{"count":39500,"next":"https://eartharxiv.org/api/articles/?format=json&limit=100&offset=13200","previous":"https://eartharxiv.org/api/articles/?format=json&limit=100&offset=13000","results":[{"pk":860,"title":"Spontaneous Isolated Celiac Artery Dissection: A Case Report","subtitle":null,"abstract":"Introduction:\n Abdominal pain is a common chief complaint that can represent a wide breadth of diagnoses, ranging from benign to life-threatening. As our diagnostic tools become more sophisticated, we are able to better identify more causes of potentially life-threatening diseases. One such disease that is relatively unfamiliar to clinicians is spontaneous isolated celiac artery dissection (SICAD).\nCase Report:\n We describe a case of a 46-year-old man who presented to our emergency department with a chief complaint of abdominal pain and was found to have a SICAD and was successfully treated with anticoagulation, antihypertensives, and observation.\nConclusion:\n It is important for emergency physicians to keep this potentially life-threatening condition in mind and to know the appropriate first steps once identified.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"SICAD"},{"word":"spontaneous isolated celiac artery dissection"},{"word":"abdominal pain"},{"word":"imaging"},{"word":"computed tomography"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5sj1j8h4","frozenauthors":[{"first_name":"Clifford","middle_name":"L.","last_name":"Freeman","name_suffix":"","institution":"Vanderbilt University Medical Center, Department of Emergency Medicine, Nashville, Tennessee","department":"None"},{"first_name":"Aaron","middle_name":"J.","last_name":"Lacy","name_suffix":"","institution":"Vanderbilt University Medical Center, Department of Emergency Medicine, Nashville, Tennessee","department":"None"},{"first_name":"Aubrey","middle_name":"","last_name":"Miner","name_suffix":"","institution":"Vanderbilt University Medical Center, Department of Emergency Medicine, Nashville, Tennessee","department":"None"},{"first_name":"Devin","middle_name":"M.","last_name":"Rogers","name_suffix":"","institution":"Vanderbilt University Medical Center, Department of Emergency Medicine, Nashville, Tennessee","department":"None"},{"first_name":"Austin","middle_name":"T.","last_name":"Smith","name_suffix":"","institution":"Intermountain Healthcare, Park City Hospital, Department of Emergency Medicine, Park City, Utah","department":"None"},{"first_name":"Karan","middle_name":"S.","last_name":"Shah","name_suffix":"","institution":"Indiana University School of Medicine, Department of Emergency Medicine, Indianapolis, Indiana","department":"None"}],"date_submitted":"2020-07-03T22:18:27+02:00","date_accepted":"2020-07-03T22:18:27+02:00","date_published":"2020-07-03T22:19:21+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/860/galley/610/download/"}]},{"pk":13532,"title":"Conference Didactic Planning and Structure: An Evidence-based Guide to Best Practices from the Council of Emergency Medicine Residency Directors","subtitle":null,"abstract":"Emergency medicine residency programs around the country develop didactic conferences to prepare residents for board exams and independent practice. To our knowledge, there is not currently an evidence-based set of guidelines for programs to follow to ensure maximal benefit of didactics for learners. This paper offers expert guidelines for didactic instruction from members of the Council of Emergency Medicine Residency Directors Best Practices Subcommittee, based on best available evidence. Programs can use these recommendations to further optimize their resident conference structure and content. Recommendations in this manuscript include best practices in formatting didactics, selection of facilitators and instructors, and duration of individual sessions. Authors also recommend following the Model of Clinical Practice of Emergency Medicine when developing content, while incorporating sessions dedicated to morbidity and mortality, research methodology, journal article review, administration, wellness, and professionalism.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Best Practicies"},{"word":"Emergency Medicine"},{"word":"Residency"},{"word":"didactics"},{"word":"conferences"},{"word":"Medical Education"},{"word":"Post-Graduate Education"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3vm9q9vr","frozenauthors":[{"first_name":"D.","middle_name":"Brian","last_name":"Wood","name_suffix":"","institution":"St. Joseph’s Medical Center, Department of Emergency Medicine, Stockton, California","department":"None"},{"first_name":"Jaime","middle_name":"","last_name":"Jordan","name_suffix":"","institution":"Ronald Reagan UCLA Medical Center, David Geffen School of Medicine, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Rob","middle_name":"","last_name":"Cooney","name_suffix":"","institution":"Geisinger Commonwealth School of Medicine, Department of Emergency Medicine, Scranton, Pennsylvania","department":"None"},{"first_name":"Katja","middle_name":"","last_name":"Goldflam","name_suffix":"","institution":"Yale University, Department of Emergency Medicine, New Haven, Connecticut","department":"None"},{"first_name":"Leah","middle_name":"","last_name":"Bright","name_suffix":"","institution":"Johns Hopkins University, Department of Emergency Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Gottlieb","name_suffix":"","institution":"Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois","department":"None"}],"date_submitted":"2020-02-04T22:28:49+02:00","date_accepted":"2020-02-04T22:28:49+02:00","date_published":"2020-07-03T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13532/galley/7085/download/"}]},{"pk":45264,"title":"TRANSIT Vol. 13.1 Traveling Forms","subtitle":null,"abstract":"TRANSIT Vol. 13.1 Call for Papers: Traveling Forms","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Open Forum","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0qh7x7f7","frozenauthors":[{"first_name":"Michael","middle_name":"","last_name":"Sandberg","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2020-07-04T00:23:54+02:00","date_accepted":"2020-07-04T00:23:54+02:00","date_published":"2020-07-03T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/transit/article/45264/galley/34056/download/"}]},{"pk":13592,"title":"A Review of Journal Impact Metrics and Characteristics to Assist Emergency Medicine Investigators with Manuscript Submission Decisions","subtitle":null,"abstract":"Introduction:\n A crucial, yet subjective and non-evidence-based, decision for researchers is where to submit their original research manuscripts. The approach of submitting to journals in descending order of impact factor (IF) is a common but imperfect strategy. The validity of the IF as a measure of journal quality and significance is suspect, and a number of other journal impact scores have emerged, such that no one scale is universally accepted. Furthermore, practical considerations, such as likelihood of manuscript acceptance rates and times for decisions, may influence how authors prioritize journals. In this report, we sought to 1) review emergency medicine (EM) journal impact metrics, and 2) provide a comprehensive list of pertinent journal characteristics that may influence researchers’ choice of submission.\nMethods:\n We systematically reviewed five impact metrics (IF, H Index, CiteScore, Source-Normalized Impact per Paper, and SCImago Journal Rank) and other relevant characteristics of 20 EM journals.\nResults: \nWe found good to excellent agreement in ordinal rankings of four of the journal impact metrics, as measured by the Spearman rank correlation coefficient. The median acceptance rate for original research manuscripts in the EM category was 25% (interquartile range [IQR] 18, 31%), and the median initial decision time was 33 days (IQR 18, 56 days). Fourteen EM journals (70%) accepted brief reports, and 15 (75%) accepted case reports/images.\nConclusion:\n We recommend replication, expansion, and formalization of this repository of information for EM investigators in a continuously updated, open-access forum sponsored by an independent organization.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Research Publishing","is_remote":true,"remote_url":"https://escholarship.org/uc/item/31n1z22z","frozenauthors":[{"first_name":"Robert","middle_name":"M.","last_name":"Rodriguez","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San Francisco, California","department":"None"},{"first_name":"Virginia","middle_name":"","last_name":"Chan","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San Francisco, California","department":"None"},{"first_name":"Angela","middle_name":"H.K.","last_name":"Wong","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San Francisco, California","department":"None"},{"first_name":"Juan Carlos","middle_name":"C.","last_name":"Montoy","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San Francisco, California","department":"None"}],"date_submitted":"2020-02-20T21:51:08+02:00","date_accepted":"2020-02-20T21:51:08+02:00","date_published":"2020-07-03T06:05:16+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13592/galley/7110/download/"}]},{"pk":13596,"title":"The Incidence of QT Prolongation and Torsades des Pointes in Patients Receiving Droperidol in an Urban  Emergency Department","subtitle":null,"abstract":"Introduction: \nDroperidol carries a boxed warning from the United States Food and Drug Administration for QT prolongation and torsades des pointes (TdP). After a six-year hiatus, droperidol again became widely available in the US in early 2019. With its return, clinicians must again make decisions regarding the boxed warning. Thus, the objective of this study was to report the incidence of QT prolongation or TdP in patients receiving droperidol in the ED.\nMethods:\n Patients receiving droperidol at an urban Level I trauma center from 1997–2001 were identified via electronic health record query. All patients were reviewed for cardiac arrest. We reviewed electrocardiogram (ECG) data for both critically-ill and noncritical patients and recorded Bazett’s corrected QT intervals (QTc). ECGs from critically-ill patients undergoing resuscitation were further risk-stratified using the QT nomogram.\nResults:\n Of noncritical patients, 15,374 received 18,020 doses of droperidol; 2,431 had an ECG. In patients with ECGs before and after droperidol, the mean QTc was 424.3 milliseconds (ms) (95% confidence interval [CI], 419.7-428.9) before and 427.6 ms (95% CI, 424.3-430.9), after droperidol(n = 170). Regarding critically-ill patients, 1,172 received droperidol and 396 had an ECG. In the critically-ill group with ECGs before and after droperidol mean QTc was 435.7 ms (95% CI, 426.7–444.7) before and 435.8 ms (95% CI, 427.5–444.1) after droperidol (n = 114). Of 337 ECGs suitable for plotting on the QT nomogram, 13 (3.8%) were above the “at-risk” line; 3/136 (2.2%; 95% CI, 0.05-6.3%) in the before group, and 10/202 (4.9%; 95% CI, 2.4%-8.9%) in the after group. A single case of TdP occurred in a patient with multiple risk factors that did not reoccur after a droperidol rechallenge. Thus, the incidence of TdP was 1/16,546 (0.006%; 95% CI, 0.00015 - 0.03367%).\nConclusion:\n We found the incidence of QTc prolongation and TdP in ED patients receiving droperidol to be extremely rare. Our data suggest the FDA “black box warning” is overstated, and that close ECG monitoring is useful only in high-risk patients.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"droperidol, QT prolongation, QT nomogram, ventricular tachycardia, torsades des pointes"}],"section":"Patient Safety","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2rc4p3bb","frozenauthors":[{"first_name":"Jon","middle_name":"B.","last_name":"Cole","name_suffix":"","institution":"University of Minnesota Medical School, Department of Emergency Medicine, Minneapolis, Minnesota; Minnesota Poison Control System, Minneapolis, Minnesota; Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota","department":"None"},{"first_name":"Samantha","middle_name":"C.","last_name":"Lee","name_suffix":"","institution":"Minnesota Poison Control System, Minneapolis, Minnesota","department":"None"},{"first_name":"Marc","middle_name":"L.","last_name":"Martel","name_suffix":"","institution":"University of Minnesota Medical School, Department of Emergency Medicine, Minneapolis, Minnesota; Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota","department":"None"},{"first_name":"Stephen","middle_name":"W.","last_name":"Smith","name_suffix":"","institution":"Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota; University of Minnesota Medical School, Department of Emergency Medicine, Minneapolis, Minnesota","department":"None"},{"first_name":"Michelle","middle_name":"H.","last_name":"Biros","name_suffix":"","institution":"University of Minnesota Medical School, Department of Emergency Medicine, Minneapolis, Minnesota","department":"None"},{"first_name":"James","middle_name":"R.","last_name":"Miner","name_suffix":"","institution":"Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota; University of Minnesota Medical School, Department of Emergency Medicine, Minneapolis, Minnesota","department":"None"}],"date_submitted":"2020-02-22T05:51:57+02:00","date_accepted":"2020-02-22T05:51:57+02:00","date_published":"2020-07-03T01:27:39+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13596/galley/7113/download/"}]},{"pk":13368,"title":"Rabies Vaccination Compliance and Reasons for Incompletion","subtitle":null,"abstract":"Introduction:\n Rabies is a fatal disease with a 91% mortality rate in the United States. Current treatment of rabies consists of post-exposure prophylaxis treatment involving a complicated vaccination regimen. Studies conducted in other countries have found that patients do not complete their rabies vaccination treatment due to forgetting about their treatment, lack of time for visits, and the financial burden of treatment. However, little is known about why patients do not complete the rabies series in the US. The objective of this study was to determine the reasons why patients in the US do not complete rabies treatment.\nMethods:\n We performed a retrospective study to evaluate rabies post-exposure prophylaxis completion in the emergency department of an academic suburban hospital between June 2014–  July 2017. Further review was performed for patients who received inadequate vaccination to determine the cause of treatment incompletion. We conducted additional follow-up by phone survey for those patients who did not complete their rabies treatment but had no explanation for discontinuation available in the medical chart review.\nResults: \nResults indicated 198 patients received rabies post-exposure treatment during the inclusion period. Of these, 145 patients completed the rabies vaccination regimen. Reasons for treatment incompletion were found for 29 patients, and 24 patients were lost to follow-up. Of the 29 patients for which discontinuation was assessed, 23 patients (79.3%) stopped treatment due to appropriate reasons – either the animal involved tested negative for the rabies virus or the patient had prior rabies treatment and only required two booster shots. Reasons for not completing the series when medically indicated included the patient deciding to not return for treatment, lack of awareness of the full vaccination regimen, and the patient declining initiation of rabies vaccination.\nConclusion:\n Most patients in the US discontinue their rabies vaccination treatment for appropriate reasons; however, there is a proportion of patients who discontinue rabies vaccination when further treatment is medically indicated. This subset of patients is particularly at risk of rabies-related mortality, and additional measures need to be taken to ensure increased treatment compliance.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Rabies Vaccination"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5x80w4z8","frozenauthors":[{"first_name":"Tony","middle_name":"","last_name":"Shi","name_suffix":"","institution":"The Pennsylvania State University College of Medicine, Hershey, Pennsylvania","department":"None"},{"first_name":"Eleanor","middle_name":"F.","last_name":"Dunham","name_suffix":"","institution":"Penn State Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, Pennsylvania","department":"None"},{"first_name":"Jennifer","middle_name":"E.","last_name":"Nyland","name_suffix":"","institution":"The Pennsylvania State University College of Medicine, Department of Neural and Behavioral Sciences, Hershey, Pennsylvania","department":"None"}],"date_submitted":"2019-11-15T02:26:09+02:00","date_accepted":"2019-11-15T02:26:09+02:00","date_published":"2020-07-02T21:42:24+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13368/galley/7017/download/"}]},{"pk":13344,"title":"Current Understanding of the Neurobiology of Agitation","subtitle":null,"abstract":"Introduction\n: Managing agitation in the clinical setting is a challenge that many practitioners faceregularly. Our evolving understanding of the etiological factors involved in aggressive acts has betterinformed our interventions through pharmacologic and behavioral strategies. This paper reviews theliterature on the neurobiological underpinnings of aggressive behaviors, linking psychopathology withproposed mechanisms of action of psychiatric medications shown to be effective in mitigating agitation.\n \n Methods\n: We performed a review of the extant literature using PubMed as a primary database.Investigation focused on neurobiology of agitation and its relation to the current evidence base forparticular interventions.\n \n Results\n: There are well-established pathways that can lead to increased autonomic response andthe potential for violence. Psychopathology and substance-induced perceptual distortions may leadto magnification and overestimation of environmental threat, heightening the potential for aggression.Additional challenges have arisen with the advent of several novel drugs of abuse, many of whichlead to atypical clinical presentations and which can elude standard drug screens. Our interventionsstill lean on the evidence base found in Project BETA (Best Practices in Evaluation and Treatmentof Agitation). Although not a new drug and not included in the Project BETA guidelines, ketamineand its use are also discussed, given its unique pharmacology and potential benefits when otherprotocoled interventions have failed.\n \n Conclusion\n: Aggression can occur due to manifold reasons in the clinical setting. Having aninformed understanding of the possible determinants of agitation can help with more tailoredresponses to individual patients, limiting the unnecessary use of medications or of interventions thatcould be deemed forceful.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Psychiatry"},{"word":"agitation"},{"word":"Psychopharmacology"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/85n1b3g2","frozenauthors":[{"first_name":"Christopher","middle_name":"W.T.","last_name":"Miller","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Psychiatry, Baltimore, Maryland","department":"None"},{"first_name":"Vedrana","middle_name":"","last_name":"Hodzic","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Psychiatry, Baltimore, Maryland","department":"None"},{"first_name":"Eric","middle_name":"","last_name":"Weintraub","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Psychiatry, Baltimore, Maryland","department":"None"}],"date_submitted":"2019-11-04T07:17:44+02:00","date_accepted":"2019-11-04T07:17:44+02:00","date_published":"2020-07-02T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13344/galley/7009/download/"}]},{"pk":13435,"title":"Diagnostic Accuracy of Point-of-Care Ultrasound for Intussusception in Children Presenting to the Emergency Department: A Systematic Review and Meta-analysis","subtitle":null,"abstract":"Introduction: \n \nIleocolic intussusception is a common cause of pediatric bowel obstruction in youngchildren but can be difficult to diagnose clinically due to vague abdominal complaints. If left untreated,it may cause significant morbidity. Point-of-care ultrasound (POCUS) is a rapid, bedside method ofassessment that may potentially aid in the diagnosis of intussusception. The purpose of this systematicreview and meta-analysis was to determine the diagnostic accuracy of POCUS for children withsuspected ileocolic intussusception by emergency physicians (EP).\n \nMethods:\n \nWe conducted a systematic search on PubMed, Embase, CINAHL, LILACS, the Cochranedatabases, Google Scholar, as well as conference abstracts, and assessed bibliographies of selectedarticles for all studies evaluating the accuracy of POCUS for the diagnosis of intussusception in children.We dual extracted data into a predefined worksheet and performed quality analysis with the QUADAS-2tool. Data were summarized and a meta-analysis was performed\n \nResults: \n \nSix studies (n = 1303 children) met our inclusion criteria. Overall, 11.9% of children hadintussusception. POCUS was 94.9% (95% confidence interval [CI], 89.9% to 97.5%) sensitive and 99.1%(95% CI, 94.7% to 99.8%) specific with a likelihood ratio (LR)+ of 105 (95% CI, 18 to 625) and a LR− of0.05 (95% CI, 0.03 to 0.10).\n \nConclusions:\n \nPOCUS by EPs is highly sensitive and specific for the identification of intussusception forchildren presenting to the emergency department.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"point-of-care ultrasound"},{"word":"pediatrics"},{"word":"Intussusception"},{"word":"emergency"}],"section":"Technology in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/31v3049k","frozenauthors":[{"first_name":"Margaret","middle_name":"","last_name":"Lin-Martore","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine and\nPediatrics, San Francisco, California","department":"None"},{"first_name":"Aaron","middle_name":"E","last_name":"Kornblith","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine and\nPediatrics, San Francisco, California","department":"None"},{"first_name":"Michael","middle_name":"A","last_name":"Kohn","name_suffix":"","institution":"Stanford University, Department of Emergency Medicine, Stanford, California\nUniversity of California, San Francisco, Department of Epidemiology & Biostatistics, San\nFrancisco, California","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Gottlieb","name_suffix":"","institution":"Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois","department":"None"}],"date_submitted":"2019-12-18T23:15:33+02:00","date_accepted":"2019-12-18T23:15:33+02:00","date_published":"2020-07-02T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13435/galley/7048/download/"}]},{"pk":859,"title":"Infected Recurrent Thyroglossal Duct Cyst: A Case Report","subtitle":null,"abstract":"Introduction:\n A thyroglossal duct cyst (TGDC) is a congenital malformation in the neck. Surgical management is often recommended due to risk of recurrent infections and rare possibility of malignancy.\nCase Report:\n Herein, we describe the case of an adult presenting with tender neck mass and fever. She had a history of previous surgical excision of her TGDC as a child. On evaluation she was found to have a recurrent TGDC complicated by acute infection via computed tomography imaging.\nConclusion:\n In patients who have had previous surgical intervention to remove a TGDC, recurrence with infection should remain a diagnostic consideration.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Thyroglossal duct cyst"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2zp6292x","frozenauthors":[{"first_name":"Jennifer","middle_name":"","last_name":"Foti","name_suffix":"","institution":"Naval Medical Center San Diego, Department of Emergency Medicine, San Diego, California","department":"None"},{"first_name":"Felipe","middle_name":"","last_name":"Grimaldo","name_suffix":"","institution":"Naval Medical Center San Diego, Department of Emergency Medicine, San Diego, California","department":"None"}],"date_submitted":"2020-07-03T00:54:48+02:00","date_accepted":"2020-07-03T00:54:48+02:00","date_published":"2020-07-02T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/859/galley/609/download/"}]},{"pk":65962,"title":"Strangulated Umbilical Hernia","subtitle":null,"abstract":"A 22-year-old male presents with abdominal pain to a district hospital in rural Uganda. The pain began this morning at the site of an unrepaired umbilical hernia, which has gradually worsened and has now spread to his whole abdomen...","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Abdomen","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8s6480zt","frozenauthors":[{"first_name":"Jimmy","middle_name":"","last_name":"Ford","name_suffix":"MD","institution":"","department":""},{"first_name":"Michael","middle_name":"","last_name":"Schick","name_suffix":"DO","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2020-07-02T06:58:38.876948+02:00","render_galley":{"label":"HTML Galley","type":"html","path":"https://journalpub.escholarship.org/usinrls/article/65962/galley/50554/download/"},"galleys":[{"label":"HTML Galley","type":"html","path":"https://journalpub.escholarship.org/usinrls/article/65962/galley/50554/download/"}]},{"pk":858,"title":"A Case Report of Acute Motor and Sensory Polyneuropathy as the Presenting Symptom of SARS-CoV-2","subtitle":null,"abstract":"Introduction:\n Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically presents with respiratory illness and fever, however some rare neurologic symptoms have been described as presenting complaints. We report a case of an acute motor and sensory polyneuropathy consistent with Miller-Fisher Syndrome (MFS) variant of Guillain Barre Syndrome (GBS) as the initial symptom.\nCase Report:\n A 31-year old Spanish speaking male presents with two months of progressive weakness, numbness, and difficult walking. He had multiple cranial nerve abnormalities, dysmetria, ataxia, and absent lower extremity reflexes. An extensive workup including infectious, autoimmune, paraneoplastic, metabolic and neurologic testing was performed. Initially SARS-CoV-2 was not suspected based on a lack of respiratory symptoms. However, workup revealed a positive SARS-CoV-2 polymerase chain reaction test as well as presence of Anti-Ganglioside – GQ1b (Anti-GQ1b) immunoglobulin G antibodies.\nDiscussion:\n Miller Fisher syndrome (MFS) is a variant of Guillain-Barre syndrome (GBS) characterized by a triad of ophthalmoplegia, ataxia, and areflexia. The patient’s exam and workup including Anti-GQ1b is consistent with MFS.