>\n<p>Although the CDM cases are similar in length (15 minutes) and format to the Structured Interview cases from the prior Oral Exam (structured discussion eliciting the steps necessary to diagnose and treat a patient with an undifferentiated presentation), ABEM has established new scoring criteria and objectives for the CDM cases. Therefore, to effectively prepare residents for this evolving assessment landscape, relevant and challenging example CDM case scenarios are essential. This CDM case focuses on eclampsia, defined as seizures occurring in a woman with pre-eclampsia or gestational hypertension during the peripartum period. This condition is a relatively rare, yet critical, emergency at the intersection of obstetrics and neurology that carries significant maternal and fetal risk and demands prompt recognition and decisive management. This case aligns directly with the exam's emphasis on high-acuity, low-occurrence presentations and provides a realistic and challenging opportunity to hone crucial clinical decision-making skills. It ensures that residents are not only well-prepared for the high-stakes Certifying Exam but are also capable of effectively managing this critical obstetric emergency in actual clinical practice.</p>\n<p>Educational Objectives: By the end of this Mock Certifying Exam session, learners should be able to: 1) demonstrate familiarity with the Clinical Decision-Making case format and structure, 2) elicit relevant historical information and connect that information to the diagnosis of eclampsia, 3) describe and interpret physical exam findings and their significance in establishing a pertinent differential diagnosis, which includes eclampsia, 4) initiate appropriate diagnostic testing, interpret results accurately, and formulate a stabilization and treatment plan for a patient with eclamptic seizures, and 5) reassess the patient's condition, modify the management plan as needed, provide relevant anticipatory guidance for disposition, and articulate the clinical decision-making rationale at each stage of the encounter.</p>\n<p>Educational Methods: This educational intervention employed a simulated ABEM Certifying Examination case. The initial case, focusing on the critical presentation of eclampsia, was developed collaboratively by a team of Emergency Medicine education faculty at a large, urban, three-year EM residency program. The structure and format were modeled after examples of the new CDM cases provided on the ABEM website. The CDM format involves a dynamic patient encounter in which the learner progresses through different phases of care, making diagnostic and therapeutic decisions and justifying their rationale to an examiner.</p>\n<p>A pilot phase was conducted to ensure realism, educational value, and appropriate timing for the examination format. Four recent graduates of the EM residency program participated in this pilot: two fellows (in Emergency Medical Services and Medical Education, respectively) and two actively practicing attending physicians in community Emergency Department settings. These individuals engaged with the case as if they were taking the actual Certifying Examination, providing detailed feedback on the clarity of the scenario, the appropriateness of the clinical challenges presented, and the overall flow and timing of the case. Based on the insights gained from pilot testing, the case underwent refinement and adjustments to optimize its effectiveness as an assessment and learning tool.</p>\n<p>The finalized eclampsia CDM case was then implemented in a testing phase involving eighteen PGY-3 (Post Graduate Year-3) EM residents. These residents participated in a simulated certifying examination experience, with two faculty members acting as examiners for each resident physician in individual exam rooms, closely resembling the actual testing environment. The examiners sat across a table from the examinee, and a separate screen was utilized to display the case stimuli and task sheet during the case. The case sessions were limited to a maximum of 15 minutes. While this CDM case was incorporated into a Mock Certifying Exam session with multiple other cases and scenarios, it could also be employed in isolation using a virtual or in-person format. Following the Mock Certifying Exam, a group debrief was conducted in-person. This session provided collective feedback to resident examinees and faculty examiners regarding the eclampsia case, the CDM case format, and key clinical learning points.</p>\n<p>Research Methods: Following each simulated case encounter, faculty examiners evaluated resident performance using a standardized scoresheet. The scoresheet, derived from ABEM Certifying Exam Score Guidelines, assessed nine domains: focused history, physical exam interpretation, differential diagnosis, diagnostics, patient stabilization, reassessment, disposition, clinical reasoning, and pathophysiology.</p>\n<p>These nine domains were collated into the standard JETem scoring rubric, which includes 25 points spread among categories associated with the CDM format. In addition to the faculty assessment, residents anonymously completed a two-question post-case evaluation. This evaluation employed a 5-point Likert scale (1 = poor, 5 = excellent) to assess the overall quality of the case, characterized by how well the session met educational objectives and resident expectations, and the degree to which the case enhanced understanding of the certifying exam format (1 = strongly disagree, 5 = strongly agree).</p>\n<p>Results: In total, 18 residents completed the case, and 17/18 residents (94.4%) completed the post-case evaluation. All residents identified eclampsia as one of the top three relevant differential diagnoses, administered intravenous magnesium as part of the treatment, and appropriately admitted the patient. However, antihypertensive medications were the most overlooked treatment modality.</p>\n<p>The mean quality rating of the case was 4.94/5, and 100% of resident respondents rated the overall quality of the case as “very good” or “excellent” on a 5-point Likert scale. Furthermore, 100% of respondents agreed or strongly agreed that the case enhanced their understanding of the certifying exam format.</p>\n<p>Discussion: The implementation of this CDM case proved highly effective in preparing EM residents for the complexities of clinical practice and the new challenge of understanding the Certifying Exam CDM format. The case was exceptionally well received, with a mean quality rating of 4.94 out of 5, and 100% of resident respondents rating its overall quality as \"very good\" or \"excellent.\" Furthermore, 100% of examinees agreed or strongly agreed that the case significantly enhanced their understanding of the certifying exam format, underscoring its utility as a preparatory tool for the newly formatted ABEM Certifying Exam.</p>\n<p>From its implementation, we learned that high-fidelity mock cases, particularly those involving critical scenarios like eclampsia, are invaluable for assessing and refining clinical decision-making skills. Eclampsia is a high-yield case due to its critical nature, requiring a wide differential diagnosis for seizures, a deep understanding of pathophysiology, and the rapid initiation of diagnostic workup and treatment to mitigate significant morbidity and mortality. This type of simulation-based training provides a safe but realistic testing environment for residents to gain experience with rare or high-acuity situations they may not frequently encounter in clinical practice.</p>\n<p>The main takeaway from this experience is the critical importance of proactive, targeted preparation for the evolving ABEM Certifying Exam. The overwhelmingly positive resident feedback and performance scores demonstrate that such simulated experiences are highly effective in enhancing understanding of the exam format. By providing a realistic, low-stakes environment for decision-making and targeted feedback, these mock cases directly contribute to residents' preparedness for board certification and, more importantly, for safe, high-quality independent practice in emergency medicine. </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.\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": "Clinical Decision-Making Case" }, { "word": "Eclampsia" }, { "word": "Seizure" }, { "word": "post-partum" }, { "word": "Certifying Exam" }, { "word": "ABEM" } ], "section": "Certifying Exam Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6md873dm", "frozenauthors": [ { "first_name": "Samuel", "middle_name": "", "last_name": "Parnell", "name_suffix": "", "institution": "UT Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Joshua", "middle_name": "", "last_name": "Ginsburg", "name_suffix": "", "institution": "UT Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Brian", "middle_name": "", "last_name": "Milman", "name_suffix": "", "institution": "UT Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Marshall", "middle_name": "", "last_name": "Howell", "name_suffix": "", "institution": "UT Southwestern Medical Center", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-06-24T16:04:41Z", "date_accepted": "2025-11-24T20:28:20.445000Z", "date_published": "2026-01-01T01:45:00Z", "render_galley": { "label": "Parnell S, et al. Clinical Decision-Making Case Seizing the Diagnosis Eclampsia. JETem 2025. 10(5)CE186-211", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52338/galley/47805/download/" }, "galleys": [ { "label": "Parnell S, et al. Clinical Decision-Making Case Seizing the Diagnosis Eclampsia. JETem 2025. 10(5)CE186-211", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52338/galley/47805/download/" } ] }, { "pk": 52335, "title": "Clinical Decision-Making Case: Pediatric Sexually Transmitted Infections and Consent", "subtitle": null, "abstract": "<p>Audience: This clinical decision-making case for the Certifying Board Exam is designed for emergency medicine residents at all training levels (PGY1 through PGY4).</p>\n<p>Introduction: Navigating consent for pediatric patients in the emergency department (ED) presents unique ethical and legal challenges. Physicians must understand parental consent requirements and the relevant exceptions that apply in the ED. Studies indicate that residents may lack confidence or knowledge in handling complex or nuanced consent scenarios, particularly regarding adolescents. We aimed to develop a structured educational intervention to address this gap. This clinical decision-making case aims to improve resident competency and comfort in managing these situations.</p>\n<p>Educational Objectives: By the end of this case the learner will be able to: 1) demonstrate competency with the new ABEM Certifying Exam Clinical Decision-Making Case format, 2) manage a simulated pediatric care encounter that requires navigating the details of pediatric consent, 3) explain common exceptions to requiring parental consent in emergency situations according to established guidelines as well as state and local laws, 4) report increased comfort managing ethical dilemmas related to pediatric consent in the ED.</p>\n<p>Educational Methods: This educational activity utilizes the new Clinical Decision-Making Case format for the American Board of Emergency Medicine Certifying Board Exam. This method simulates realistic ED encounters where residents must gather information, apply ethical and legal principles, and make decisions regarding pediatric consent under time constraints, similar to the new structure used in the board certification process for emergency medicine physicians. Additionally, a short presentation accompanied the debrief of this session to highlight the relevant clinical learning points.</p>\n<p>Research Methods: We administered pre- and post-intervention surveys assessing self-perceived comfort (using Likert scales) and objective knowledge (using multiple-choice questions) regarding pediatric consent, as well as comparing audience vs. participants experience. This study was approved by the Baylor Research Institute Institutional Review Board, approval number 025-322. Informed consent was obtained from all participants electronically.</p>\n<p>Results: Thirteen EM residents (PGY1-PGY3) participated in this activity. In the presurvey, only 30.8% of residents reported to be somewhat or very comfortable, while in the post survey, 100% reported to be somewhat or very comfortable with pediatric consenting. When asked to evaluate the learning value of the case, 76.9% selected very valuable and 15.4% selected valuable.</p>\n<p>Discussion: This clinical decision-making case provides a standardized, active learning method to address emergency medicine residency training regarding pediatric consent, which has previously been identified as an area of difficulty for EM trainees. 1 The format allows for assessment of not just knowledge, but also application, communication, and ethical reasoning. Providing specific, constructive feedback immediately following the session is crucial for maximizing educational benefit.</p>\n<p>Topics: Clinical decision-making case, board certification, pediatrics, ethics, legal.</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.\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": "board certification" }, { "word": "pediatrics" }, { "word": "Ethics" }, { "word": "Legal" }, { "word": "Emergency Medicine" }, { "word": "Clinical Decision-Making Case" } ], "section": "Certifying Exam Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4759d8gp", "frozenauthors": [ { "first_name": "Emily", "middle_name": "", "last_name": "Drone", "name_suffix": "", "institution": "John Peter Smith Hospital", "department": "Department of Emergency Medicine" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Shedd", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Leslie", "middle_name": "", "last_name": "Rodriguez", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center", "department": "Department of Graduate Medical Education" }, { "first_name": "Chinmay", "middle_name": "", "last_name": "Patel", "name_suffix": "", "institution": "Baylor Scott and White All Saints Medical Center", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-06-17T19:14:09Z", "date_accepted": "2025-12-04T21:56:42.106000Z", "date_published": "2026-01-01T01:28:00Z", "render_galley": { "label": "Drone E, et al. Clinical Decision-Making Case Pediatric Sexually Transmitted Infections and Consent. JETem 2025. 10(5)CE166-185", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52335/galley/47804/download/" }, "galleys": [ { "label": "Drone E, et al. Clinical Decision-Making Case Pediatric Sexually Transmitted Infections and Consent. JETem 2025. 10(5)CE166-185", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52335/galley/47804/download/" } ] }, { "pk": 52171, "title": "Clinical Decision-Making Case: Intussusception", "subtitle": null, "abstract": "<p>Audience: This clinical decision making case is intended for emergency medicine residents of all levels.</p>\n<p>Introduction/Background:</p>\n<p>To become board certified in emergency medicine, graduates must pass both a qualifying exam and an oral exam. In 2026, the American Board of Emergency Medicine (ABEM) is transitioning to a Certifying Exam. Historically, the oral exam included two structured interview (now retitled clinical decision making [CDM]) cases and one pediatric case. Vomiting and abdominal pain are two of the top five reasons pediatric patients present to the emergency department. Being able to take a complete history and exam, regardless of age, and form an appropriate differential diagnosis is a critical skill for emergency physicians. There are many resources available to prepare for standardized single patient encounters, but there are very few resources available for candidates to prepare for the CDM cases. Here we present a CDM case of irritability and vomiting in an 18-month-old for learners to familiarize themselves with the CDM format and to demonstrate management of a pediatric patient. </p>\n<p>Educational Objectives: </p>\n<p>By the end of this mock oral boards session, learners will (1) demonstrate familiarity with the CDM case format and case play, (2) model a problem-based history and physical exam, (3) generate a differential diagnosis for pediatric abdominal pain, and (4) demonstrate the ability to manage intussusception. </p>\n<p>Educational Methods:</p>\n<p>This CDM case is based on the sample script available on the ABEM website. Individual residents were tested by a faculty member virtually via Zoom. After all residents completed the case, a group debrief was held virtually on Zoom. </p>\n<p>Research Methods:</p>\n<p>This case was originally tested with a pilot group of five learners who provided verbal feedback following the case. Adjustments were made to the case based on that feedback. The case was then tested with 36 second- and third-year emergency medicine residents from two residency programs. At the completion of each case, a faculty examiner scored each resident’s performance based on a standardized scoresheet. Residents received one-point for completing each task and the overall score was calculated out of 25 possible points. Residents were surveyed on prior experience with the CDM format and the educational value of this oral boards session. Educational value was evaluated on a 5-point Likert scale with 5 being excellent. </p>\n<p>Results:</p>\n<p>In total, 36 residents completed this mock CDM case. The average score was 20.3/25. All examinees performed palpation on abdominal exam, ordered and provided justification for an abdominal ultrasound, ordered and provided justification for an air contrast enema, and stated the correct diagnosis of intussusception. Nearly all examinees provided an appropriate differential diagnosis for the patient. The most common items that examinees missed included asking about surgical history, asking about blood in the patient’s stool, listening for bowel sounds on exam, and providing at least one vital sign when the inpatient team was called for admission. </p>\n<p>Twenty residents responded to the post-case survey (55.6%). When asked if they had previous knowledge of the CDM format, only 30% of respondents were aware of this case format, and only 10% of respondents had previously participated in a CDM practice case. The learners rated the educational value of this case a 4.7/5 with 95% “agreeing” or “strongly agreeing” that the case was helpful in preparing for their oral board exam and 90% feeling like the educational value was “very good” or “excellent.” </p>\n<p>Discussion:</p>\n<p>We present a CDM case of intussusception that allows the resident to become familiar with this type of case while demonstrating their ability to obtain a history from, examine, and treat a pediatric patient. Through this case, residents are asked specific questions about the thought process behind the history and physical exam they perform. They are also required to provide a differential diagnosis, treatment plan, and disposition for the patient. Through this clinical decision-making process, our residents felt that the case was of high educational value and was helpful in preparing for the certifying exam. </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.\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": "Structured Interview" }, { "word": "pediatric abdominal pain" }, { "word": "Intussusception" }, { "word": "Oral Board Exam" } ], "section": "Certifying Exam Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/87r081x4", "frozenauthors": [ { "first_name": "Brian", "middle_name": "", "last_name": "Milman", "name_suffix": "", "institution": "UT Southwestern Medical Center", "department": "" }, { "first_name": "Samuel", "middle_name": "", "last_name": "Parnell", "name_suffix": "", "institution": "UT Southwestern Medical Center", "department": "Department of Emergency Medicine" } ], "date_submitted": "2024-07-29T17:33:16Z", "date_accepted": "2025-11-18T16:06:40.984000Z", "date_published": "2026-01-01T01:15:00Z", "render_galley": { "label": "Milman B, et al. Clinical Decision-Making Case Intussusception. JETem 2025. 10(5)CE148-165", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52171/galley/47803/download/" }, "galleys": [ { "label": "Milman B, et al. Clinical Decision-Making Case Intussusception. JETem 2025. 10(5)CE148-165", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52171/galley/47803/download/" } ] }, { "pk": 52365, "title": "Ultrasound Case: Syncope in PE", "subtitle": null, "abstract": "<p>Audience: This certifying exam practice ultrasound case is intended for emergency physicians (EP) in training.</p>\n<p>Introduction: Point-of-care ultrasound (POCUS) has become an essential tool in the practice of Emergency Medicine (EM). EM physicians routinely use POCUS to expedite diagnostic evaluations, guide resuscitative efforts, enhance the safety and success of bedside procedures, and reassess critically ill patients in real-time. Furthermore, POCUS is listed in the Model of the Clinical Practice of Emergency Medicine from ABEM, including diagnostic, resuscitative, and procedural components. Training during residency, however, remains variable while POCUS continues to grow in importance. Incorporating structured, competency-based ultrasound education into EM training has the potential to standardize skill with image acquisition, enhance image interpretation, improve confidence with clinical integration, and ultimately lead to better patient care in the acute setting.</p>\n<p>Educational Objectives: By the end of the session, learners will be able to: 1) obtain and interpret the parasternal short-axis view of the heart to assess right ventricular size and function, 2) identify ultrasound findings suggestive of pulmonary embolism (PE) on cardiac short-axis view, including right ventricular dilation and septal bowing, 3) demonstrate appropriate probe selection and positioning to obtain optimal images of the heart and inferior vena cava (IVC), 4) evaluate the IVC using a subxiphoid or longitudinal view to assess distension and lack of respiratory collapse as supportive findings for elevated right heart pressures, 5) identify the anatomy of the neck vasculature, differentiate between the internal jugular vein and carotid artery, and select the appropriate puncture site, 6) describe ultrasound-guided central venous catheterization via the right internal jugular vein, using a sterile technique and real-time guidance</p>\n<p>Educational Methods: We developed a single-station Objective Structured Clinical Examination (OSCE) focused on point-of-care ultrasound (POCUS) in the evaluation of a patient with syncope and suspected pulmonary embolism (PE). This format aligns with the American Board of Emergency Medicine’s (ABEM) newly implemented certification examination, emphasizing real-time clinical reasoning and ultrasound skills in a simulated encounter. The OSCE features a simulated participant and a standardized examiner script mirroring the ABEM certification exam format to ensure realism and consistency. ABEM has not released specific scoring elements to our knowledge. As a result, a novel set of grading criteria was developed based on patient-centered care, image acquisition, and image interpretation. The case was co-developed by experts in emergency ultrasound and simulation-based education, and then peer-reviewed to ensure clinical accuracy, clarity, and educational value. </p>\n<p>During the station, the examinee is presented with a focused clinical case involving a patient with syncope and is expected to demonstrate foundational POCUS knowledge, including image acquisition, optimization, and interpretation to assess for signs of PE, such as right ventricular strain or plethoric inferior vena cava. The examiner follows a structured and standardized script that evaluates the participant using a checklist, including de-identified images and clips of pathology. This tool assesses image acquisition, interpretation, and the integration of ultrasound findings into clinical decision-making. This OSCE provides a standardized method to assess diagnostic and procedural competence in a common application of ultrasound.