\nConclusion:\n SARS-CoV-2 infection in patients can have atypical presentations similar to this neurologic presentation. Prompt recognition and diagnosis can minimize the risk of transmission to hospital staff and facilitate initiation of treatment.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"SARS-CoV-2"},{"word":"COVID"},{"word":"COVID-19"},{"word":"Miller Fisher syndrome"},{"word":"Guillain-Barré syndrome"},{"word":"motor and sensory polyneuropathy"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/35j1f5zf","frozenauthors":[{"first_name":"Michael","middle_name":"R.","last_name":"Kopscik","name_suffix":"","institution":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina","department":"None"},{"first_name":"Barbra","middle_name":"K.","last_name":"Giourgas","name_suffix":"","institution":"Medical University of South Carolina, Department of Neurology, Charleston, South Carolina","department":"None"},{"first_name":"Bradley","middle_name":"C.","last_name":"Presley","name_suffix":"","institution":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina","department":"None"}],"date_submitted":"2020-07-02T01:46:05+02:00","date_accepted":"2020-07-02T01:46:05+02:00","date_published":"2020-07-02T01:47:19+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/858/galley/608/download/"}]},{"pk":857,"title":"Mixed Purpuric and Maculopapular Lesions in a Patient with COVID-19: A Case Report","subtitle":null,"abstract":"Introduction:\n The coronavirus disease of 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 is a global pandemic that expresses itself with a wide variety of presenting symptoms in patients. There is a paucity of literature describing the dermatologic manifestations of the virus, particularly in the United States.\nCase Report:\n Here we present a case of COVID-19 that manifested with a purpuric rash on the lower extremities and a maculopapular eruption on the abdomen in a patient in acute diabetic ketoacidosis and normal platelet count.\nDiscussion:\n The reported presenting symptoms of patients with COVID-19 vary greatly. This is the first documented case of COVID-19 presenting with mixed cutaneous manifestations of a purpuric as well as maculopapular rash.\nConclusion:\n The cutaneous lesions associated with the COVID-19 infection may mimic or appear similar to other well-known conditions. We illustrate a case of COVID-19 infection presenting with purpuric rash on the lower extremities and a maculopapular rash on the abdomen.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19"},{"word":"coronavirus"},{"word":"rash"},{"word":"dermatologic"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5wd1f1cs","frozenauthors":[{"first_name":"Randall","middle_name":"","last_name":"Beaupre II","name_suffix":"","institution":"Creighton University Arizona Health Education Alliance, Department of Emergency Medicine, Phoenix, Arizona","department":"None"},{"first_name":"Cody","middle_name":"","last_name":"Petrie","name_suffix":"","institution":"Creighton University Arizona Health Education Alliance, Department of Emergency Medicine, Phoenix, Arizona","department":"None"},{"first_name":"Alexander","middle_name":"","last_name":"Toledo","name_suffix":"","institution":"Creighton University Arizona Health Education Alliance, Department of Emergency Medicine, Phoenix, Arizona","department":"None"}],"date_submitted":"2020-07-02T01:36:06+02:00","date_accepted":"2020-07-02T01:36:06+02:00","date_published":"2020-07-02T01:37:30+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/857/galley/607/download/"}]},{"pk":856,"title":"A Case Report: Co-presenting COVID-19 Infection and Acute Drug Intoxication","subtitle":null,"abstract":"Background:\n Coronavirus disease 2019 (COVID-19) has spread throughout the world since late 2019. Symptoms appear after a two-week incubation period and commonly include fever, cough, myalgia or fatigue, and shortness of breath.\nCase Report:\n A 32-year-old male with a history of opiate abuse presented to the emergency department with altered mental status. The patient was lethargic and hypoxic with improvement from naloxone. Official chest radiograph was read as normal; however, the treating clinicians noted bilateral interstitial opacities, raising concern for underlying infectious etiology. Opiates and cocaine were positive on drug screen, and an arterial blood gas on room air showed hypoxemia with respiratory acidosis. The patient was intubated during the treatment course due to persistent hypoxemia and for airway protection after resuscitation. The COVID-19 test was positive on admission, and later computed tomography showed ground-glass opacities. The patient was extubated and discharged after one week on the ventilator.\nConclusion:\n When screening patients at and during evaluation, physicans should consider a broad differential as patients with atypical presentations may be overlooked as candidates for COVID-19 testing. As screening and evaluation protocols evolve, we emphasize maintaining a high index of suspicion for COVID-19 in patients with atypical symptoms or presenting with other chief complaints in order to avoid spreading the disease","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19"},{"word":"Anchoring bias"},{"word":"Opiates"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3t3841qd","frozenauthors":[{"first_name":"Jeremy","middle_name":"","last_name":"Riekena","name_suffix":"","institution":"New York-Presbyterian Queens, Department of Emergency Medicine, Flushing, New York","department":"None"},{"first_name":"Irene","middle_name":"","last_name":"Lee","name_suffix":"","institution":"New York-Presbyterian Queens, Department of Emergency Medicine, Flushing, New York","department":"None"},{"first_name":"Anita","middle_name":"","last_name":"Lui","name_suffix":"","institution":"New York-Presbyterian Queens, Department of Emergency Medicine, Flushing, New York","department":"None"},{"first_name":"Marion-Vincent","middle_name":"","last_name":"Mempin","name_suffix":"","institution":"New York-Presbyterian Queens, Department of Emergency Medicine, Flushing, New York","department":"None"}],"date_submitted":"2020-07-02T01:29:36+02:00","date_accepted":"2020-07-02T01:29:36+02:00","date_published":"2020-07-02T01:30:14+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/856/galley/606/download/"}]},{"pk":61787,"title":"Can Ultrasound Aid in the Diagnosis of Gout and Septic Arthritis in the Setting of Monoarticular Joint Pain?","subtitle":null,"abstract":"Monoarticular joint pain is commonly encountered in the emergency department (ED) with a broad differential diagnosis. Septic arthritis represents a “can’t miss” diagnosis while gout represents a chronic, painful arthropathy. Traditionally these diagnoses are made with arthrocentesis in addition to history, physical exam, imaging and laboratory studies. Ultrasound (US) represents a novel modality that may aid in the diagnosis of gout without requiring arthrocentesis. Furthermore, the sonographic features of gout may exclude the diagnosis of septic arthritis. Additional research is required in the ED setting to better clarify the role of US in these two disease states.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\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":"gout, ultrasound, joint pain"}],"section":"Review Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1nw9c836","frozenauthors":[{"first_name":"John","middle_name":"M","last_name":"Kiel","name_suffix":"","institution":"University of Florida College of Medicine Jacksonville","department":""},{"first_name":"Gurjit","middle_name":"","last_name":"Kaeley","name_suffix":"","institution":"Division of Rheumatology and Clinical Immunology, University of Florida College of Medicine, Jacksonville, United States","department":""}],"date_submitted":"2020-04-07T15:41:48+02:00","date_accepted":"2020-04-07T15:41:48+02:00","date_published":"2020-07-01T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uciem_medjem/article/61787/galley/47671/download/"}]},{"pk":38296,"title":"Anvil Age Economy: A Map of the Spread of Iron Metallurgy across Afro-Eurasia","subtitle":null,"abstract":"A large dataset is used to map the historical spread of iron use across Afro-Eurasia using a number of different methodologies. Traditional dates for the beginning of what archaeologists call the “Iron Age” in each region are unacceptable because they are imprecise and the dates themselves are reached on the basis of different methodologies. The author maps the spread of iron with a primary focus on its acceleration in use across many object classes. Three additional maps are also provided: the first critical use of iron for cutting tool or weapon, the spread of iron helmets and the spread of high-quality steel swords. While many of the maps are at the experimental stage, the results give a unique insight into technological change across history and can be used to test predictive models of historical change. As the mapping of the rise and spread of a technology has rarely or never been done before on this scale, the maps, the methodologies used, and the problems encountered provide a fork in the scholarship for more accurate and detailed successors.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"iron metallurgy"}],"section":"Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4t32q1mj","frozenauthors":[{"first_name":"Edward","middle_name":"A. L.","last_name":"Turner","name_suffix":"","institution":"Seshat Global History Databank","department":"None"}],"date_submitted":"2019-11-15T19:46:43+02:00","date_accepted":"2019-11-15T19:46:43+02:00","date_published":"2020-06-30T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/38296/galley/28813/download/"}]},{"pk":38309,"title":"Complexities of Collapse: A Review of \"Understanding Collapse: Ancient History and Modern Myths\" by Guy D. Middleton (Cambridge University Press, 2017)","subtitle":null,"abstract":"A Review of \"Understanding Collapse: Ancient History and Modern Myths\" by Guy D. Middleton (Cambridge University Press, 2017)","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Book Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5bg8f4r1","frozenauthors":[{"first_name":"Eugene","middle_name":"N.","last_name":"Anderson","name_suffix":"","institution":"University of California, Riverside","department":"None"}],"date_submitted":"2020-05-11T18:58:22+02:00","date_accepted":"2020-05-11T18:58:22+02:00","date_published":"2020-06-30T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/38309/galley/28816/download/"}]},{"pk":38308,"title":"New Technology, Same Culture: A Review of “Cultural Evolution in the Digital Age” by Alberto Acerbi (Oxford University Press, 2019)","subtitle":null,"abstract":"A Review of “Cultural Evolution in the Digital Age” by Alberto Acerbi (Oxford University Press, 2019)","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Cultural Evolution, Digital History"}],"section":"Book Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8hg2441f","frozenauthors":[{"first_name":"Joshua","middle_name":"Conrad","last_name":"Jackson","name_suffix":"","institution":"UNC","department":"None"}],"date_submitted":"2020-04-26T18:57:52+02:00","date_accepted":"2020-04-26T18:57:52+02:00","date_published":"2020-06-30T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/38308/galley/28815/download/"}]},{"pk":38273,"title":"The Causes and Mechanisms of the Ukrainian Crisis of 2014: A Structural–Demographic Approach","subtitle":null,"abstract":"This article tests the hypothesis that Ukraine experienced a state breakdown in 2014. The methodology employed to test this statement is based on achievements of structural-demographic theory, created by Jack Goldstone and developed by Peter Turchin. The reasons for a fiscal crisis, intra-elite conflict and mass mobilization (the three criteria for a state breakdown) are discussed. It is demonstrated that budget management in Ukraine was ineffective, and, coupled with an unbalanced political system, led to the fiscal crisis. The intra-elite conflict was caused by Yanukovych’s politics and by lack of resources as a consequence of elite overproduction, which led to fewer opportunities among the traditional elites. To demonstrate the mass discontent that was the main factor for the protests and rallies, evidence is presented that the population of Ukraine experienced immiseration in 2010–13. The final factor determining the future of the Ukrainian system was the delegitimization of power. This could happen only under the conditions of intra-elite conflict. All of these factors arose because of the high degree of capital concentration in the hands of the economic elite. The article concludes that we have every reason to say that a state breakdown occurred in Ukraine.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"stuctural-demographic theory"},{"word":"revolution of Dignity"},{"word":"State collapse"},{"word":"Ukranian state breakdown"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/97f4c489","frozenauthors":[{"first_name":"Dmitry","middle_name":"","last_name":"Shevsky","name_suffix":"","institution":"National Research University Higher School of Economics","department":"None"}],"date_submitted":"2019-01-15T12:56:35+02:00","date_accepted":"2019-01-15T12:56:35+02:00","date_published":"2020-06-30T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/38273/galley/28803/download/"}]},{"pk":38311,"title":"The Equinox2020 Seshat Data Release","subtitle":null,"abstract":"This report describes the current canonical time-series dataset named “Equinox2020,” a subset of Seshat: Global History Databank data for a well-curated list of polities and variables available on the Seshat Data Browser. The report provides an introduction to the methods and procedures of the Seshat project relating to the curation and release of the Equinox2020 dataset.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Seshat, Databases, Databanks"}],"section":"Databases","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4wj1j1vb","frozenauthors":[{"first_name":"Peter","middle_name":"","last_name":"Turchin","name_suffix":"","institution":"","department":"None"},{"first_name":"Daniel","middle_name":"","last_name":"Hoyer","name_suffix":"","institution":"","department":"None"},{"first_name":"James","middle_name":"","last_name":"Bennett","name_suffix":"","institution":"","department":"None"},{"first_name":"Kiran","middle_name":"","last_name":"Basava","name_suffix":"","institution":"","department":"None"},{"first_name":"Enrico","middle_name":"","last_name":"Cioni","name_suffix":"","institution":"","department":"None"},{"first_name":"Kevin","middle_name":"","last_name":"Feeney","name_suffix":"","institution":"","department":"None"},{"first_name":"Pieter","middle_name":"","last_name":"Francois","name_suffix":"","institution":"","department":"None"},{"first_name":"Samantha","middle_name":"","last_name":"Holder","name_suffix":"","institution":"","department":"None"},{"first_name":"Jill","middle_name":"","last_name":"Levine","name_suffix":"","institution":"","department":"None"},{"first_name":"Selin","middle_name":"","last_name":"Nugent","name_suffix":"","institution":"","department":"None"},{"first_name":"Jenny","middle_name":"","last_name":"Reddish","name_suffix":"","institution":"","department":"None"},{"first_name":"Chelsea","middle_name":"","last_name":"Thorpe","name_suffix":"","institution":"","department":"None"},{"first_name":"Sal","middle_name":"","last_name":"Wiltshire","name_suffix":"","institution":"","department":"None"},{"first_name":"Harvey","middle_name":"","last_name":"Whitehouse","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2020-06-08T21:41:14+02:00","date_accepted":"2020-06-08T21:41:14+02:00","date_published":"2020-06-30T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/38311/galley/28818/download/"}]},{"pk":13812,"title":"Novel Barrier Enclosure for Both Aerosol and Droplet Protection Model","subtitle":null,"abstract":"Emergency physicians are on the front lines of treating patients with highly infectious respiratory diseases. Personal protective equipment is one defense against contamination from droplet and aerosol secretions. Intubation is a procedure that greatly can increase provider’s risk of exposure. Utilization of an intubation box has been discussed and recommended on social media platforms. There has been scant literature demonstrating the effectiveness of such devices. This study aimed to determine degree of droplet contamination to the intubator utilizing a novel barrier enclosure with a fluorescent simulated respiratory contagion. This model confirmed both added protection to the providers preforming intubation, and reduction of spread of the droplets when such a device is applied to patient care.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID19, Droplet, Aerosol, Simulation Model, Intbation, Intubation Box"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8db208ph","frozenauthors":[{"first_name":"Chad","middle_name":"E.","last_name":"Branecki","name_suffix":"","institution":"University of Nebraska College of Medicine, Department of Emergency Medicine, Omaha, Nebraska","department":"None"},{"first_name":"Nicholas","middle_name":"J.","last_name":"Jobeun","name_suffix":"","institution":"University of Nebraska College of Medicine, Department of Emergency Medicine, Omaha, Nebraska","department":"None"},{"first_name":"Tyler","middle_name":"J.","last_name":"Ronnfeldt","name_suffix":"","institution":"University of Nebraska College of Medicine, Department of Emergency Medicine, Omaha, Nebraska","department":"None"},{"first_name":"Michael","middle_name":"A.","last_name":"Ash","name_suffix":"","institution":"University of Nebraska College of Medicine, Department of Internal Medicine, Omaha, Nebraska","department":"None"},{"first_name":"Thomas","middle_name":"E.","last_name":"Schulte","name_suffix":"","institution":"University of Nebraska College of Medicine, Department of Anesthesia, Omaha, Nebraska","department":"None"},{"first_name":"Jason","middle_name":"G.","last_name":"Langenfeld","name_suffix":"","institution":"University of Nebraska College of Medicine, Department of Emergency Medicine, Omaha, Nebraska","department":"None"}],"date_submitted":"2020-04-23T23:23:49+02:00","date_accepted":"2020-04-23T23:23:49+02:00","date_published":"2020-06-30T03:24:49+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13812/galley/7194/download/"}]},{"pk":13241,"title":"Practice Gap in Atrial Fibrillation Oral Anticoagulation Prescribing at Emergency Department Home Discharge","subtitle":null,"abstract":"Introduction:\n Current U.S. cardiology guidelines recommend oral anticoagulation (OAC) to reduce stroke risk in selected patients with atrial fibrillation (AF), but no formal AF OAC recommendations exist to guide emergency medicine clinicians in the acute care setting. We sought to characterize emergency department (ED) OAC prescribing practices after an ED AF diagnosis.\nMethods:\n This retrospective study included index visits for OAC-naive patients ≥18 years old who were discharged home from the ED at an urban, academic, tertiary hospital with a primary diagnosis of AF from 2012-2014. Five hypothesis-blinded, chart reviewers abstracted data from patient problem lists and medical history in the electronic health record to assess stroke (CHA2DS2-VASc) and bleeding risk (HAS-BLED). The primary outcome was the provision of an OAC prescription at discharge in OAC-naive patients with high stroke risk. Descriptive statistics and multivariable logistic regression assessed associations between OAC prescription and patient characteristics.\nResults: \nWe included 138 patient visits in our analysis, of whom 39.9% (n = 55) were low stroke risk (CHA2DS2-VASc = 0 in males and 1 in females), 15.9% (n = 22) were intermediate risk (CHA2DS2-VASc = 1 in males), and 44.2% (n = 61) were high risk (CHA2DS2-VASc ≥ 2). Of patients with high stroke risk and low-to-intermediate bleeding risk (n = 57), 80.7% were not prescribed an OAC at discharge. Cardiology consultation and female gender, but not stroke risk (CHA2DS2-VASc score), were predictors of an ED provider prescribing an OAC to an OAC-naive AF patient at ED discharge.\nConclusion:\n The majority of OAC-eligible patients were discharged home without an OAC prescription. In OAC-naive patients discharged home from the ED, cardiology consultation and female gender were associated with OAC prescription. Our findings suggest that access to expert opinion may improve provider comfort with OAC prescribing and highlight the need for improved guidelines specific to ED-management of AF.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"atrial fibrillation, emergency department, cardiology consult, warfarin, anticoagulation"}],"section":"Health Outcomes","is_remote":true,"remote_url":"https://escholarship.org/uc/item/30n769qp","frozenauthors":[{"first_name":"Bory","middle_name":"","last_name":"Kea","name_suffix":"","institution":"Oregon Health & Science University, Center for Policy and Research—Emergency Medicine, Department of Emergency Medicine, Portland, Oregon","department":"None"},{"first_name":"Bethany","middle_name":"T.","last_name":"Waites","name_suffix":"","institution":"Kaiser Permanente, Department of Obstetrics and Gynecology, San Francisco, California","department":"None"},{"first_name":"Amber","middle_name":"","last_name":"Lin","name_suffix":"","institution":"Oregon Health & Science University, Center for Policy and Research—Emergency Medicine, Department of Emergency Medicine, Portland, Oregon","department":"None"},{"first_name":"Merritt","middle_name":"","last_name":"Raitt","name_suffix":"","institution":"Oregon Health & Science University, Knight Cardiovascular Institute, VA Portland Health Care System, Portland, Oregon","department":"None"},{"first_name":"David","middle_name":"R.","last_name":"Vinson","name_suffix":"","institution":"The Permanente Medical Group and Kaiser Permanente Division of Research, Oakland, California","department":"None"},{"first_name":"Niroj","middle_name":"","last_name":"Ari","name_suffix":"","institution":"Portland State University, School of Public Health, Portland, Oregon","department":"None"},{"first_name":"Luke","middle_name":"","last_name":"Welle","name_suffix":"","institution":"Oregon Health & Science University, School of Medicine, Department of Emergency Medicine, Portland, Oregon","department":"None"},{"first_name":"Andrew","middle_name":"","last_name":"Sill","name_suffix":"","institution":"Oregon Health & Science University, School of Medicine, Department of Emergency Medicine, Portland, Oregon","department":"None"},{"first_name":"Dana","middle_name":"","last_name":"Button","name_suffix":"","institution":"Oregon Health & Science University, School of Medicine, Department of Emergency Medicine, Portland, Oregon","department":"None"},{"first_name":"Benjamin","middle_name":"C.","last_name":"Sun","name_suffix":"","institution":"University of Pennsylvania, Department of Emergency Medicine, Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania","department":"None"}],"date_submitted":"2019-09-12T07:05:17+02:00","date_accepted":"2019-09-12T07:05:17+02:00","date_published":"2020-06-29T21:24:30+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13241/galley/6971/download/"}]},{"pk":5550,"title":"Assessment of Canine Temperament: Predictive or Prescriptive?","subtitle":null,"abstract":"Canine temperament testing has historically been linked to the predictability of future behavior. A \npredictive\n model of canine temperament testing assumes that a dog’s behavior in one situation will likely be similar to its behavior in a variety of other situations. An alternative model is proposed for a canine temperament test that could identify areas in which a dog might fail to perform certain test items, but by using modern behavior analysis techniques, behaviors could be modified through a \nprescriptive\n approach. This article describes the AKC Temperament Test (ATT), which is the first prescriptive canine temperament test. The ATT is designed to provide pet dog owners with information about potential problem areas that can be modified through training.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"temperament, temperament tests, canine temperament tests, predictive validity"}],"section":"Special Issue: Canine Research","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4mw7n5tj","frozenauthors":[{"first_name":"Mary","middle_name":"Ruth","last_name":"Burch","name_suffix":"","institution":"American Kennel Club","department":"None"}],"date_submitted":"2019-10-10T04:10:07+02:00","date_accepted":"2019-10-10T04:10:07+02:00","date_published":"2020-06-29T20:18:26+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uclapsych_ijcp/article/5550/galley/3360/download/"}]},{"pk":42991,"title":"North American Counterterritoriality: Nineteenth-Century Black Activism and Alternative Legal Spatiality","subtitle":null,"abstract":"This contribution uses the terms “territoriality” and “legal spatiality” to consider how they shape our understanding of the significance of the North American border between the US and Canada (British North America) in the nineteenth century. It looks, first, at the ways in which Black intellectual leaders constructed Upper Canada as a counterterritory to the United States in the context of debating Black emigration by combining politics and geography to challenge conflicting territorialities. Canada’s ambiguous position as a safe haven under the British lion’s paw that was formerly invested in slavery and the slave trade is reinforced, second, by the increasing numbers of black fugitives onto its territories. This perceived mass exodus provoked aggressive reactions from US slaveholders who relied on the fugitive slave laws to lay claims on their “property” in the form of fugitive slave extradition cases. The activism by Black communities along the border that emerged from the crises to save fugitives from being returned to bondage, this contribution shows, enacted a form of counterterritoriality that called on the British imperial center to challenge the legality of slavery, introducing alternative forms of “legal spatiality.”","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"Upper Canada and fugitive slave laws"},{"word":"US-Canada borderland"},{"word":"Black fugitives in Canada"},{"word":"Black activism around fugitive slave laws"},{"word":"Transnational American Studies"},{"word":"JTAS"}],"section":"SPECIAL FORUM: (Im)Mobilities","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4cg540np","frozenauthors":[{"first_name":"Nele","middle_name":"","last_name":"Sawallisch","name_suffix":"","institution":"Mainz University","department":"None"}],"date_submitted":"2020-02-17T23:01:42+02:00","date_accepted":"2020-02-17T23:01:42+02:00","date_published":"2020-06-29T16:40:17+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42991/galley/32041/download/"}]},{"pk":42995,"title":"Borderwaters: Archipelagic Geometries between Indonesia and the United States","subtitle":null,"abstract":"Generally speaking, the border/borderlands complex has oriented itself around interactions between the border as a one-dimensional Euclidean line and the borderlands’ set of contestations growing out of cultural currents that exceed the state’s superimposed Euclidean geometry/geography. In complement and contradistinction, this essay advances a borderwaters framework as interlinked with governmentality’s engagement in and with modes of \nnon\n-Euclidean spatial perception, in which the state’s imagination of borders has not been the evocation of, in Gloria Anzaldúa’s term, an “unnatural boundary” but has rather been a partial function of the geological and hydrological materialities and processes to which governmentality has tended to affix water-based and water-dependent borders. These water-dependent and natural-cultural borders (with their attendant notions of human sovereignty) are intertwined with an arena of borderwaters where nonhuman actants (currents, waves, shorelines, and nonhuman animals) play roles in establishing how human borders will attain perception. In outlining some of the dynamics of the borderwaters, this essay turns toward the oceanic and archipelagic work of the Greater Mexican visual artist Miguel Covarrubias, whose midcentury representations of Indonesia and the United States’s Trust Territory of the Pacific Islands help contextualize and theorize state, Indigenous, and nonhuman cultures as they have converged and diverged across non-Euclidean modes of imagining boundaries, nonboundaries, and spatial area on a terraqueous planet.