</p>\n<p>Research Methods: This simulation case can be used as a standalone scenario or part of an ABEM Certifying Exam practice. For best results, residents should complete it individually, with some assigned as facilitators to better understand the examiner's role. The case runs for about 10 minutes, followed by a 10-minute debrief. Optimal setup includes examiner control over room lighting and ultrasound display. The case was trialed with EM residents across multiple sites using an iterative process. Feedback was collected via anonymous Qualtrics surveys using Likert scales and open-ended comments. The Boston University Institutional Review Board reviewed the project and deemed it exempt.</p>\n<p>Results: Initial testing with two residents and a facilitator showed the case was clear, easy to use, and valuable for exam prep. A second round at the 2025 SAEM Annual Meeting included four learners and one facilitator. Feedback led to case revisions. Survey scores were consistently positive, with high ratings for clarity, usability, and relevance to ABEM exam preparation.</p>\n<p>Discussion: The development and implementation of a syncope-focused ultrasound case for ABEM certification preparation highlights the growing integration of POCUS into emergency medicine training and assessment. Syncope is a high-yield chief complaint in the emergency department and serves as a common clinical context in which critical diagnoses like PE may be encountered. In this case, the use of bedside ultrasound to identify right heart strain consistent with PE not only mirrors real-world clinical practice but also reinforces the diagnostic reasoning and image interpretation skills essential for contemporary emergency physicians. The favorable reception from learners underscores the value of ultrasound-based cases in exam preparation and supports the continued development of high-quality, board-style ultrasound assessments in emergency medicine training programs.</p>\n<p>Topics: Ultrasound, cardiac, inferior vena cava, vascular, pulmonary embolism.</p>\n<p> </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.\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": "ultrasound" }, { "word": "Cardiac" }, { "word": "Inferior Vena Cava" }, { "word": "vascular" }, { "word": "pulmonary embolism" } ], "section": "Certifying Exam Practice", "is_remote": false, "remote_url": "https://jetem.org/us_case_pe/", "frozenauthors": [ { "first_name": "Neil", "middle_name": "", "last_name": "Wallace", "name_suffix": "", "institution": "University of Arizona/Banner Medical Center", "department": "" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Melendez", "name_suffix": "", "institution": "Yale University", "department": "" }, { "first_name": "Lars", "middle_name": "K", "last_name": "Beattie", "name_suffix": "", "institution": "University of Florida", "department": "" }, { "first_name": "Tina", "middle_name": "H", "last_name": "Chen", "name_suffix": "", "institution": "St. Louis University", "department": "" }, { "first_name": "David", "middle_name": "", "last_name": "Fernandez", "name_suffix": "", "institution": "Mount Sinai Hospital", "department": "" }, { "first_name": "Amrita", "middle_name": "", "last_name": "Vempati", "name_suffix": "", "institution": "Creighton School of Medicine Phoenix", "department": "Department of Emergency Medicine" }, { "first_name": "Kelly", "middle_name": "", "last_name": "Roszczynialski", "name_suffix": "", "institution": "Stanford University", "department": "" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Cohen", "name_suffix": "", "institution": "University of Central Florida", "department": "" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Stapleton", "name_suffix": "", "institution": "Boston University/Boston Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Tiffany", "middle_name": "", "last_name": "Moadel", "name_suffix": "", "institution": "Zucker School of Medicine at Hofstra/Northwell Health", "department": "" } ], "date_submitted": "2025-08-01T18:18:58Z", "date_accepted": "2025-12-08T19:58:38.279000Z", "date_published": "2026-01-01T01:03:00Z", "render_galley": { "label": "Wallace N, et al. Ultrasound Case Syncope in PE. JETem 2025. 10(5)CE126-147", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52365/galley/47802/download/" }, "galleys": [ { "label": "Wallace N, et al. Ultrasound Case Syncope in PE. JETem 2025. 10(5)CE126-147", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52365/galley/47802/download/" } ] }, { "pk": 61927, "title": "Introduction: Yoga in Global Muslim Contexts: Cultural Representations and Spiritual Practices", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Introduction", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4pr2x2sv", "frozenauthors": [ { "first_name": "Narin", "middle_name": "", "last_name": "Hassan", "name_suffix": "", "institution": "None", "department": "" }, { "first_name": "Farha", "middle_name": "", "last_name": "Ternikar", "name_suffix": "", "institution": "Other", "department": "" } ], "date_submitted": "2025-12-31T18:12:46.075000Z", "date_accepted": "2025-12-31T20:22:30.340000Z", "date_published": "2025-12-31T21:29:00Z", "render_galley": { "label": "GalleyFinal_Intro", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/61927/galley/47943/download/" }, "galleys": [ { "label": "Galley2Final_Intro", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/61927/galley/47942/download/" }, { "label": "GalleyFinal_Intro", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/61927/galley/47943/download/" } ] }, { "pk": 53004, "title": "Yoga in Gaza: A Conversation Featuring Hadeel Al-Gharbawi of Al-Jawad Camp", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [ { "word": "ceasefire" }, { "word": "Gaza" }, { "word": "Genocide" }, { "word": "hope" }, { "word": "Islam" }, { "word": "Occupation" }, { "word": "Palestine" }, { "word": "trauma-informed yoga" } ], "section": "Interviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/25n1c174", "frozenauthors": [ { "first_name": "Sheena", "middle_name": "", "last_name": "Sood", "name_suffix": "", "institution": "Delaware Valley University", "department": "Sociology" } ], "date_submitted": "2025-10-02T01:49:59.525000Z", "date_accepted": "2025-12-18T21:27:41.617000Z", "date_published": "2025-12-31T20:36:00Z", "render_galley": { "label": "Galley_Sood", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/53004/galley/47813/download/" }, "galleys": [ { "label": "Galley_Sood", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/53004/galley/47813/download/" } ] }, { "pk": 52364, "title": "Procedural Case: Neonatal Lumbar Puncture", "subtitle": null, "abstract": "<p>ABSTRACT:<br>Audience: This case was specifically designed for senior emergency medicine (EM) resident physicians as a preparatory tool for the American Board of Emergency Medicine (ABEM) Certifying Exam. However, it is applicable for EM residents at all levels of training.</p>\n<p>Introduction: Lumbar puncture (LP) is a critical diagnostic procedure in evaluating for central nervous system infections in febrile neonates. Recognizing its significance, ABEM has identified LP as a procedure that is integral to the practice of emergency medicine. Additionally, ABEM’s new Certifying Exam, launching in 2026, will include LP among the procedural skills that examinees may encounter. Despite its importance, neonatal LP can be technically challenging, with reported success rates of only 50-60%. Many EM clinicians hesitate to perform the procedure due to concerns about complications and limited hands-on experience during residency training. Furthermore, the American Academy of Pediatrics’ updated clinical practice guideline for the evaluation and management of febrile infants has led to a substantial decline in the number of LPs performed in this patient population, further reducing opportunities for trainees to gain clinical experience. This simulation case was designed to allow learners to practice and demonstrate the cognitive and technical skills necessary for performing a neonatal LP in a structured, risk-free environment.</p>\n<p>Educational Objectives: This is a Procedure case involving a neonatal LP. The overarching educational goal of this case is to assess learners’ clinical decision-making, technical proficiency, and communication skills when performing a neonatal LP. Participants will be evaluated on their ability to identify indications and contraindications, obtain informed consent, prepare for and perform the procedure with sterile technique, and implement appropriate post-procedure care. By the end of the session, learners should be able to: 1) describe the indications and contraindications associated with performing a neonatal LP, 2) obtain informed consent for a neonatal LP, using clear, patient-centered language to explain the procedure and to discuss risks, benefits, and alternative options, 3) demonstrate proper preparation for a neonatal LP, including equipment setup, patient positioning, patient monitoring, use of sterile technique, and analgesia, 4) perform a neonatal LP on a procedural task trainer with technical proficiency, demonstrating proper needle insertion, cerebrospinal (CSF) collection, and adherence to sterile technique, and 5) outline appropriate post-procedure management for the patient, including interpreting CSF results, initiating appropriate treatment, monitoring for complications, and providing caregivers with clear follow-up guidance.</p>\n<p>Educational Methods: We developed a single-station Objective Structured Clinical Examination (OSCE) centered on the neonatal LP procedure. This format aligns with the Procedures module of the new ABEM Certifying Exam, which emphasizes real-time procedural performance within simulated clinical encounters. This OSCE station incorporates a neonatal LP procedural task trainer and a standardized examiner script modeled after the ABEM Certifying Exam format to promote realism, consistency, and educational relevance. The case was collaboratively developed by experts in EM and simulation-based education and was externally peer-reviewed to ensure clinical accuracy, scenario clarity, and educational value.</p>\n<p>During the OSCE, the learner is presented with a brief case summary describing a febrile neonate requiring a lumbar puncture and is expected to demonstrate the essential cognitive and technical skills for performing the procedure. The examiner follows a structured script to deliver standardized prompts, offer procedural cues, and evaluate performance using a detailed, behaviorally anchored checklist that captures both procedural steps and critical decision-making elements.</p>\n<p>Research Methods: The simulation case was originally developed by three experts in simulation-based education and EM. To enhance accuracy, realism, and educational value, the case underwent a structured peer review process involving a panel of three additional experts. Reviewers used the Simulation Scenario Evaluation Tool (SSET) to provide standardized feedback on key elements, including scenario flow, realism, clarity of learning objectives, and alignment with assessment criteria.</p>\n<p>The case was subsequently piloted at two academic institutions and a national EM conference to assess its feasibility, clarity, and instructional design in real-world educational settings. During these pilot sessions, faculty facilitators and participating learners interacted with the case using a standardized examiner script and procedural checklist. Feedback and observations from this testing informed refinements to case logistics, examiner prompts, and assessment criteria to enhance usability and educational effectiveness.</p>\n<p>Results: Our expert reviewers, using the SSET survey, strongly agreed that the simulation case’s learning objectives were specific, action-oriented, relevant, and appropriately tailored to the target audience’s skill level and knowledge base. They also strongly agreed that the clinical context, embedded critical actions, and patient states effectively supported these learning objectives. Faculty facilitators reported that the scenario materials and resources provided sufficient information to enable independent facilitation of the case at their own institutions. Participating learners indicated that the written materials and verbal instructions were clear and that the experience was valuable for preparing for the ABEM Certifying Exam.</p>\n<p>Discussion: This neonatal LP simulation case was effective in achieving its educational objectives and served as a valuable tool for preparing learners for the Procedures module of the ABEM Certifying Exam. Facilitators rated the case highly across key domains, highlighting the clarity, usability, and cohesiveness of the provided materials. Learners consistently reported that the scenario provided meaningful opportunities to practice both procedural skills and clinical reasoning. These findings support the incorporation of structured procedural OSCEs into EM training programs. By leveraging simulation, this case helps address educational gaps, promote consistency in training, and enhance learner preparedness for board certification.</p>\n<p>Topics: Lumbar puncture, meningitis, procedure, American Board of Emergency Medicine, Certifying Exam.</p>\n<p> </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.\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": "lumbar puncture" }, { "word": "meningitis" }, { "word": "procedure" }, { "word": "American Board of Emergency Medicine" }, { "word": "Certifying Exam" } ], "section": "Certifying Exam Practice", "is_remote": false, "remote_url": "https://jetem.org/neonatal_lp/", "frozenauthors": [ { "first_name": "Charles", "middle_name": "", "last_name": "Lei", "name_suffix": "", "institution": "Hennepin County Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Cohen", "name_suffix": "", "institution": "University of Central Florida", "department": "Department of Emergency Medicine" }, { "first_name": "Alaa", "middle_name": "", "last_name": "Aldalati", "name_suffix": "", "institution": "University of Kansas School of Medicine-Wichita", "department": "Wesley Medical Center Emergency Department" }, { "first_name": "Andrew", "middle_name": "", "last_name": "Melendez", "name_suffix": "", "institution": "Yale University", "department": "Department of Emergency Medicine" }, { "first_name": "Neil", "middle_name": "", "last_name": "Wallace", "name_suffix": "", "institution": "University of Arizona/Banner Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Tiffany", "middle_name": "", "last_name": "Moadel", "name_suffix": "", "institution": "Zucker School of Medicine at Hofstra/Northwell", "department": "Department of Emergency Medicine" }, { "first_name": "Lars", "middle_name": "K", "last_name": "Beattie", "name_suffix": "", "institution": "University of Florida", "department": "Department of Emergency Medicine" }, { "first_name": "Tina", "middle_name": "H", "last_name": "Chen", "name_suffix": "", "institution": "St. Louis University", "department": "Department of Emergency Medicine" }, { "first_name": "David", "middle_name": "", "last_name": "Fernandez", "name_suffix": "", "institution": "Mount Sinai Hospital", "department": "Department of Emergency Medicine" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Stapleton", "name_suffix": "", "institution": "Boston University/Boston Medical Center", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-07-30T18:26:37Z", "date_accepted": "2025-12-01T21:33:48.067000Z", "date_published": "2025-12-31T20:33:00Z", "render_galley": { "label": "Lei C, et al. Procedural Case Neonatal Lumbar Puncture. JETem 2025. 10(5)CE106-125", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52364/galley/47801/download/" }, "galleys": [ { "label": "Lei C, et al. Procedural Case Neonatal Lumbar Puncture. JETem 2025. 10(5)CE106-125", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52364/galley/47801/download/" } ] }, { "pk": 52354, "title": "Difficult Conversation Case: Death Notification", "subtitle": null, "abstract": "<p>Audience: This case is meant for senior emergency medicine (EM) resident physicians as a preparatory tool for the American Board of Emergency Medicine Certifying Exam. However, it is applicable for EM residents at all levels of training.</p>\n<p>Introduction: Difficult conversations are an integral part of the practice of emergency medicine. Competent EM physicians routinely engage in challenging conversations with patients and their families (eg, delivering bad news, disclosing medical errors, providing death notifications). Despite their importance, communication skills are often not formally taught in residency training. Instead, learners frequently rely on role modeling to develop the skills necessary to navigate these difficult situations. Incorporating structured education and training around these challenging encounters has the potential to significantly enhance both learner preparedness and patient care.</p>\n<p>Educational Objectives: This Observed Structured Clinical Examination (OSCE) is intended to cover the topic of Difficult Conversations. The overarching educational goal of this case is to assess learners’ communication skills, emotional responsiveness, and ability to facilitate a death notification conversation. Participants will be evaluated on their ability to communicate in an empathic, patient-centered manner while leading a difficult discussion. Successful participants will establish rapport, actively listen, disclose sensitive information clearly and compassionately, and respond appropriately to emotional reactions. By the end of the session, learners should be able to: (1) establish rapport with the patient’s family by initiating introductions and creating a supportive environment, (2) assess the family’s baseline understanding of the patient’s condition by using open-ended questions and active listening to elicit their perspective, (3) communicate the patient’s death clearly and compassionately, using concise, non-technical language, (4) demonstrate empathy by responding appropriately to emotional reactions, validating concerns, and addressing questions thoughtfully, and (5) provide closure to the conversation by summarizing key points, offering emotional support, and clarifying the next steps in the patient’s care.</p>\n<p>Educational Methods: We designed a single-station OSCE focused on the delivery of a death notification. This format is aligned with the Difficult Conversations module of the newly implemented ABEM Certifying Exam, which emphasizes communication skills and emotional responsiveness in a challenging simulated clinical encounter. In this OSCE, the learner is presented with a brief case summary describing the unsuccessful resuscitation of a patient in cardiac arrest and is tasked with delivering the bad news to the patient’s family. The family member is portrayed by a standardized participant who follows a structured script and provides standardized emotional and verbal cues. The examiner assesses learner performance using a detailed, behaviorally anchored checklist that includes both verbal and nonverbal communication skills. This OSCE structure mirrors the ABEM Certifying Exam to promote realism, consistency, and educational relevance.</p>\n<p>Research Methods: This simulation case was initially developed by three subject matter experts with backgrounds in EM and simulation-based education. To ensure clinical accuracy, coherence, and educational relevance, the case underwent a structured peer review process. Using the Simulation Scenario Evaluation Tool (SSET), a panel of three external reviewers evaluated the case and provided targeted feedback on elements such as case realism, scenario progression, clarity of learning objectives, and alignment with assessment metrics. Following peer review, the case was pilot-tested at two EM residency programs and a national EM academic conference. These pilot implementations aimed to evaluate the case’s clarity, feasibility, and instructional design within authentic educational environments. During these sessions, faculty facilitators and learners engaged with case materials, including a standardized participant script, examiner overview, and critical actions checklist. Feedback from this beta testing phase guided revisions to enhance standardized actor prompts, case logistics, and assessment materials. </p>\n<p>Results: Expert reviewers reported strong agreement that the learning objectives of the simulation case were specific, measurable, action-oriented, relevant, time-bound, and appropriately aligned with the experience level of the intended learners. They also noted that the clinical context, scenario progression, and integrated critical actions effectively supported these learning objectives. Faculty facilitators expressed strong agreement that the accompanying case materials and resources offered adequate guidance to support independent implementation of the case at their own institutions. Learner feedback indicated that both the written and verbal instructions were easy to follow and that the experience was valuable for preparing them for the ABEM Certifying Exam.</p>\n<p>Discussion: This simulation case effectively met its educational goals and proved to be a useful resource for preparing learners for the Difficult Conversations module of the ABEM Certifying Exam. Facilitators gave high ratings across key areas, emphasizing the clarity and quality of the learning objectives, scenario flow, and supporting materials. Learners consistently noted that the case offered valuable practice in communication skills and emotional engagement. These results support the use of structured OSCEs within EM residency curricula. Through simulation, this case contributes to closing educational gaps, fostering standardization, and improving learner readiness for board certification.</p>\n<p> </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.