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"borderwaters"},{"word":"nonhuman agency"},{"word":"non-Euclidean geometry"},{"word":"Miguel Covarrubias"},{"word":"Transnational American Studies"},{"word":"JTAS"}],"section":"SPECIAL FORUM: (Im)Mobilities","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7010021b","frozenauthors":[{"first_name":"Brian","middle_name":"Russell","last_name":"Roberts","name_suffix":"","institution":"Brigham Young University","department":"None"}],"date_submitted":"2020-02-21T11:24:15+02:00","date_accepted":"2020-02-21T11:24:15+02:00","date_published":"2020-06-29T06:25:11+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42995/galley/32045/download/"}]},{"pk":42986,"title":"The Banality of American Empire: The Curious Case of Guam, USA","subtitle":null,"abstract":"The title of a 2004 \nNew York Times \narticle sums up well the curious political existence of the island of Guam: “Looking for friendly base overseas, Pentagon finds it already has one.” Guam is known as the “tip of America’s spear” and has for more than a century played a crucial role in securing US strategic interests in the Asia-Pacific region. Guam is also one of seventeen remaining colonies in the world, as recognized by the United Nations, in need of decolonization. In media representations and critical discourse around US imperialism, Guam also occupies a curious space, where it is a US military colony that somehow does not represent colonialism or imperialism. This essay will use the concept of \nbanality \nto interrogate how this simultaneous fullness of Guam as a site for American military power, and its emptiness as a site for American critique, enable the US to project force largely unchallenged over a significant part of the globe.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"Guam"},{"word":"US Imperialism"},{"word":"US military colony"},{"word":"unincorporated territory"},{"word":"banality"},{"word":"US overseas bases"},{"word":"Transnational American Studies"},{"word":"JTAS"}],"section":"SPECIAL FORUM: (Im)Mobilities","is_remote":true,"remote_url":"https://escholarship.org/uc/item/361824dg","frozenauthors":[{"first_name":"Michael","middle_name":"Lujan","last_name":"Bevacqua","name_suffix":"","institution":"University of Guam","department":"None"},{"first_name":"Manuel","middle_name":"Lujan","last_name":"Cruz","name_suffix":"","institution":"Auckland University of Technology","department":"None"}],"date_submitted":"2020-02-17T22:42:04+02:00","date_accepted":"2020-02-17T22:42:04+02:00","date_published":"2020-06-28T19:05:57+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42986/galley/32037/download/"}]},{"pk":39546,"title":"Cleaning up the U.S.-Mexico Border: NADBank’s Efforts to Close the Wastewater Infrastructure Gap","subtitle":null,"abstract":"The North American Development Bank (NADBank) was established in 1994 to “cleanup” the border region, which was characterized at the time as an open sewer. This research examines NADBank’s cleanup efforts to date by analyzing data from published reports, articles, and archival records using descriptive statistics and geospatial analysis. Overall, NADBank has provided almost $760 million in loans and grants to support the implementation of 133 wastewater infrastructure projects that have a total construction cost of $1.9 billion. Although a substantial investment, these projects have not fully addressed the wastewater infrastructure needs of the border, estimated in 1993 to be between $4.3 and $6 billion. However, these infrastructure projects have resulted in some tangible improvements in water quality in major transboundary rivers. Unfortunately, the border region continues to be plagued by discharges of raw sewage and additional investment in infrastructure and institutional capacity is needed to fully resolve the problems.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"NADBank, Mexico, Border, Wastewater Infrastructure, Water Quality"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0x13s2dk","frozenauthors":[{"first_name":"Linda","middle_name":"","last_name":"Allen","name_suffix":"","institution":"Other","department":"None"}],"date_submitted":"2020-05-15T23:26:58+02:00","date_accepted":"2020-05-15T23:26:58+02:00","date_published":"2020-06-26T22:05:29+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39546/galley/29852/download/"}]},{"pk":12785,"title":"Adult Patients with Respiratory Distress: Current Evidence-based Recommendations for Prehospital Care","subtitle":null,"abstract":"Introduction: \nWe developed evidence-based recommendations for prehospital evaluation and treatment of adult patients with respiratory distress. These recommendations are compared with current protocols used by the 33 local emergency medical services agencies (LEMSA) in California.\nMethods: \nWe performed a review of the evidence in the prehospital treatment of adult patients with respiratory distress. The quality of evidence was rated and used to form guidelines. We then compared the respiratory distress protocols of each of the 33 LEMSAs for consistency with these recommendations.\nResults: \nPICO (population/problem, intervention, control group, outcome) questions investigated were treatment with oxygen, albuterol, ipratropium, steroids, nitroglycerin, furosemide, and non-invasive ventilation. Literature review revealed that oxygen titration to no more than 94-96% for most acutely ill medical patients and to 88-92% in patients with acute chronic obstructive pulmonary disease (COPD) exacerbation is associated with decreased mortality. In patients with bronchospastic disease, the data shows improved symptoms and peak flow rates after the administration of albuterol. There is limited data regarding prehospital use of ipratropium, and the benefit is less clear. The literature supports the use of systemic steroids in those with asthma and COPD to improve symptoms and decrease hospital admissions. There is weak evidence to support the use of nitrates in critically ill, hypertensive patients with acute pulmonary edema (APE) and moderate evidence that furosemide may be harmful if administered prehospital to patients with suspected APE. Non-invasive positive pressure ventilation (NIPPV) is shown in the literature to be safe and effective in the treatment of respiratory distress due to acute pulmonary edema, bronchospasm, and other conditions. It decreases both mortality and the need for intubation. Albuterol, nitroglycerin, and NIPPV were found in the protocols of every LEMSA. Ipratropium, furosemide, and oxygen titration were found in a proportion of the protocols, and steroids were not prescribed in any LEMSA protocol.\nConclusion:\n Prehospital treatment of adult patients with respiratory distress varies widely across California. We present evidence-based recommendations for the prehospital treatment of undifferentiated adult patients with respiratory distress that will assist with standardizing management and may be useful for EMS medical directors when creating and revising protocols.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"ambulance"},{"word":"Dyspnea"},{"word":"emergency medical services"},{"word":"prehospital"},{"word":"Evidence-based"},{"word":"Guideline"},{"word":"clinical protocol"}],"section":"Emergency Medical Services","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9895j871","frozenauthors":[{"first_name":"Sammy","middle_name":"S.","last_name":"Hodroge","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San Francisco, California","department":"None"},{"first_name":"Melody","middle_name":"","last_name":"Glenn","name_suffix":"","institution":"University of Arizona, Department of Emergency Medicine, Tucson, Arizona","department":"None"},{"first_name":"Amelia","middle_name":"","last_name":"Breyre","name_suffix":"","institution":"Alameda Health System, Highland Hospital, Department of Emergency Medicine, Oakland, California","department":"None"},{"first_name":"Bennett","middle_name":"","last_name":"Lee","name_suffix":"","institution":"Hawaii Emergency Physicians Associated, Kailua, Hawaii","department":"None"},{"first_name":"Nick","middle_name":"R.","last_name":"Aldridge","name_suffix":"","institution":"Kaiser Permanente San Diego, Department of Emergency Medicine, San Diego, California","department":"None"},{"first_name":"Karl","middle_name":"A.","last_name":"Sporer","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San Francisco, California","department":"None"},{"first_name":"Kristi","middle_name":"L.","last_name":"Koenig","name_suffix":"","institution":"County of San Diego Health & Human Services Agency, EMS, University of California, Irvine, Department of Emergency Medicine, Orange, California","department":"None"},{"first_name":"Marianne","middle_name":"","last_name":"Gausche-Hill","name_suffix":"","institution":"Harbor-UCLA Medical Center, Department of Emergency Medicine, Los Angeles County EMS Agency, Santa Fe Springs, California","department":"None"},{"first_name":"Angelo","middle_name":"A.","last_name":"Salvucci","name_suffix":"","institution":"Santa Barbara EMS agency, Santa Barbara, California","department":"None"},{"first_name":"Eric","middle_name":"M.","last_name":"Rudnick","name_suffix":"","institution":"Northern California EMS Agency, Redding, California","department":"None"},{"first_name":"John","middle_name":"F.","last_name":"Brown","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San Francisco, California","department":"None"},{"first_name":"Gregory","middle_name":"H.","last_name":"Gilbert","name_suffix":"","institution":"Stanford University, Department of Emergency Medicine, Palo Alto, California","department":"None"}],"date_submitted":"2019-05-30T01:06:06+02:00","date_accepted":"2019-05-30T01:06:06+02:00","date_published":"2020-06-26T01:10:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12785/galley/6739/download/"}]},{"pk":13386,"title":"Social Determinants of Hallway Bed Use","subtitle":null,"abstract":"Introduction: \nHallway beds in the emergency department (ED) produce lower patient satisfaction and inferior care. We sought to determine whether socioeconomic factors influence which visits are assigned to hallway beds, independent of clinical characteristics at triage.\nMethods:\n We studied 332,919 visits, across 189,326 patients, to two academic EDs from 2013-2016. We estimated a logistic model of hallway bed assignment, conditioning on payor, demographics, triage acuity, chief complaint, patient visit frequency, and ED volume. Because payor is not generally known at the time of triage, we interpreted it as a proxy for other observable characteristics that may influence bed assignment. We estimated a Cox proportional hazards model of hallway bed assignment on length of stay.\nResults: \nMedian patient age was 53. 54.0% of visits were by women. 42.1% of visits were paid primarily by private payors, 37.1% by Medicare, and 20.7% by Medicaid. A total of 16.2% of visits were assigned to hallway beds. Hallway bed assignment was more likely for frequent ED visitors, for lower acuity presentations, and for psychiatric, substance use, and musculoskeletal chief complaints, which were more common among visits paid primarily by Medicaid. In a logistic model controlling for these factors, as well as for other patient demographics and for the volume of recent ED arrivals, Medicaid status was nevertheless associated with 22% greater odds of assignment to a hallway bed (odds ratio 1.22, [95% confidence interval, CI, 1.18-1.26]), compared to private insurance. Visits assigned to hallway beds had longer lengths of stay than roomed visits of comparable acuity (hazard ratio for departure 0.91 [95% CI, 0.90-0.92]).\nConclusion:\n We find evidence of social determinants of hallway bed use, likely involving epidemiologic, clinical, and operational factors. Even after accounting for different distributions of chief complaints and for more frequent ED use by the Medicaid population, as well as for other visit characteristics known at the time of triage, visits paid primarily by Medicaid retain a disproportionate association with hallway bed assignment. Further research is needed to eliminate potential bias in the use of hallway beds.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Emergency Medicine"},{"word":"health disparities"},{"word":"Health Economics"}],"section":"Population Health and Social Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4dp5p5pd","frozenauthors":[{"first_name":"David","middle_name":"A.","last_name":"Kim","name_suffix":"","institution":"Stanford University, Department of Emergency Medicine, Palo Alto, California","department":"None"},{"first_name":"Leon","middle_name":"D.","last_name":"Sanchez","name_suffix":"","institution":"Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"David","middle_name":"","last_name":"Chiu","name_suffix":"","institution":"Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Ian","middle_name":"P.","last_name":"Brown","name_suffix":"","institution":"Stanford University, Department of Emergency Medicine, Palo Alto, California","department":"None"}],"date_submitted":"2019-11-26T02:16:44+02:00","date_accepted":"2019-11-26T02:16:44+02:00","date_published":"2020-06-24T20:22:32+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13386/galley/7026/download/"}]},{"pk":13364,"title":"Novice Physician Ultrasound Evaluation of Pediatric Tricuspid Regurgitant Jet Velocity","subtitle":null,"abstract":"Introduction: \nPulmonary hypertension, associated with high mortality in pediatric patients, is traditionally screened for by trained professionals by measuring a tricuspid regurgitant jet velocity (TRJV). Our objective was to test the feasibility of novice physician sonographers (NPS) to perform echocardiograms of adequate quality to exclude pathology (defined as TRJV > 2.5 meters per second).\nMethods:\n We conducted a cross-sectional study of NPS to assess TRJV by echocardiogram in an urban pediatric emergency department. NPS completed an educational course consisting of a didactic curriculum and hands-on workshop. NPS enrolled a convenience sample of patients aged 7-21 years. Our primary outcome was the proportion of echocardiograms with images of adequate quality to exclude pathology. Our secondary outcome was NPS performance on four image elements. We present descriptive statistics, binomial proportions, kappa coefficients, and logistic regression analysis.\nResults:\n Eight NPS completed 80 echocardiograms. We found 82.5% (95% confidence interval [CI], 74.2-90.8) of echocardiograms had images of adequate quality to exclude pathology. Among image elements, NPS obtained a satisfactory, apical 4-chamber view in 85% (95% CI, 77.1-92.9); positioned the color box accurately 65% (95% CI, 54.5-75.5); optimized TRJV color signal 78.7% (95% CI, 69.8-87.7); and optimized continuous-wave Doppler in 55% (95% CI, 44.1-66.0) of echocardiograms.\nConclusion:\n NPS obtained images of adequate quality to exclude pathology in a majority of studies; however, optimized acquisition of specific image elements varied. This work establishes the basis for future study of NPS assessment of TRJV pathology when elevated pulmonary pressures are of clinical concern.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"tricuspid regurgitant jet velocity, pediatric echocardiography, point-of-care ultrasound, novice echocardiography, pulmonary hypertension"}],"section":"Technology in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1nt70759","frozenauthors":[{"first_name":"Zachary","middle_name":"W.","last_name":"Binder","name_suffix":"","institution":"Boston Medical Center, Boston University School of Medicine, Department of Pediatrics, Boston, Massachusetts","department":"None"},{"first_name":"Sharon","middle_name":"E.","last_name":"O'Brien","name_suffix":"","institution":"Boston Medical Center, Boston University School of Medicine, Department of Pediatrics, Boston, Massachusetts","department":"None"},{"first_name":"Tehnaz","middle_name":"P.","last_name":"Boyle","name_suffix":"","institution":"Boston Medical Center, Boston University School of Medicine, Department of Pediatrics, Boston, Massachusetts","department":"None"},{"first_name":"Howard","middle_name":"J.","last_name":"Cabral","name_suffix":"","institution":"Boston University School of Public Health, Department of Biostatistics, Boston, Massachusetts","department":"None"},{"first_name":"Sepehr","middle_name":"","last_name":"Sekhavat","name_suffix":"","institution":"Boston Medical Center, Boston University School of Medicine, Department of Pediatrics, Boston, Massachusetts","department":"None"},{"first_name":"Joseph","middle_name":"R.","last_name":"Pare","name_suffix":"","institution":"Boston Medical Center, Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts","department":"None"}],"date_submitted":"2019-11-14T03:02:52+02:00","date_accepted":"2019-11-14T03:02:52+02:00","date_published":"2020-06-24T20:16:59+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13364/galley/7016/download/"}]},{"pk":13377,"title":"Patient and Community Organization Perspectives on  Accessing Social Resources from the Emergency Department: A Qualitative Study","subtitle":null,"abstract":"Introduction:\n Social risks adversely affect health and are associated with increased healthcare utilization and costs. Emergency department (ED) patients have high rates of social risk; however, little is known about best practices for ED-based screening or linkage to community resources. We examined the perspectives of patients and community organizations regarding social risk screening and linkage from the ED.\nMethods:\n Qualitative interviews were conducted with a purposive sample of ED patients and local community organization staff. Participants completed a brief demographic survey, health literacy assessment, and qualitative interview focused on barriers/facilitators to social risk screening in the ED, and ideas for screening and linkage interventions in the ED. Interviews were conducted in English or Spanish, recorded, transcribed, and coded. Themes were identified by consensus.\nResults: \nWe conducted 22 interviews with 16 patients and six community organization staff. Three categories of themes emerged. The first related to the importance of social risk screening in the ED. The second category encompassed challenges regarding screening and linkage, including fear, mistrust, transmission of accurate information, and time/resource constraints. The third category included suggestions for improvement and program development. Patients had varied preferences for verbal vs electronic strategies for screening. Community organization staff emphasized resource scarcity and multimodal communication strategies.\nConclusion:\n The development of flexible, multimodal, social risk screening tools, and the creation and maintenance of an accurate database of local resources, are strategies that may facilitate improved identification of social risk and successful linkage to available community resources.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"emergency medicine, social determinants of health, qualitative"}],"section":"Population Health and Social Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7tk7m3hd","frozenauthors":[{"first_name":"Margaret","middle_name":"E.","last_name":"Samuels-Kalow","name_suffix":"","institution":"Massachusetts General Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Melanie","middle_name":"F.","last_name":"Molina","name_suffix":"","institution":"Massachusetts General Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Gia","middle_name":"E.","last_name":"Ciccolo","name_suffix":"","institution":"Massachusetts General Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Alexa","middle_name":"","last_name":"Curt","name_suffix":"","institution":"Massachusetts General Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Emily","middle_name":"C.","last_name":"Cleveland Manchanda","name_suffix":"","institution":"Massachusetts General Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Nicole","middle_name":"C.","last_name":"de Paz","name_suffix":"","institution":"Boston Children’s Hospital, Harvard Medical School, Division of General Pediatrics, Boston, Massachusetts","department":"None"},{"first_name":"Carlos","middle_name":"A.","last_name":"Camargo Jr.","name_suffix":"","institution":"Massachusetts General Hospital, Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts","department":"None"}],"date_submitted":"2019-11-19T20:15:44+02:00","date_accepted":"2019-11-19T20:15:44+02:00","date_published":"2020-06-24T20:13:18+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13377/galley/7022/download/"}]},{"pk":13395,"title":"Assessment of Emergency Medicine Residents’ Clinical Reasoning: Validation of a Script Concordance Test","subtitle":null,"abstract":"Introduction: \nA primary aim of residency training is to develop competence in clinical reasoning. However, there are few instruments that can accurately, reliably, and efficiently assess residents’ clinical decision-making ability. This study aimed to externally validate the script concordance test in emergency medicine (SCT-EM), an assessment tool designed for this purpose.\nMethods:\n Using established methodology for the SCT-EM, we compared EM residents’ performance on the SCT-EM to an expert panel of emergency physicians at three urban academic centers. We performed adjusted pairwise t-tests to compare differences between all residents and attending physicians, as well as among resident postgraduate year (PGY) levels. We tested correlation between SCT-EM and Accreditation Council for Graduate Medical Education Milestone scores using Pearson’s correlation coefficients. Inter-item covariances for SCT items were calculated using Cronbach’s alpha statistic.\nResults:\n The SCT-EM was administered to 68 residents and 13 attendings. There was a significant difference in mean scores among all groups (mean + standard deviation: PGY-1 59 + 7; PGY-2 62 + 6; PGY-3 60 + 8; PGY-4 61 + 8; 73 + 8 for attendings, p < 0.01). Post hoc pairwise comparisons demonstrated that significant difference in mean scores only occurred between each PGY level and the attendings (p < 0.01 for PGY-1 to PGY-4 vs attending group). Performance on the SCT-EM and EM Milestones was not significantly correlated (r = 0.12, p = 0.35). Internal reliability of the exam was determined using Cronbach’s alpha, which was 0.67 for all examinees, and 0.89 in the expert-only group.\nConclusion:\n The SCT-EM has limited utility in reliably assessing clinical reasoning among EM residents. Although the SCT-EM was able to differentiate clinical reasoning ability between residents and expert faculty, it did not between PGY levels, or correlate with Milestones scores. Furthermore, several limitations threaten the validity of the SCT-EM, suggesting further study is needed in more diverse settings.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Medical Education"},{"word":"Assessment"},{"word":"clinical reasoning"},{"word":"Emergency Medicine, Graduate Medical Education"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/92b825mf","frozenauthors":[{"first_name":"Eric","middle_name":"","last_name":"Steinberg","name_suffix":"","institution":"St. Joseph’s University Medical Center, Department of Emergency Medicine, Paterson, New Jersey","department":"None"},{"first_name":"Ethan","middle_name":"","last_name":"Cowan","name_suffix":"","institution":"Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Michelle","middle_name":"P.","last_name":"Lin","name_suffix":"","institution":"Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai","department":"None"},{"first_name":"Anthony","middle_name":"","last_name":"Sielicki","name_suffix":"","institution":"Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Steven","middle_name":"","last_name":"Warrington","name_suffix":"","institution":"Orange Park Medical Center, Department of Emergency Medicine, Orange Park, Florida","department":"None"}],"date_submitted":"2019-12-01T18:19:29+02:00","date_accepted":"2019-12-01T18:19:29+02:00","date_published":"2020-06-24T20:02:08+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13395/galley/7033/download/"}]},{"pk":13254,"title":"Fever Incidence Is Much Lower in the Morning than the Evening: Boston and US National Triage Data","subtitle":null,"abstract":"Introduction:\n In this observational study, we evaluated time-of-day variation in the incidence of fever that is seen at triage. The observed incidence of fever could change greatly over the day because body temperatures generally rise and fall in a daily cycle, yet fever is identified using a temperature threshold that is unchanging, such as ≥38.0° Celsius (C) (≥100.4° Fahrenheit [F]).