\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": "Death notification" }, { "word": "delivering bad news" }, { "word": "Communication" }, { "word": "difficult conversations" }, { "word": "American Board of Emergency Medicine" }, { "word": "Certifying Exam" } ], "section": "Certifying Exam Practice", "is_remote": false, "remote_url": "https://jetem.org/difficult_conversation_death_notification/", "frozenauthors": [ { "first_name": "Charles", "middle_name": "", "last_name": "Lei", "name_suffix": "", "institution": "Hennepin County Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Tiffany", "middle_name": "", "last_name": "Moadel", "name_suffix": "", "institution": "Zucker School of Medicine at Hofstra/Northwell", "department": "Department of Emergency Medicine" }, { "first_name": "Suzanne", "middle_name": "", "last_name": "Bentley", "name_suffix": "", "institution": "NYC Health + Hospitals/Elmhurst; Icahn SOM at Mount Sinai", "department": "Department of Emergency Medicine" }, { "first_name": "Amrita", "middle_name": "", "last_name": "Vempati", "name_suffix": "", "institution": "Creighton School of Medicine Phoenix", "department": "Department of Emergency Medicine" }, { "first_name": "David", "middle_name": "", "last_name": "Fernandez", "name_suffix": "", "institution": "Mount Sinai Hospital", "department": "Department of Emergency Medicine" }, { "first_name": "Daniela", "middle_name": "", "last_name": "Ortiz", "name_suffix": "", "institution": "Baylor College of Medicine", "department": "Department of Emergency Medicine," }, { "first_name": "Anita", "middle_name": "", "last_name": "Rohra", "name_suffix": "", "institution": "Baylor College of Medicine", "department": "Department of Emergency Medicine" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Stapleton", "name_suffix": "", "institution": "Boston University/Boston Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Hillary", "middle_name": "", "last_name": "Moss", "name_suffix": "", "institution": "Montefiore Medical Center", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-07-18T02:22:57Z", "date_accepted": "2025-12-01T21:18:58.708000Z", "date_published": "2025-12-31T20:32:00Z", "render_galley": { "label": "Lei C, et al. Difficult Conversation Case Death Notification. JETem 2025. 10(5)CE14-29", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52354/galley/47796/download/" }, "galleys": [ { "label": "Lei C, et al. Difficult Conversation Case Death Notification. JETem 2025. 10(5)CE14-29", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52354/galley/47796/download/" } ] }, { "pk": 52353, "title": "Reassessment Case: Acute Pulmonary Edema in a Boarding Patient", "subtitle": null, "abstract": "<p>Audience: The target audience for this communication case is senior residents and junior faculty preparing for the American Board of Emergency Medicine (ABEM) Certifying Exam. Secondary audiences include junior emergency medicine (EM) residents. </p>\n<p>Introduction: Rapid identification of clinical changes, reassessment of previous diagnoses, and appropriate adjustment of interventions are critical skills in EM. This case highlights the skills needed to recognize and manage a change in condition with acute pulmonary edema, a life-threatening condition that requires prompt intervention.</p>\n<p>Educational Objectives: By the end of the case, the learner should will be able to: 1) demonstrate competency with the new ABEM Certifying Exam Reassessment case format, 2) demonstrate the ability to evaluate new information and integrate it into an existing care plan, 3) recognize signs and symptoms of pulmonary edema, 4) review possible etiologies of acute respiratory distress and the evaluation/work up to differentiate and diagnose those causes, and 5) manage pulmonary edema including implementing afterload reduction, positive pressure ventilation, and diuresis.</p>\n<p>Educational Method: This is a standardized patient scenario, in alignment with the expected reassessment case format of the ABEM Certifying Exam. This educational modality is advantageous for assessing the learner’s ability to acquire history and physical examination data in a clinical environment, as well as to communicate with a patient using clear, understandable, and appropriate language.</p>\n<p>Research Methods: This case was iteratively evaluated using facilitator and learner surveys at three sites: an academic EM residency program, the 2025 Society for Academic Emergency Medicine Annual Meeting, and a second academic EM residency program. Feedback at each site informed further refinements. A total of 11 senior resident learners and four facilitators tested the case, providing feedback on its quality and usefulness.</p>\n<p>Results: Learners and facilitators found the case well-written and effective. All 11 learners felt that the case was helpful practice for the ABEM Certifying Examination. Additionally, all facilitators felt the case materials were easy to use and would use the case again in the future. </p>\n<p>Discussion: The case was well-received by both learners and facilitators and appears to be a good preparatory tool for the Reassessment case format of the ABEM Certifying Exam.</p>\n<p> </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.\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": "pulmonary edema" }, { "word": "Sign-out" }, { "word": "reassessment" }, { "word": "Certifying Exam" } ], "section": "Certifying Exam Practice", "is_remote": false, "remote_url": "https://jetem.org/pulm_edema_reassessment/", "frozenauthors": [ { "first_name": "Tina", "middle_name": "H", "last_name": "Chen", "name_suffix": "", "institution": "St. Louis University", "department": "Department of Emergency Medicine" }, { "first_name": "David", "middle_name": "", "last_name": "Fernandez", "name_suffix": "", "institution": "Mount Sinai Hospital", "department": "" }, { "first_name": "Amrita", "middle_name": "", "last_name": "Vempati", "name_suffix": "", "institution": "Creighton University School of Medicine in Phoenix", "department": "" }, { "first_name": "Kelly", "middle_name": "", "last_name": "Roszczynialski", "name_suffix": "", "institution": "Stanford University", "department": "" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Cohen", "name_suffix": "", "institution": "University of Central Florida", "department": "" }, { "first_name": "Charles", "middle_name": "", "last_name": "Lei", "name_suffix": "", "institution": "Hennepin County Medical Center", "department": "" }, { "first_name": "Hillary", "middle_name": "", "last_name": "Moss", "name_suffix": "", "institution": "Montefiore Medical Center", "department": "" }, { "first_name": "Tiffany", "middle_name": "", "last_name": "Moadel", "name_suffix": "", "institution": "Zucker School of Medicine at Hofstra/Northwell Health", "department": "" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Stapleton", "name_suffix": "", "institution": "Boston University/Boston Medical Center", "department": "" }, { "first_name": "Lars", "middle_name": "K", "last_name": "Beattie", "name_suffix": "", "institution": "University of Florida", "department": "" } ], "date_submitted": "2025-07-18T01:47:08Z", "date_accepted": "2025-12-23T04:07:56.791000Z", "date_published": "2025-12-31T20:12:00Z", "render_galley": { "label": "Chen T, et al. Reassessment Case Acute Pulmonary Edema in a Boarding Patient. JETem 2025. 10(5)CE77-105", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52353/galley/47800/download/" }, "galleys": [ { "label": "Chen T, et al. Reassessment Case Acute Pulmonary Edema in a Boarding Patient. JETem 2025. 10(5)CE77-105", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52353/galley/47800/download/" } ] }, { "pk": 52360, "title": "Patient-Centered Communication Case: Threatened Miscarriage", "subtitle": null, "abstract": "<p>Audience: This communication case is intended for EM residents of all levels.</p>\n<p>Introduction: Patient-centered communication is a necessary skill in the practice of emergency medicine. This style of communication is crucial for promoting high-quality healthcare by prioritizing patient needs, perspectives, and values. This patient-centered communication case centers on miscarriage, a diagnosis where patient-centered communication is requisite. Approximately one in six or 17.1% of patients with a final diagnosis of miscarriage, also known as early pregnancy loss, present initially to the emergency department. Advising a patient of the diagnosis of miscarriage requires excellent communication skills including facile rapport building, empathy, nonverbal communication, and explanation of management options. </p>\n<p>Educational Objectives: By the end of this certifying exam practice case, learners will be able to: 1) establish a supportive and compassionate environment through verbal and non-verbal communication when engaging with a patient experiencing distress, anxiety, or grief related to potential pregnancy loss, 2) actively explore the patient’s understanding, concerns, values, and goals related to their pregnancy and presenting symptoms, 3) recognize and normalize a range of emotional reactions, offering validation and support regardless of the patient’s obstetric history or desired pregnancy outcomes, 4) clearly explain the diagnosis of a “threatened miscarriage,” outlining its clinical implications, inherent uncertainty, and potential outcomes, 5) review the results of any imaging or lab studies succinctly and empathetically, while verifying the patient's understanding, 6) collaborate with the patient to develop a mutually agreeable care plan, including medical recommendations, appropriate follow-up, monitoring, and return precautions.</p>\n<p>Educational Methods: This standardized patient case provides an opportunity to practice patient-centered communication and debrief on areas for improvement for the learner. The case was co-developed by experts in simulation-based education and emergency medicine resident leadership. </p>\n<p>Research Methods: Facilitators evaluated the standardized patient case via a survey for efficacy, while learners evaluated it via a survey from the learner perspective. This case was tested in a serial fashion with incremental improvements based on feedback at each step: initially, both learners and facilitators at the case writer’s institution, then learners and facilitators at the annual SAEM meeting, and finally with both at an institution outside of the case writer’s institution. Three unique learners and three unique facilitators tested the case throughout the entire process.</p>\n<p>Results: The case was reviewed favorably with minor recommendations noted, such as additional notes for the facilitator and stronger alignment between objectives and critical actions expected. Both surveys asked for demographic information and an evaluation of the case on a scale of 1-5, with 5 being the highest rating. Learners ranked the case 4.5, and then 4.8 on iterative trialing sessions. Facilitators ranked the case above 4 out of 5 for all questions. Comments centered on clarifying verbal prompts and debriefing plan.</p>\n<p>Discussion: Overall, this standardized patient case for patient communication was received positively and is recommended for use in preparation for the ABEM certifying examination.</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.\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": "Patient-centered communication" }, { "word": "threatened miscarriage" }, { "word": "Health Communication" } ], "section": "Certifying Exam Practice", "is_remote": false, "remote_url": "https://jetem.org/pcc_miscarriage/", "frozenauthors": [ { "first_name": "Anita", "middle_name": "", "last_name": "Rohra", "name_suffix": "", "institution": "Baylor College of Medicine", "department": "Department of Emergency Medicine" }, { "first_name": "Daniela", "middle_name": "", "last_name": "Ortiz", "name_suffix": "", "institution": "Baylor College of Medicine", "department": "Department of Emergency Medicine" }, { "first_name": "Shagun", "middle_name": "", "last_name": "Berry", "name_suffix": "", "institution": "Rush University Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Colleen", "middle_name": "", "last_name": "Donovan", "name_suffix": "", "institution": "Rutgers Robert Wood Johnson Medical School", "department": "Department of Emergency Medicine" }, { "first_name": "Nicole", "middle_name": "", "last_name": "Novotny", "name_suffix": "", "institution": "Ochnser Health System", "department": "Department of Emergency Medicine" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Cohen", "name_suffix": "", "institution": "University of Central Florida", "department": "Department of Emergency Medicine" }, { "first_name": "Charles", "middle_name": "", "last_name": "Lei", "name_suffix": "", "institution": "Hennepin County Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Alaa", "middle_name": "", "last_name": "Aldalati", "name_suffix": "", "institution": "University of Kansas School of Medicine-Wichita", "department": "Wesley Medical Center Emergency Department" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Stapleton", "name_suffix": "", "institution": "Boston University/Boston Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "David", "middle_name": "", "last_name": "Fernandez", "name_suffix": "", "institution": "Mount Sinai Hospital", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-07-22T19:01:28Z", "date_accepted": "2025-12-08T19:58:28.559000Z", "date_published": "2025-12-31T20:08:00Z", "render_galley": { "label": "Rohra A, et al. Patient Centered Communication Case Threatened Miscarriage. JETem 2025. 10(5)CE58-76", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52360/galley/47799/download/" }, "galleys": [ { "label": "Rohra A, et al. Patient Centered Communication Case Threatened Miscarriage. JETem 2025. 10(5)CE58-76", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52360/galley/47799/download/" } ] }, { "pk": 47233, "title": "Returning to Fitra: Teaching Yogic Mindfulness to Children through Meddy Teddy", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Articles and Personal Narratives", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/92v8r2sb", "frozenauthors": [ { "first_name": "Neda", "middle_name": "", "last_name": "Ahson", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2025-04-14T22:58:51.649000Z", "date_accepted": "2025-12-01T15:57:44.293000Z", "date_published": "2025-12-31T19:12:00Z", "render_galley": { "label": "New Galley_Ahson", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/47233/galley/47817/download/" }, "galleys": [ { "label": "Galley_Ahson", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/47233/galley/47806/download/" }, { "label": "New Galley_Ahson", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/47233/galley/47817/download/" } ] }, { "pk": 53815, "title": "Managing Conflict Case: The Difficult Consultant", "subtitle": null, "abstract": "<p>Audience: This communication case is intended for emergency medicine (EM) resident physicians and junior faculty preparing for the ABEM Certifying Exam.</p>\n<p>Introduction: Conflict management is a common and significant challenge in the emergency department (ED), with potential negative impact on both physicians and patients. At the individual level, hospital-based conflicts can lead to emotional stress, impaired concentration, decreased trust among providers, and feelings of dehumanization.¹ For patients, conflicts between physicians can compromise the quality of care and contribute to delays in treatment.¹ In the ED, conflict often arises between emergency physicians (EPs) and various stakeholders, including patients, family members, nursing staff, hospitalists, and consultants.² Recognizing its importance, the American Board of Emergency Medicine (ABEM) has identified conflict management as a core competency for emergency medicine residents and has incorporated it into the oral certification examination.³ This oral examination case was developed to help train EM residents in managing conflict—specifically between an emergency physician and a consultant—in a structured environment. </p>\n<p>Educational Objectives: By the end of the session, the learner should be able to: 1) review format and have become familiar with an ABEM Certifying Exam conflict management communication case, 2) demonstrate the ability to initiate the consultation call, establish rapport, and present a concise, evidence-based summary of the patient’s STEMI findings, 3) recognize concerns raised by the cardiologist and respond with an empathetic acknowledgment (eg, validating workload, uncertainty, or resource constraints) to support a collaborative tone, 4) articulate differing viewpoint by referencing objective clinical data (eg, ST-segment elevations, ongoing chest pain, risk from delays) when conflict is encountered and justify why urgent catheterization lab activation is indicated, and 5) identify shared goals in optimizing patient care (reducing myocardial damage and preventing deterioration) and use these to negotiate a mutually acceptable plan.</p>\n<p>Educational Methods: This is a standardized patient scenario in alignment with the expected Managing Conflict case format of the ABEM Certifying Exam. The benefits of this educational modality are that it allows for direct observation and assessment of a learner’s ability to communicate with a consultant and to observe the use of conflict resolution strategies.</p>\n<p>Research Methods: We used an iterative case trialing process with a convenience sample of EM residents. Feedback from each site was used to make iterative changes to the case material. Facilitators completed a Simulation Scenario Evaluation Tool4 (SSET) survey during the written and alpha trials to evaluate the quality of key simulation elements. Facilitators and learners used modified usability surveys to evaluate cases during the beta trials. All surveys were completed anonymously using 5-point Likert scales and free text responses. All data were collected using Qualtrics (https://www.qualtrics.com) and analyzed using Excel (Microsoft, Redmond, WA). The Boston University Institutional Review Board reviewed the project and deemed it exempt.</p>\n<p>Results: A total of 14 senior resident learners and 4 facilitators evaluated the case. The SSET data were largely positive; case objectives, key actions and materials were clear. The facilitators found the case was easy to use, and thought others would feel similarly. They felt confident using the case and would like to use this case for ABEM certifying exam practice. Over 90% of residents found both the written and verbal case materials to be clear. Ninety percent of residents reported that the experience was helpful practice for the ABEM certifying exam.</p>\n<p>Discussion: The case was well-received by both learners and facilitators due to its realism and similarity to real-life encounters and appears to be a useful preparatory tool for the ABEM Certifying Exam’s Managing Conflict case because it allows learners to practice conflict resolution skills.</p>\n<p> </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.\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": "Conflict Resolution" }, { "word": "Communication" }, { "word": "ABEM Certifying Exam" } ], "section": "Certifying Exam Practice", "is_remote": false, "remote_url": "https://jetem.org/managing_conflict_difficult_consultant/", "frozenauthors": [ { "first_name": "Amrita", "middle_name": "", "last_name": "Vempati", "name_suffix": "", "institution": "Creighton School of Medicine Phoenix", "department": "Department of Emergency Medicine" }, { "first_name": "Suzanne", "middle_name": "", "last_name": "Bentley", "name_suffix": "", "institution": "NYC Health + Hospitals/Elmhurst; Icahn SOM at Mount Sinai", "department": "Department of Emergency Medicine" }, { "first_name": "Anita", "middle_name": "", "last_name": "Rohra", "name_suffix": "", "institution": "Baylor College of Medicine", "department": "Department of Emergency Medicine" }, { "first_name": "Daniela", "middle_name": "", "last_name": "Ortiz", "name_suffix": "", "institution": "Baylor College of Medicine", "department": "Department of Emergency Medicine" }, { "first_name": "David", "middle_name": "", "last_name": "Fernandez", "name_suffix": "", "institution": "Mount Sinai Hospital", "department": "Department of Emergency Medicine" }, { "first_name": "Shagun", "middle_name": "", "last_name": "Berry", "name_suffix": "", "institution": "Rush University Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Colleen", "middle_name": "", "last_name": "Donovan", "name_suffix": "", "institution": "Rutgers Robert Wood Johnson Medical School", "department": "Department of Emergency Medicine" }, { "first_name": "Nicole", "middle_name": "", "last_name": "Novotny", "name_suffix": "", "institution": "Ochnser Health System", "department": "Department of Emergency Medicine" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Cohen", "name_suffix": "", "institution": "University of Central Florida", "department": "Department of Emergency Medicine" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Stapleton", "name_suffix": "", "institution": "Boston University/Boston Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Tiffany", "middle_name": "", "last_name": "Moadel", "name_suffix": "", "institution": "Zucker School of Medicine at Hofstra/Northwell", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-11-08T03:46:40.151000Z", "date_accepted": "2025-12-23T04:09:51.936000Z", "date_published": "2025-12-31T18:57:00Z", "render_galley": { "label": "Vempati A, et al. Managing Conflict Case The Difficult Consultant. JETem 2025. 10(5)CE43-57.pdf", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/53815/galley/47798/download/" }, "galleys": [ { "label": "Vempati A, et al. Managing Conflict Case The Difficult Consultant. JETem 2025. 10(5)CE43-57.pdf", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/53815/galley/47798/download/" } ] }, { "pk": 52341, "title": "Managing Conflict Case: Admission of a Patient with Decompensated Schizophrenia, Hypertension, and Diabetes", "subtitle": null, "abstract": "<p>Audience: This practice Certifying Exam Communication case is intended for emergency medicine resident physicians (both junior and senior).</p>\n<p>Introduction: Conflict is the result of two parties who differ in their expectations, agendas, personal needs, backgrounds, and/or communication styles. Emergency medicine physicians are faced with conflict in various forms in the workplace on a regular basis related to task content, interpersonal differences, and processes. When conflict is not managed appropriately, it can result in subpar patient care and poor team morale. Thus, conflict management is an important skill for all emergency medicine physicians. With this in mind, ABEM (the American Board of Emergency Medicine) has now chosen to assess candidates’ conflict management proficiency as part of its new Certifying Exam. As educators, we must prepare trainees for both the certification exam and the clinical setting by creating opportunities for practice, focused evaluation, and formative feedback. To strengthen our certifying exam preparation curriculum, we designed a certifying exam practice case to help residents learn how to manage conflict.</p>\n<p>Educational Objectives: The following objectives, which align with ABEM’s recommended objectives, address the nuances of managing conflict. By the end of the session, learners should be able to: 1) demonstrate familiarity with the ABEM Managing Conflict case format and structure, 2) establish rapport by developing connection and trust with the admitting physicians, 3) demonstrate understanding of the other party's position by verbalizing thoughtful and specific questions about his/her concerns, 4) explain his/her own position clearly and insightfully, 5) acknowledge divergent positions with thoughtfulness and insight, 6) identify interests shared by both the psychiatrist and hospitalist as well as what is in the best interest of the patient, and 7) propose a path forward which accounts for the interests of all parties involved.</p>\n<p>Educational Methods: We developed a 10-minute OSCE (Objective Structured Clinical Examination)-style case requiring the resident examinee to manage a conflict with consulting physicians. The ABEM certifying exam will utilize standardized patient actors. For our case, the faculty examiner served as the actor who alternated between the two roles required by the case.</p>\n<p>Research Methods: We piloted this case with 18 PGY-3 emergency medicine residents. We developed a grading rubric based on ABEM’s six published conflict-management case learning objectives. To pass the case, learners had to score 12 or more of the 18 available points (67%). Each learner was also asked to complete a post-case evaluation associated with a 5-point Likert scale.</p>\n<p>Results: When asked whether the case increased their understanding of the new ABEM certifying exam format, 18/18 (100%) of the participants replied “agree” or “strongly agree.\" When asked to assess the overall quality of the case, 16/18 (88.89%) of the participants stated that it was “very good” or “excellent.” The case received a mean score of 4.61/5. The mean critical action completion score was 17.61/18.</p>\n<p>Discussion: We sought to create a practice certifying exam case that provided learners with a high-fidelity opportunity to both understand ABEM’s new certifying exam requirements and to be evaluated on how well they managed conflict. Our results reflect that most learners felt we addressed these aims, and that overall, our educational assessment was effective.</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.\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": "conflict management" }, { "word": "Communication" }, { "word": "Certifying Exam" } ], "section": "Certifying Exam Practice", "is_remote": false, "remote_url": "https://jetem.org/managing_conflict_psych_admit/", "frozenauthors": [ { "first_name": "Monique", "middle_name": "", "last_name": "Graf", "name_suffix": "", "institution": "Baylor Scott & White All Saints Medical Center-Fort Worth", "department": "Department of Emergency Medicine" }, { "first_name": "Sonika", "middle_name": "", "last_name": "Raj", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Jedidiah", "middle_name": "", "last_name": "Leaf", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Marshall", "middle_name": "", "last_name": "Howell", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine," }, { "first_name": "Joshua", "middle_name": "", "last_name": "Ginsburg", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Brian", "middle_name": "", "last_name": "Milman", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Samuel", "middle_name": "", "last_name": "Parnell", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-06-26T14:44:23Z", "date_accepted": "2025-12-01T21:10:23.411000Z", "date_published": "2025-12-31T18:45:00Z", "render_galley": { "label": "Graf M, et al. Managing Conflict Case Admission of a Patient with Decompensated Schizophrenia, Hypertension, and Diabetes. JETem 2025. 10(5)CE30-42", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52341/galley/47797/download/" }, "galleys": [ { "label": "Graf M, et al. Managing Conflict Case Admission of a Patient with Decompensated Schizophrenia, Hypertension, and Diabetes. JETem 2025. 10(5)CE30-42", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52341/galley/47797/download/" } ] }, { "pk": 52336, "title": "Difficult Conversation Case: Missed Testicular Cancer", "subtitle": null, "abstract": "<p>Audience: We administered this case to senior emergency medicine (EM) residents, but it is appropriate for senior medical students and EM residents at all levels of training.</p>\n<p>Introduction: The practice of emergency medicine regularly requires navigating challenging conversations and delivering difficult news. The way physicians interact with patients in these cases can significantly influence outcomes, including the patient’s understanding of their diagnosis and treatment plan, satisfaction with care, and willingness to follow medical advice. It is therefore imperative that emergency medicine residency training emphasizes communication skills, which will also be tested on the new American Board of Emergency Medicine (ABEM) Certifying Exam.</p>\n<p>Educational Objectives: This difficult conversation case is intended to assess the examinee’s ability to disclose sensitive, unexpected information to a patient regarding a missed diagnosis of testicular cancer. By the end of this session, learners should be able to, 1) demonstrate effective communication, including establishing rapport, acknowledging a prior misdiagnosis, and disclosing a revised diagnosis of cancer, 2) elicit and react to the patient’s emotional and informational needs in an empathetic and professional manner, and 3) convey a patient-centered plan of care, including appropriate next steps and coordination with specialist services.</p>\n<p>Educational Methods: We created a 10-minute case in the style of an Objective Structured Clinical Exam (OSCE) requiring resident examinees to break bad news. The case was revised after pilot testing on two additional faculty members. Materials included a task sheet for examinees based on example Certifying Exam materials provided by ABEM, a script for examiners with specific attention to eliciting elements of the SPIKES and NURSE frameworks, and a scoring sheet. The faculty who created the case then served as examiners during a Mock Certifying Exam Day for PGY-3 Emergency Medicine residents; alternatively, this case can be run with a standardized patient. For the remainder of this case, we will refer to the person playing the role of patient as “examiner.” </p>\n<p>Research Methods: Residents were evaluated using a 15-point rubric, with a score of 11/15 (73%) required to pass. The rubric, which was developed based on the objectives for Difficult Conversations Cases published on the ABEM website, included the following categories: establish rapport, determine baseline knowledge, disclose information, respond and react appropriately, and provide closure. Consistent with our program’s usual OSCE workflow, each resident was evaluated by a single faculty examiner. After completing the case, each resident completed an anonymous two-item evaluation: The first item, “This case increased my understanding of the certifying exam format,” was scored on a 5-point Likert scale from “strongly disagree” to “strongly agree.” The second item, “How would you rate the overall quality of this case?” was scored on a 5-point Likert scale from “poor” to “excellent.” The survey and protocol were reviewed by our institutional IRB on 12/3/2024, and this project was determined not to meet the definition of human subjects research.</p>\n<p>Results: Seventeen PGY-3 emergency medicine residents completed the case, with a mean score of 13.35/15. Seventeen residents (100%) completed the post-case evaluation. When asked if this case increased understanding of the certifying exam format, 17 (100%) agreed or strongly agreed. When asked about the overall quality of the case, 17 (100%) said either very good or excellent. The case received a score of 4.82/5 for overall quality. </p>\n<p>Discussion: This case was effective, as evidenced by the results that all residents agreed or strongly agreed that the case increased their understanding of the certifying exam content, and all residents considered the case quality to be very good or excellent. Residents overall performed well on the case but may benefit from additional instruction on disclosure of sensitive, unwanted, or unexpected information. Specifically, residents should be taught to use the SPIKES (Setting, Perception, Invitation, Knowledge, Emotions/Empathy, Strategy/Summary) or GRIEV_ING (Gather, Resources, Identify, Educate, Verify, Give Space, Inquire, Nuts and Bolts, Give) frameworks for breaking bad news and NURSE (Naming, Understanding, Respecting, Supporting, Exploring) statements for responding to emotions. This case and its grading rubric could easily be adapted to other difficult conversation scenarios to prepare emergency medicine residents or graduates for their certifying exam. However, because each resident was evaluated by a single examiner within one residency program, inter-rater reliability could not be assessed, and generalizability may be limited. </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.\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": "Medical Education" }, { "word": "difficult conversations" }, { "word": "Breaking Bad News" }, { "word": "Communication" }, { "word": "certifying exam preparation" } ], "section": "Certifying Exam Practice", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0xp2r7sk", "frozenauthors": [ { "first_name": "Joshua", "middle_name": "", "last_name": "Ginsburg", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Sarah", "middle_name": "", "last_name": "Zamamiri", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Marshall", "middle_name": "", "last_name": "Howell", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine" }, { "first_name": "Samuel", "middle_name": "", "last_name": "Parnell", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine," }, { "first_name": "Brian", "middle_name": "", "last_name": "Milman", "name_suffix": "", "institution": "University of Texas Southwestern Medical Center", "department": "Department of Emergency Medicine" } ], "date_submitted": "2025-06-19T17:52:49Z", "date_accepted": "2025-11-22T00:07:23.465000Z", "date_published": "2025-12-31T18:14:00Z", "render_galley": { "label": "Ginsburg J, et al. Difficult Conversation Case Missed Testicular Cancer. JETem 2025. 10(5)CE1-13", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52336/galley/47794/download/" }, "galleys": [ { "label": "Ginsburg J, et al. Difficult Conversation Case Missed Testicular Cancer. JETem 2025. 10(5)CE1-13", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52336/galley/47794/download/" }, { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/uciem_jetem/article/52336/galley/47795/download/" } ] }, { "pk": 47389, "title": "Evaluation of Dizziness in the Emergency Department: Prevalence and Diagnostic Utility of Clinical Scales for Functional Vertigo", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> Functional vertigo is commonly missed in the emergency department (ED) and often misdiagnosed as other peripheral vestibular disorders. It is strongly associated with anxiety and depression, yet standardized diagnostic criteria are lacking in the ED setting, leading to unnecessary tests and misdiagnosis. We aimed to assess the diagnostic accuracy of the Vertigo Symptom Scale - Short Form - Autonomic (VSS-SF-A) and the Hospital Anxiety and Depression Scale – Anxiety (HADS-A) and – Depression (HADS-D) for distinguishing functional vertigo from other peripheral vertigos in the ED and to determine its prevalence. </p>\n<p><strong>Methods:</strong> This was a prospective, cross-sectional, observational studey of adult patients of a tertiary-care ED with dizziness.. We included patients who received an initial peripheral vertigo diagnosis from attending emergency physicians. Blinded otolaryngologists (ENT) verified all final diagnoses through standardized evaluation methods performed on the same day as the ED visit. We excluded patients with central, metabolic, cardiovascular conditions. Study participants received thorough vestibular evaluations while a separate physician, also blinded to diagnostic outcomes, administered the VSS and HADS tests, which typically require 15-20 minutes to complete. The final ENT evaluation served as the criterion reference for the diagnosis of functional vertigo. We evaluated the diagnostic accuracy of the scales through receiver operating characteristic (ROC) analysis.</p>\n<p><strong>Results: </strong>During the study period, 694 patients presented to the ED with dizziness-related complaints, of whom 69 (9.9%) met the inclusion criteria and were enrolled in the study. Of 69 patients initially diagnosed with peripheral vertigo in the ED, ENT specialists confirmed functional vertigo in 25 (36.2%) and peripheral vertigo in 44 (63.8%). Functional vertigo patients were significantly younger (43.4 ± 16.9 vs 60.1 ± 14.9 years of age, P < .001). In patients with functional vertigo, the mean VSS-SF-A, HADS-A, and HADS-D scores were 9.04, 9.28, and 7.52, respectively, compared to 3.80, 4.18, and 2.91 in peripheral vertigo cases. Conversely, the VSS-SF subscale—Vestibular-Balance (VSS-SF-V)—scores were higher in peripheral vertigo patients (13.05 vs 6.56), all P < .001. The ROC analysis showed that VSS-SF-A (cutoff ≥ 8, area under the curve [AUC] 0.85, 95% CI, 0.76-0.94) had the highest accuracy for diagnosing functional vertigo, with a sensitivity of 72% and specificity of 84.1%, followed by the HADS-A (cutoff ≥ 8, AUC = 0.81, 95% CI, 0.70-0.91), which had a sensitivity of 68% and specificity of 88.6%, while HADS-D (cutoff ≥ 4, AUC = 0.80 95% CI, 0.60-0.90) showed 76% sensitivity and 75% specificity.</p>\n<p><strong>Conclusion:</strong> Functional vertigo is an underdiagnosed condition that produces dizziness in patients. The Vertigo Symptom Scale and Hospital Anxiety and Depression Scale show promise for enhancing early diagnosis while reducing unnecessary imaging and improving patient care. Future research is needed to confirm these findings through larger multicenter cohorts. </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": "Functional vertigo" }, { "word": "dizziness" }, { "word": "Emergency Medicine" }, { "word": "Vertigo Symptom Scale" }, { "word": "Hospital Anxiety and Depression Scale" }, { "word": "Peripheral vertigo" }, { "word": "HADS" }, { "word": "VSS" } ], "section": "Neurology", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7rp5m67h", "frozenauthors": [ { "first_name": "Melis", "middle_name": "", "last_name": "Dorter", "name_suffix": "", "institution": "Primary Health Care Corporation, Doha, Qatar", "department": "" }, { "first_name": "Yusuf", "middle_name": "", "last_name": "Koksal", "name_suffix": "", "institution": "Primary Health Care Corporation, Doha, Qatar", "department": "" }, { "first_name": "Can", "middle_name": "", "last_name": "Aktas", "name_suffix": "", "institution": "Koç University Hospital, Department of Emergency Medicine, Istanbul, Türkiye", "department": "" } ], "date_submitted": "2025-05-10T06:34:58.415000Z", "date_accepted": "2025-09-15T16:13:08.931000Z", "date_published": "2025-12-31T16:37:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/47389/galley/47905/download/" } ] }, { "pk": 48368, "title": "Disrupting Monoliths: Yogi Haider's Localization of Yoga in Pakistan", "subtitle": null, "abstract": "<p>Yogi Haider, a contemporary yoga teacher from Phalia, Punjab, now based in Islamabad, offers a compelling example of what teaching yoga in Pakistan entails. Despite the shared cultural heritage between India and Pakistan, post-Partition tensions have made yoga a controversial practice in Pakistan. This study explores how Yogi Haider’s individual narrative challenges stereotypical portrayals of Pakistan and reveals yoga’s often overlooked presence in the country. It provides an alternative perspective that situates yoga within Pakistan’s cultural, religious, and political landscape, countering its exclusive association with Hindu and Indian identity. This paper argues that Yogi Haider strategically uses social media to display how he localizes his teachings by incorporating poetry, spatial markers, and historical elements. In doing so, he challenges both Pakistan’s global image and India’s sole claim to yoga. His work highlights how yoga in Pakistan is under-represented in academic and media discourse due to prevailing biases. To analyze how Yogi Haider frames his teachings for a Pakistani audience, this study employs digital ethnography and discourse analysis of his public content on Facebook and YouTube posted in both Urdu and English. Digital ethnography enables immersion in his online community to observe how he constructs his persona and represents himself. Discourse analysis offers insight into his language and intertextual references revealing how he positions yoga within the Pakistani context and disrupts dominant narratives linking it exclusively to India and Hinduism.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [ { "word": "digital ethnography" }, { "word": "Transnational Yoga" }, { "word": "Yoga and Islam" }, { "word": "Yoga in Pakistan" } ], "section": "Articles and Personal Narratives", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/99k5m865", "frozenauthors": [ { "first_name": "Diane", "middle_name": "", "last_name": "Charmey", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2025-05-31T15:43:38Z", "date_accepted": "2025-10-25T01:14:25Z", "date_published": "2025-12-31T16:23:00Z", "render_galley": { "label": "Galley_Charmey", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/48368/galley/47774/download/" }, "galleys": [ { "label": "Galley_Charmey", "type": "pdf", "path": "https://journalpub.escholarship.org/raceandyoga/article/48368/galley/47774/download/" } ] }, { "pk": 48701, "title": "Adherence to Accelerated Diagnostic Protocol for Chest Pain in Five Emergency Departments in Canada", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> In this study we sought to to assess the extent to which emergency physicians adhered to an institutional protocol for rapid chest pain assessment that incorporates a high sensitivity troponin I (hs-TnI) assay. We also sought to characterize clinical outcomes stratified by protocol adherence.</p>\n<p><strong>Methods:</strong> We conducted a retrospective cohort study that included all adult patients presenting to five major metropolitan hospital emergency departments (ED) with suspected cardiac chest pain who had at least one troponin measured. The study period was November 9, 2020–June 20, 2022. The primary outcome was protocol adherence for indeterminate-risk and high-risk patients, as defined by the protocol in use at the time of each patient’s presentation to hospital. Adjusted odds ratios (aOR) are reported with associated 95% confidence intervals.</p>\n<p><strong>Results:</strong> A total of 14,027 patients were included in the study, among whom 8,962 (63.9%) were classified as low risk, 4,064 (29.0%) as indeterminate risk, and 1,001 (7.1%) who were in the high-risk/rule-in group. Overall, 35.9% of patients had care that adhered to the chest pain pathway protocol—22.1% of indeterminate-risk patients and 91.6% of high-risk/rule-in patients. Protocol adherence among indeterminate-risk patients was 6.6% when the initial troponin was in the range of 4-19 nanograms per liter (ng/L) and 75.4% for initial troponin levels 20-99 ng/L. Male sex was most strongly associated with protocol adherence; among those receiving adherent care, 65.8% were male compared to 34.2% female (aOR 1.67; 95% CI, 1.46-1.91). Patients in the non-adherent group with an initial troponin 4-19 ng/L experienced a significantly higher incidence of major adverse cardiac events (4.5% vs 1.7%, P < .001), compared to those in the low-risk group.</p>\n<p><strong>Conclusion: </strong>Adherence to proposed assessment protocols for patients presenting to the ED with chest pain was low. This lack of adherence appears to disproportionally affect females and is associated with poor outcomes. Improving adherence to evidence-based guidelines in this setting is urgently needed.</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": "chest pain" }, { "word": "Physician Adherence" }, { "word": "Troponin" } ], "section": "Cardiology", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1053v87p", "frozenauthors": [ { "first_name": "Jesse", "middle_name": "", "last_name": "Hill", "name_suffix": "", "institution": "University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Emergency Medicine, Edmonton, Alberta, Canada", "department": "" }, { "first_name": "Esther", "middle_name": "", "last_name": "Yang", "name_suffix": "", "institution": "University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Emergency Medicine, Edmonton, Alberta, Canada; Alberta Health Services, The Alberta Strategy for Patient-Oriented Research Support Unit, Edmonton, Alberta, Canada", "department": "" }, { "first_name": "Shandra", "middle_name": "", "last_name": "Doran", "name_suffix": "", "institution": "University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Emergency Medicine, Edmonton, Alberta, Canada", "department": "" }, { "first_name": "Michelle", "middle_name": "M.", "last_name": "Graham", "name_suffix": "", "institution": "University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Medicine, Division of Cardiology, Mazankowski Heart Institute, Edmonton, Alberta, Canada", "department": "" }, { "first_name": "Sean", "middle_name": "", "last_name": "van Diepen", "name_suffix": "", "institution": "University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Medicine, Division of Cardiology, Mazankowski Heart Institute, Edmonton, Alberta, Canada", "department": "" }, { "first_name": "Joshua", "middle_name": "E.", "last_name": "Raizman", "name_suffix": "", "institution": "University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Laboratory Medicine and Pathology, Edmonton, Alberta, Canada; Alberta Precision Laboratories, Edmonton, Alberta, Canada", "department": "" }, { "first_name": "Albert", "middle_name": "KY", "last_name": "Tsui", "name_suffix": "", "institution": "University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Laboratory Medicine and Pathology, Edmonton, Alberta, Canada; Alberta Precision Laboratories, Edmonton, Alberta, Canada", "department": "" }, { "first_name": "Brian", "middle_name": "H.", "last_name": "Rowe", "name_suffix": "", "institution": "University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Emergency Medicine, Edmonton, Alberta, Canada", "department": "" } ], "date_submitted": "2025-06-19T14:51:35.094000Z", "date_accepted": "2025-10-12T21:56:30.620000Z", "date_published": "2025-12-31T16:22:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/48701/galley/47924/download/" } ] }, { "pk": 47491, "title": "First-Generation Antihistamine Use in Geriatric Emergency Department Patients: Retrospective Review", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> First-generation antihistamines are frequently used in the emergency department (ED) but are discouraged in older adults due to increased adverse drug effects. Whether concerns about adverse drug effects apply to the ED is uncertain, as ED-specific data are limited, and risks with single-dose administration may differ from risks with chronic use. In this study we assessed frequency of use, adverse drug effects, and indications of first-generation antihistamines administered to older adults during ED visits.</p>\n<p><strong>Methods:</strong> This retrospective cohort study identified adults ≥ 65 years of age who received first?generation antihistamines from January 1–December 31, 2022 in the ED at a single, urban, academic medical center. Abstractors blinded to study hypotheses identified indications for use and adverse effects through chart review. Indications other than severe allergic reactions and continuation of home use were classified as potentially inappropriate. We evaluated sex, age ≥ 85, history of cognitive impairment, drug received, and number of doses for association with adverse drug effects by regression analysis.</p>\n<p><strong>Results:</strong> First-generation antihistamines were administered in 261 encounters (3% of geriatric ED encounters). Median patient age was 71 (range 65-107, interquartile range [IQR] 67-77) and 60.5% were female. Adverse drug effects occurred in 15% of encounters, with delirium (n = 20, 7.7%) and urinary retention (n = 11, 4.2%) being the most common. On multivariate analysis, patient age ≥ 85, history of cognitive impairment, and receipt of multiple doses were associated with elevated risk of adverse drug effects, with risk ratios of 5.5 (95% CI, 2.7-11.4), 3.1 (95% CI, 1.8-5.4), and 1.9 (95% CI, 1.1-3.6), respectively. Indications were classified as potentially inappropriate in 92% of encounters. Diphenhydramine was most used in patients with headache (n = 53, 30.1% of doses) and history of iodinated contrast media reaction (n = 46, 26.1% of doses), while hydroxyzine was most used for anxiety (n = 51, 60% of doses). The kappa value between abstractors was 0.84, indicating excellent agreement. </p>\n<p><strong>Conclusion:</strong> Emergency department use of first-generation antihistamines in older adults, especially those ≥ 85 years of age and with prior cognitive impairment, was associated with infrequent but clinically significant harm. Most use was potentially inappropriate. Prophylactic use of diphenhydramine for patients with a prior reaction to iodinated contrast media emerged as a common indication.