\nMethods:\n We analyzed 93,225 triage temperature measurements from a Boston emergency department (ED) (2009-2012) and 264,617 triage temperature measurements from the National Hospital Ambulatory Medical Care Survey (NHAMCS, 2002-2010), making this the largest study of body temperature since the mid-1800s. Boston data were investigated exploratorily, while NHAMCS was used to corroborate Boston findings and check whether they generalized. NHAMCS results are nationally representative of United States EDs. Analyses focused on adults.\nResults:\n In the Boston ED, the proportion of patients with triage temperatures in the fever range (≥38.0°C, ≥100.4°F) increased 2.5-fold from morning to evening (7:00-8:59 PM vs 7:00-8:59 AM: risk ratio [RR] 2.5, 95% confidence interval [CI], 2.0-3.3). Similar time-of-day changes were observed when investigating alternative definitions of fever: temperatures ≥39.0°C (≥102.2°F) and ≥40.0°C (≥104.0°F) increased 2.4- and 3.6-fold from morning to evening (7:00-8:59 PM vs 7:00-8:59 AM: RRs [95% CIs] 2.4 [1.5-4.3] and 3.6 [1.5-17.7], respectively). Analyses of adult NHAMCS patients provided confirmation, showing mostly similar increases for the same fever definitions and times of day (RRs [95% CIs] 1.8 [1.6-2.1], 1.9 [1.4-2.5], and 2.8 [0.8-9.3], respectively), including after adjusting for 12 potential confounders using multivariable regression (adjusted RRs [95% CIs] 1.8 [1.5-2.1], 1.8 [1.3-2.4], and 2.7 [0.8-9.2], respectively), in age-group analyses (18-64 vs 65+ years), and in several sensitivity analyses. The patterns observed for fever mirror the circadian rhythm of body temperature, which reaches its highest and lowest points at similar times.\nConclusion:\n Fever incidence is lower at morning triages than at evening triages. High fevers are especially rare at morning triage and may warrant special consideration for this reason. Studies should examine whether fever-causing diseases are missed or underappreciated during mornings, especially for sepsis cases and during screenings for infectious disease outbreaks. The daily cycling of fever incidence may result from the circadian rhythm.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"fever"},{"word":"Febrile"},{"word":"body temperature"},{"word":"Circadian"},{"word":"Emergency Departments"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/95w229gq","frozenauthors":[{"first_name":"Charles","middle_name":"","last_name":"Harding","name_suffix":"","institution":"Independent Statistical Analyst, Seattle, Washington","department":"None"},{"first_name":"Francesco","middle_name":"","last_name":"Pompei","name_suffix":"","institution":"Exergen Corporation, Watertown, Massachusetts","department":"None"},{"first_name":"Samantha","middle_name":"F.","last_name":"Bordonaro","name_suffix":"","institution":"Gates Vascular Institute, Professional Emergency Services, Buffalo, New York","department":"None"},{"first_name":"Daniel","middle_name":"C.","last_name":"McGillicuddy","name_suffix":"","institution":"Saint Joseph Mercy Hospital, Department of Emergency Medicine, Ann Arbor, Michigan\nUniversity of Michigan, Department of Emergency Medicine, Ann Arbor, Michigan","department":"None"},{"first_name":"Dmitriy","middle_name":"","last_name":"Burmistrov","name_suffix":"","institution":"Independent Statistical Analyst, Massachusetts","department":"None"},{"first_name":"Leon","middle_name":"D.","last_name":"Sanchez","name_suffix":"","institution":"Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts\nHarvard Medical School, Boston, Massachusetts","department":"None"}],"date_submitted":"2019-10-29T16:14:50+02:00","date_accepted":"2019-10-29T16:14:50+02:00","date_published":"2020-06-24T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13254/galley/6979/download/"}]},{"pk":13815,"title":"Mobilization of a Simulation Platform to Facilitate a System-wide Response to the COVID-19 Pandemic","subtitle":null,"abstract":"N/A","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19"},{"word":"Simulation"},{"word":"resource utilization"},{"word":"Pandemic"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0v23k0sk","frozenauthors":[{"first_name":"David","middle_name":"J.","last_name":"Carlberg","name_suffix":"","institution":"Georgetown University School of Medicine, MedStar Georgetown University Hospital, Department of Emergency Medicine, Washington, District of Columbia","department":"None"},{"first_name":"Tiffany","middle_name":"M.","last_name":"Chan","name_suffix":"","institution":"MedStar Harbor Hospital, Department of Emergency Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Diana","middle_name":"","last_name":"Ladkany","name_suffix":"","institution":"Georgetown University School of Medicine, MedStar Washington Hospital Center, Department of Emergency Medicine, Washington, District of Columbia","department":"None"},{"first_name":"Jessica","middle_name":"","last_name":"Palmer","name_suffix":"","institution":"Georgetown University School of Medicine, MedStar Southern Maryland Hospital Center, Department of Emergency Medicine, Prince George’s County, Maryland","department":"None"},{"first_name":"Kevin","middle_name":"","last_name":"Bradshaw","name_suffix":"","institution":"MedStar Health Simulation Training and Education Lab, Washington, District of Columbia","department":"None"}],"date_submitted":"2020-04-23T18:25:08+02:00","date_accepted":"2020-04-23T18:25:08+02:00","date_published":"2020-06-24T03:32:30+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13815/galley/7197/download/"}]},{"pk":13932,"title":"Emergency Department Admissions During COVID-19: Implications from the 2002-2004 SARS Epidemic","subtitle":null,"abstract":"N/A","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Severe Acute Respiratory Syndrome"},{"word":"Public health"},{"word":"Coronavirus disease 2019"},{"word":"Emergency Department Admissions"},{"word":"Pandemic"},{"word":"coronavirus"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2nc3k9v4","frozenauthors":[{"first_name":"Muhammad","middle_name":"M.","last_name":"Munir","name_suffix":"","institution":"Aga Khan University Hospital, Karachi City, Sindh, Pakistan","department":"None"},{"first_name":"Russell","middle_name":"S.","last_name":"Martins","name_suffix":"","institution":"Aga Khan University Hospital, Karachi City, Sindh, Pakistan","department":"None"},{"first_name":"Asad","middle_name":"I.","last_name":"Mian","name_suffix":"","institution":"Aga Khan University Hospital, Department of Emergency Medicine, Karachi City, Sindh, Pakistan","department":"None"}],"date_submitted":"2020-05-17T21:39:40+02:00","date_accepted":"2020-05-17T21:39:40+02:00","date_published":"2020-06-24T03:29:55+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13932/galley/7239/download/"}]},{"pk":13921,"title":"Telehealth Solutions for In-hospital Communication with Patients Under Isolation During COVID-19","subtitle":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic is a public health crisis that has quickly overwhelmed our healthcare system. It has led to significant shortages in personal protective equipment (PPE), ventilators, and intensive care unit beds across the nation. As the initial entry point for patients with suspected COVID illness, emergency departments (ED) have had to adapt quickly to prioritize the safety of patients and providers while still delivering optimal, timely patient care. COVID-19 has presented many challenges for the ED that also extend to all inpatient services. Some of these key challenges are the fundamental tasks of communicating with patients in respiratory isolation while minimizing PPE usage and enabling all patients who have been affected by hospitals’ visitor restrictions to connect with their families. We discuss the design principles behind implementing a robust in-hospital telehealth system for patient-provider and patient-family communication, provide a review of the strengths and weaknesses of potential videoconferencing options, and deliver concise, step-by-step guides for setting up a secure, low-cost, user-friendly solution that can be rapidly deployed.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Telemedicine"},{"word":"Telehealth"},{"word":"palliative care"},{"word":"COVID-19"},{"word":"Pandemic"}],"section":"Technology in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0nb053tn","frozenauthors":[{"first_name":"Jennifer","middle_name":"","last_name":"Fang","name_suffix":"","institution":"Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California","department":"None"},{"first_name":"Yiju","middle_name":"T.","last_name":"Liu","name_suffix":"","institution":"Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California\nUniversity of California, Los Angeles, Department of Emergency Medicine, Los Angeles, California\nThe Lundquist Institute for Biomedical Innovation, Torrance, California","department":"None"},{"first_name":"Ernest","middle_name":"Y.","last_name":"Lee","name_suffix":"","institution":"University of California, Los Angeles, Department of Bioengineering, Los Angeles, California\nUniversity of California, Los Angeles, Department of Medicine, Division of Dermatology, Los Angeles, California\nDavid Geffen School of Medicine at UCLA, UCLA-Caltech Medical Scientist Training Program, Los Angeles, California","department":"None"},{"first_name":"Kabir","middle_name":"","last_name":"Yadav","name_suffix":"","institution":"Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California\nUniversity of California, Los Angeles, Department of Emergency Medicine, Los Angeles, California\nThe Lundquist Institute for Biomedical Innovation, Torrance, California","department":"None"}],"date_submitted":"2020-05-13T00:32:03+02:00","date_accepted":"2020-05-13T00:32:03+02:00","date_published":"2020-06-24T03:26:57+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13921/galley/7235/download/"}]},{"pk":853,"title":"Alternative Diagnostic Strategy for the Assessment and Treatment of Pulmonary Embolus: A Case Series","subtitle":null,"abstract":"Introduction:\n Ferumoxytol-enhanced magnetic resonance angiography (FeMRA) can be used as an alternate and safe method to diagnose patients with compromised renal function who present with acute pulmonary embolus in the emergency department (ED) setting.\nCase Report:\n A 62-year old man with a history of renal transplant and lymphoproliferative disease described new onset of breathlessness. His clinical symptoms were suggestive of pulmonary embolus. He underwent FeMRA in the ED to avoid exposure to intravenous iodinated contrast. FeMRA demonstrated a left main pulmonary artery embolus, which extended to the left interlobar pulmonary artery. Afterward, the patient initiated anticoagulation therapy. With preserved renal function he was able to continue his outpatient chemotherapy regimen.\nConclusion:\n This case highlights a safe imaging technique for emergency physicians to diagnose pulmonary embolus and subsequently guide anticoagulation therapy for patients in whom use of conventional contrast is contraindicated.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"FE-MRA"},{"word":"pulmonary embolus"},{"word":"renal transplant"},{"word":"lymphoproliferative"}],"section":"Case Series","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5sv71400","frozenauthors":[{"first_name":"Ayaz","middle_name":"","last_name":"Aghayev","name_suffix":"","institution":"Brigham and Women’s Hospital, Department of Radiology, Boston, Massachusetts","department":"None"},{"first_name":"Aliza","middle_name":"A.","last_name":"Memon","name_suffix":"","institution":"Brigham and Women’s Hospital, Department of Internal Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Paul","middle_name":"Gregg","last_name":"Greenough","name_suffix":"","institution":"Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Lakshmi","middle_name":"","last_name":"Nayak","name_suffix":"","institution":"Dana Farber Cancer Institute, Boston, Massachusetts","department":"None"},{"first_name":"Sijie","middle_name":"","last_name":"Zheng","name_suffix":"","institution":"Kaiser Permanente, Oakland, California","department":"None"},{"first_name":"Andrew","middle_name":"M.","last_name":"Siedlecki","name_suffix":"","institution":"Brigham and Women’s Hospital, Department of Internal Medicine, Boston, Massachusetts","department":"None"}],"date_submitted":"2020-06-23T02:30:25+02:00","date_accepted":"2020-06-23T02:30:25+02:00","date_published":"2020-06-23T02:31:03+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/853/galley/605/download/"}]},{"pk":852,"title":"Acute Transverse Myelitis Secondary to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Case Report","subtitle":null,"abstract":"Introduction:\n Respiratory viral illnesses are associated with diverse neurological complications, including acute transverse myelitis (ATM). Among the respiratory viral pathogens, the Coronaviridae family and its genera coronaviruses have been implicated as having neurotropic and neuroinvasive capabilities in human hosts. Despite previous strains of coronaviruses exhibiting neurotropic and neuroinvasive capabilities, little is known about the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its involvement with the central nervous system (CNS). The current pandemic has highlighted the diverse clinical presentation of SARS-CoV-2 including a possible link to CNS manifestation with disease processes such as Guillain-Barré syndrome and cerebrovascular disease. It is critical to shed light on the varied neurological manifestation of SARS-CoV-2 to ensure clinicians do not overlook at-risk patient populations and are able to provide targeted therapies appropriately.\nCase Report:\n While there are currently no published reports on post-infectious ATM secondary to SARS-CoV-2, there is one report of parainfectious ATM attributed to SARS-CoV-2 in pre-print. Here, we present a case of infectious ATM attributed to SARS-CoV-2 in a 24-year-old male who presented with bilateral lower-extremity weakness and overflow urinary incontinence after confirmed SARS-CoV-2 infection. Magnetic resonance imaging revealed non-enhancing T2-weighted hyperintense signal abnormalities spanning from the seventh through the twelfth thoracic level consistent with acute myelitis.\nConclusion:\n The patient underwent further workup and treatment with intravenous corticosteroids with improvement of symptoms and a discharge diagnosis of ATM secondary to SARS-CoV-2.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Acute Transverse Myelitis"},{"word":"Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)"},{"word":"Para-infectious Acute Transverse Myelitis"},{"word":"Post-infectious Acute Transverse Myelitis"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2fs6w4c3","frozenauthors":[{"first_name":"Muhammad","middle_name":"","last_name":"Durrani","name_suffix":"","institution":"Inspira Medical Center, Department of Emergency Medicine, Vineland, New Jersey","department":"None"},{"first_name":"Kevin","middle_name":"","last_name":"Kucharski","name_suffix":"","institution":"Inspira Medical Center, Department of Emergency Medicine, Vineland, New Jersey","department":"None"},{"first_name":"Zachary","middle_name":"","last_name":"Smith","name_suffix":"","institution":"Inspira Medical Center, Department of Emergency Medicine, Vineland, New Jersey","department":"None"},{"first_name":"Stephanie","middle_name":"","last_name":"Fien","name_suffix":"","institution":"Inspira Medical Center, Department of Emergency Medicine, Vineland, New Jersey","department":"None"}],"date_submitted":"2020-06-22T22:49:12+02:00","date_accepted":"2020-06-22T22:49:12+02:00","date_published":"2020-06-22T22:49:46+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/852/galley/604/download/"}]},{"pk":851,"title":"Optimizing Non-invasive Oxygenation for COVID-19 Patients Presenting to the Emergency Department with Acute Respiratory Distress: A Case Report","subtitle":null,"abstract":"Introduction:\n The novel coronavirus (COVID-19) pandemic has led to an increase in the number of patients presenting to the emergency department (ED) with severe hypoxia and acute respiratory distress. With limited resources and ventilators available, emergency physicians working at a hospital within the epicenter of the United States outbreak developed a stepwise, non-invasive oxygenation strategy for treating COVID-19 patients presenting with severe hypoxia and acute respiratory distress.\nCase Report:\n A 72-year-old male suspected of having the COVID-19 virus presented to the ED with shortness of breath. He was found to be severely tachypneic, febrile, with rales in all lung fields. His initial oxygen saturation registered at SpO2 (blood oxygenation saturation) 55% on room air. Emergency physicians employed a novel non-invasive oxygenation strategy using a nasal cannula, non-rebreather, and self-proning. This approach led to a reversal of the patient’s respiratroy distress and hypoxia (SpO2 88-95%) for the following 24 hours.This non-invasive intervention allowed providers time to obtain and initiate high-flow nasal cannula and discuss end-of-life wishes with the patient and his family.\nConclusion:\n Our case highlights a stepwise, organized approach to providing non-invasive oxygenation for COVID-19 patients presenting with severe hypoxia and acute respiratory distress. This approach primarily employs resources and equipment that are readily available to healthcare providers around the world. The intent of this strategy is to provide conventional alternatives to aid in the initial airway management of confirmed or suspected COVID-19 patients.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19"},{"word":"hypoxia"},{"word":"non-invasive"},{"word":"Oxygenation"},{"word":"airway"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/47j5g4cw","frozenauthors":[{"first_name":"David","middle_name":"","last_name":"Zodda","name_suffix":"","institution":"Hackensack University Medical Center School of Medicine at Seton Hall, Nutley, New Jersey; Hackensack University Medical Center, Department of Emergency Medicine, Hackensack, New Jersey","department":"None"},{"first_name":"Allyson","middle_name":"","last_name":"Hanson","name_suffix":"","institution":"Hackensack University Medical Center, Department of Emergency Medicine, Hackensack, New Jersey","department":"None"},{"first_name":"Alyssa","middle_name":"","last_name":"Berns","name_suffix":"","institution":"Hackensack University Medical Center, Department of Emergency Medicine, Hackensack, New Jersey","department":"None"}],"date_submitted":"2020-06-22T22:43:23+02:00","date_accepted":"2020-06-22T22:43:23+02:00","date_published":"2020-06-22T22:43:59+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/851/galley/603/download/"}]},{"pk":850,"title":"Cardioembolic Stroke in a Patient with Coronavirus Disease of 2019 (COVID-19) Myocarditis: A Case Report","subtitle":null,"abstract":"Introduction:\n There is a growing body of literature detailing coronavirus 2019 (COVID-19) cardiovascular complications and hypercoagulability, although little has been published on venous or arterial thrombosis risk.\nCase Report:\n In this report, we present a single case of cardioembolic stroke in the setting of COVID-19 related myocarditis, diagnosed via cardiac magnetic resonance imaging and echocardiography. COVID-19 infection was confirmed via a ribonucleic acid polymerase chain reaction assay.\nConclusion:\n Further research is needed to evaluate the hypercoagulable state of patients with COVID-19 to determine whether prophylactic anticoagulation may be warranted to prevent intracardiac thrombi and cardioembolic disease in patients with COVID-19 related myocarditis.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19"},{"word":"SARS-CoV-2"},{"word":"Myocarditis"},{"word":"thromboembolic stroke"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3bn795s3","frozenauthors":[{"first_name":"James","middle_name":"S.","last_name":"Ford","name_suffix":"","institution":"UC Davis Health, Department of Emergency Medicine, Sacramento, California","department":"None"},{"first_name":"James","middle_name":"F.","last_name":"Holmes","name_suffix":"","institution":"UC Davis Health, Department of Emergency Medicine, Sacramento, California","department":"None"},{"first_name":"Russell","middle_name":"F.","last_name":"Jones","name_suffix":"","institution":"UC Davis Health, Department of Emergency Medicine, Sacramento, California","department":"None"}],"date_submitted":"2020-06-22T22:38:33+02:00","date_accepted":"2020-06-22T22:38:33+02:00","date_published":"2020-06-22T22:39:07+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/850/galley/602/download/"}]},{"pk":13778,"title":"Point-of-care Lung Ultrasound Is More Sensitive than Chest Radiograph for Evaluation of COVID-19","subtitle":null,"abstract":"Introduction:\n Current recommendations for diagnostic imaging for moderately to severely ill patients with suspected coronavirus disease 2019 (COVID-19) include chest radiograph (CXR). Our primary objective was to determine whether lung ultrasound (LUS) B-lines, when excluding patients with alternative etiologies for B-lines, are more sensitive for the associated diagnosis of COVID-19 than CXR.\nMethods: \nThis was a retrospective cohort study of all patients who presented to a single, academic emergency department in the United States between March 20 and April 6, 2020, and received LUS, CXR, and viral testing for COVID-19 as part of their diagnostic evaluation. The primary objective was to estimate the test characteristics of both LUS B-lines and CXR for the associated diagnosis of COVID-19. Our secondary objective was to evaluate the proportion of patients with COVID-19 that have secondary LUS findings of pleural abnormalities and subpleural consolidations.\nResults:\n We identified 43 patients who underwent both LUS and CXR and were tested for COVID-19. Of these, 27/43 (63%) tested positive. LUS was more sensitive (88.9%, 95% confidence interval (CI), 71.1-97.0) for the associated diagnosis of COVID-19 than CXR (51.9%, 95% CI, 34.0-69.3; p = 0.013). LUS and CXR specificity were 56.3% (95% CI, 33.2-76.9) and 75.0% (95% CI, 50.0-90.3), respectively (p = 0.453). Secondary LUS findings of patients with COVID-19 demonstrated 21/27 (77.8%) had pleural abnormalities and 10/27 (37%) had subpleural consolidations.\nConclusion: \nAmong patients who underwent LUS and CXR, LUS was found to have a higher sensitivity than CXR for the evaluation of COVID-19. This data could have important implications as an aid in the diagnostic evaluation of COVID-19, particularly where viral testing is not available or restricted. If generalizable, future directions would include defining how to incorporate LUS into clinical management and its role in screening lower-risk populations.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19, Coronavirus, Ultrasound, B-lines, Chest Radiograph"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1x83j2gv","frozenauthors":[{"first_name":"Joseph","middle_name":"R.","last_name":"Pare","name_suffix":"","institution":"Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts\nBoston Medical Center, Department of Emergency Medicine, \nBoston, Massachusetts","department":"None"},{"first_name":"Ingrid","middle_name":"","last_name":"Camelo","name_suffix":"","institution":"Boston University School of Medicine, Department of Pediatric Infectious Diseases, Boston, Massachusetts","department":"None"},{"first_name":"Kelly","middle_name":"C.","last_name":"Mayo","name_suffix":"","institution":"Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts\nBoston Medical Center, Department of Emergency Medicine, \nBoston, Massachusetts","department":"None"},{"first_name":"Megan","middle_name":"M.","last_name":"Leo","name_suffix":"","institution":"Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts\nBoston Medical Center, Department of Emergency Medicine, \nBoston, Massachusetts","department":"None"},{"first_name":"Julianne","middle_name":"N.","last_name":"Dugas","name_suffix":"","institution":"Boston Medical Center, Department of Emergency Medicine, \nBoston, Massachusetts","department":"None"},{"first_name":"Kerrie","middle_name":"P.","last_name":"Nelson","name_suffix":"","institution":"Boston University School of Public Health, Department of Biostatistics, Boston, Massachusetts","department":"None"},{"first_name":"William","middle_name":"E.","last_name":"Baker","name_suffix":"","institution":"Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts\nBoston Medical Center, Department of Emergency Medicine, \nBoston, Massachusetts","department":"None"},{"first_name":"Faizah","middle_name":"","last_name":"Shareef","name_suffix":"","institution":"Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Patrica","middle_name":"M.","last_name":"Mitchell R.N.","name_suffix":"","institution":"Boston Medical Center, Department of Emergency Medicine, \nBoston, Massachusetts","department":"None"},{"first_name":"Elissa","middle_name":"M.","last_name":"Schechter-Perkins","name_suffix":"","institution":"Boston University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts\nBoston Medical Center, Department of Emergency Medicine, \nBoston, Massachusetts","department":"None"}],"date_submitted":"2020-04-16T23:46:09+02:00","date_accepted":"2020-04-16T23:46:09+02:00","date_published":"2020-06-20T02:03:01+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13778/galley/7177/download/"}]},{"pk":849,"title":"Respiratory Failure Due to a Large Mediastinal Mass in a 4-year-old Female with Blast Cell Crisis: A Case Report","subtitle":null,"abstract":"Introduction:\n Symptomatic leukostasis is an exceptionally atypical presentation of blast crisis; and when coupled with an enlarged neoplastic mediastinal mass in a four-year-old female, an extremely rare and challenging pediatric emergency arises.\nCase Report:\n We present a unique case of a four-year-old female who arrived via emergency medical services in cardiopulmonary arrest with clinical and radiographic evidence suggestive of bilateral pneumothoraces, prompting bilateral chest tube placement. Further evaluation revealed a large mediastinal mass and a concurrent white blood cell count of 428,400 per milliliter (/mL) (4,400-12,900/mL), with a 96% blast differential, consistent with complications of T-cell acute lymphoblastic leukemia.