</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": [], "section": "Geriatrics", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7230n5z1", "frozenauthors": [ { "first_name": "Emily", "middle_name": "", "last_name": "Killen", "name_suffix": "", "institution": "Saint Louis University School of Medicine, St. Louis, Missouri", "department": "" }, { "first_name": "Michael", "middle_name": "", "last_name": "Cusumano", "name_suffix": "", "institution": "Saint Louis University School of Medicine, St. Louis, Missouri", "department": "" }, { "first_name": "Zidong", "middle_name": "", "last_name": "Zhang", "name_suffix": "", "institution": "Saint Louis University School of Medicine, Advanced Health Data Institute, St. Louis, Missouri", "department": "" }, { "first_name": "Richard", "middle_name": "", "last_name": "Newman", "name_suffix": "", "institution": "Saint Louis University School of Medicine, Division of Emergency Medicine, St. Louis, Missouri", "department": "" }, { "first_name": "Jamie", "middle_name": "", "last_name": "Voigtmann", "name_suffix": "", "institution": "Saint Louis University Hospital, Department of Pharmacy, St. Louis, Missouri", "department": "" }, { "first_name": "Angela", "middle_name": "M.", "last_name": "Sanford", "name_suffix": "", "institution": "Saint Louis University School of Medicine, Division of Geriatric Medicine, St. Louis, Missouri", "department": "" }, { "first_name": "Cindy", "middle_name": "C.", "last_name": "Bitter", "name_suffix": "", "institution": "Saint Louis University School of Medicine, Division of Emergency Medicine, St. Louis, Missouri", "department": "" } ], "date_submitted": "2025-05-21T01:21:17.382000Z", "date_accepted": "2025-10-12T21:53:56.199000Z", "date_published": "2025-12-31T16:13:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/47491/galley/47926/download/" } ] }, { "pk": 61874, "title": "Introduction to <em>Territories</em> issue on Gastrodiplomacy", "subtitle": null, "abstract": "", "language": "eng", "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": "Gastrodiplomacy" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1mx4126v", "frozenauthors": [ { "first_name": "Paul", "middle_name": "", "last_name": "Rockower", "name_suffix": "", "institution": "Levantine Public Diplomacy", "department": "" } ], "date_submitted": "2025-12-30T18:12:06.955000Z", "date_accepted": "2025-12-30T18:13:17.711000Z", "date_published": "2025-12-31T04:08:00Z", "render_galley": { "label": "Other", "type": "other", "path": "https://journalpub.escholarship.org/territories/article/61874/galley/47788/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/territories/article/61874/galley/47787/download/" }, { "label": "Other", "type": "other", "path": "https://journalpub.escholarship.org/territories/article/61874/galley/47788/download/" } ] }, { "pk": 61920, "title": "Review: Levine, Jill <em>Unfaithful. A Translator's Memoir </em>(2025)", "subtitle": null, "abstract": "", "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.\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": [], "section": "Book Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/80c2f4q1", "frozenauthors": [ { "first_name": "Madison", "middle_name": "", "last_name": "Felman-Panagotacos", "name_suffix": "", "institution": "Otterbein Univeristy", "department": "Department of History, Political Science, Languages & Cultures" } ], "date_submitted": "2025-12-30T19:56:18.716000Z", "date_accepted": "2025-12-30T19:57:02.180000Z", "date_published": "2025-12-31T03:58:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/territories/article/61920/galley/47786/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/territories/article/61920/galley/47786/download/" } ] }, { "pk": 39905, "title": "Thinking gastrodiplomacy through a gastrological reading of conflict", "subtitle": null, "abstract": "<p>The combination of the fields of study of gastronomy and diplomacy is generating a number of highly valuable academic works that cover multiple dimensions of knowledge and social spheres. However, the potential of gastrodiplomacy to explore conflict (or the possibility of it) has not been fully explored. This article aims to fill this gap by complementing the concept of gastrodiplomacy with that of gastrology. In this way, it aims to consider the relationship between gastronomy, diplomacy and conflict, understanding the latter as the conflict zones that emerge between communities, identities, worldviews or even different ways of understanding the value and uses of gastronomy. Based on this analysis, and assuming that gastronomy is part of every culture and, therefore, is open to a multiplicity of meanings giving rise to ambivalences, paradoxes and tensions, it will be argued that gastronomy (and gastrodiplomacy) as a tool, practice and discourse of mediation (and expansion) of estrangement tends to oscillate between the ordinary, the sublime and the grotesque. To this end, the article will refer to violent conflicts between minority and majority national groups. The aim is not to analyse each case in depth, but rather to explore the interrelationship between diplomacy and gastronomy and these conflicts. In doing so, the article will contribute to a better understanding of the potential of gastronomy and diplomacy to think about and work on difference, estrangement and conflict.</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.\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": "Gastrodiplomacy" }, { "word": "gastrology" }, { "word": "Diplomacy" }, { "word": "Conflict" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6cs404vr", "frozenauthors": [ { "first_name": "Dennis", "middle_name": "", "last_name": "Sorondo Salazar", "name_suffix": "", "institution": "University of the Basque Country", "department": "None" } ], "date_submitted": "2024-11-03T17:17:17Z", "date_accepted": "2025-10-13T00:09:00.240000Z", "date_published": "2025-12-31T03:45:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/territories/article/39905/galley/47785/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/territories/article/39905/galley/47785/download/" } ] }, { "pk": 48539, "title": "Korean War POWs’ Individual Gastrodiplomacy: Comparing Morris R. Wills and Clarence Adams’ Odyssey ", "subtitle": null, "abstract": "<p>How does food operate as a medium for informal diplomacy between individuals and nations? In what ways do citizen culinary diplomacy and individual gastrodiplomacy diverge from official or state-sponsored culinary exchanges? This article examines these questions through the experiences of two American POWs from the Korean War, Morris R. Wills and Clarence Adams, focusing on food as a site of private, people-to-people interaction. As POWs in Korea and later as foreign guests in China, Adams and Wills navigated identities suspended between official representation and personal agency, granting them unique access to Chinese diplomats and political elites. How did their trajectories evolve after returning to the United States during the Cultural Revolution? Wills attained a prestigious position at Harvard in the late 1960s, while Adams became the first African American millionaire through his ownership of a Chinese restaurant chain in the 1970s. While Wills prioritized survival—securing basic livelihood—Adams leveraged culinary entrepreneurship as a means of self-empowerment. Adams’ story, in particular, illuminates the role of semi-official food diplomacy and citizen culinary diplomacy in fostering cross-cultural understanding during a critical phase of U.S.-China relations.</p>", "language": "eng", "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": [], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/99p1t8tt", "frozenauthors": [ { "first_name": "Yanli", "middle_name": "", "last_name": "He", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2025-06-12T12:07:19.024000Z", "date_accepted": null, "date_published": "2025-12-31T03:35:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/territories/article/48539/galley/47784/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/territories/article/48539/galley/47784/download/" } ] }, { "pk": 39901, "title": "Food as a vehicle for successful inter-cultural communication among college students: Collaborative Online International Learning (COIL) in food and nutrition courses", "subtitle": null, "abstract": "<p>This case study examines how food may play a role in enhancing inter-cultural communication and collaboration through a food-related COIL project among students who are enrolled in food and nutrition courses in two different countries. Students taking a semester-long nutrition course at a university in California and students in a culinary art course in Ecuador worked in groups to complete a Food Product Analysis and Development project. The project focused on Ecuadorian food products, and most of the COIL activities involved examination of food. A qualitative evaluation revealed that food played an important role in enhancing inter-cultural communication and collaboration in different ways. First, food was an effective ice breaker and a tool for team building. Second, food also played a role in learning about culture and identifying similarities between the two cultures in a unique way. The project gave Ecuadorian students the opportunity to showcase their own culture, which provided them with a sense of pride. Among American students, learning about the history and consumption of food that was foreign to them sparked their curiosity about Ecuador. Finally, experiential learning through food, such as cooking and tasting food, appeared to help students keep motivated about the project and make the group project more enjoyable. Our findings suggest that food may be used as a vehicle for inter-cultural communication and global competency in higher education. Further research is needed to effectively evaluate learning outcomes of food-related COIL projects. The importance of developing interdisciplinary, community-based food-related COIL projects is also discussed.</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.\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": "COIL" }, { "word": "Higher education" }, { "word": "Food" }, { "word": "Culture" }, { "word": "experiential learning" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5mq2s8nk", "frozenauthors": [ { "first_name": "Keiko", "middle_name": "", "last_name": "Goto", "name_suffix": "", "institution": "Other", "department": "" }, { "first_name": "Sebastian", "middle_name": "", "last_name": "Navas", "name_suffix": "", "institution": "Universidad San Francisco de Quito (USFQ).", "department": "None" }, { "first_name": "Sally", "middle_name": "", "last_name": "Mead", "name_suffix": "", "institution": "", "department": "None" } ], "date_submitted": "2022-11-17T22:48:39Z", "date_accepted": "2025-12-30T19:03:34.703000Z", "date_published": "2025-12-31T03:07:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/territories/article/39901/galley/47783/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/territories/article/39901/galley/47783/download/" } ] }, { "pk": 62212, "title": "[SoK] Systematizing Inference Placement For Deep Learning Across Edge And Cloud Platforms: A Multi-Objective Optimization Perspective", "subtitle": null, "abstract": "<p>Edge intelligent applications like VR/AR and language model based chatbots have become widespread with the rapid expansion of IoT and mobile devices. However, constrained edge devices often cannot serve the increasingly large and complex deep learning (DL) models. To mitigate these challenges, researchers have proposed optimizing and offloading partitions of DL models among user devices, edge servers, and the cloud. In this setting, users can take advantage of different services to support their intelligent applications. For example, edge resources offer low response latency. In contrast, cloud platforms provide low monetary cost computation resources for computation-intensive workloads. However, communication between DL model partitions can introduce transmission bottlenecks and pose risks of data leakage. Recent research aims to balance accuracy, computation delay, transmission delay, and privacy concerns. They address these issues with model compression, model distillation, transmission compression, and model architecture adaptations, including internal classifiers. This survey contextualizes the state-of-the-art model offloading methods and model adaptation techniques by studying their implication to a multi-objective optimization comprising inference latency, data privacy, and resource monetary cost.</p>", "language": "eng", "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": [], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/23j1s4bg", "frozenauthors": [ { "first_name": "Zongshun", "middle_name": "", "last_name": "Zhang", "name_suffix": "", "institution": "Boston University", "department": "Department of Computer Science", "country": "United States" }, { "first_name": "Ibrahim", "middle_name": "", "last_name": "Matta", "name_suffix": "", "institution": "Boston University", "department": "Department of Computer Science", "country": "United States" } ], "date_submitted": null, "date_accepted": null, "date_published": "2025-12-30T18:45:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jsys/article/62212/galley/48046/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jsys/article/62212/galley/48046/download/" } ] }, { "pk": 61917, "title": "Review of Austin Frerick, Barons: Money, Power, and the Corruption of America’s Food Industry (Island Press, 2024)", "subtitle": null, "abstract": "", "language": null, "license": { "name": "Creative Commons Attribution-NonCommercial-ShareAlike 4.0", "short_name": "CC BY-NC-SA", "text": "<p>Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.<br>NonCommercial — You may not use the material for commercial purposes.<br>ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</p>", "url": "https://creativecommons.org/licenses/by-nc-sa/4.0/" }, "keywords": [], "section": "Book Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4r21v31z", "frozenauthors": [ { "first_name": "Carolina", "middle_name": "", "last_name": "Saito", "name_suffix": "", "institution": "University of São Paulo", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2025-12-30T16:17:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/lawandpoliticaleconomy/article/61917/galley/47782/download/" } ] }, { "pk": 61916, "title": "Review of Gerald Epstein, Busting the Bankers’ Club: Finance for the Rest of Us (University of California Press, 2024)", "subtitle": null, "abstract": "", "language": null, "license": { "name": "Creative Commons Attribution-NonCommercial-ShareAlike 4.0", "short_name": "CC BY-NC-SA", "text": "<p>Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.<br>NonCommercial — You may not use the material for commercial purposes.<br>ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</p>", "url": "https://creativecommons.org/licenses/by-nc-sa/4.0/" }, "keywords": [], "section": "Book Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9z76x7jx", "frozenauthors": [ { "first_name": "Shohini", "middle_name": "", "last_name": "Sengupta", "name_suffix": "", "institution": "UNSW Sydney", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2025-12-30T16:15:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/lawandpoliticaleconomy/article/61916/galley/47781/download/" } ] }, { "pk": 61915, "title": "Human Rights Risks in Clean Energy Supply Chains: Racial Capitalism, Critical Minerals, and Corporate Responsibility", "subtitle": null, "abstract": "<p>This paper argues that decarbonization will fail to deliver climate justice unless the transition to clean energy confronts the racialized political economy that has historically structured extractive activity and shaped international economic law. Grounding its analysis in racial capitalism, the paper contends that the growing demand for critical minerals risks reproducing patterns of exploitation, expropriation, and expulsion. Using lithium extraction in Chile as a case study, it shows how colonial legacies, dictator-era neoliberal reforms, and present-day regulatory architectures governing foreign investment and natural resource extraction have prioritized investors over human rights and the environment. Recent decisions of the International Court of Justice and the Inter-American Court of Human Rights on climate change provide a normative counterweight to international investment law and potentially a pathway for inclusive and transformative reforms. By foregrounding racial equity, the clean energy transition can avoid replicating the distributive injustices of the fossil fuel era.</p>", "language": null, "license": { "name": "Creative Commons Attribution-NonCommercial-ShareAlike 4.0", "short_name": "CC BY-NC-SA", "text": "<p>Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.<br>NonCommercial — You may not use the material for commercial purposes.<br>ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</p>", "url": "https://creativecommons.org/licenses/by-nc-sa/4.0/" }, "keywords": [], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8555p25c", "frozenauthors": [ { "first_name": "Erika", "middle_name": "", "last_name": "George", "name_suffix": "", "institution": "Boston University", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2025-12-30T16:13:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/lawandpoliticaleconomy/article/61915/galley/47780/download/" } ] }, { "pk": 61914, "title": "Racializing Nature and Naturalizing Race: Intertwined Harms in International Law", "subtitle": null, "abstract": "<p>The way people treat each other and the way they treat their environment are inextricably intertwined. Thus, it is unsurprising that five centuries of colonialism, genocide, slavery, apartheid, and racial discrimination have produced climate change, mass extinction, desertification, deforestation, and polluted air, water, and lands. The West has used international law to institutionalize unaccountability for its racism and environmental harms. This article argues that international law’s inability to stem accelerating ecological decline is attributable to and inseparable from the discipline’s racism, and vice versa. This article explores five legal techniques—comparison, objectification, exploitation, taming, and extermination—that produce racist and environmentally harmful outcomes while cloaked in the legitimacy of the law. The racializing of nature and the naturalizing of race through international law depend on the erasure of subaltern worldviews. But another international law is possible where diverse sustainable legal traditions heretofore silenced make international law on their own terms.</p>", "language": null, "license": { "name": "Creative Commons Attribution-NonCommercial-ShareAlike 4.0", "short_name": "CC BY-NC-SA", "text": "<p>Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.<br>NonCommercial — You may not use the material for commercial purposes.<br>ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</p>", "url": "https://creativecommons.org/licenses/by-nc-sa/4.0/" }, "keywords": [], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/52h256gp", "frozenauthors": [ { "first_name": "Usha", "middle_name": "", "last_name": "Natarajan", "name_suffix": "", "institution": "The University of the West Indies", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2025-12-30T16:12:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/lawandpoliticaleconomy/article/61914/galley/47779/download/" } ] }, { "pk": 61902, "title": "Racialized Landscapes and Climate Adaptation Economies", "subtitle": null, "abstract": "<p>This article examines how the enduring legacies of racial capitalism and discriminatory land policies shape climate vulnerability and adaptation in US cities, using Miami as a primary example. It highlights how flooding and heat waves disproportionately impact marginalized, historically disinvested neighborhoods, which are further threatened by displacement resulting from “climate gentrification.” Miami illustrates these dynamics, as affluent residents relocate from vulnerable coastal zones to higher-elevation, previously segregated neighborhoods, driving investment and property value increases that endanger longtime residents with displacement. The article explores how factors such as land use policy, zoning, and public investments embed racialized landscapes and drive displacement risk in these communities. The article calls for “just adaptation economies” that embed antidisplacement measures in resilience investments, support community ownership and stewardship of land instead of speculative development in historically marginalized neighborhoods, and prioritize policies that counteract persistent social and spatial inequities. The article explores a few examples of where adaptation economies are emerging through designated justice-oriented green urban development zones. </p>", "language": null, "license": { "name": "Creative Commons Attribution-NonCommercial-ShareAlike 4.0", "short_name": "CC BY-NC-SA", "text": "<p>Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.<br>NonCommercial — You may not use the material for commercial purposes.<br>ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</p>", "url": "https://creativecommons.org/licenses/by-nc-sa/4.0/" }, "keywords": [], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1f56v96k", "frozenauthors": [ { "first_name": "Sheila", "middle_name": "R.", "last_name": "Foster", "name_suffix": "", "institution": "Columbia University", "department": "" } ], "date_submitted": null, "date_accepted": null, "date_published": "2025-12-29T21:35:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/lawandpoliticaleconomy/article/61902/galley/47771/download/" } ] }, { "pk": 61901, "title": "Front Matter v5 iss4", "subtitle": null, "abstract": "", "language": null, "license": { "name": "Creative Commons Attribution-NonCommercial-ShareAlike 4.0", "short_name": "CC BY-NC-SA", "text": "<p>Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.<br>NonCommercial — You may not use the material for commercial purposes.<br>ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</p>", "url": "https://creativecommons.org/licenses/by-nc-sa/4.0/" }, "keywords": [], "section": "Front Matter", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4rn2m88w", "frozenauthors": [], "date_submitted": null, "date_accepted": null, "date_published": "2025-12-29T21:27:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/lawandpoliticaleconomy/article/61901/galley/47770/download/" }, { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/lawandpoliticaleconomy/article/61901/galley/47947/download/" } ] }, { "pk": 61756, "title": "A Tribute to Alfred Hornung, On the Occasion of His Eightieth Birthday", "subtitle": null, "abstract": "<p>.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Special Section in Honor of Alfred Hornung", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0m34p885", "frozenauthors": [ { "first_name": "Craig", "middle_name": "", "last_name": "Howes", "name_suffix": "", "institution": "U of Hawaii Manoa", "department": "" } ], "date_submitted": "2025-12-21T03:55:25.916000Z", "date_accepted": "2025-12-21T03:56:04.427000Z", "date_published": "2025-12-29T17:45:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61756/galley/47640/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61756/galley/47640/download/" } ] }, { "pk": 61877, "title": "Climate Injustice, Racial Capitalism, and the Contradictions of Property", "subtitle": null, "abstract": "<p>This article examines the legal constitution of racialized climate injustice, assessing the racialized dynamics of property in the context of climate change. It explores these examples: first, the failure of the international climate regime to contest unjust appropriation of the atmosphere by industrialized countries regarding historical emissions; second, the limitations of the “no-harm” rule, which is effectively the internationalization of the domestic principles of the tort of nuisance, in providing compensation for the racialized harm caused by climate change; and third, how international investment law is allowing fossil fuel companies to seek compensation if governmental actions in response to climate concern impact their investment or hoped-for returns.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-ShareAlike 4.0", "short_name": "CC BY-NC-SA", "text": "<p>Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.<br>NonCommercial — You may not use the material for commercial purposes.<br>ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</p>", "url": "https://creativecommons.org/licenses/by-nc-sa/4.0/" }, "keywords": [ { "word": "racial capitalism" }, { "word": "climate justice" }, { "word": "assets" }, { "word": "investment law" }, { "word": "Reparations" }, { "word": "carbon markets" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2qg8s9zw", "frozenauthors": [ { "first_name": "Julia", "middle_name": "", "last_name": "Dehm", "name_suffix": "", "institution": "La Trobe University", "department": "", "country": "Australia" } ], "date_submitted": null, "date_accepted": null, "date_published": "2025-12-29T17:00:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/lawandpoliticaleconomy/article/61877/galley/47755/download/" }, { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/lawandpoliticaleconomy/article/61877/galley/47767/download/" } ] }, { "pk": 61876, "title": "The Color of Carbon: Racial Capitalism, Climate Change, and Law", "subtitle": null, "abstract": "<p>Climate change is a direct consequence of capitalism’s drive to maximize profits through the unbridled extraction of wealth from humans and nature, aided and abetted at every turn by law. In its voracious demand for cheap labor, cheap raw materials, and cheap waste disposal, capitalism has created a treadmill of fossil fuel–dependent production and consumption that has triggered a planetary emergency. It has also produced extreme economic inequality—a racialized division of wealth grounded in colonialism that enables the ultrarich to capture the spoils of the capitalist global economy while billions of people continue to live in extreme poverty. The articles published in this special issue examine the climate emergency and other ecological crises through the framework of racial capitalism. The theory of racial capitalism offers valuable insights into capitalism’s inherently eco-destructive logic and its reliance on racial stratification for the extraction of profit.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-ShareAlike 4.0", "short_name": "CC BY-NC-SA", "text": "<p>Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.<br>NonCommercial — You may not use the material for commercial purposes.<br>ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</p>", "url": "https://creativecommons.org/licenses/by-nc-sa/4.0/" }, "keywords": [], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/02z8w43b", "frozenauthors": [ { "first_name": "Sumudu", "middle_name": "", "last_name": "Atapattu", "name_suffix": "", "institution": "University of Wisconsin", "department": "", "country": "United States" }, { "first_name": "Carmen", "middle_name": "G.", "last_name": "Gonzalez", "name_suffix": "", "institution": "Loyola University Chicago", "department": "", "country": "United States" } ], "date_submitted": null, "date_accepted": null, "date_published": "2025-12-29T17:00:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/lawandpoliticaleconomy/article/61876/galley/47754/download/" } ] }, { "pk": 53969, "title": "An updated checklist of Italian cave springtails (Collembola), with new records, species descriptions and DNA barcodes", "subtitle": null, "abstract": "<p>Springtails (Collembola) are among the most abundant subterranean invertebrates, yet knowledge of their diversity in Italian caves remains incomplete. This study serves to update the Italian cave springtail checklist, which has been previously documented as containing 106 species. The updated checklist, which incorporates data from literature up to the year 2025, as well as the results of new field surveys conducted in northern Italy and DNA barcoding analyses, now lists 134 species. Among the recorded taxa, 38 are obligate cave-dwellers and 28 are endemic, with Onychiuridae being the most represented family. The following three new species are described: <em>Onychiuroides alpinus</em> n. sp., <em>Deuteraphorura venetiana</em> n. sp., and <em>Protaphorura baldanii</em> n. sp. These species are from Veneto and Lombardy. The analysis of data from ice caves has led to the conclusion that these environments serve as refugia for cold-adapted species. Furthermore, the data suggest the presence of a previously unrecognized shared Alpine–Pyrenean lineage. These findings underscore the rich and understudied subterranean biodiversity in Italy and highlight the importance of continued taxonomic and ecological research to inform conservation strategies for vulnerable cave ecosystems.</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.\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": "Collembola" }, { "word": "Cave Biodiversity" }, { "word": "troglobiont" }, { "word": "DNA barcoding" } ], "section": "Articles", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/196133z6", "frozenauthors": [ { "first_name": "Barbara", "middle_name": "", "last_name": "Valle", "name_suffix": "", "institution": "University of Siena", "department": "Department of Life Sciences,", "country": "Italy" } ], "date_submitted": "2025-11-16T19:10:34.167000Z", "date_accepted": "2025-12-24T11:02:51.478000Z", "date_published": "2025-12-29T09:21:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/biogeographia/article/53969/galley/47763/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/biogeographia/article/53969/galley/47763/download/" } ] }, { "pk": 61338, "title": "Review of Cannon, Footsteps of the Traveller", "subtitle": null, "abstract": "", "language": "eng", "license": { "name": "Creative Commons Attribution 4.0 International (CC BY 4.0)", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes 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": "Reviews", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/76p765qd", "frozenauthors": [ { "first_name": "Thomas", "middle_name": "", "last_name": "McIlwraith", "name_suffix": "", "institution": "University of Guelph", "department": "Sociology and Anthropology" } ], "date_submitted": "2025-12-05T14:26:21.908000Z", "date_accepted": "2025-12-05T15:02:31.374000Z", "date_published": "2025-12-26T22:00:00Z", "render_galley": { "label": "Review of Cannon Footsteps of the Travel by McIlwraith", "type": "pdf", "path": "https://journalpub.escholarship.org/jac/article/61338/galley/47752/download/" }, "galleys": [ { "label": "Review of Cannon Footsteps of the Travel by McIlwraith", "type": "pdf", "path": "https://journalpub.escholarship.org/jac/article/61338/galley/47752/download/" } ] }, { "pk": 48925, "title": "Comparison of Acute Stroke Outcomes Between Code Trauma vs Code Stroke Activations", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> Patients with acute stroke may occasionally present as trauma activations, particularly after being found down or sustaining falls. This atypical presentation can delay diagnosis and treatment. Our objective in this study was to compare time to brain imaging, use of reperfusion therapies, and clinical outcomes, including discharge disposition and mortality, between patients with acute stroke presenting as code trauma activations and those presenting as code stroke activations.</p>\n<p><strong>Methods:</strong> We conducted a retrospective review of all trauma activations at our Level I trauma center from January 2018-December 2024. Patients diagnosed with acute stroke on initial trauma imaging after trauma evaluation formed the code trauma activation (CTA) group. These patients were compared to all patients diagnosed with acute stroke after a code stroke activation (CSA) in 2024. The primary outcome was door-to-imaging time; secondary outcomes included door-to-intervention time, discharge disposition, and mortality. </p>\n<p><strong>Results:</strong> There were 208 CSA patients and 198 CTA patients. The CTA patients were older (75.3 vs 70.3 years of age, P < .001) and had a higher percentage of hemorrhagic stroke (43.9% vs 14.4%, P < .001). The CTA patients had a higher National Institutes of Health Stroke Scale score (14.44 vs 9.67, P < .001). Despite minimal injuries (mean Injury Severity Score 3.3), CTA patients experienced longer times to initial brain imaging (47.4 vs 24.8 minutes, P < .001). Mean door-to-thrombolysis (50.3 vs 43.7 minutes, P = .19) and door-to-puncture time (98 vs 82 minutes, P =.18) did not differ significantly. The CTA patients had lower rates of discharge home (23.2% vs 42.8%, P < .001) and higher mortality (24.2% vs 12%, P < .001). On multivariate analysis, trauma activation itself was not independently associated with mortality (OR 1.57, CI, 0.53-4.27, P =.42). Age, stroke severity scores, hemorrhagic stroke, and early imaging were independently associated with mortality after acute stroke. </p>\n<p><strong>Conclusion:</strong> Acute stroke patients presenting as trauma activations face significant delays in imaging and lower rates of thrombolytic treatment, despite low injury burden. While trauma activation designation was not independently associated with mortality, delays in imaging and higher hemorrhage prevalence were strongly linked to worse outcomes. These findings highlight modifiable workflow opportunities, particularly streamlined imaging and early stroke recognition in low-impact trauma presentations, to improve delivery of care.</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": "stroke" }, { "word": "Trauma" } ], "section": "Neurology", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7jd8j373", "frozenauthors": [ { "first_name": "Jacob", "middle_name": "", "last_name": "Brown", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California", "department": "" }, { "first_name": "Mallory", "middle_name": "", "last_name": "Jebbia", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Surgery, Palm Springs, California", "department": "" }, { "first_name": "Esther", "middle_name": "", "last_name": "Lee", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Surgery, Palm Springs, California", "department": "" }, { "first_name": "Albert", "middle_name": "", "last_name": "Kazi", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Surgery, Palm Springs, California", "department": "" }, { "first_name": "Aaron", "middle_name": "", "last_name": "Strumwasser", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Surgery, Palm Springs, California", "department": "" }, { "first_name": "Bryan", "middle_name": "", "last_name": "Love", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Surgery, Palm Springs, California", "department": "" }, { "first_name": "John", "middle_name": "", "last_name": "Woods", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Surgery, Palm Springs, California", "department": "" }, { "first_name": "Babak", "middle_name": "", "last_name": "Khazaeni", "name_suffix": "", "institution": "Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California", "department": "" } ], "date_submitted": "2025-07-09T06:17:37.888000Z", "date_accepted": "2025-09-23T17:34:05.050000Z", "date_published": "2025-12-26T18:13:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/48925/galley/47904/download/" } ] }, { "pk": 47285, "title": "Resuscitation Leadership Education: A Needs Assessment of Emergency Medicine Residencies", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> Effective resuscitation leadership is a critical competency for emergency physicians, with evidence correlating strong leadership with improved team performance and patient outcomes during resuscitations. Despite its importance, the extent and nature of structured resuscitation leadership education in emergency medicine (EM) residency training remains unclear.</p>\n<p><strong>Methods:</strong> We conducted a voluntary, anonymous, needs assessment survey of United States (US) EM residency programs between August–October 2021. The survey assessed for the presence, content, and methods of formal resuscitation leadership curricula within these programs. We used descriptive statistics to analyze responses.</p>\n<p><strong>Results:</strong> Of the 261 US EM residency programs invited to participate, 80 responded (30.7%). Nineteen programs (23.8%) reported offering resuscitation leadership training through formal curricula, with considerable variation in both educational methods and content. Additionally, 68.4% of responding programs offered external generalized leadership development opportunities through partnerships with hospitals, universities, community organizations, and research entities.</p>\n<p><strong>Conclusion:</strong> A minority of surveyed US EM residency programs incorporate formal resuscitation leadership training into their curricula with significant variance in curricular content and educational methods. Given the critical role of resuscitation leadership in EM, our findings highlight the need for further research to evaluate the effectiveness of existing curricula and educational approaches.</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": "leadership" }, { "word": "resuscitation" }, { "word": "Graduate Medical Education" } ], "section": "Education", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/24m0p18h", "frozenauthors": [ { "first_name": "Michael", "middle_name": "", "last_name": "Sobin", "name_suffix": "", "institution": "Corewell Health William Beaumont University Hospital, Department of Emergency Medicine, Royal Oak, Michigan", "department": "" }, { "first_name": "Brett", "middle_name": "", "last_name": "Todd", "name_suffix": "", "institution": "Corewell Health William Beaumont University Hospital, Department of Emergency Medicine, Royal Oak, Michigan", "department": "" }, { "first_name": "Nai-Wei", "middle_name": "", "last_name": "Chen", "name_suffix": "", "institution": "University of Missouri School of Medicine, Department of Biomedical Informatics, Biostatistics and Medical Epidemiology, Columbia, Missouri", "department": "" }, { "first_name": "Danielle", "middle_name": "", "last_name": "Turner-Lawrence", "name_suffix": "", "institution": "Corewell Health William Beaumont University Hospital, Department of Emergency Medicine, Royal Oak, Michigan", "department": "" } ], "date_submitted": "2025-05-07T20:34:04.437000Z", "date_accepted": "2025-10-03T16:31:44.531000Z", "date_published": "2025-12-26T17:41:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/47285/galley/47902/download/" } ] }, { "pk": 49092, "title": "A Mathematical Model of Civilizational Dynamics: Quantifying Toynbee’s Challenge–Response Theory with Newtonian Mechanics", "subtitle": null, "abstract": "<p>This study presents a civilizational dynamics model that applies Newtonian mechanics to Toynbee's challenge-response theory. By defining quantifiable indicators of societal response (α) and challenge (β), the model constructs a civilizational sustainability index S(t)=lnα(t)−lnβ(t). The first, second, and third differences of S(t) are interpreted as civilizational velocity, acceleration, and jerk, respectively, offering dynamic insights into the non-linear changes of civilizational states. Simulations applied to Roman civilization (BC 100 – AD 100) identify critical transitions within this historical period, providing empirical support for Toynbee’s hypothesis that civilizations collapse when challenges are either too weak or overwhelming. The model offers a novel quantitative method to analyze civilizational resilience and decay by capturing structural transformations through mathematical dynamics. While acknowledging the limitations of quantitative modeling in the humanities, this interdisciplinary approach demonstrates significant potential for extension to fields such as economics, politics, and systemic risk analysis.</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.\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": "Toynbee’s theory" }, { "word": " civilizational dynamics" }, { "word": " Newtonian mechanics" }, { "word": " challenge-response" }, { "word": " simulation modeling" }, { "word": " historical cycles" }, { "word": " S-curve" }, { "word": " systemic collapse" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/58z1j452", "frozenauthors": [ { "first_name": "Jung", "middle_name": "Won", "last_name": "Lee", "name_suffix": "", "institution": "Lee Institute for Mathematical Science (Informal Research Center)", "department": "" } ], "date_submitted": "2025-07-22T20:58:59.467000Z", "date_accepted": "2025-11-17T12:38:23.752000Z", "date_published": "2025-12-25T12:03:00Z", "render_galley": { "label": "Final version", "type": "pdf", "path": "https://journalpub.escholarship.org/cliodynamics/article/49092/galley/48733/download/" }, "galleys": [ { "label": "Final version", "type": "pdf", "path": "https://journalpub.escholarship.org/cliodynamics/article/49092/galley/48733/download/" } ] }, { "pk": 53812, "title": "On the Life Cycle of Empires", "subtitle": null, "abstract": "<p>We provide empirical evidence that the distribution of empires' lifetime is exponential with a typical time-scale of 300 years. After introducing and computing a proxy measure for the dimension of a large polity we interpret the data by means of a simple dynamical model for the empires' evolution. The resulting theory suggests that the behavior of a long-lived empire is qualitatively different from a short-lived one. They all experience an initial expansion phase but while the former goes through a contraction period over the last $20\\%$ of its life, the latter stays essentially unchanged after reaching its maximum size. In both cases, a sudden collapse occurs when the empire's size is still close to its own historical average.</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.\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": "Empires" }, { "word": "Life cycle" }, { "word": "Collapse" }, { "word": "World History" }, { "word": "civilizations" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8p0176zr", "frozenauthors": [ { "first_name": "Stefano", "middle_name": "", "last_name": "Ciliberti", "name_suffix": "", "institution": "Paris Sciences Lettres", "department": "EPHE" } ], "date_submitted": "2025-10-31T16:53:34.124000Z", "date_accepted": "2025-11-20T13:01:33.241000Z", "date_published": "2025-12-25T11:54:00Z", "render_galley": { "label": "PDF_final", "type": "pdf", "path": "https://journalpub.escholarship.org/cliodynamics/article/53812/galley/48732/download/" }, "galleys": [ { "label": "Manuscript_final", "type": "other", "path": "https://journalpub.escholarship.org/cliodynamics/article/53812/galley/48731/download/" }, { "label": "PDF_final", "type": "pdf", "path": "https://journalpub.escholarship.org/cliodynamics/article/53812/galley/48732/download/" } ] }, { "pk": 48378, "title": "Grain Yields and the Causes of the Russian Revolution", "subtitle": null, "abstract": "<p>In the study of the causes of the Russian Revolution, the problem of the standard of living of the population plays an important role. This problem, in turn, is linked to the question of agricultural productivity. In modern historiography, both domestic and foreign, the thesis of the growing productivity of Russian agriculture in the post-reform period is considered proven - and in particular the increase in grain yields. This thesis is based on the well-known works of V.G. Mikhailovsky, V.M. Obukhov and A.S. Nifontov, in which time series of grain yields in European Russia were constructed on the basis of official statistics. Meanwhile, the opinion of the experts of the 1901 Commission is well known, who believed that the increase in yields recorded in official statistics was explained by the improvement in the system of collecting harvest data. Reforms to improve the survey system were carried out in 1870, 1883 and 1893. The author examines the dynamics of 4-year averages and shows that when 4-year periods containing the years indicated are excluded from consideration, the yield in the remaining time intervals does not increase. In other words, the increase in yield in the time series shown was explained by more detailed accounting.</p>\n<p> The period 1893-1914 is considered separately, when it is assumed that the yield data were quite accurate and no new reforms were made in the field of their collection. Previously it was assumed that the yield, calculated by the regression coefficient of the linear model, increased by 12% during this period. The author conducts a more detailed analysis and shows that the regression coefficient used previously is statistically insignificant. Thus, the claim of an increase in returns over this period cannot be statistically substantiated. Perhaps the return was a random variable independent of time.</p>\n<p>The paper also examines the dynamics of gross cereal yields per capita and shows that average per capita yields did not increase between 1893 and 1914.</p>\n<p> Thus, the prevailing opinion about the growth of agricultural productivity in Russia in the post-reform period needs to be revised</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.