\nConclusion:\n This case highlights how pulmonary capillary hypoperfusion secondary to leukostasis, coupled with a ventilation/perfusion mismatch due to compression atelectasis by an enlarged thymus, resulted in this patient’s respiratory arrest. Furthermore, the case highlights how mediastinal masses in pediatric patients present potential diagnostic challenges for which ultrasound may prove beneficial.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Blast Cell Crisis"},{"word":"Hyperleukocytosis with Leukostasis"},{"word":"Thymus"},{"word":"Mediastinal Mass"},{"word":"Acute Lymphoblastic Leukemia"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7581435h","frozenauthors":[{"first_name":"Christian","middle_name":"I.","last_name":"Wade","name_suffix":"","institution":"Uniformed Services University of the Health Sciences, School of Medicine, Department of Emergency Medicine, Bethesda, Maryland","department":"None"},{"first_name":"Cody","middle_name":"J.","last_name":"Couperus-Mashewske","name_suffix":"","institution":"University of Maryland Medical Center, Department of Emergency Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Mia","middle_name":"E.","last_name":"Geurts","name_suffix":"","institution":"Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington","department":"None"},{"first_name":"Nicholas","middle_name":"","last_name":"Derfler","name_suffix":"","institution":"Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington","department":"None"},{"first_name":"John","middle_name":"","last_name":"Ngo","name_suffix":"","institution":"Providence St. Peter Hospital Olympia, Department of Emergency Medicine, Olympia, Washington","department":"None"},{"first_name":"Kyle","middle_name":"S.","last_name":"Couperus","name_suffix":"","institution":"Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington","department":"None"}],"date_submitted":"2020-06-19T23:51:11+02:00","date_accepted":"2020-06-19T23:51:11+02:00","date_published":"2020-06-19T23:51:52+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/849/galley/601/download/"}]},{"pk":13150,"title":"Prevalence and Predictors of Driving after Prescription Opioid Use in an Adult ED Sample","subtitle":null,"abstract":"Introduction:\n Prescription opioid use and driving is a public health concern given the risks associated with drugged driving, but the issue remains under-studied. We examined the prevalence and correlates of driving after taking prescription opioids (DAPO) among adults seeking emergency department (ED) treatment.\nMethods:\n Participants (aged 25-60) seeking ED care at a Level I trauma center completed a computerized survey. Validated instruments measured prescription opioid use, driving behaviors, and risky driving. Patients who reported past three-month prescription opioid use and drove at least twice weekly were administered an extended study survey measuring DAPO, depression, pain, and substance use.\nResults: \nAmong participants completing the screening survey (n = 756; mean age = 42.8 [standard deviation {SD} =10.4]), 37.8% reported past three-month prescription opioid use (30.8% of whom used daily), and 14.7% reported past three-month DAPO. Of screened participants, 22.5% (n = 170) were eligible for the extended study survey. Unadjusted analyses demonstrated that participants reporting DAPO were more likely to use opioids daily (51.1% vs 15.9%) and had higher rates of opioid misuse (mean Current Opioid Misuse Measure score 3.4 [SD = 3.8] vs 1.1 [SD = 2.1]) chronic pain (80.7% vs 42.7%), and driving after marijuana or alcohol use (mean intoxicated driving score 2.1 [SD = 1.3] vs 0.3 [SD = 0.8]) compared to patients not reporting DAPO (all p<0.001). Adjusting for age, gender, employment, and insurance in a logistic regression model, participants reporting DAPO were more likely to report a chronic pain diagnosis (odds ratio [OR] = 3.77, 95% confidence interval [CI], 1.55-9.17), daily opioid use (OR = 3.81, 95% CI, 1.64-8.85), and higher levels of intoxicated driving (OR = 1.62, 95% CI, 1.07-2.45). Alcohol and marijuana use, depression, and opioid misuse were not associated with DAPO in adjusted analyses.\nConclusion:\n Nearly one in six adult patients seeking ED care reported DAPO. The ED may be an important site for interventions addressing opioid-related drugged driving.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"opioids, emergency department, risky driving"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4606z9bb","frozenauthors":[{"first_name":"Aaron","middle_name":"D.","last_name":"Dora-Laskey","name_suffix":"","institution":"University of Michigan, Department of Emergency Medicine, Ann Arbor, Michigan\nUniversity of Michigan, Department of Psychiatry, Ann Arbor, Michigan \nUniversity of Michigan Addiction Center, Ann Arbor, Michigan \nUniversity of Michigan Injury Prevention Center, Ann Arbor, Michigan\nHurley Medical Center, Department of Emergency Medicine, Flint, Michigan","department":"None"},{"first_name":"Jason","middle_name":"E.","last_name":"Goldstick","name_suffix":"","institution":"University of Michigan, Department of Emergency Medicine, Ann Arbor, Michigan\nUniversity of Michigan Injury Prevention Center, Ann Arbor, Michigan","department":"None"},{"first_name":"Brooke","middle_name":"J.","last_name":"Arterberry","name_suffix":"","institution":"University of Michigan Addiction Center, Ann Arbor, Michigan \nIowa State University, Department of Psychology, Ames, Iowa","department":"None"},{"first_name":"Suni Jo","middle_name":"","last_name":"Roberts","name_suffix":"","institution":"University of Michigan, Department of Psychiatry, Ann Arbor, Michigan","department":"None"},{"first_name":"Rebecca","middle_name":"L.","last_name":"Haffajee","name_suffix":"","institution":"University of Michigan Injury Prevention Center, Ann Arbor, Michigan\nUniversity of Michigan School of Public Health, Department of Health Management and Policy, Ann Arbor, Michigan and RAND Corporation, Boston, Massachusetts","department":"None"},{"first_name":"Amy","middle_name":"S.B.","last_name":"Bohnert","name_suffix":"","institution":"University of Michigan, Department of Psychiatry, Ann Arbor, Michigan \nUniversity of Michigan, Department of Anesthesiology, Ann Arbor, Michigan\nVA Center for Clinical Management and Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan","department":"None"},{"first_name":"Rebecca","middle_name":"M.","last_name":"Cunningham","name_suffix":"","institution":"University of Michigan, Department of Emergency Medicine, Ann Arbor, Michigan\nUniversity of Michigan Injury Prevention Center, Ann Arbor, Michigan\nHurley Medical Center, Department of Emergency Medicine, Flint, Michigan","department":"None"},{"first_name":"Patrick","middle_name":"M/","last_name":"Carter","name_suffix":"","institution":"University of Michigan, Department of Emergency Medicine, Ann Arbor, Michigan\nUniversity of Michigan Injury Prevention Center, Ann Arbor, Michigan","department":"None"}],"date_submitted":"2019-08-06T07:03:49+02:00","date_accepted":"2019-08-06T07:03:49+02:00","date_published":"2020-06-19T21:27:55+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13150/galley/6918/download/"}]},{"pk":5555,"title":"Do honey bees (Apis mellifera) form cognitive representations of unconditioned stimuli?","subtitle":null,"abstract":"Previous research looking at expectancy in animals has used various experimental designs focusing on appetitive and avoidance behaviors. In this study, honey bees (\nApis mellifera\n) were tested ina series of three proboscis extension response (PER) experiments to determine to what degree honey bees’ form a cognitive-representation of an unconditioned stimulus (US). Tthe first experiment, bees were presented with either a 2 sec. sucrose US or 2 sec. honey US appetitive reward and the proboscis-extension duration was measured under each scenario. The PER duration was longer for the honey US even though each US was presented for just 2 sec.   Honey bees in the second experiment were tested during extinction trials on a conditioned stimulus (CS) of cinnamon or lavender that was paired with either the sucrose US or honey US in the acquisition trials.  The proportion of bees showing the PER response to the CS was recorded for each extinction trial for each US scenario, as was the duration of the proboscis extension for each bee.  Neither measure differed between the honey US and sucrose US scenarios,  In experiment three, bees were presented with a cinnamon or lavender CS paired with either honey US or sucrose US in a set of acquisition trials, but here the US was not given until after the proboscis was retracted. The PER duration after the CS, and again subsequent after the US, were recorded. While the PER duration after the US was longer for honey, the PER duration after the CS did not differ between honey US and sucrose US.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Anticipation, Apis mellifera, expectancy learning"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1qj7w169","frozenauthors":[{"first_name":"KiriLi","middle_name":"N","last_name":"Stauch","name_suffix":"","institution":"Oklahoma State University","department":"None"},{"first_name":"Harrington","middle_name":"","last_name":"Wells","name_suffix":"","institution":"University of Tulsa","department":"None"},{"first_name":"Charles","middle_name":"Ira","last_name":"Abramson","name_suffix":"","institution":"Oklahoma State University","department":"None"}],"date_submitted":"2020-01-26T19:41:18+02:00","date_accepted":"2020-01-26T19:41:18+02:00","date_published":"2020-06-19T17:54:52+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uclapsych_ijcp/article/5555/galley/3362/download/"}]},{"pk":63376,"title":"Early Childhood Education and Care and the Use of Digital Media in Informal Environments","subtitle":null,"abstract":"Early childhood is a time of rapid development when children are constantly influenced by experiences and relationships formed in informal environments. In a world that is increasingly reliant on digital media, parents and other caregivers play an important role in managing their children’s use of it. Parents’ choices regarding digital media use heavily depend on their understanding of how children learn from them and how they impact children’s development at different ages and developmental stages. The use of digital media has potential benefits in terms of improved cognitive and literacy skills, but it also has potential risks in terms of lower executive functioning and social-emotional skills due to a lack of social interactions. This article informs the role of parents and other caregivers who can help children benefit from the opportunities that digital media present, while making sure that children experience real-life interactions that are vital to children’s overall development.","language":"en","license":null,"keywords":[{"word":"Early childhood education and care"},{"word":"parents"},{"word":"digital media"},{"word":"screen devices"},{"word":"interactivity"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/64k433qs","frozenauthors":[{"first_name":"Zara","middle_name":"","last_name":"Qaiser","name_suffix":"","institution":"University of Cambridge","department":""}],"date_submitted":"2019-01-03T14:56:52+02:00","date_accepted":"2019-01-03T14:56:52+02:00","date_published":"2020-06-19T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/bre/article/63376/galley/48836/download/"}]},{"pk":2899,"title":"Collective Conclusion: Collective Reflections on Critical Storytelling for Racial and Social Justice","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"Conclusion to Issue","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0mm8z490","frozenauthors":[{"first_name":"Brianna","middle_name":"","last_name":"Ramirez","name_suffix":"","institution":"","department":"None"},{"first_name":"Mayra","middle_name":"","last_name":"Puente","name_suffix":"","institution":"UC San Diego","department":"None"},{"first_name":"James","middle_name":"","last_name":"Crawford","name_suffix":"","institution":"","department":"None"},{"first_name":"Andrew","middle_name":"","last_name":"Matschiner","name_suffix":"","institution":"","department":"None"},{"first_name":"Katherine","middle_name":"Arias","last_name":"Garcia","name_suffix":"","institution":"","department":"None"},{"first_name":"Zaynab","middle_name":"","last_name":"Gates","name_suffix":"","institution":"","department":"None"},{"first_name":"Kirk","middle_name":"","last_name":"Rogers Jr.","name_suffix":"","institution":"","department":"None"},{"first_name":"Ramon","middle_name":"","last_name":"Stephens","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2020-01-31T22:23:08+02:00","date_accepted":"2020-01-31T22:23:08+02:00","date_published":"2020-06-17T20:19:15+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2899/galley/1719/download/"}]},{"pk":2894,"title":"A Latina pursuing her medical dream (MD)","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[{"word":"Counterstory, Latina, microaggressions"}],"section":"CounterStory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6v03r1f7","frozenauthors":[{"first_name":"Katherine","middle_name":"Arias","last_name":"Garcia","name_suffix":"","institution":"UC San Diego, Education Studies Department","department":"None"}],"date_submitted":"2019-12-03T07:44:08+02:00","date_accepted":"2019-12-03T07:44:08+02:00","date_published":"2020-06-17T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2894/galley/1716/download/"}]},{"pk":2889,"title":"Introduction: When the Magic Happens. Critical Race Storytelling","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[{"word":"critical race theory, counterstories, teaching"}],"section":"Introduction to Issue","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8v36956m","frozenauthors":[{"first_name":"Thandeka","middle_name":"K","last_name":"Chapman","name_suffix":"","institution":"UC San Diego","department":"None"}],"date_submitted":"2019-12-03T03:16:46+02:00","date_accepted":"2019-12-03T03:16:46+02:00","date_published":"2020-06-17T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2889/galley/1712/download/"}]},{"pk":2885,"title":"Leaving La Puente: A Critical Race Counterstory of Rural Chicana/Latina College Choice","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[{"word":"College choice, college proximity, spatial inequity, rural students, Chicanx/Latinx students, critical race theory, counterstorytelling methodology"}],"section":"CounterStory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8w36c2km","frozenauthors":[{"first_name":"Mayra","middle_name":"","last_name":"Puente","name_suffix":"","institution":"University of California, San Diego","department":"None"}],"date_submitted":"2019-12-03T08:30:44+02:00","date_accepted":"2019-12-03T08:30:44+02:00","date_published":"2020-06-17T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2885/galley/1709/download/"}]},{"pk":2893,"title":"Liberation","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"Cover Art","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8k10k1qf","frozenauthors":[{"first_name":"Mario","middle_name":"","last_name":"MillerJr","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2019-12-03T07:03:11+02:00","date_accepted":"2019-12-03T07:03:11+02:00","date_published":"2020-06-17T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2893/galley/1715/download/"}]},{"pk":2892,"title":"Pop: A Critical Race Story of Racialized Violence in America","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"CounterStory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2zc0p8n1","frozenauthors":[{"first_name":"Kirk","middle_name":"D","last_name":"RogersJr","name_suffix":"","institution":"UC San Diego","department":"None"}],"date_submitted":"2019-12-03T06:52:04+02:00","date_accepted":"2019-12-03T06:52:04+02:00","date_published":"2020-06-17T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2892/galley/1714/download/"}]},{"pk":2891,"title":"Seen Without (in)Sight","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[{"word":"CRT"},{"word":"school discipline"},{"word":"restorative justice"},{"word":"anti-blackness"}],"section":"CounterStory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/81g3d1d8","frozenauthors":[{"first_name":"James","middle_name":"","last_name":"Crawford","name_suffix":"","institution":"UC San Diego","department":"None"}],"date_submitted":"2019-12-03T03:38:14+02:00","date_accepted":"2019-12-03T03:38:14+02:00","date_published":"2020-06-17T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2891/galley/1713/download/"}]},{"pk":2895,"title":"The Daily Dose: The End to Social Inequity","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"CounterStory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3fs599mq","frozenauthors":[{"first_name":"Ramon","middle_name":"","last_name":"Stephens","name_suffix":"","institution":"UC San Diego","department":"None"}],"date_submitted":"2019-12-03T08:00:34+02:00","date_accepted":"2019-12-03T08:00:34+02:00","date_published":"2020-06-17T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2895/galley/1717/download/"}]},{"pk":2875,"title":"The Hypervisibility and Disciplining of the Young Brown Mujer Body in School:  A Counternarrative of Mother-Daughter-Sister Pedagogies for Survival and Resistance","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[{"word":"CRT, Chicana Feminism, Young Girls of Color"}],"section":"CounterStory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/53d4m8m6","frozenauthors":[{"first_name":"Brianna","middle_name":"R","last_name":"Ramirez","name_suffix":"","institution":"UC San Diego","department":"None"}],"date_submitted":"2019-12-03T07:43:24+02:00","date_accepted":"2019-12-03T07:43:24+02:00","date_published":"2020-06-17T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2875/galley/1705/download/"}]},{"pk":2888,"title":"The price we pay","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[{"word":"Indigenous peoples, Argentina, Education"}],"section":"CounterStory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9bv1552g","frozenauthors":[{"first_name":"Zaynab","middle_name":"Amelia","last_name":"Gates","name_suffix":"","institution":"UC San Diego","department":"None"}],"date_submitted":"2019-12-03T05:49:12+02:00","date_accepted":"2019-12-03T05:49:12+02:00","date_published":"2020-06-17T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2888/galley/1711/download/"}]},{"pk":2886,"title":"What He Learned to Think He Earned","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[{"word":"Critical Whiteness Studies"},{"word":"White Racial Socialization"},{"word":"White Youth"}],"section":"CounterStory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/69b4c63b","frozenauthors":[{"first_name":"Andrew","middle_name":"","last_name":"Matschiner","name_suffix":"","institution":"UC San Diego","department":"None"}],"date_submitted":"2019-12-01T01:09:51+02:00","date_accepted":"2019-12-01T01:09:51+02:00","date_published":"2020-06-17T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2886/galley/1710/download/"}]},{"pk":42985,"title":"Cartographies of the Self: Indigenous Territoriality and Literary Sovereignty in Contemporary Native American Life Writing","subtitle":null,"abstract":"This contribution sets out to show how contemporary Indigenous autobiographers critically counter hegemonic territorial inscriptions of “America” and American citizenship and explore alternatives that often connect to but are not identical with tribal–nationalist notions of territoriality in their insistence on sovereignty. In the context of Indigenous life writing, this contribution suggests, “territoriality“ can be broadly understood as a land-based and transgenerational relationality; the Indigenous authors whose autobiographical work is discussed in detail—N. Scott Momaday, Leslie Marmon Silko, and Louise Erdrich—engage with territoriality as a category of selfhood by way of a self-reflexive storytelling that draws its authority from reference to earlier storytelling and to storytelling conventions, but also from its orientation towards an individual and collective Indigenous future.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"N. Scott Momaday"},{"word":"Leslie Marmon Silko"},{"word":"Louise Erdrich"},{"word":"Native American autobiography"},{"word":"Indigenous storytelling"},{"word":"land-based relationality"},{"word":"Indigenous sovereignty"},{"word":"transnational Indigenous studies"},{"word":"Transnational American Studies"},{"word":"JTAS"}],"section":"SPECIAL FORUM: (Im)Mobilities","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1hw3p4kx","frozenauthors":[{"first_name":"Katja","middle_name":"","last_name":"Sarkowsky","name_suffix":"","institution":"Augsburg University","department":"None"}],"date_submitted":"2020-02-17T22:38:18+02:00","date_accepted":"2020-02-17T22:38:18+02:00","date_published":"2020-06-16T15:38:36+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42985/galley/32036/download/"}]},{"pk":848,"title":"Acute Acalculous Cholecystitis from Infection with Epstein–Barr Virus in a Previously Healthy Child: A Case Report","subtitle":null,"abstract":"Background:\n Acute cholecystitis is the acute inflammation of the gallbladder. In adults it is most frequently caused by a gallstone(s) obstructing outflow from the cystic duct, leading to gallbladder distention and edema with eventual development of biliary stasis and bacterial overgrowth, often requiring operative management. However, in children acalculous cholecystitis is more common and is often the result of an infectious process.\nCase Report:\n Here we present a case of acute acalculous cholecystitis caused by infection with Epstein-Barr virus in an otherwise healthy three-year-old male.\nConclusion:\n Acalculous cholecystitis is an uncommon but potentially significant complication of Epstein-Barr virus infection in the pediatric population. Emergency providers should consider this diagnosis in any child being evaluated for EBV with the complaint of abdominal pain.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Epstein-Barr"},{"word":"acalculous cholecystitis"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3qj0687m","frozenauthors":[{"first_name":"Robert","middle_name":"","last_name":"Langenohl","name_suffix":"","institution":"Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington","department":"None"},{"first_name":"Scott","middle_name":"","last_name":"Young","name_suffix":"","institution":"Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington","department":"None"},{"first_name":"Kyle","middle_name":"","last_name":"Couperus","name_suffix":"","institution":"Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington","department":"None"}],"date_submitted":"2020-06-15T21:42:29+02:00","date_accepted":"2020-06-15T21:42:29+02:00","date_published":"2020-06-15T21:43:02+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/848/galley/600/download/"}]},{"pk":13392,"title":"Patient Safety Event Reporting and Opportunities for Emergency Medicine Resident Education","subtitle":null,"abstract":"Introduction:\n Healthcare systems often expose patients to significant, preventable harm causing an estimated 44,000 to 98,000 deaths or more annually. This has propelled patient safety to the forefront, with reporting systems allowing for the review of local events to determine their root causes. As residents engage in a substantial amount of patient care in academic emergency departments, it is critical to use these safety event reports for resident-focused interventions and educational initiatives. This study analyzes reports from the Virginia Commonwealth University Health System to understand how the reports are categorized and how it relates to opportunities for resident education.\nMethods: \nIdentifying categories from the literature, three subject matter experts (attending physician, nursing director, registered nurse) categorized an initial 20 reports to resolve category gaps and then 100 reports to determine inter-rater reliability. Given sufficient agreement, the remaining 400 reports were coded individually for type of event and education among other categories.\nResults:\n After reviewing 513 events, we found that the most common event types were issues related to staff and resident training (25%) and communication (18%), with 31% requiring no education, 46% requiring directed educational feedback to an individual or group, 20% requiring education through monthly safety updates or meetings, 3% requiring urgent communication by email or in-person, and <1% requiring simulation.\nConclusion:\n Twenty years after the publication of To Err is Human, gains have been made integrating quality assurance and patient safety within medical education and hospital systems, but there remains extensive work to be done. Through a review and analysis of our patient safety event reporting system, we were able to gain a better understanding of the events that are submitted, including the types of events and their severity, and how these relate to the types of educational interventions provided (eg, feedback, simulation). We also determined that these events can help inform resident education and learning using various types of education. Additionally, incorporating residents in the review process, such as through root cause analyses, can provide residents with high-quality, engaging learning opportunities and useful, lifelong skills, which is invaluable to our learners and future physicians.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"safety, resident, education"}],"section":"Patient Safety","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0092g4rn","frozenauthors":[{"first_name":"V.","middle_name":"Ramana","last_name":"Feeser","name_suffix":"","institution":"Virginia Commonwealth University School of Medicine, Department of Emergency Medicine, Richmond, Virginia","department":"None"},{"first_name":"Anne","middle_name":"","last_name":"Jackson","name_suffix":"","institution":"Virginia Commonwealth University Health System, Department of Emergency Medicine, Richmond, Virginia","department":"None"},{"first_name":"Regina","middle_name":"","last_name":"Senn","name_suffix":"","institution":"Virginia Commonwealth University Health System, Department of Emergency Medicine, Richmond, Virginia","department":"None"},{"first_name":"Timothy","middle_name":"","last_name":"Layng","name_suffix":"","institution":"Virginia Commonwealth University Health System, Department of Emergency Medicine, Richmond, Virginia","department":"None"},{"first_name":"Sally","middle_name":"A.","last_name":"Santen","name_suffix":"","institution":"Virginia Commonwealth University School of Medicine, Department of Emergency Medicine, Richmond, Virginia","department":"None"},{"first_name":"Angela","middle_name":"B.","last_name":"Creditt","name_suffix":"","institution":"Virginia Commonwealth University School of Medicine, Department of Emergency Medicine, Richmond, Virginia","department":"None"},{"first_name":"Harinder","middle_name":"S.","last_name":"Dhindsa","name_suffix":"","institution":"Virginia Commonwealth University Health System, Department of Emergency Medicine, Division of Emergency Medical Services, Richmond, Virginia","department":"None"},{"first_name":"Michael","middle_name":"J.","last_name":"Vitto","name_suffix":"","institution":"Virginia Commonwealth University School of Medicine, Department of Emergency Medicine, Richmond, Virginia","department":"None"},{"first_name":"Nastassia","middle_name":"M.","last_name":"Savage","name_suffix":"","institution":"Virginia Commonwealth University School of Medicine, Office of Assessment, Evaluation, and Scholarship, Richmond, Virginia","department":"None"},{"first_name":"Robin","middle_name":"R.","last_name":"Hemphill","name_suffix":"","institution":"Virginia Commonwealth University Health System, Department of Emergency Medicine, Richmond, Virginia","department":"None"}],"date_submitted":"2019-11-28T03:59:37+02:00","date_accepted":"2019-11-28T03:59:37+02:00","date_published":"2020-06-15T21:39:35+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13392/galley/7031/download/"}]},{"pk":847,"title":"A Case Report: Point-of-care Ultrasound in the Diagnosis of Post-Myocardial Infarction Ventricular Septal Rupture","subtitle":null,"abstract":"Introduction:\n Ventricular septal rupture (VSR) is a rare complication of ST-elevation myocardial infarction (STEMI), typically discovered post-revascularization.\nCase report:\n We present the first case of VSR detected on point-of-care ultrasound (POCUS) in the emergency department immediately prior to emergent angiography, with management positively affected by this discovery. The VSR was quickly confirmed via right heart catheterization. Subsequently, hemodynamic stability was achieved using an intra-aortic balloon pump. A delayed surgical VSR repair, with concomitant coronary artery bypass grafting, was implemented for definitive management.\nConclusion:\n This case highlights the utility of POCUS in a STEMI patient with a suspected mechanical complication.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Coronary artery disease"},{"word":"mechanical circulatory support"},{"word":"ST-elevation myocardial infarction"},{"word":"ventricular septal rupture"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6434249q","frozenauthors":[{"first_name":"Andrew","middle_name":"J.","last_name":"Portuguese","name_suffix":"","institution":"University of Rochester Medical Center, Department of Medicine, Rochester, New York","department":"None"},{"first_name":"Khaled","middle_name":"H.","last_name":"Abdulla","name_suffix":"","institution":"University of Rochester Medical Center, Department of Medicine, Rochester, New York","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Vornovitsky","name_suffix":"","institution":"University of Rochester Medical Center, Department of Cardiology, Rochester, New York","department":"None"},{"first_name":"John","middle_name":"","last_name":"DeAngelis","name_suffix":"","institution":"University of Rochester Medical Center, Department of Emergency Medicine, Rochester, New York","department":"None"}],"date_submitted":"2020-06-15T21:33:36+02:00","date_accepted":"2020-06-15T21:33:36+02:00","date_published":"2020-06-15T21:34:22+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/847/galley/599/download/"}]},{"pk":13577,"title":"Documentation Displaces Teaching in an Academic Emergency Department","subtitle":null,"abstract":"Introduction:\n Adverse effects of administrative burden on emergency physicians have been described previously, but the impact of electronic health record documentation by academic emergency attendings on resident education is not known. In this observational study of a quaternary care, academic emergency department, we sought to assess whether the amount of time attending physicians spent on documentation affected the amount of time they spent teaching.\nMethods:\n A fourth-year emergency medicine (EM) resident observed 10 attending physicians over 42 hours during 11 shifts, recording their activities every 30 seconds. Activity categories were developed iteratively by the study team and validated through co-observation by an EM education fellow with a kappa of 0.89. We used regression analysis to assess the relationship between time spent documenting and time spent teaching, as well as the relationship between these two activities and all other attending activity categories.\nResults:\n Results demonstrate that time spent documenting was significantly and specifically associated with less time spent teaching, controlling for patient arrivals per hour; every minute spent on documentation was associated with 0.48 fewer minutes spent teaching (p<0.05). Further, documentation time was not strongly associated with time spent on any other activity including patient care, nor did any other activity significantly predict teaching time.\nConclusion:\n Findings suggest that academic attendings may face a trade-off between their documentation and teaching duties. Further study is needed to explore how administrative expectations placed on academic emergency physicians might interfere with trainee education.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Documentation, education, administrative burden, on-shift teaching"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/93x523k5","frozenauthors":[{"first_name":"Joshua","middle_name":"J.","last_name":"Baugh","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Derek","middle_name":"L.","last_name":"Monette","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"James","middle_name":"K.","last_name":"Takayesu","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Ali","middle_name":"S.","last_name":"Raja","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Brian","middle_name":"J.","last_name":"Yun","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"}],"date_submitted":"2020-02-15T01:56:42+02:00","date_accepted":"2020-02-15T01:56:42+02:00","date_published":"2020-06-15T21:33:39+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13577/galley/7102/download/"}]},{"pk":13864,"title":"In Young Adults with COVID-19, Obesity Is Associated with Adverse Outcomes","subtitle":null,"abstract":"Introduction:\n For patients with COVID-19, several characteristics have been identified that may be associated with adverse outcomes. However, there is a paucity of data regarding the effect of obesity on young adult patients with COVID-19. We sought to identify whether adverse outcomes are associated with obesity, particularly in COVID-19 patients 45 years and younger.\nMethods:\n This was a two-center, retrospective cohort study that included 210 patients. Eligible patients were between the ages of 18-45 years old, had tested positive for SARS-CoV-2 on real-time reverse transcription polymerase chain reaction via nasopharyngeal swab, and were not pregnant. Primary outcomes were defined as follows: 1) in-hospital mortality during the study period; 2) need for mechanical ventilation; and 3) admission to the hospital. We analyzed baseline characteristics of the cohort using descriptive statistics. Odds ratios (OR) were calculated to assess associations between outcomes and obesity, defined as body mass index (BMI) >30.\nResults:\n Of those patients who tested positive, 18 died during hospitalization (9%), 36 (17%) required mechanical ventilation, and 94 (45%) were admitted. Each of the primary outcomes was significantly associated with a BMI >30 (mortality OR = 6.29, 95% confidence interval [CI], 1.76-22.46, p = 0.0046; mechanical ventilation OR = 6.01, 95% CI, 2.5-14.48, p = 0.0001; admission OR 2.61, 95% CI, 1.49-4.58, p = .0008).\nConclusion:\n Obesity appears to be an independent risk factor for poor outcomes in young patients with COVID-19. Future studies examining the clinical characteristics and risk factors of COVID-19 patients across large, diverse populations will strengthen our understanding of this novel and complex disease.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19"},{"word":"coronavirus"},{"word":"Infectious disease"},{"word":"obesity"},{"word":"Pandemic"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2wg2k7qn","frozenauthors":[{"first_name":"Eric","middle_name":"","last_name":"Steinberg","name_suffix":"","institution":"St. Joseph’s Health, Department of Emergency Medicine, Paterson, New Jersey","department":"None"},{"first_name":"Ellsworth","middle_name":"","last_name":"Wright","name_suffix":"","institution":"St. Joseph’s Health, Department of Emergency Medicine, Paterson, New Jersey","department":"None"},{"first_name":"Beth","middle_name":"","last_name":"Kushner","name_suffix":"","institution":"St. Joseph’s Health, Department of Emergency Medicine, Paterson, New Jersey","department":"None"}],"date_submitted":"2020-05-01T17:12:55+02:00","date_accepted":"2020-05-01T17:12:55+02:00","date_published":"2020-06-15T21:30:50+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13864/galley/7216/download/"}]},{"pk":846,"title":"Euglycemic Diabetic Ketoacidosis Precipitated by SGLT-2 Inhibitor Use, Pericarditis, and Fasting: A Case Report","subtitle":null,"abstract":"Introduction:\n Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Less prevalent is euglycemic DKA (eDKA)—DKA with serum glucose less than 200 mg/dL; however, it is increasing in frequency with the introduction of sodium glucose cotransporter 2 (SGLT-2) inhibitors for treatment of type 2 diabetes.\nCase Report:\n We report a case of SGLT-2 inhibitor-associated eDKA presenting with concurrent acute pericarditis.\nDiscussion:\n Our case suggests that the cause of eDKA can be multifactorial when decreased oral intake occurs in the setting of an acute cause of physiologic stress.\nConclusion:\n Prompt recognition of eDKA in the emergency department may allow earlier diagnosis and treatment directed at one or more of its underlying causes.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Euglycemic DKA"},{"word":"SGLT-2 Inhibitor"},{"word":"Pericarditis"},{"word":"Fasting"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1gn8w43x","frozenauthors":[{"first_name":"Rebecca","middle_name":"A.","last_name":"Mendelsohn","name_suffix":"","institution":"Florida Atlantic University Charles E. Schmidt College of Medicine, Department of Emergency Medicine, Boca Raton, Florida","department":"None"},{"first_name":"Anabelle","middle_name":"N.","last_name":"Taveras","name_suffix":"","institution":"Florida Atlantic University Charles E. Schmidt College of Medicine, Department of Emergency Medicine, Boca Raton, Florida","department":"None"},{"first_name":"Benjamin","middle_name":"A.","last_name":"Mazer","name_suffix":"","institution":"Florida Atlantic University Charles E. Schmidt College of Medicine, Department of Emergency Medicine, Boca Raton, Florida","department":"None"},{"first_name":"Lisa","middle_name":"M.","last_name":"Clayton","name_suffix":"","institution":"Florida Atlantic University Charles E. Schmidt College of Medicine, Department of Emergency Medicine, Boca Raton, Florida","department":"None"}],"date_submitted":"2020-06-15T21:23:01+02:00","date_accepted":"2020-06-15T21:23:01+02:00","date_published":"2020-06-15T21:25:16+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/846/galley/598/download/"}]},{"pk":13782,"title":"Home-based Testing for SARS-CoV-2: Leveraging Prehospital Resources for Vulnerable Populations","subtitle":null,"abstract":"Introduction:\n Expanded testing for SARS-CoV-2 is critical to characterizing the extent of community spread of COVID-19 and to identifying infectious cohorts. Unfortunately, current facility-based testing compounds shortcomings in testing availability, neglecting those who are frail or physically unable to travel to a testing facility.\nMethods:\n We developed an emergency medical service (EMS)-based home testing and evaluation program, leveraging existing community EMS resources. This program has kept vulnerable populations out of the emergency department, reduced cost, and improved access to care.\nResults:\n Our EMS-based testing program can test approximately 15 homebound patients per day. Through April 2020 our program had performed 477 home-based tests. Additionally, we have recently undertaken several mass testing operations, testing up to 900 patients per testing site.\nConclusion:\n Facility-based SARS-CoV-2 testing requires that a patient physically present to a facility for a nasopharyngeal swap to be collected. Unfortunately, access may be limited for patients that are homebound, chronically ill, or without a means of private transportation. By leveraging existing EMS infrastructure in new ways, our community has been able to keep almost 500 vulnerable patients in their home. Using EMS, we can strengthen the healthcare system’s response to the evolving COVID-19 pandemic and support at-risk populations, including those that are underserved, homebound, and frail.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Emergency Medical Services, Emergency Medicine, Public Health, SARS-CoV-2, COVID-19"}],"section":"Emergency Medical Services","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0gq9k58p","frozenauthors":[{"first_name":"Scott","middle_name":"A.","last_name":"Goldberg","name_suffix":"","institution":"Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Robert","middle_name":"A.","last_name":"Bonacci","name_suffix":"","institution":"Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Lucas","middle_name":"C.","last_name":"Carlson","name_suffix":"","institution":"Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts \nPopulation Health Management, Partners HealthCare, Boston, Massachusetts","department":"None"},{"first_name":"Charles","middle_name":"T.","last_name":"Pu","name_suffix":"","institution":"Population Health Management, Partners HealthCare, Boston, Massachusetts \nMassachusetts General Hospital, Department of Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Christine","middle_name":"S.","last_name":"Ritchie","name_suffix":"","institution":"Massachusetts General Hospital, Department of Medicine, Division of Palliative Care and Geriatric Medicine and the Mongan Institute, Boston, Massachusetts","department":"None"}],"date_submitted":"2020-04-17T21:39:23+02:00","date_accepted":"2020-04-17T21:39:23+02:00","date_published":"2020-06-15T21:24:37+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13782/galley/7180/download/"}]},{"pk":13712,"title":"Recommendations for Prehospital Airway Management in Patients with Suspected COVID-19 Infection","subtitle":null,"abstract":"In light of the rapid spread of coronavirus disease 2019 (COVID-19) across the United States, the Centers for Disease Control and Prevention (CDC) and hospitals nationwide have developed new protocols to address infection control as well as the care of critical patients. Airway management has been particularly difficult; the challenge of quickly establishing an airway in patients must be balanced by the risk of aerosolizing respiratory secretions and putting the provider at risk of infection. Significant attention has been given to developing protocols for the emergency department and critical care units, but little guidance regarding establishing airway and respiratory support for patients in the prehospital setting has been made available. While some of the recommendations can be extrapolated from hospital guidelines, other factors such as environment and available resources make these protocols unfeasible. Through review of current literature the authors established recommendations regarding airway management and the provision of respiratory support to patients developing respiratory failure related to COVID-19.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19, Airway Management, EMS, Prehospital Care"}],"section":"Emergency Medical Services","is_remote":true,"remote_url":"https://escholarship.org/uc/item/28z3b3nv","frozenauthors":[{"first_name":"James","middle_name":"","last_name":"Hart","name_suffix":"","institution":"Southern Illinois University School of Medicine","department":"None"},{"first_name":"Rebecca","middle_name":"","last_name":"Tracy","name_suffix":"","institution":"Southern Illinois University School of Medicine, Department of Emergency Medicine, Springfield, Illinois","department":"None"},{"first_name":"Matthew","middle_name":"","last_name":"Johnston","name_suffix":"","institution":"Southern Illinois University School of Medicine, Department of Emergency Medicine, Springfield, Illinois","department":"None"},{"first_name":"Sara","middle_name":"","last_name":"Brown","name_suffix":"","institution":"Memorial Medical Center, Springfield, Illinois","department":"None"},{"first_name":"Connor","middle_name":"","last_name":"Stephenson","name_suffix":"","institution":"Southern Illinois University School of Medicine, Springfield, Illinois","department":"None"},{"first_name":"Jason","middle_name":"","last_name":"Kegg","name_suffix":"","institution":"Southern Illinois University School of Medicine, Department of Emergency Medicine, Springfield, Illinois\nState of Illinois EMS Medical Director, Department of Public Health, Springfield, Illinois","department":"None"},{"first_name":"James","middle_name":"","last_name":"Waymack","name_suffix":"","institution":"Southern Illinois University School of Medicine, Department of Emergency Medicine, Springfield, Illinois","department":"None"}],"date_submitted":"2020-04-02T21:33:55+02:00","date_accepted":"2020-04-02T21:33:55+02:00","date_published":"2020-06-15T21:19:02+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13712/galley/7158/download/"}]},{"pk":845,"title":"Keratolysis Associated with Methamphetamine Use – Incidental Diagnosis of Corneal Melt in a Patient with Acute Methamphetamine Intoxication","subtitle":null,"abstract":"Case Presentation:\n A 38-year-old male presented to the emergency department with methamphetamine-induced agitation. Physical exam showed clouding of the left cornea, with gelatinous appearance and associated conjunctivitis, consistent with corneal melt, or keratolysis.\nDiscussion:\n Keratolysis is dissolution of the corneal stroma that can lead to corneal ulceration and vision loss. Smoking stimulants has been shown to be associated with this pattern of ocular injury, although this is a relatively rare presentation. Acute keratolysis is a unique complication of methamphetamine preparation and ingestion via smoking that can lead to corneal ulceration and loss of vision.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"corneal ulceration"},{"word":"keratolysis"},{"word":"methamphetamine"}],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4962t66v","frozenauthors":[{"first_name":"Jagdipak","middle_name":"S.","last_name":"Heer","name_suffix":"","institution":"Kern Medical Center, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"Sean","middle_name":"","last_name":"Heavey","name_suffix":"","institution":"Kern Medical Center, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"Daniel","middle_name":"","last_name":"Quesada","name_suffix":"","institution":"Kern Medical Center, Department of Emergency Medicine, Bakersfield, California; LAC+ USC Medical Center, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Phillip","middle_name":"","last_name":"Aguìñiga-Navarrete","name_suffix":"","institution":"Kern Medical Center, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"Madison","middle_name":"B.","last_name":"Garrett","name_suffix":"","institution":"Kern Medical Center, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"Kieron","middle_name":"","last_name":"Barkataki","name_suffix":"","institution":"Kern Medical Center, Department of Emergency Medicine, Bakersfield, California","department":"None"}],"date_submitted":"2020-06-15T21:06:21+02:00","date_accepted":"2020-06-15T21:06:21+02:00","date_published":"2020-06-15T21:07:04+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/845/galley/597/download/"}]},{"pk":42994,"title":"Introduction: Mapping American Territorialities","subtitle":null,"abstract":"Editors’ introduction.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"territoritoriality"},{"word":"US Imperialism"},{"word":"Indigenous sovereignty"},{"word":"Transnational American Studies"},{"word":"JTAS"}],"section":"SPECIAL FORUM: (Im)Mobilities","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3js9b5td","frozenauthors":[{"first_name":"Jens","middle_name":"","last_name":"Temmen","name_suffix":"","institution":"Mainz University","department":"None"},{"first_name":"Nicole","middle_name":"","last_name":"Waller","name_suffix":"","institution":"University of Potsdam","department":"None"}],"date_submitted":"2020-02-18T15:22:12+02:00","date_accepted":"2020-02-18T15:22:12+02:00","date_published":"2020-06-15T09:57:03+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42994/galley/32044/download/"}]},{"pk":42993,"title":"Afterword: Militant Territoriality","subtitle":null,"abstract":"Afterword for the Special Forum on American Territorialities","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"political geography"},{"word":"challenges to US political geography"},{"word":"martial territoriality"},{"word":"militant territoriality"},{"word":"Transnational American Studies"},{"word":"JTAS"}],"section":"SPECIAL FORUM: (Im)Mobilities","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3520p9jc","frozenauthors":[{"first_name":"Vincent","middle_name":"","last_name":"Brown","name_suffix":"","institution":"Harvard University","department":"None"}],"date_submitted":"2020-02-17T23:07:11+02:00","date_accepted":"2020-02-17T23:07:11+02:00","date_published":"2020-06-15T09:56:27+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42993/galley/32043/download/"}]},{"pk":42990,"title":"‘Neither citizen nor alien’: Migration, Territoriality, and Malfunctioning Empire in the US Virgin Islands","subtitle":null,"abstract":"In 1924, Leander Holder, an Afro-Danish housewife living in New York City, attempted to buy a steamship ticket home after a visit to the US Virgin Islands. The steamship company refused to sell her passage, arguing that she lacked the needed documents to prove her American citizenship. The snafu sent a flurry of letters, cables, and memos circulating through the islands–mainland circuit. As Virgin Islands activists, the American Civil Liberties Union (ACLU), federal officials, and Holder’s family became embroiled in a debate over how she might return to the mainland, their conundrum became indicative of how migrating imperial subjects revealed the reach and limits of American power. This article considers Holder’s predicament through the lens of territoriality and migration to reveal the deficiencies of not only America’s territorial regime but also how the movements of ordinary women and men across, to, and from imperial spaces lay bare the way empire exerts power through incoherence. Opening with the facts of the case, the article then explores how rapid changes in conceptions of territoriality and citizenship influenced its events. It then considers migration as the key malfunction point in the increasingly racialized context of American empire in the early twentieth century. The article ends by examining the ways that Holder’s story speaks to the function of dysfunction in the history of American empire, a migrant’s ability to disrupt empire’s assumed efficiency, and the ways empire wields power even as its judicial congruency fails, its bureaucracies bicker, and its processes malfunction.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"US Virgin Islander citizenship"},{"word":"migration and American imperial territoriality"},{"word":"USVI rights to travel"},{"word":"Transnational American Studies"},{"word":"JTAS"}],"section":"SPECIAL FORUM: (Im)Mobilities","is_remote":true,"remote_url":"https://escholarship.org/uc/item/24k7423t","frozenauthors":[{"first_name":"Amelia","middle_name":"","last_name":"Flood","name_suffix":"","institution":"St. Louis University","department":"None"}],"date_submitted":"2020-02-17T22:59:31+02:00","date_accepted":"2020-02-17T22:59:31+02:00","date_published":"2020-06-15T09:54:56+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42990/galley/32040/download/"}]},{"pk":42987,"title":"‘We’d rather eat rocks’: Contesting the Thirty Meter Telescope in a Struggle over Science and Sovereignty in Hawai‘i","subtitle":null,"abstract":"The selection of the sacred summit of Mauna Kea on the Big Island of Hawaiʻi as the site for a Thirty Meter Telescope (TMT) inaugurated a surge in activism against desecration of the mountain, particularly following a TMT groundbreaking ceremony in October 2014. Drawing on fieldwork I conducted immediately preceding and following the groundbreaking, I argue that the protectors in these initial years of protection were theorizing an Indigenous future that can be seen unfolding in the immediate present. The accumulated tensions between the state’s parameters for recognition and the existence of Kanaka Maoli (Native Hawaiian) people and practice results in a dangerous dichotomy between Hawaiian knowledges and Western science that delegitimizes the former, so that Kānaka Maoli protecting Mauna Kea from the Thirty Meter Telescope are framed as antiscience, rather than anti-occupation. In response to the state’s disavowal of settler colonialism through the denial of Kanaka knowledges, Kanaka protection of Mauna Kea asserts itself as an anti-occupation reclamation of not just sovereign territory, but also of Kanaka ontologies. This combination demonstrates the mutually constituted nature of science, the sacred, and sovereignty under a Kanaka worldview. Kānaka Maoli position the struggle as a part of an ongoing sovereignty movement to assert continuities between their historical, contemporary, and emergent claims to land and knowledge.