\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": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/3rt8w616", "frozenauthors": [ { "first_name": "Sergey", "middle_name": "", "last_name": "Nefedov", "name_suffix": "", "institution": "Sergey Nefedov", "department": "" } ], "date_submitted": "2025-06-02T05:07:33.807000Z", "date_accepted": "2025-06-02T05:08:23.446000Z", "date_published": "2025-12-25T10:30:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/cliodynamics/article/48378/galley/36431/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/cliodynamics/article/48378/galley/36431/download/" } ] }, { "pk": 53009, "title": "Growth of human capital in the regions of the Russian Empire in 1897-1913: the role of local self-government bodies (zemstva) financing ", "subtitle": null, "abstract": "<p>The previous research with incomplete data revealed that zemstva expenditure on education per capita were higher in regions with low level of education, but these spending did not make much of a difference – human capital in these regions remained relatively low (Popov, Konchakov, Didenko, 2024). The results reported in this paper provide additional and more rigorous proof that zemstva activities and the increase in their spending for education in 1897-1913 contributed to the spread of primary education and to the decline in the inequality of the distribution of human capital not only between the regions< but also within the regions (ratio of secondary to primary education enrollment). </p>\n<p>But we also show that there were more powerful forces at play – education for tuition fees, central government and city/town administration financing – that were pushing the development in an opposite direction, increasing the secondary education enrollment in most regions faster than the primary education enrollment. The result was the widening gap between low and high educated individuals that could have contributed to the formation of the intelligentsia phenomenon – educated intellectuals that were not able to find the proper place in the national economy to apply their knowledge. Intelligentsia opposition to the tsarist regime, however, did not take violent forms – regions with fast growing educational disparities registered lower, not higher increases in peasants’ unrest, industrial strikes and crimes against persons.</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.\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": "school enrollment" }, { "word": "inequality" }, { "word": "land distribution" }, { "word": "growth" }, { "word": "educational attainment" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/20p8h7j2", "frozenauthors": [ { "first_name": "Vladimir", "middle_name": "", "last_name": "Popov", "name_suffix": "", "institution": "Russian Academy of Siences", "department": "CEMI RAN" }, { "first_name": "Roman", "middle_name": "", "last_name": "Konchakov", "name_suffix": "", "institution": "RANEPA", "department": "" }, { "first_name": "Dmitry", "middle_name": "", "last_name": "Didenko", "name_suffix": "", "institution": "RANEPA", "department": "" } ], "date_submitted": "2025-10-02T16:34:47.776000Z", "date_accepted": "2025-11-18T12:09:57.663000Z", "date_published": "2025-12-25T09:41:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/cliodynamics/article/53009/galley/48762/download/" } ] }, { "pk": 50853, "title": "Quantifying History Across Eras: Benchmarking the Battle of Granicus from Troy to WWII through DEA Analysis", "subtitle": null, "abstract": "<p>The paper aims to suggest Data Envelopment Analysis (DEA), as a preliminary tool of military efficiency. This approach examines battles as a decision-making unit (DMU) characterized by multiple inputs and outputs. Data: Data are measurable indicators such as battles won, territorial expansion, casualties, and historical impact. By assigning quantitative values, the study facilitates cross-temporal comparisons of military effectiveness. Analysis: The strategic performance of Alexander the Great at the Battle of Granicus River (334 BCE) serves as a primary case study of DEA employment. The scope of analysis extends to a range of historically significant conflicts, from the Trojan War to World War II to compare with and be used as benchmarks. Results: The study demonstrates the practical utility of quantifying historical events into a single comparable metric, facilitating clearer comparisons across diverse battles ranked from highest to lowest values. </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.\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": "Quantifying history" }, { "word": "Data Envelopment Analysis (DEA)" }, { "word": "Battle of Granicus River" }, { "word": "Battlefield Benchmarking" }, { "word": "Military History Modeling" } ], "section": "Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/07k5m5q4", "frozenauthors": [ { "first_name": "Christina", "middle_name": "", "last_name": "Laspa", "name_suffix": "", "institution": "", "department": "" }, { "first_name": "Alexander", "middle_name": "", "last_name": "Laspas", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2025-09-05T21:32:30.543000Z", "date_accepted": "2025-11-18T12:09:13.950000Z", "date_published": "2025-12-25T09:32:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/cliodynamics/article/50853/galley/48751/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/cliodynamics/article/50853/galley/48751/download/" } ] }, { "pk": 47475, "title": "Emergency Department Presentations of West Nile Virus", "subtitle": null, "abstract": "<p><strong>Introduction: </strong>Maricopa County, Arizona, experienced its largest West Nile virus outbreak in 2021, with 1,487 cases and 101 deaths, in the midst of the COVID-19 pandemic. We sought to describe initial presentations of emergency department (ED) patients ultimately diagnosed with West Nile virus and determine how often patients presented to the ED before their diagnosis. To assist with disease recognition during future outbreaks, we examined in detail cases where emergency physicians initially did not suspect West Nile virus.</p>\n<p><strong>Methods:</strong> We reviewed records from May–December 2021 for patients with a positive West Nile virus result and at least one ED visit within 15 days. Data included age, sex, race, Emergency Severity Index (ESI) score, number of ED visits, chief complaint, vital signs, blood or cerebrospinal fluid (CSF) testing, diagnosis, and disposition. We excluded cases with only immoglobulin G-positive results or outpatient tests, leaving 147 cases.</p>\n<p><strong>Results: </strong>Among 147 ED West Nile virus cases, the median patient age was 67 years, with patients being predominantly male (66.7%) and White (97.3%). The most common presenting chief complaints included fever (23.8%), headache (17.7%), and generalized weakness (11.6%). Emergency physicians initiated testing for the virus in 63 cases (42.9%). Patients dispositioned (n = 84, either discharged or admitted) from the ED without initiation of testing tended to be older (median 73 vs 62 years, P < .001), with higher triage respiratory rate (mean 19.4 vs 18.3 breaths per minute, P = .05) and lower triage oxygen saturation (median 96% vs 97%; P =.02). Emergency physicians predominantly performed CSF testing (n = 42 patients) over serum testing (n = 21 patients). Patients tested via CSF had lower ESI scores than those tested via serum (ESI score of 1-2 45.3% vs 14.3%, P = .03). </p>\n<p><strong>Conclusion:</strong> Emergency physicians did not initiate testing in 57.1% of initial ED encounters of patients ultimately found to have West Nile virus. During West Nile virus outbreaks, emergency physicians should stay vigilant for less acute presentations, such as generalized weakness in elderly patients, along with typical presentations including fever and headache, to avoid delayed diagnosis.</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": "emergency department" }, { "word": "West Nile virus" } ], "section": "Endemic Infections", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/392348zt", "frozenauthors": [ { "first_name": "Kylie", "middle_name": "", "last_name": "Jenkins", "name_suffix": "", "institution": "Creighton University School of Medicine, Department of Emergency Medicine, Phoenix, Arizona; Mayo Clinic Arizona, Department of Emergency Medicine, Phoenix, Arizona", "department": "" }, { "first_name": "Wayne", "middle_name": "", "last_name": "Martini", "name_suffix": "", "institution": "Mayo Clinic Arizona, Department of Emergency Medicine, Phoenix, Arizona", "department": "" }, { "first_name": "Alyssa", "middle_name": "K.", "last_name": "McGary", "name_suffix": "", "institution": "Mayo Clinic, Department of Quantitative Health Sciences, Scottsdale, Arizona", "department": "" }, { "first_name": "Heidi", "middle_name": "E.", "last_name": "Kosiorek", "name_suffix": "", "institution": "Mayo Clinic, Department of Quantitative Health Sciences, Scottsdale, Arizona", "department": "" }, { "first_name": "Nicole", "middle_name": "R.", "last_name": "Hodgson", "name_suffix": "", "institution": "Mayo Clinic Arizona, Department of Emergency Medicine, Phoenix, Arizona", "department": "" } ], "date_submitted": "2025-05-19T17:24:00.859000Z", "date_accepted": "2025-10-08T22:57:42.289000Z", "date_published": "2025-12-24T16:19:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/47475/galley/47925/download/" } ] }, { "pk": 47456, "title": "Case Study and Qualitative Analysis of Emergency Department Community Advisory Council on Intimate Partner Violence", "subtitle": null, "abstract": "<p><strong>Introduction: </strong>As part of a quality improvement initiative, our emergency department (ED) implemented a community advisory council consisting of leaders from five community-based organizations (CBO) that provide services for survivors of intimate partner violence. We used qualitative interviews with participants from the organizations to evaluate the council by identifying factors that promoted and hindered their engagement in this partnership between the community and the ED as well as best practices for future collaborations</p>\n<p><strong>Methods:</strong> We conducted five, 30-minute semi-structured interviews, one for each CBO representative on the council. Interview questions were based on validated toolkits for evaluating community-based participatory research. We conducted thematic analysis using a barriers and facilitators framework.</p>\n<p><strong>Results:</strong> Our focus on building relationships within the community advisory council facilitated collaboration between the ED and the CBOs. We identified structural barriers to and facilitators of the relationship-building process, as well as four behaviors that promoted relationship-building within the council. These behaviors included a joint problem-solving orientation, a culture of curiosity, shared empathy between emergency clinicians and CBO members, and a deeper understanding of barriers to caring for survivors of intimate partner violence in the ED. Themes regarding the impact of the council included the results of tangible projects as well as cultural shifts in the ED as perceived by leaders of the CBOs.</p>\n<p><strong>Conclusion:</strong> We share a case study of a collaboration between the ED and community-based organizations that illustrates barriers to and facilitators of engagement by leaders of these organizations in community-healthcare partnerships. The ED is a short but meaningful stop in recovery for many survivors, and a warm handoff to a CBO can be an essential next step in their care. When rooted in mutually respectful, trusting relationships, ED-CBO partnerships have the potential to enable survivor-centered, quality improvement efforts that work to improve the continuum of care between the ED and the community.</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": "intimate partner violence" }, { "word": "community partnerships" }, { "word": "Quality Improvement" } ], "section": "Behavioral Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9xn885dr", "frozenauthors": [ { "first_name": "Eva", "middle_name": "", "last_name": "Kitlen", "name_suffix": "", "institution": "University of California, San Francisco School of Medicine, San Francisco, California", "department": "" }, { "first_name": "Alice", "middle_name": "", "last_name": "Lu", "name_suffix": "", "institution": "University of California, San Francisco School of Medicine, San Francisco, California; Mass General Brigham, Department of Emergency Medicine, Boston, Massachusetts", "department": "" }, { "first_name": "Katrin", "middle_name": "", "last_name": "Jaradeh", "name_suffix": "", "institution": "University of California, San Francisco, San Francisco General Hospital, Department of Emergency Medicine, San Francisco, California", "department": "" }, { "first_name": "Stephanie", "middle_name": "", "last_name": "Lawless", "name_suffix": "", "institution": "University of California, San Francisco, San Francisco General Hospital, Department of Emergency Medicine, San Francisco, California", "department": "" }, { "first_name": "Elizabeth", "middle_name": "", "last_name": "Raby", "name_suffix": "", "institution": "University of California, San Francisco School of Medicine, San Francisco, California", "department": "" }, { "first_name": "Theresa", "middle_name": "H", "last_name": "Cheng", "name_suffix": "", "institution": "University of California, San Francisco, San Francisco General Hospital, Department of Emergency Medicine, San Francisco, California", "department": "" }, { "first_name": "Leigh", "middle_name": "", "last_name": "Kimberg", "name_suffix": "", "institution": "University of California, San Francisco, San Francisco General Hospital, Division of General Internal Medicine, San Francisco, California", "department": "" }, { "first_name": "Christopher", "middle_name": "", "last_name": "Peabody", "name_suffix": "", "institution": "University of California, San Francisco School of Medicine, San Francisco, California; University of California, San Francisco, San Francisco General Hospital, Department of Emergency Medicine, San Francisco, California", "department": "" } ], "date_submitted": "2025-05-16T04:47:04.533000Z", "date_accepted": "2025-09-22T15:38:09.798000Z", "date_published": "2025-12-23T17:52:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/47456/galley/47912/download/" } ] }, { "pk": 4378, "title": "Pioneers of Egyptian Language Studies (1822 – 1880)", "subtitle": null, "abstract": "<p>During the six decades between 1822 and 1880, Egyptology initially witnessed intense debate over Jean-François Champollion’s decipherment of the hieroglyphic script and an emerging consensus over its validity. This was followed by an era of growing lexicographic understanding and outstanding achievements in philology and translation. The time was not yet ripe, however, for a truly linguistic analysis of the Egyptian language. For this, the Egyptological community had to wait until the 1880s—for the discoveries of a circle of scholars headed by Adolf Erman, known as the “Berlin School.”</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": [], "section": "Language, Text and Writing", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/22t5c422", "frozenauthors": [ { "first_name": "Sami", "middle_name": "", "last_name": "Uljas", "name_suffix": "", "institution": "Uppsala University", "department": "Department of Archaeology, Ancient History and Conservation; Egyptology", "country": "Sweden" } ], "date_submitted": "2009-01-29T17:47:29Z", "date_accepted": "2025-12-23T16:05:25.929000Z", "date_published": "2025-12-23T15:52:00Z", "render_galley": null, "galleys": [ { "label": "4378_Uljas_Pioneers", "type": "pdf", "path": "https://journalpub.escholarship.org/nelc_uee/article/4378/galley/47720/download/" } ] }, { "pk": 47302, "title": "Factors Associated with Patients Leaving Without Being Seen in a Canadian Emergency Department", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> Patients leaving without being seen is a critical quality metric for emergency department (ED) performance and is associated with negative patient outcomes and operational inefficiencies. In this study we aimed to systematically assess patient- and system-level factors influencing leaving-without-being-seen behavior.</p>\n<p><strong>Methods:</strong> We conducted a retrospective cohort study at The Ottawa Hospital, a tertiary-care ED with 85,000 annual ED visits in Ottawa, Canada. We analyzed all patient encounters for two years from May 2022–April 2024. Variables included demographics characteristics (age, sex), visit specifics (arrival day and time, Canadian Triage and Acuity Scale [CTAS] scores, presenting complaints), and operational metrics (ED occupancy metrics). Multivariate logistic regression analyses evaluated the influence of these factors on rates of leaving without being seen.</p>\n<p><strong>Results: </strong>Of 170,536 ED visits, 15,473 (9.1%) patients left without being seen, and 2,716 (1.6%) left before triage. Each additional 10 years of age reduced the adjusted odds of leaving without being seen by 20.2% (older patients left less frequently). Male patients had 9.4% higher adjusted odds of leaving without being seen compared to females. For every five patients waiting to be seen, the adjusted odds of leaving increased by 16.9% for a newly arriving patient. For every five patients already seen but awaiting disposition, the adjusted odds of leaving increased by 9.6% for a newly arriving patient. Compared to CTAS 2 patients (high acuity), CTAS 3 patients had 67.1% higher adjusted odds of leaving, CTAS 4 patients had 134% higher adjusted odds, and CTAS 5 patients (lowest acuity) had 176% higher adjusted odds of leaving.</p>\n<p><strong>Conclusion:</strong> Younger age, male sex, lower acuity, and ED crowding independently and significantly increase rates of leaving without being seen. Importantly, both crowding and volume of patients waiting impact left-without-being-seen behaviour. Optimizing patient flow through strategic movement within the ED may enhance the perception of progress, encouraging patients to remain for care.</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": "ED operations" }, { "word": "Patient flow" }, { "word": "Left without being seen" } ], "section": "Emergency Department Operations", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/1gt267d7", "frozenauthors": [ { "first_name": "Scott", "middle_name": "", "last_name": "Odorizzi", "name_suffix": "", "institution": "University of Ottawa, Department of Emergency Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada", "department": "" }, { "first_name": "Sandra", "middle_name": "", "last_name": "Blais-Amyot", "name_suffix": "", "institution": "The Ottawa Hospital, Ottawa, Ontario, Canada", "department": "" }, { "first_name": "Peter", "middle_name": "", "last_name": "Greenstreet", "name_suffix": "", "institution": "The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada", "department": "" }, { "first_name": "Omar", "middle_name": "", "last_name": "Anjum", "name_suffix": "", "institution": "University of Ottawa, Department of Emergency Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada", "department": "" }, { "first_name": "Jeffrey", "middle_name": "J.", "last_name": "Perry", "name_suffix": "", "institution": "University of Ottawa, Department of Emergency Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada", "department": "" } ], "date_submitted": "2025-04-25T02:33:20.935000Z", "date_accepted": "2025-09-24T23:18:14.578000Z", "date_published": "2025-12-23T14:43:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/47302/galley/47910/download/" } ] }, { "pk": 48698, "title": "Association of Shock Index and Variants with Mortality in Acute Pulmonary Embolism", "subtitle": null, "abstract": "<p><strong>Introduction: </strong>Pulmonary embolism (PE) is common with potential for morbidity and mortality. Several PE risk-stratification tools exist; however, more granular and patient-specific indicators of potential decompensation or short-term mortality that can be easily obtained are needed for the bedside clinician to further sub-stratify risk and inform management decisions. We sought to determine the association of early emergency department (ED) measurement of the shock index (SI) and SI variants (modified SI, SI to peripheral oxygen saturation ratio, age-adjusted SI, respiratory-adjusted SI, and double product) and mortality among patients with acute PE. </p>\n<p><strong>Methods: </strong>This was an observational case-control study of adult patients who presented to the ED at a single health system (January 2021–April 2023) and had PE response team (PERT) activation for newly diagnosed acute PE. We evaluated the association of 30-day in-hospital mortality with the SI (heart rate/systolic blood pressure) and variants of the SI—modified SI = heart rate/mean arterial pressure; SI to peripheral oxygen saturation ratio = SI/peripheral oxygen saturation; age-adjusted SI = age x SI; respiratory-adjusted SI = SI x (respiratory rate/10); double product = systolic blood pressure x heart rate—in addition to the Simplified Pulmonary Embolism Severity Index (sPESI) and European Society of Cardiology (ESC) risk schema. We used the area under the receiver operating characteristic curve (AUC) to assess discriminatory efficiency of the SI and each variant with the primary outcome. Multivariable logistic regression measured the association between SI and variants with 30-day mortality. </p>\n<p><strong>Results: </strong>Of 121 patients included in the study, 12 (9.9%) died. The SI and variants were all significantly different between survivors and non-survivors (P < .05), while the sPESI was not different (P = .30). The age-adjusted SI had the highest discriminatory efficiency for mortality (AUC 0.82; 95% CI, 0.71-0.93), followed by the SI (AUC 0.78; 0.67-0.89), the SI/peripheral oxygen saturation (AUC 0.77; 0.65-0.90), double product (AUC 0.76; 0.61-0.91), modified SI (AUC 0.75; 0.61-0.90), ESC risk schema (AUC 0.71; 0.52-0.90), and the respiratory-adjusted SI (AUC 0.70; 0.54-0.87).</p>\n<p><strong>Conclusion: </strong>Among patients presenting to the ED who had a PERT activation for acute PE, the age-adjusted SI had the highest discriminatory efficiency for mortality, followed by the SI and its other variants. Further investigation regarding use of the age-adjusted SI for prognostication of acute PE and implications on PE management is warranted.</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": "pulmonary embolism" }, { "word": "Shock index" }, { "word": "spesi" }, { "word": "pulmonary embolism response team" } ], "section": "Critical Care", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5cj2c69s", "frozenauthors": [ { "first_name": "Cameron", "middle_name": "P.", "last_name": "Upchurch", "name_suffix": "", "institution": "University of Vermont Larner College of Medicine, Department of Emergency Medicine, Burlington, Vermont; University of Vermont Larner College of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Burlington, Vermont", "department": "" }, { "first_name": "Kristen", "middle_name": "", "last_name": "Sanfilippo", "name_suffix": "", "institution": "Washington University in St. Louis School of Medicine, Department of Medicine, Division of Hematology, St. Louis, Missouri", "department": "" }, { "first_name": "Daphne", "middle_name": "", "last_name": "Lew", "name_suffix": "", "institution": "Washington University in St. Louis School of Medicine, Institute for Informatics, Data Science, and Biostatistics, Center for Biostatistics and Data Science, St. Louis, Missouri", "department": "" }, { "first_name": "Maanasi", "middle_name": "", "last_name": "Samant", "name_suffix": "", "institution": "Northwestern University Feinberg School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Chicago, Illinois", "department": "" }, { "first_name": "Rachel", "middle_name": "", "last_name": "McDonald", "name_suffix": "", "institution": "Washington University in St. Louis School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, St. Louis, Missouri", "department": "" } ], "date_submitted": "2025-06-19T10:07:37.254000Z", "date_accepted": "2025-09-28T10:36:45.106000Z", "date_published": "2025-12-23T13:04:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/48698/galley/47914/download/" } ] }, { "pk": 52395, "title": "Seven Steps for Emergency Physicians to Dismantle Access Barriers and Build Equitable Care Systems", "subtitle": null, "abstract": "<p>n/a</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": "Emergency Medicine" }, { "word": "addiction" }, { "word": "Reproductive Healthcare" }, { "word": "practice reform" }, { "word": "practice change" }, { "word": "buprenorphine" }, { "word": "mifepristone" }, { "word": "physician leadership" } ], "section": "Health Equity", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0m70f789", "frozenauthors": [ { "first_name": "Alicia", "middle_name": "", "last_name": "Gonzalez", "name_suffix": "", "institution": "Public Health Institute, The Bridge Center, Oakland, California; Pioneers Memorial Hospital, Brawley, California", "department": "" }, { "first_name": "Elizabeth", "middle_name": "", "last_name": "Keating", "name_suffix": "", "institution": "Public Health Institute, The Bridge Center, Oakland, California", "department": "" }, { "first_name": "Aimee", "middle_name": "", "last_name": "Moulin", "name_suffix": "", "institution": "University of California Davis Health, Department of Emergency Medicine, Davis, California; University of California Davis Health, Department of Psychiatry, Davis, California; Public Health Institute, The Bridge Center, Oakland, California", "department": "" } ], "date_submitted": "2025-09-11T21:59:26.016000Z", "date_accepted": "2025-09-14T23:09:50.518000Z", "date_published": "2025-12-23T12:03:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/52395/galley/47898/download/" } ] }, { "pk": 48357, "title": "Women with Suicidal Ideation, Substance Use Disorder, or Intimate Partner Violence in the Emergency Department: Retrospective Analysis of Contraceptive Documentation", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> Prior research demonstrates that emergency department (ED) patients with suicidal ideation (SI), substance use (SUD), and/or intimate partner violence (IPV) have disproportionate adverse outcomes for both women and infants. The 2013 Hague Protocol suggested that children with caregivers with the above characteristics are also more likely to suffer from child maltreatment. Of all pregnancies in this group, as many as 90% are unintended. We hypothesized that women with SI/SUD/IPV have gaps in care access, high levels of unscheduled care use, and reduced ED contraceptive inquiry, which if addressed could potentially improve outcomes.