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"Mauna Kea"},{"word":"Hawaiian sovereignty"},{"word":"transnational Indigenous studies"},{"word":"TMT"},{"word":"Kanaka Maoli activism"},{"word":"thirty meter telescope"},{"word":"Transnational American Studies"},{"word":"Journal of Transnational American Studies"},{"word":"JTAS"}],"section":"SPECIAL FORUM: (Im)Mobilities","is_remote":true,"remote_url":"https://escholarship.org/uc/item/70z6w502","frozenauthors":[{"first_name":"Aanchal","middle_name":"","last_name":"Saraf","name_suffix":"","institution":"Yale University","department":"None"}],"date_submitted":"2020-02-17T22:51:04+02:00","date_accepted":"2020-02-17T22:51:04+02:00","date_published":"2020-06-15T09:50:41+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42987/galley/32038/download/"}]},{"pk":61292,"title":"Black Magic, Sex Rituals, and the Law: A Case Study of Sexual Assault by Religious Fraud in Thailand","subtitle":null,"abstract":"This Article critically examines the criminalization of religious fraudulent sex as sexual assault (i.e., rape and indecent acts) in Thailand and makes descriptive and normative contributions to the fields of comparative criminal law and constitutional law. With respect to criminal law, we find that Thai courts utilize a creative doctrinal maneuver (i.e., a victim’s naivety is a form of ‘inability to resist’) to convict alleged fraudsters with statutory provisions that do not readily criminalize fraudulent sex. We argue that while the doctrinal maneuver does desirably extend the otherwise limited scope of Thai sexual offense provisions, the emphasis on the cognitive deficiencies of the defrauded victim reflects a paternalistic victim-blaming that is problematic. With respect to constitutional law, we find that Thai courts are both comfortable in directly adjudicating religious claims, and intrinsically skeptical of any supernatural or religious claims involving sex as part of a ritual. We argue that while the assessment method of the Thai courts does not accord with principles of religious liberty espoused in the United States and Europe, it is an inevitable outcome of the prevailing constitutional ordering and societal understanding of religious freedom in Thailand.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Sexual Assault"},{"word":"Thai law"},{"word":"criminal law"},{"word":"constitutional law"},{"word":"Religious Freedom"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3wr4c80p","frozenauthors":[{"first_name":"Jianlin","middle_name":"","last_name":"Chen","name_suffix":"","institution":"","department":""},{"first_name":"Phapit","middle_name":"","last_name":"Triratpan","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-17T22:49:43+02:00","date_accepted":"2020-06-17T22:49:43+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_pblj/article/61292/galley/47326/download/"}]},{"pk":60256,"title":"Bringing Balance to the Antitrust Force: Revising the Paramount Decrees for the Modern Motion Picture Market","subtitle":null,"abstract":"Concentration of market power is nothing new in the media industries—and neither is government intervention to break it up.  For over seventy years, the entertainment industry has operated under the shadow of agreements between the historically powerful film studios and the Department of Justice to stay out of the exhibition market, where the studios had cemented their dominance in the naissance of the American film industry.  During the same period, however, understandings of antitrust law have evolved and what was once a discrete “film” industry has ballooned into a massive entertainment marketplace.  While today’s streaming and technology giants battle the threat of increased regulatory oversight and calls for bolder antitrust enforcement, the general trend of legal and practical developments suggests a far less bleak outlook than that of their Hollywood progenitors.\n \nIn fact, the policies and arguments supporting the consent decrees that emerged from the 1948 \nParamount\n decision have been severely weakened with the passing of time.  The acceleration of diversification in content and content providers has created new industry leaders like Netflix, HBO, and Hulu—and a proliferation of innovative competitors like Quibi and Peacock—that are apparently excused from \nParamount\n’s constrictions.  Instead, the \nParamount\n Decrees’ narrow focus risks stifling the competitive flexibility of “traditional” producers and distributors of theatrical feature films as they seek to combat these new market entrants.  In short, the \nParamount\n Decrees appear obsolete given the realities of the film industry today.\n This Article argues for revisions to, or rescission of, the \nParamount\n Decrees in order to better align the permissible activities of traditional film studios with those of their modern competitors.  It provides a thorough review of the concerns underlying the Supreme Court’s holding in 1948 and determines that the Court’s concerns have been undercut either by subsequent developments in antitrust law or the practical realities of new and dynamic market entrants.  While the Court’s anticompetitive concerns may still be valid, they appear misplaced when focused solely on those parties still subject to the Decrees.  Future antitrust enforcement will instead need to reframe the picture in order to more accurately address risks of market concentration.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"antitrust"},{"word":"Paramount"},{"word":"film studio"},{"word":"media industries"},{"word":"streaming"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4pq7547z","frozenauthors":[{"first_name":"Jonathan","middle_name":"A.","last_name":"Schwartz","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-22T20:58:29+02:00","date_accepted":"2020-06-22T20:58:29+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_elr/article/60256/galley/46215/download/"}]},{"pk":60254,"title":"Cashing Out Children's Television","subtitle":null,"abstract":"Under current rules, a television broadcaster is presumed to satisfy its obligation to air educational programming as long as it offers an average of three hours of self-described “educational” content each week.  I propose replacing this toothless presumption with one under which a broadcaster would be deemed to satisfy the obligation only if the broadcaster donates, in cash, to a qualifying educational nonprofit, the aggregate economic value of three weekly hours of television airtime.  The idea is to address an inconsistency that has undermined the traditional approach since its inception: the rules require broadcasters to air educational television because market forces would not otherwise create an adequate incentive for them to do so, but the same rules then rely on market forces to discipline broadcasters as they determine which programs are sufficiently “educational” in substance.  My proposal, by contrast, would strip unmotivated broadcasters of creative control, cash them out, and move the money instead to motivated nonprofits.  The burden placed on broadcasters would be the same as it is today; either way, the real cost to broadcasters is the lost opportunity to earn revenue on three hours of more profitable programming.  But the value created would be substantially more.  Broadcasters, in short, would no longer be told to provide educational television; they would simply be told to pay for it.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Television"},{"word":"educational programming"},{"word":"broadcasters"},{"word":"airtime"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/87m709hb","frozenauthors":[{"first_name":"Doug","middle_name":"","last_name":"Lichtman","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-22T20:50:38+02:00","date_accepted":"2020-06-22T20:50:38+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_elr/article/60254/galley/46213/download/"}]},{"pk":61295,"title":"Change of Regulatory Scheme: China’s New Foreign Investment Law and Reshaped Legal Landscape","subtitle":null,"abstract":"Protection of foreign investment has long been an issue facing China.  The newly adopted Foreign Investment Law (FIL) and Implementation Regulations not only unify the foreign investment regulations but also reformulate the regulatory regime that governs foreign investment in the country.  In response to the mounting criticism of the practices in China that damage the interests of foreign investors, including, among others, forced technology transfer and commercial theft, the FIL is purposed to build a better environment so that foreign investment will be more effectively protected.\nThe FIL changes the main themes of China’s regulation of foreign investment and puts new market access rules and measures in place on the foreign investment horizon.  The FIL Implementation Regulations intend to fill the gaps left in the FIL.  Still, many questions remain unanswered.  Both the broadness and vagueness of the FIL require further clarification and specific measures in different aspects.  The Supreme People’s Court is expected to issue judicial interpretations on various practical matters.\nThe FIL is charged with the mission to even the playing field by providing fair treatment to foreign investors in the country, but the challenges encountering foreign businesses seeking establishment in China remain.  The clear rules of implementation aside, an effective enforcement mechanism is essential to the achievement of the intended goals of the FIL.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"foreign investment law"},{"word":"China"},{"word":"regulations"},{"word":"foreign investment"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5xh829ms","frozenauthors":[{"first_name":"Mo","middle_name":"","last_name":"Zhang","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-17T22:59:52+02:00","date_accepted":"2020-06-17T22:59:52+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_pblj/article/61295/galley/47329/download/"}]},{"pk":61291,"title":"Corporate Social Responsibility, Casino Capitalism, and the Constitution of Macau","subtitle":null,"abstract":"Macau’s competitive foreign investment environment places it at the crossroads of global conceptions and articulations of corporate social responsibility (CSR). With tremendous financial resources at its disposal, including revenues six times those of Las Vegas, the Macau Government has a rare opportunity to position itself as a global leader in CSR practice. Nonetheless, systemic challenges such as low levels of public education and political development, the influence of mafia gangs, and high levels of human trafficking, problem gambling, and drug use persist. Although Macau’s situs as a Special Administrative Region of the People’s Republic of China ensures that CSR here will take its own form, these issues could be better addressed with open acknowledgement of the problems and improved channeling of local resources. Utilizing Matten and Moon’s methodology, this Article provides an overview of Macau’s CSR repertoires at this important point in local history: on the eve of the expiration of the first concessions granted to foreign operators as well as twenty years into Macau’s practice of semi-autonomous government under Chinese administration. This snapshot records how local CSR norms have developed historically, observes a cultural divide in the local conceptualization of CSR objectives between local and foreign operators, and makes a case for the normative basis for enhancement contained within the Macau Basic Law that should underlie directions for the future.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Macau"},{"word":"Corporate Social Responsibility"},{"word":"casino capitalism"},{"word":"semi-autonomous government"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7v21z5jk","frozenauthors":[{"first_name":"Jason","middle_name":"","last_name":"Buhi","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-17T22:42:20+02:00","date_accepted":"2020-06-17T22:42:20+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_pblj/article/61291/galley/47325/download/"}]},{"pk":61294,"title":"Difficulties With Drug Conspiracies in Singapore: Can You Conspire  to Traffic Drugs to Yourself?","subtitle":null,"abstract":"If Person A delivers drugs to Person B at the latter’s request, Person A is liable for drug trafficking—a serious offense in many jurisdictions.  However, the liability of Person B for drug trafficking is unclear as much may depend on Person B’s intention with the drugs.  The Singaporean Courts recently had to grapple with this issue in \nLiew Zheng Yang v. Public Prosecutor\n and \nAli bin Mohamad Bahashwan v. Public Prosecutor\n and other appeals.  Prior to these two cases, the position in Singapore was clear—Person B should be liable for drug trafficking as an accessory to Person A, in line with Singapore’s strong stance against drug offenses.  However, since these cases, the Singaporean Courts have taken a contrary position and held that Person B may not be liable if the drugs were for his/her own consumption.\nThis Article examines the law with respect to this drug conspiracy offense in Singapore, looking at its history, the primary legislation and similar cases.  It also scrutinizes the judicial reasoning in the two cases above and considers whether this can be reconciled with the Courts’ prior position on the issue.  In this analysis, the Article also investigates the position taken in other comparable common law jurisdictions—including the UK, Australia, Canada and the United States—and concludes that the Singaporean Courts’ reasoning in the aforementioned two cases may not be tenable and warrant a reexamination.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"drug trafficking"},{"word":"Singapore"},{"word":"common law"},{"word":"drug conspiracy offense"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/30x226bn","frozenauthors":[{"first_name":"Kenny","middle_name":"","last_name":"Yang","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-17T22:57:36+02:00","date_accepted":"2020-06-17T22:57:36+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_pblj/article/61294/galley/47328/download/"}]},{"pk":61290,"title":"Front Matter","subtitle":null,"abstract":"","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Front Matter","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4n79q1rp","frozenauthors":[{"first_name":"Editors","middle_name":"","last_name":"Editors","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-17T22:35:57+02:00","date_accepted":"2020-06-17T22:35:57+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_pblj/article/61290/galley/47324/download/"}]},{"pk":60252,"title":"Front Matter","subtitle":null,"abstract":"","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Front Matter","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1q3068d8","frozenauthors":[{"first_name":"Editors","middle_name":"","last_name":"Editors","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-22T20:44:02+02:00","date_accepted":"2020-06-22T20:44:02+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_elr/article/60252/galley/46211/download/"}]},{"pk":60257,"title":"Let’s Get Ready to Unbundle!  It’s Time for the UFC to Offer Individual Fights For Purchase","subtitle":null,"abstract":"A bedrock principle of U.S. Copyright law normally dictates that when a person steals your original work of authorship, a court should issue an injunction and require the violator to pay damages.  For centuries this principle has sufficed; however, a lack of deep-pocket defendants and continued lobbying efforts by internet service providers have made this principle untenable when applied to illegal online streaming.  This is especially true for the Ultimate Fighting Championship (UFC), a mixed martial arts promoter that has seen its live broadcasts pirated over the internet at an alarming rate, thereby threatening the bulk of its revenue.\n \nThis Comment advocates that the UFC unbundle its current pay-per-view business model in favor of charging market-based prices for each individual fight.  The primary benefit of this approach includes increased revenue for the UFC by enticing consumers away from illegal online streaming with lower prices.  Potential adjacent benefits include reforming fighter compensation schemes, incentivizing fighters to promote their own individual fights, easing controversies regarding unionization efforts by the fighters, and providing the UFC with greater marketing data.  Therefore, by unbundling its business model, the UFC will ultimately be able to bypass the shortcomings of U.S. Copyright law and take the lead in a digital media landscape already changing at lightning speeds.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"UFC"},{"word":"copyright law"},{"word":"online streaming"},{"word":"pay-per"},{"word":"internet service providers"},{"word":"unbundle"}],"section":"Comments","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7k678644","frozenauthors":[{"first_name":"Nick","middle_name":"","last_name":"Cornor","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-22T21:24:49+02:00","date_accepted":"2020-06-22T21:24:49+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_elr/article/60257/galley/46216/download/"}]},{"pk":61293,"title":"Securitizing Innovation to Protect Trade Secrets Between  “the East” and “the West”: A Neo-Schumpeterian Public Legal Reading","subtitle":null,"abstract":"The first target of today’s global commercial and military espionage, trade secrets, are the only form of intellectual property protection to be based on the necessity of nondisclosure and secrecy rather than on the paradigm of publicity and exploitability, with the obvious consequence that where confidentiality ends, no trade secret factually exists anymore.  As such, current judicial remedies to trade secret thefts simply miss the point, treating trade secrets as rights which can be restored, rather than as assets that once stolen, are lost forever.  Moreover, trade secrets often represent the “backbone” of a country’s development: an invaluable strategic advantage for entire industrial systems, innovation environments, and national economies.  Whereas a trade secret theft occurring within domestic borders transfers exploitability rather than causing damage to the economic ecosystem of the country concerned, international trade secret thefts may jeopardize states’ economy and public security alike.  For these reasons, the only way to protect trade secrets by law is through ensuring that their secrecy is reasonably safe by means of compulsory cybersecurity and cyber-hygiene standards to be complied with by their owners.  When it comes to this specific form of IP, the only protection is afforded with prevention: injunctions and compensations can work as remedies for other IP rights’ misappropriations and misexploitations, but do nothing to restore the peculiarity of a trade secret which is, indeed, its secrecy.  Not only should companies be compelled to adopt and implement reasonable sector-specific IT security measures and procedures, but licensing agreements including know-how should feature a specific cybersecurity clause to be carefully negotiated.  The new cybersecurity regimes of world powers like China seem to capture this problem, and to (involuntarily?) provide useful tools for addressing it beyond the schemes of intellectual property or tort (confidentiality) laws.  Regrettably, other countries in the Pacific region appear to keep the belief that trade secret thefts are a private affair of the breached companies, which should seek redress via traditional judicial channels.  This is to be deemed an outdated, misleading, shortsighted and ineffective approach.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Cybersecurity"},{"word":"trade secrets"},{"word":"intellectual property"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/34v3715n","frozenauthors":[{"first_name":"Riccardo","middle_name":"","last_name":"Vecellio Segate","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-17T22:54:05+02:00","date_accepted":"2020-06-17T22:54:05+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_pblj/article/61293/galley/47327/download/"}]},{"pk":60259,"title":"Sending Agents to the Principal’s Office: How Talent Agency Packaging and Producing Breach the Fiduciary Duties Agents Owe Their Artist-Clients","subtitle":null,"abstract":"Talent agents have always been indispensable to writers, actors, and other creative workers in the entertainment industry, providing independent representation to their artist-clients in dealings with sophisticated corporate employers.  But following a historical shift in their revenues from commissioning clients to lucrative television packaging fees, the power and profits of the biggest agencies grew exponentially.  Revenues from packaging fees allowed these agencies to diversify into other businesses and attracted outside investment by private equity firms leading to further vertical integration.  Now, the largest agencies have turned their eye toward a new revenue stream: producing and owning content through agency-affiliate production companies.\n These innovations have come at the cost of the independent representation agents are supposed to provide their clients.  Packaging and producing by talent agencies and their affiliates breach the well-established fiduciary duties agents owe their clients under the law by aligning the agency’s own interests with the interests of its clients’ employers.  Outside investment in the agencies only exacerbates these conflicts.  These departures from traditional agenting undermine the avowed purpose of the California Talent Agencies Act: to protect vulnerable artists from the conflicted practices of their agents.  While these issues are at the heart of the ongoing industry dispute between the Writers Guild of America and the big agencies, their importance should concern all agency clients and their unions.  The California Legislature should amend the outdated Talent Agencies Act to enumerate and reaffirm the fiduciary duties talent agents owe their clients under common law and prevent the erosion of legal protections for creative workers in one of the state’s largest and most important industries.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"talent agencies"},{"word":"Packaging"},{"word":"Talent Agencies Act"}],"section":"Comments","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4q22v4rd","frozenauthors":[{"first_name":"Brian","middle_name":"T.","last_name":"Smith","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-22T21:31:10+02:00","date_accepted":"2020-06-22T21:31:10+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_elr/article/60259/galley/46218/download/"}]},{"pk":60253,"title":"Table of Contents","subtitle":null,"abstract":"","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Table of Contents","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2c09x2k5","frozenauthors":[{"first_name":"Editors","middle_name":"","last_name":"Editors","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-22T20:46:49+02:00","date_accepted":"2020-06-22T20:46:49+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_elr/article/60253/galley/46212/download/"}]},{"pk":61289,"title":"Table of Contents","subtitle":null,"abstract":"","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Table of Contents","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9jb9m924","frozenauthors":[{"first_name":"Editors","middle_name":"","last_name":"Editors","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-17T22:34:53+02:00","date_accepted":"2020-06-17T22:34:53+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_pblj/article/61289/galley/47323/download/"}]},{"pk":60255,"title":"The Necessity of Blanket License Agreements in Light of 17 U.S.C. 110(4) Unveiled","subtitle":null,"abstract":"For decades universities and other educational institutions have contracted with performance rights organizations in order to be able to publicly perform and use their respective musical catalogues freely without the fear of litigation.  For educational institutions, this is a significant drain on their financial resources, which otherwise could be used for the support of students through scholarships, new equipment or higher quality instructors.  This Article proposes a method for determining whether such blanket license agreements are actually necessary for an individual institution, or whether such an annual budget item is legitimately justified.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"17 U.S.C. 110(4)"},{"word":"blanket license agreement"},{"word":"Higher education"},{"word":"music licensing"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9fv3d0v3","frozenauthors":[{"first_name":"Fabiana","middle_name":"","last_name":"Wells","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-22T20:53:39+02:00","date_accepted":"2020-06-22T20:53:39+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_elr/article/60255/galley/46214/download/"}]},{"pk":60258,"title":"Tuning Into the On-Demand Streaming Culture—Hollywood Guilds’ Evolution Imperative in Today’s Media Landscape","subtitle":null,"abstract":"Hollywood television and film production has largely been unionized since the early 1930s.  Today, due in part to technological advances, the industry is much more expansive than it has ever been, yet the Hollywood unions, known as “guilds,” have arguably not evolved at a similar pace.  Although the guilds have adapted to the needs of their members in many aspects, have they successfully adapted to the evolving Hollywood business model?  This Comment puts a focus on the Writers Guild of America, Directors Guild of America, and the Screen Actors Guild, known as SAG-AFTRA following its merger in 2012, and asks whether their respective collective bargaining agreements are out-of-step with the evolution of the industry over the past ten years, particularly in the areas of new media and the direct-to-consumer model.  While analyzing the guilds in the context of the industry environment as it is today, this Comment contends that as the guilds continue to feel more pronounced effects from the evolving media landscape, they will need to adapt at a much more rapid pace than ever before in order to meet the needs of their members.  However only time will reveal whether the current trajectory is idyllic or flawed.