</p>\n<p><strong>Methods:</strong> We conducted a chart review of 62,284 ED visits from 2018–2021 from a suburban four-hospital system in the Southern United States. We compared women of reproductive age (15-44) with SI/SUD/IPV (4,776) against controls (57,508). The exposures were defined as women with SI, SUD, and/or IPV. We analyzed results using the chi-square test (χ²) with Bonferroni adjustment to test for independence and logistic regression.</p>\n<p><strong>Results: </strong>Women suffering from SI/SUD/IPV who present to the ED have contraceptive status less frequently documented compared to controls without these factors (39.5 vs 51.7%, RR 0.77, CI, 0.74-0.79, P < .001). They also have reduced access to care, with higher rates of uninsurance (32.7 vs 26.1%, P < .001), more care in the acute care environment, longer ED length of stay (LOS) (mean was 10.38 vs 3.87 hours, P < .001), higher hospitalization rates (61.0 vs 8.7%, P < .001), and higher 30-day ED revisits (11.8 vs 8.8%, P < .001), even after adjusting for the Social Vulnerability Index, acuity, age, and obesity (adjusted odds ratio 1.52 95% CI 1.36-1.70 P < .001).</p>\n<p><strong>Conclusion: </strong>Despite significant morbidity coupled with reduced access to ambulatory care and disproportionately increased ED use, little ED contraceptive documentation exists. This practice contributes to inequity, given the increased number of unintended pregnancies and greater need of contraceptives in women with suicidal ideation/substance use disorder/intimate partner violence.</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": "adverse childhood experiences" }, { "word": "Substance Use Disorder" }, { "word": "Suicide" }, { "word": "intimate partner violence" }, { "word": "Behavioral Emergencies" }, { "word": "contraception" } ], "section": "Women's Health", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8f27376k", "frozenauthors": [ { "first_name": "Alison", "middle_name": "", "last_name": "Ruch", "name_suffix": "", "institution": "Northeast Georgia Medical Center, Department of Emergency Medicine, Gainesville, Georgia", "department": "" }, { "first_name": "Adam", "middle_name": "", "last_name": "Henderson", "name_suffix": "", "institution": "Medical College of Georgia at Augusta University, Department of Emergency Medicine, Augusta, Georgia", "department": "" }, { "first_name": "Ania", "middle_name": "Izabela", "last_name": "Rynarzewska", "name_suffix": "", "institution": "Georgia College and State University, Department of Management, Marketing & Logistics Department, Milledgeville, Georgia", "department": "" }, { "first_name": "Hardeep", "middle_name": "", "last_name": "Singh", "name_suffix": "", "institution": "Northeast Georgia Medical Center, Department of GME Research & Quality Improvement, Gainesville, Georgia", "department": "" }, { "first_name": "louise", "middle_name": "", "last_name": "jones", "name_suffix": "", "institution": "Northeast Georgia Medical Center, Department of GME Research & Quality Improvement, Gainesville, Georgia", "department": "" } ], "date_submitted": "2025-05-30T08:06:22.091000Z", "date_accepted": "2025-09-24T23:10:57.296000Z", "date_published": "2025-12-23T09:28:00Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/48357/galley/47907/download/" } ] }, { "pk": 61859, "title": "<em>JRWS</em>, vol. 3, iss. 2 (2025)", "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": "Full Issue", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/21z721js", "frozenauthors": [], "date_submitted": "2025-12-23T04:56:31.424000Z", "date_accepted": "2025-12-23T04:57:34.111000Z", "date_published": "2025-12-23T05:02:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/61859/galley/47717/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/61859/galley/47717/download/" } ] }, { "pk": 61696, "title": "Introduction", "subtitle": null, "abstract": "<p>.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Special Section in Honor of Alfred Hornung", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9zn3355z", "frozenauthors": [ { "first_name": "Mita", "middle_name": "", "last_name": "Banerjee", "name_suffix": "", "institution": "Johannes Gutenberg-Universitaet Mainz", "department": "", "country": "Germany" } ], "date_submitted": "2025-12-18T01:09:28.489000Z", "date_accepted": "2025-12-18T01:10:13.700000Z", "date_published": "2025-12-23T01:31:00Z", "render_galley": { "label": "Other", "type": "other", "path": "https://journalpub.escholarship.org/jtas/article/61696/galley/47715/download/" }, "galleys": [ { "label": "Other", "type": "other", "path": "https://journalpub.escholarship.org/jtas/article/61696/galley/47715/download/" } ] }, { "pk": 43559, "title": "“A Planet-Wide Race War”: The Global Circulation of White Supremacist Violence in the Late Twentieth Century", "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": "White Supremacy" }, { "word": "Political violence" }, { "word": "terrorism" }, { "word": "Neo-Nazism" }, { "word": "Europe" }, { "word": "Britain" }, { "word": "Rhodesia" }, { "word": "Yugoslavia" }, { "word": "Northern Ireland" }, { "word": "Central America" }, { "word": "transnational right" }, { "word": "global terrorism" } ], "section": "Research Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/4ch6s67r", "frozenauthors": [ { "first_name": "Kyle", "middle_name": "", "last_name": "Burke", "name_suffix": "", "institution": "University of South Florida", "department": "History" } ], "date_submitted": "2025-02-21T20:27:29.790000Z", "date_accepted": "2025-12-22T05:21:37.912000Z", "date_published": "2025-12-23T00:59:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/43559/galley/47650/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/43559/galley/47650/download/" } ] }, { "pk": 46804, "title": "Mapping the Influence of Conservative Catholic Political Thought on the American Right", "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": "American political thought" }, { "word": "authoritarianism" }, { "word": "postliberlism" }, { "word": "conservative Catholicism" }, { "word": "integralism" }, { "word": "communitarianism" } ], "section": "Research Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8r36g830", "frozenauthors": [ { "first_name": "Chelsea", "middle_name": "", "last_name": "Ebin", "name_suffix": "", "institution": "Drew University", "department": "" } ], "date_submitted": "2025-03-10T15:27:58.116000Z", "date_accepted": "2025-12-22T05:13:50.122000Z", "date_published": "2025-12-23T00:56:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/46804/galley/47647/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/46804/galley/47647/download/" } ] }, { "pk": 43546, "title": "The Klandidate: Senator Earle B. Mayfield and the Ku Klux Klan in Federal Politics", "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": "Ku Klux Klan" }, { "word": "Nativism" }, { "word": "racism" }, { "word": "1920s" }, { "word": "United States federal politics" } ], "section": "Research Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/853199mj", "frozenauthors": [ { "first_name": "Felix", "middle_name": "", "last_name": "Harcourt", "name_suffix": "", "institution": "Austin College", "department": "History" } ], "date_submitted": "2025-02-19T17:09:18.476000Z", "date_accepted": "2025-12-22T05:19:49.896000Z", "date_published": "2025-12-23T00:52:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/43546/galley/47649/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/43546/galley/47649/download/" } ] }, { "pk": 61763, "title": "Introduction—When the Radical Becomes Ordinary: A State of the Field of the Far Right in US History", "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": "Research Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9sg020kg", "frozenauthors": [ { "first_name": "Olivier", "middle_name": "", "last_name": "Burtin", "name_suffix": "", "institution": "", "department": "" } ], "date_submitted": "2025-12-22T05:08:16.234000Z", "date_accepted": "2025-12-22T05:09:33.686000Z", "date_published": "2025-12-23T00:50:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/61763/galley/47646/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/61763/galley/47646/download/" } ] }, { "pk": 46988, "title": "“Democracy Must Be Made Safe for the World”: Ralph Adams Cram and the Tradition of American Monarchism", "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": "Ralph Adams Cram" }, { "word": "Curtis Yarvin" }, { "word": "Dark Enlightenment" }, { "word": "far-right" }, { "word": "monarchism" }, { "word": "Neoreaction" }, { "word": "Political Thought" } ], "section": "Research Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2rx1b05z", "frozenauthors": [ { "first_name": "Christian", "middle_name": "T.", "last_name": "Ruth", "name_suffix": "", "institution": "University of Florida", "department": "Civics and Classical Education" } ], "date_submitted": "2025-03-10T21:52:12.961000Z", "date_accepted": "2025-12-22T05:17:19.444000Z", "date_published": "2025-12-23T00:48:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/46988/galley/47648/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/46988/galley/47648/download/" } ] }, { "pk": 61766, "title": "3.2 front matter", "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": "Front Matter", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/2q15k8jh", "frozenauthors": [], "date_submitted": "2025-12-22T06:03:45Z", "date_accepted": "2025-12-22T06:05:51.972000Z", "date_published": "2025-12-23T00:44:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/61766/galley/47654/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/61766/galley/47654/download/" } ] }, { "pk": 61764, "title": "God's Soldiers: Clerico-Fascism and the Deep History of Christian Nationalism", "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": "Essay", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/56z0s6qc", "frozenauthors": [ { "first_name": "Alex", "middle_name": "", "last_name": "McPhee-Browne", "name_suffix": "", "institution": "Cambridge University", "department": "" } ], "date_submitted": "2025-12-22T05:29:17.724000Z", "date_accepted": "2025-12-22T05:30:39.056000Z", "date_published": "2025-12-23T00:13:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/61764/galley/47652/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/61764/galley/47652/download/" } ] }, { "pk": 45136, "title": "\"Chased from the Mainstream\": Tito Perdue and Far-Right Fiction Read via Bourdieu's Field Theory", "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": "Tito Perdue" }, { "word": "Greg Johnson" }, { "word": "Literary Field" }, { "word": "Pierre Bourdieu" }, { "word": "Metapolitics" }, { "word": "far-right fiction" } ], "section": "Research Article", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8w7855vc", "frozenauthors": [ { "first_name": "Sof", "middle_name": "", "last_name": "Sabbioni", "name_suffix": "", "institution": "University of Basel", "department": "Department of Languages and Literatures" } ], "date_submitted": "2025-02-28T12:11:44.643000Z", "date_accepted": "2025-12-22T05:25:04.275000Z", "date_published": "2025-12-23T00:11:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/45136/galley/47651/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/45136/galley/47651/download/" } ] }, { "pk": 61741, "title": "Alfred at Eighty--Really?", "subtitle": null, "abstract": "<p>.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Special Section in Honor of Alfred Hornung", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/9z37g8ds", "frozenauthors": [ { "first_name": "Susanne", "middle_name": "", "last_name": "Becker von Dadelsen", "name_suffix": "", "institution": "ZDF public broadcaster", "department": "Culture" } ], "date_submitted": "2025-12-19T22:08:11.846000Z", "date_accepted": "2025-12-20T11:47:31.035000Z", "date_published": "2025-12-22T20:44:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61741/galley/47644/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61741/galley/47644/download/" } ] }, { "pk": 61667, "title": "Reflective Essay for Alfred Hornung's Eightieth Birthday", "subtitle": null, "abstract": "<p>.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Special Section in Honor of Alfred Hornung", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6795q6sc", "frozenauthors": [ { "first_name": "Aiko", "middle_name": "", "last_name": "Takeuchi-Demirci", "name_suffix": "", "institution": "Stanford University", "department": "International Relations" } ], "date_submitted": "2025-12-15T23:11:11.760000Z", "date_accepted": "2025-12-15T23:12:02.247000Z", "date_published": "2025-12-22T19:12:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61667/galley/47577/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61667/galley/47577/download/" } ] }, { "pk": 61765, "title": "3.2 letter from the editor", "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": "Letter from the Editor", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6bb1x8mm", "frozenauthors": [ { "first_name": "Lawrence", "middle_name": "", "last_name": "Rosenthal", "name_suffix": "", "institution": "University of California, Berkeley", "department": "" } ], "date_submitted": "2025-12-22T05:34:47.906000Z", "date_accepted": "2025-12-22T06:01:10.019000Z", "date_published": "2025-12-22T18:47:10.059000Z", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/61765/galley/47653/download/" }, { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jrws/article/61765/galley/47711/download/" } ] }, { "pk": 61854, "title": "American Eagles and Tibetan Vultures", "subtitle": null, "abstract": "<p>.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Special Section in Honor of Alfred Hornung", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/364789zk", "frozenauthors": [ { "first_name": "Nadja", "middle_name": "", "last_name": "Gernalzick", "name_suffix": "", "institution": "Johannes Gutenberg-Universitaet Mainz", "department": "Obama Institute for Transnational American Studies" } ], "date_submitted": "2025-12-22T17:47:53.075000Z", "date_accepted": "2025-12-22T17:48:34.926000Z", "date_published": "2025-12-22T16:59:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61854/galley/47708/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61854/galley/47708/download/" } ] }, { "pk": 54369, "title": "The new Checklist of the Italian Fauna: Cladocera (Branchiopoda: Ctenopoda, Anomopoda, Onychopoda, and Haplopoda)", "subtitle": null, "abstract": "<p>The new Checklist of the Italian Fauna provides an updated inventory of Cladocera species in Italy, encompassing the orders Ctenopoda, Anomopoda, Onychopoda, and Haplopoda. The checklist contains 121 species belonging to 13 families, with Chydoridae and Daphniidae being the most abundant. Seven freshwater species have been added since the previous checklist, while the number of marine species remains unchanged at six. Following recent taxonomic revisions, changes in the nomenclature have been introduced, primarily within the subfamily Aloninae. None of the species is endemic to Italy, but six are considered alien. The presence of species in each macroregion and administrative region is reported, with the number of species per region ranging from 10 in Molise to 77 in Lombardy administrative regions. A total of 165 new regional citations are recorded, with southern regions showing increases exceeding 40% of their total records respect to the previously reported ones in the CKmap database published in 2005. Although the total number of Italian cladoceran species is well known, their taxonomy is still evolving, particularly within Aloninae and Daphniinae. Molecular studies are expected to reveal cryptic species and refine biogeographic patterns.</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.\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": "biogeography" }, { "word": "Limnology" }, { "word": "Marine biology" }, { "word": "species list" }, { "word": "species distribution" }, { "word": "taxonomy" } ], "section": "Special Section: The new Checklist of the Italian Fauna", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/8zx3540x", "frozenauthors": [ { "first_name": "Daria", "middle_name": "", "last_name": "Vagaggini", "name_suffix": "", "institution": "1 Italian Institute for Environmental Protection and Research (ISPRA)", "department": "" }, { "first_name": "Federico", "middle_name": "", "last_name": "Marrone", "name_suffix": "", "institution": "University of Palermo", "department": "STEBICEF" }, { "first_name": "Fabio", "middle_name": "", "last_name": "Stoch", "name_suffix": "", "institution": "Université libre de Bruxelles", "department": "Evolutionary Biology & Ecology" }, { "first_name": "Fiorenza", "middle_name": "Gabriella", "last_name": "Margaritora", "name_suffix": "", "institution": "Sapienza Università di Roma", "department": "Dipartimento di Biologia e Biotecnologie ‘Charles Darwin’" } ], "date_submitted": "2025-11-24T17:22:38.368000Z", "date_accepted": "2025-12-12T19:29:44.985000Z", "date_published": "2025-12-22T07:30:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/biogeographia/article/54369/galley/47656/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/biogeographia/article/54369/galley/47656/download/" } ] }, { "pk": 61850, "title": "A Tribute to Alfred Hornung", "subtitle": null, "abstract": "<p>.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Special Section in Honor of Alfred Hornung", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/7275g53j", "frozenauthors": [ { "first_name": "Greg", "middle_name": "", "last_name": "Robinson", "name_suffix": "", "institution": "Université du Québec À Montréal", "department": "", "country": "Canada" } ], "date_submitted": "2025-12-22T16:37:21.324000Z", "date_accepted": "2025-12-22T16:40:35.032000Z", "date_published": "2025-12-22T05:01:00Z", "render_galley": { "label": "PDF", "type": "other", "path": "https://journalpub.escholarship.org/jtas/article/61850/galley/47704/download/" }, "galleys": [ { "label": "PDF", "type": "other", "path": "https://journalpub.escholarship.org/jtas/article/61850/galley/47704/download/" } ] }, { "pk": 61670, "title": "Ceci n'est pas une Laudatio", "subtitle": null, "abstract": "<p>.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Special Section in Honor of Alfred Hornung", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5g99346k", "frozenauthors": [ { "first_name": "Kerstin", "middle_name": "", "last_name": "Vogel", "name_suffix": "", "institution": "Johannes Gutenberg University Mainz", "department": "President's Office" } ], "date_submitted": "2025-12-16T07:29:07.764000Z", "date_accepted": "2025-12-17T17:07:45.271000Z", "date_published": "2025-12-22T05:01:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61670/galley/47603/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61670/galley/47603/download/" } ] }, { "pk": 61677, "title": "George Saunders and the NASDAQ Variations: An Introduction for Students of American Literature", "subtitle": null, "abstract": "<p>.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [ { "word": "George Saunders" }, { "word": "large language models" }, { "word": "Alfred Hornung" }, { "word": "literary quality" }, { "word": "artistic quality" } ], "section": "Special Section in Honor of Alfred Hornung", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6fw975x2", "frozenauthors": [ { "first_name": "Birgit", "middle_name": "", "last_name": "Däwes", "name_suffix": "", "institution": "University of Flensburg", "department": "English and American Studies" } ], "date_submitted": "2025-12-16T11:32:26.697000Z", "date_accepted": "2025-12-17T17:09:59.760000Z", "date_published": "2025-12-22T05:01:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61677/galley/47713/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61677/galley/47713/download/" } ] }, { "pk": 61683, "title": "To the Only \"Super Global Professor of American Studies\" I Know ", "subtitle": null, "abstract": "<p>.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Special Section in Honor of Alfred Hornung", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/229136d6", "frozenauthors": [ { "first_name": "Carmen", "middle_name": "", "last_name": "Birkle", "name_suffix": "", "institution": "Marburg University", "department": "Institute of English and American Studies" } ], "date_submitted": "2025-12-16T19:43:07.210000Z", "date_accepted": "2025-12-17T17:06:46.300000Z", "date_published": "2025-12-22T05:01:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61683/galley/47602/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61683/galley/47602/download/" } ] }, { "pk": 61724, "title": "Alfred Hornung: An Inspiring Transnational Scholar", "subtitle": null, "abstract": "<p>.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0", "short_name": "CC BY-NC-ND 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by-nc-nd/4.0" }, "keywords": [], "section": "Special Section in Honor of Alfred Hornung", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5jg5k0cx", "frozenauthors": [ { "first_name": "Hubert", "middle_name": "", "last_name": "Zapf", "name_suffix": "", "institution": "University of Augsburg", "department": "Enghlish and American Studies" } ], "date_submitted": "2025-12-19T10:52:25.273000Z", "date_accepted": "2025-12-19T11:15:52.876000Z", "date_published": "2025-12-21T23:01:00Z", "render_galley": { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61724/galley/47642/download/" }, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/jtas/article/61724/galley/47642/download/" } ] } ] }