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"on-demand"},{"word":"streaming"},{"word":"SAG-AFTRA"},{"word":"Hollywood guilds"},{"word":"collective bargaining"}],"section":"Comments","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2152q2t4","frozenauthors":[{"first_name":"Blaine","middle_name":"","last_name":"Roth","name_suffix":"","institution":"","department":""}],"date_submitted":"2020-06-22T21:27:52+02:00","date_accepted":"2020-06-22T21:27:52+02:00","date_published":"2020-06-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_elr/article/60258/galley/46217/download/"}]},{"pk":65959,"title":"Tropical Pyomyositis","subtitle":null,"abstract":"A 6-year-old boy presents to an emergency department in Northern Laos with a 2-week history of right leg pain...","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Musculoskeletal","is_remote":true,"remote_url":"https://escholarship.org/uc/item/70d434r0","frozenauthors":[{"first_name":"Navneet","middle_name":"","last_name":"Dhillon","name_suffix":"MD","institution":"","department":""},{"first_name":"Michael","middle_name":"","last_name":"Schick","name_suffix":"DO","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2020-06-12T19:12:18.561136+02:00","render_galley":{"label":"HTML Galley","type":"html","path":"https://journalpub.escholarship.org/usinrls/article/65959/galley/50551/download/"},"galleys":[{"label":"HTML Galley","type":"html","path":"https://journalpub.escholarship.org/usinrls/article/65959/galley/50551/download/"}]},{"pk":44966,"title":"A Legacy of Mistrust: African Americans and the US Healthcare System","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Commentary"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0p85k34s","frozenauthors":[{"first_name":"Lindsay","middle_name":"","last_name":"Wells","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Arjun","middle_name":"","last_name":"Gowda","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2020-06-12T16:39:15+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44966/galley/33759/download/"}]},{"pk":44965,"title":"Treatment of Muir-Torre Syndrome with Low-Dose Isotretinoin","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/93n0b43d","frozenauthors":[{"first_name":"David","middle_name":"I.","last_name":"Weiss","name_suffix":"PhD, MS3","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Ladan","middle_name":"","last_name":"Shahabi","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Daniel","middle_name":"Q.","last_name":"Bach","name_suffix":"MD, MPH","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2020-06-11T21:28:55+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44965/galley/33758/download/"}]},{"pk":44964,"title":"Giant Dedifferentiated Liposarcoma Presenting as GERD","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/67r3m752","frozenauthors":[{"first_name":"Terrence","middle_name":"M.","last_name":"Hammer","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2020-06-11T21:27:06+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44964/galley/33757/download/"}]},{"pk":844,"title":"Pneumocephalus and Facial Droop on an Airplane: A Case Report","subtitle":null,"abstract":"Introduction:\n Pneumocephalus (PNC) is most commonly associated with trauma or intracranial surgery, less commonly secondary to an infectious source, and is rarely caused by barotrauma.\nCase report:\n A 32-year-old woman presented to the emergency department with complaint of resolved left-sided facial droop and a lingering paresthesia of her left upper extremity after a cross-country flight. Computed tomography demonstrated several foci of air in the subdural space consistent with PNC.\nConclusion:\n For PNC to occur there must be a persistent negative intracranial pressure gradient, with or without an extracranial pressure change. In this case the pressure change occurred due to cabin pressure.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Pneumocephalus"},{"word":"facial droop"},{"word":"Barotrauma"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/77k6c143","frozenauthors":[{"first_name":"Irina","middle_name":"","last_name":"Sanjeevan-Cabeza","name_suffix":"","institution":"Thomas Jefferson University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":"None"},{"first_name":"Morgan","middle_name":"","last_name":"Oakland","name_suffix":"","institution":"Thomas Jefferson University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":"None"}],"date_submitted":"2020-06-10T21:24:27+02:00","date_accepted":"2020-06-10T21:24:27+02:00","date_published":"2020-06-10T21:25:37+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/844/galley/596/download/"}]},{"pk":62811,"title":"An Open Data Framework for the San Francisco Estuary","subtitle":null,"abstract":"","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"open science, data publishing, Interagency Ecological Program"}],"section":"Essay","is_remote":true,"remote_url":"https://escholarship.org/uc/item/02q969kt","frozenauthors":[{"first_name":"Melinda","middle_name":"R.","last_name":"Baerwald","name_suffix":"","institution":"California Department of Water Resources","department":""},{"first_name":"Brittany","middle_name":"E.","last_name":"Davis","name_suffix":"","institution":"California Department of Water Resources","department":""},{"first_name":"Sarah","middle_name":"","last_name":"Lesmeister","name_suffix":"","institution":"California Department of Water Resources","department":""},{"first_name":"Brian","middle_name":"","last_name":"Mahardja","name_suffix":"","institution":"Pacific Southwest Region, US Fish and Wildlife Service","department":""},{"first_name":"Rachel","middle_name":"","last_name":"Pisor","name_suffix":"","institution":"California Department of Water Resources","department":""},{"first_name":"Jenna","middle_name":"","last_name":"Rinde","name_suffix":"","institution":"California Department of Water Resources","department":""},{"first_name":"Brian","middle_name":"","last_name":"Schreier","name_suffix":"","institution":"California Department of Water Resources","department":""},{"first_name":"Vanessa","middle_name":"","last_name":"Tobias","name_suffix":"","institution":"US Fish and Wildlife Service","department":""}],"date_submitted":"2020-05-30T17:07:52+02:00","date_accepted":"2020-05-30T17:07:52+02:00","date_published":"2020-06-09T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62811/galley/48492/download/"}]},{"pk":62814,"title":"Comparing and Integrating Fish Surveys in the San Francisco Estuary: Why Diverse Long-Term Monitoring Programs are Important","subtitle":null,"abstract":"Many fishes in the San Francisco Estuary have suffered declines in recent decades, as shown by numerous long-term monitoring programs. A long-term monitoring program, such as the Interagency Ecological Program, comprises a suite of surveys, each conducted by a state or federal agency or academic institution. These types of programs have produced rich data sets that are useful for tracking species trends over time. Problems arise from drawing conclusions based on one or few surveys because each survey samples a different subset of species or reflects different spatial or temporal trends in abundance. The challenges in using data sets from these surveys for comparative purposes stem from methodological differences, magnitude of data, incompatible data formats, and end-user preference for familiar surveys. To improve the utility of these data sets and encourage multi-survey analyses, we quantitatively rate these surveys based on their ability to represent species trends, present a methodology for integrating long-term data sets, and provide examples that highlight the importance of expanded analyses. We identify areas and species that are under-sampled, and compare fish salvage data from large water export facilities with survey data. Our analysis indicates that while surveys are redundant for some species, no two surveys are completely duplicative. Differing trends become evident when considering individual and aggregate survey data, because they imply spatial, seasonal, or gear-dependent catch. Our quantitative ratings and integrated data set allow for improved and better-informed comparisons of species trends across surveys, while highlighting the importance of the current array of sampling methodologies.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"San Francisco Estuary, fisheries, long-term monitoring, data, population decline, Pelagic Organism Decline, Delta, abundance"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0b91527k","frozenauthors":[{"first_name":"Dylan","middle_name":"K.","last_name":"Stompe","name_suffix":"","institution":"Center for Watershed Sciences, University of California, Davis","department":""},{"first_name":"Peter","middle_name":"B.","last_name":"Moyle","name_suffix":"","institution":"Center for Watershed Sciences, University of California, Davis","department":""},{"first_name":"Avery","middle_name":"","last_name":"Kruger","name_suffix":"","institution":"Center for Watershed Sciences, University of California, Davis","department":""},{"first_name":"John","middle_name":"R.","last_name":"Durand","name_suffix":"","institution":"Center for Watershed Sciences, University of California, Davis","department":""}],"date_submitted":"2020-05-30T18:15:50+02:00","date_accepted":"2020-05-30T18:15:50+02:00","date_published":"2020-06-09T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62814/galley/48495/download/"}]},{"pk":62812,"title":"Drought and the Sacramento-San Joaquin Delta, 2012–2016: Environmental Review and Lessons","subtitle":null,"abstract":"This paper reviews environmental management and the use of science in the Sacramento–San Joaquin Delta during California’s 2012–2016 drought. The review is based on available reports and data, and guided by discussions with 27 agency staff, stake-holders, and researchers. Key management actions for the drought are discussed relative to four major drought water management priorities stated by water managers: support public health and safety, control saltwater intrusion, preserve cold water in Shasta Reservoir, and maintain minimum protections for endangered species. Despite some success in streamlining communication through interagency task forces, conflicting management mandates sometimes led to confusion about priorities and actions during the drought (i.e., water delivery, the environment, etc.). This report highlights several lessons and offers suggestions to improve management for future droughts. Recommendations include use of pre-drought warnings, timely drought declarations, improved transparency and useful documentation, better scientific preparation, development of a Delta drought management plan (including preparing for salinity barriers), and improved water accounting. Finally, better environmental outcomes occur when resources are applied to improving habitat and bolstering populations of native species during inter-drought periods, well before stressful conditions occur.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Sacramento-San Joaquin Delta, drought, California water, water management, scientific monitoring"}],"section":"Policy and Program Analysis","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6hq949t6","frozenauthors":[{"first_name":"John","middle_name":"R.","last_name":"Durand","name_suffix":"","institution":"Center for Watershed Sciences, University of California, Davis;\nDept. of Wildlife, Fish and Conservation Biology,\nUniversity of California, Davis","department":""},{"first_name":"Fabian","middle_name":"","last_name":"Bombardelli","name_suffix":"","institution":"Center for Watershed Sciences, University of California, Davis;\nDept. of Civil and Environmental Engineering, University of California, Davis","department":""},{"first_name":"William","middle_name":"E.","last_name":"Fleenor","name_suffix":"","institution":"Center for Watershed Sciences, University of California, Davis","department":""},{"first_name":"Yumiko","middle_name":"","last_name":"Henneberry","name_suffix":"","institution":"Delta Science Program, Delta Stewardship Council","department":""},{"first_name":"Jon","middle_name":"","last_name":"Herman","name_suffix":"","institution":"Center for Watershed Sciences, University of California, Davis;\nDept. of Civil and Environmental Engineering, University of California, Davis","department":""},{"first_name":"Carson","middle_name":"","last_name":"Jeffres","name_suffix":"","institution":"Center for Watershed Sciences, University of California, Davis","department":""},{"first_name":"Michelle","middle_name":"","last_name":"Leinfelder–Miles","name_suffix":"","institution":"Cooperative Extension, \nUC Agriculture and Natural Resources","department":""},{"first_name":"Jay","middle_name":"R.","last_name":"Lund","name_suffix":"","institution":"Center for Watershed Sciences, \nUniversity of California, Davis;\nDelta Science Program, Delta Stewardship Council","department":""},{"first_name":"Robert","middle_name":"","last_name":"Lusardi","name_suffix":"","institution":"Center for Watershed Sciences, \nUniversity of California, Davis","department":""},{"first_name":"Amber","middle_name":"D.","last_name":"Manfree","name_suffix":"","institution":"Center for Watershed Sciences, \nUniversity of California, Davis","department":""},{"first_name":"Josué","middle_name":"","last_name":"Medellín-Azuara","name_suffix":"","institution":"Center for Watershed Sciences, \nUniversity of California, Davis; \nDept. of Environmental Engineering, \nUniversity of California, Merced","department":""},{"first_name":"Brett","middle_name":"","last_name":"Milligan","name_suffix":"","institution":"Center for Watershed Sciences and\nLandscape Architecture, Dept. of Human Ecology\nUniversity of California, Davis","department":""},{"first_name":"Peter","middle_name":"B.","last_name":"Moyle","name_suffix":"","institution":"Center for Watershed Sciences, \nUniversity of California, Davis","department":""}],"date_submitted":"2020-05-30T17:42:38+02:00","date_accepted":"2020-05-30T17:42:38+02:00","date_published":"2020-06-09T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62812/galley/48493/download/"}]},{"pk":62813,"title":"Introduction of Bluefin Killifish \nLucania goodei\n into the Sacramento-San Joaquin Delta","subtitle":null,"abstract":"Biological invasion by non-native species has been identified as one of the major threats to native fish communities worldwide. The fish community of San Francisco Estuary is no exception, as the estuary has been recognized as one of the most invaded on the planet and the system has been impacted significantly by these invasions. Here, we summarize the introduction and probable establishment of a new species in the Sacramento–San Joaquin Delta, the Bluefin Killifish (\nLucania goodei\n), as discovered by the US Fish and Wildlife Service Delta Juvenile Fish Monitoring Program (DJFMP). The DJFMP has conducted a large-scale beach seine survey since 1976, and it is the longest-running monitoring program in the San Francisco Estuary that extensively monitors the shallow-water nearshore habitat. Possibly introduced as discarded aquarium fish within the vicinity of the Delta Cross Channel, Bluefin Killifish is a close relative of the Rainwater Killifish (\nLucania parva\n), another non-native fish species that has been present in the San Francisco Estuary system for decades. Studies in their native range suggest that Bluefin Killifish will fill a similar niche to Rainwater Killifish, albeit with a more freshwater distribution. The potential ecological impact of Bluefin Killifish remains unclear in the absence of additional studies. However, we have been able to track the spread of the species within the Sacramento–San Joaquin Delta through the existence of long-term monitoring programs. Our findings demonstrate the value of monitoring across various habitats for the early detection and proactive management of invasive species.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"biological invasion, introduced species, bluefin killifish, Lucania goodei, life history"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/855742qk","frozenauthors":[{"first_name":"Brian","middle_name":"","last_name":"Mahardja","name_suffix":"","institution":"Lodi Fish and Wildlife Office, US Fish and Wildlife Service","department":""},{"first_name":"Andrew","middle_name":"","last_name":"Goodman","name_suffix":"","institution":"Lodi Fish and Wildlife Office, US Fish and Wildlife Service","department":""},{"first_name":"Alisha","middle_name":"","last_name":"Goodbla","name_suffix":"","institution":"Department of Animal Science, University of California, Davis","department":""},{"first_name":"Andrea","middle_name":"D.","last_name":"Schreier","name_suffix":"","institution":"Dept. of Animal Science, University of California, Davis","department":""},{"first_name":"Catherine","middle_name":"","last_name":"Johnston","name_suffix":"","institution":"Lodi Fish and Wildlife Office, US Fish and Wildlife Service","department":""},{"first_name":"Rebecca","middle_name":"C.","last_name":"Fuller","name_suffix":"","institution":"Universtiy of Illinois, Urbana–Champaign","department":""},{"first_name":"Dave","middle_name":"","last_name":"Contreras","name_suffix":"","institution":"California Department of Fish and Wildlife","department":""},{"first_name":"Louanne","middle_name":"","last_name":"McMartin","name_suffix":"","institution":"Lodi Fish and Wildlife Office, US Fish and Wildlife Service","department":""}],"date_submitted":"2020-05-30T18:02:50+02:00","date_accepted":"2020-05-30T18:02:50+02:00","date_published":"2020-06-09T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62813/galley/48494/download/"}]},{"pk":62815,"title":"Spawn Timing of Winter-Run Chinook Salmon in the Upper Sacramento River","subtitle":null,"abstract":"Spawn timing in anadromous Pacific salmon may be especially sensitive to environmental cues such as river temperature and flow regimes. In this study, we explored correlations between peak spawn timing and water temperature in endangered Sacramento River winter-run Chinook Salmon. In recent drought years, rising water temperatures during egg incubation have negatively affected the winter-run Chinook Salmon population. This paper seeks to understand how winter-run spawn timing may be affected by temperatures during the staging period prior to spawning, and how water releases from Shasta Dam might affect these dynamics. We fit a proportional-odds logistic regression model to evaluate annual spawn timing as a function of average temperatures in April and May below Keswick Dam. While the start date of spawning remains relatively constant from year to year, the timing of peak spawning varies annually. Cool springtime temperatures trigger winter-run Chinook Salmon to spawn earlier, whereas warm springtime temperatures trigger fish to spawn later. Before dam construction, winter-run Chinook Salmon spawned in cool, spring-fed streams that are now inaccessible to migrating salmonids. In their natal spawning grounds, temperature-driven spawn timing would have primarily ensured sufficient time for egg maturation in cool years, while secondarily preventing egg and alevin mortality in warm years. In the current winter-run spawning grounds, the relationship between temperature and spawn timing may have important applications to management of Shasta Dam water releases, especially during conditions when thermal mortality can affect developing winter-run Chinook Salmon eggs.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"spawning, temperature, winter-run Chinook Salmon, model, spawn timing"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/00c1r2mz","frozenauthors":[{"first_name":"Eva","middle_name":"","last_name":"Dusek Jennings","name_suffix":"","institution":"Cheva Consulting","department":""},{"first_name":"A.","middle_name":"Noble","last_name":"Hendrix","name_suffix":"","institution":"QEDA Consulting","department":""}],"date_submitted":"2020-05-30T18:23:10+02:00","date_accepted":"2020-05-30T18:23:10+02:00","date_published":"2020-06-09T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62815/galley/48496/download/"}]},{"pk":44963,"title":"Schistosoma Infection Presenting as Iron Deficiency Anemia","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2b5569hs","frozenauthors":[{"first_name":"Rajinder","middle_name":"","last_name":"Kaushal","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Sittiporn","middle_name":"","last_name":"Bencharit","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2020-06-08T20:01:46+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44963/galley/33756/download/"}]},{"pk":44962,"title":"Takotsubo Cardiomyopathy in the Setting of Left Ventricular Outflow Tract Obstruction","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9k76f00k","frozenauthors":[{"first_name":"Rahul","middle_name":"","last_name":"Vasavada","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2020-06-08T19:59:45+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44962/galley/33755/download/"}]},{"pk":13939,"title":"The Next Pandemic: Prepare for “Disease X”","subtitle":null,"abstract":"The organism that will cause the next pandemic, which WHO labels “Disease X,” probably already exists. The COVID-19 pandemic will, slowly, and with some hiccups and many tragedies, pass into memory. This coronavirus may disappear and later recur, continue endemically under vaccine control, or simply attenuate and vanish. The economy and healthcare systems will return to a new normal, some parts more quickly than others. Like the multiple plagues humanity has endured since our ancestors gathered into cities, it will generate recriminations for slow and misguided responses, profiteering, and over- or under reacting to economic, social, and healthcare events that will, retrospectively, be obvious. The individuals and organizations most culpable for exacerbating the disaster will escape responsibility while they scapegoat others and try to re-write history. Heroes, whether individuals who helped provide clear risk communication and leadership or groups that persevered in the face of fear and life-threatening danger will emerge. Without fanfare, most will return to their normal jobs, scarred but proud of their efforts. As they have before, pundits and scholars will write endlessly about the pandemic’s cause, effects, and ways to ameliorate the next pandemic’s brutal destruction of lives and ways of life. The problem is, we have done all this before and seemed not to have learned the lessons our predecessors taught.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19, pandemics, preparation"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3mv630c1","frozenauthors":[{"first_name":"Kenneth","middle_name":"V.","last_name":"Iserson","name_suffix":"","institution":"The University of Arizona, Department of Emergency Medicine, Tucson, Arizona","department":"None"}],"date_submitted":"2020-05-14T20:46:33+02:00","date_accepted":"2020-05-14T20:46:33+02:00","date_published":"2020-06-08T16:39:38+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13939/galley/7243/download/"}]},{"pk":42992,"title":"Afterword: What’s Law Got to Do With It?","subtitle":null,"abstract":"Afterword for the Special Forum on American Territorialities","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"law and territoriality"},{"word":"law and US empire"},{"word":"challenges to Westphalian sovereignty"},{"word":"Transnational American Studies"},{"word":"JTAS"}],"section":"SPECIAL FORUM: (Im)Mobilities","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5ns1n0pw","frozenauthors":[{"first_name":"Lucy","middle_name":"E.","last_name":"Salyer","name_suffix":"","institution":"University of New Hampshire","department":"None"},{"first_name":"Lila","middle_name":"M.","last_name":"Teeters","name_suffix":"","institution":"University of New Hampshire","department":"None"}],"date_submitted":"2020-02-17T23:04:55+02:00","date_accepted":"2020-02-17T23:04:55+02:00","date_published":"2020-06-07T14:00:15+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42992/galley/32042/download/"}]},{"pk":843,"title":"Case Report: Disposition of Symptomatic Probable COVID-19","subtitle":null,"abstract":"Introduction:\n The novel coronavirus disease 2019 (COVID-19) presents a challenge for healthcare providers in terms of diagnosis, management, and triage of cases requiring admission.\nCase Report:\n A 47-year-old male with symptoms suspicious for COVID-19, pulse oximetry of 93% on room air, and multifocal pneumonia was risk stratified and safely discharged from the emergency department (ED) despite having moderate risk of progression to acute respiratory distress syndrome. He had resolution of his symptoms verified by telephone follow-up.\nConclusion:\n Various risk-stratifying tools and techniques can aid clinicians in identifying COVID-19 patients who can be safely discharged from the ED.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19"},{"word":"coronavirus"},{"word":"pneumonia"},{"word":"disposition"},{"word":"MulBSTA"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8sq802rd","frozenauthors":[{"first_name":"Aleq","middle_name":"","last_name":"Jaffery","name_suffix":"","institution":"Hackensack University Medical Center, Department of Emergency Medicine, Hackensack, New Jersey","department":"None"},{"first_name":"John","middle_name":"","last_name":"Slakey","name_suffix":"","institution":"Hackensack University Medical Center, Department of Emergency Medicine, Hackensack, New Jersey","department":"None"},{"first_name":"David","middle_name":"","last_name":"Zodda","name_suffix":"","institution":"Hackensack Meridian School of Medicine at Seton Hall University, Department of Emergency Medicine, Hackensack, New Jersey","department":"None"},{"first_name":"Douglas","middle_name":"","last_name":"Finefrock","name_suffix":"","institution":"Hackensack Meridian School of Medicine at Seton Hall University, Department of Emergency Medicine, Hackensack, New Jersey","department":"None"}],"date_submitted":"2020-06-05T22:52:50+02:00","date_accepted":"2020-06-05T22:52:50+02:00","date_published":"2020-06-05T22:53:40+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/843/galley/595/download/"}]},{"pk":13797,"title":"COVID-19 Pandemic and Care of Older Adults at Risk for Delirium and Cognitive Vulnerability","subtitle":null,"abstract":"NA","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"COVID-19, Delirium, Encephalopathy"}],"section":"Geriatrics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3qz9b3gm","frozenauthors":[{"first_name":"Sangil","middle_name":"","last_name":"Lee","name_suffix":"","institution":"University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa","department":"None"}],"date_submitted":"2020-04-21T02:29:42+02:00","date_accepted":"2020-04-21T02:29:42+02:00","date_published":"2020-06-04T21:34:38+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13797/galley/7188/download/"}]}]}