{"count":38741,"next":"https://eartharxiv.org/api/articles/?format=json&limit=100&offset=15200","previous":"https://eartharxiv.org/api/articles/?format=json&limit=100&offset=15000","results":[{"pk":44653,"title":"A Case of Asymptomatic Patient with Pericardial Calcification and Constrictive Pericarditis","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/0pk450t3","frozenauthors":[{"first_name":"Andrew","middle_name":"","last_name":"Mathew","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Ramin","middle_name":"","last_name":"Tabibiazar","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Ravi","middle_name":"","last_name":"Dave","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2019-03-08T19:33:39+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44653/galley/33446/download/"}]},{"pk":44640,"title":"Tumor Lysis Syndrome and Possible G6PD Deficiency","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3gh8s21f","frozenauthors":[{"first_name":"Kanwarpal","middle_name":"S.","last_name":"Kahlon","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2019-03-08T19:30:05+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44640/galley/33433/download/"}]},{"pk":44639,"title":"Coronary Artery Vasculitis and Aneurysm Formation due to Lupus Erythematosus","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/64q682zv","frozenauthors":[{"first_name":"Junya","middle_name":"","last_name":"Kayano","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Anthony","middle_name":"","last_name":"Koppula","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2019-03-08T19:27:57+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44639/galley/33432/download/"}]},{"pk":652,"title":"Identifying a Disc-shaped Foreign Body","subtitle":null,"abstract":"N/A","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/03s114gx","frozenauthors":[{"first_name":"Michael","middle_name":"","last_name":"Lee","name_suffix":"","institution":"Boston Children's Hospital, Division of Emergency Medicine, Boston, Massachussetts","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"George","name_suffix":"","institution":"Boston Children’s Hospital, Division of Radiology, Boston, Massachusetts","department":"None"},{"first_name":"Kate","middle_name":"E.","last_name":"Dorney","name_suffix":"","institution":"Boston Children’s Hospital, Division of Emergency Medicine, Boston, Massachusetts","department":"None"}],"date_submitted":"2019-02-07T00:32:29+01:00","date_accepted":"2019-02-07T00:32:29+01:00","date_published":"2019-03-05T22:50:26+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/652/galley/412/download/"}]},{"pk":655,"title":"Empagliflozin-induced Diabetic Ketoacidosis Unmasking a Type 1 Diabetes Diagnosis","subtitle":null,"abstract":"Empagliflozin is a sodium glucose cotransporter-2 inhibitor that inhibits renal glucose reabsorption through an insulin-independent mechanism. This class of drugs is used in the management of type 2 diabetes. A 49-year-old female with type 2 diabetes treated with empagliflozin presented to the emergency department in diabetic ketoacidosis (DKA). This case report details the series of events leading to the diagnosis of drug-induced DKA, which led to a change in the patient’s diagnosis from type 2 diabetes to type 1 diabetes.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/60k8s17c","frozenauthors":[{"first_name":"Gretchen","middle_name":"M.","last_name":"Ray","name_suffix":"","institution":"The University of New Mexico College of Pharmacy, Department of Pharmacy Practice and Administrative Sciences, Albuquerque, New Mexico","department":"None"},{"first_name":"Chelsea","middle_name":"","last_name":"Rodriguez","name_suffix":"","institution":"The University of New Mexico College of Pharmacy, Albuquerque, New Mexico","department":"None"},{"first_name":"Samantha","middle_name":"","last_name":"Schulman","name_suffix":"","institution":"The University of New Mexico College of Pharmacy, Albuquerque, New Mexico","department":"None"},{"first_name":"Preeyaporn","middle_name":"","last_name":"Sarangarm","name_suffix":"","institution":"The University of New Mexico Hospitals, Department of Pharmacy, Albuquerque, New Mexico","department":"None"},{"first_name":"Michelle","middle_name":"","last_name":"Bardack","name_suffix":"","institution":"The University of New Mexico School of Medicine, Department of Family and Community Medicine, Albuquerque, New Mexico","department":"None"},{"first_name":"Matthew","middle_name":"F.","last_name":"Bouchonville","name_suffix":"","institution":"The University of New Mexico School of Medicine, Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, Albuquerque, New Mexico","department":"None"}],"date_submitted":"2019-02-14T21:56:39+01:00","date_accepted":"2019-02-14T21:56:39+01:00","date_published":"2019-03-05T22:49:12+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/655/galley/415/download/"}]},{"pk":653,"title":"Acute Angle-Closure Glaucoma Secondary to a Phakic Intraocular Lens, an Ophthalmic Emergency","subtitle":null,"abstract":"Implantable collamer lenses (ICL) are phakic (natural lens remains in place) lenses that were first developed in the 1990s for correction of high myopia. The effectiveness and safety of ICLs are making them an increasingly popular option for vision correction in the myopic patient, competing with traditional options like glasses, contacts, and procedures such as laser-assisted in situ keratomileusis. Although generally safe, due to the position of the phakic ICL in the eye, pupillary block remains a rare but vision-threatening complication of ICL implantation. Pupillary block caused by phakic ICL is a serious complication that requires urgent recognition and intervention and is poorly described in emergency medicine literature. We describe a case of pupillary block five years after ICL implantation that was refractory to standard medical therapy, highlighting the importance of early diagnosis and referral for more definitive therapy.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2mj439p9","frozenauthors":[{"first_name":"Arian","middle_name":"","last_name":"Frost","name_suffix":"","institution":"University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin","department":"None"},{"first_name":"Daniel","middle_name":"J.","last_name":"Ritter","name_suffix":"","institution":"University of Wisconsin-Madison, School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin","department":"None"},{"first_name":"Alana","middle_name":"","last_name":"Trotter","name_suffix":"","institution":"University of Wisconsin-Madison, School of Medicine and Public Health, Department of Ophthalmology and Visual Sciences, Madison, Wisconsin","department":"None"},{"first_name":"Michael","middle_name":"S.","last_name":"Pulia","name_suffix":"","institution":"University of Wisconsin-Madison, School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin","department":"None"}],"date_submitted":"2019-02-08T22:28:00+01:00","date_accepted":"2019-02-08T22:28:00+01:00","date_published":"2019-03-05T22:48:24+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/653/galley/413/download/"}]},{"pk":645,"title":"Rare Cause of Inguinal Pain in 39-year-old Male","subtitle":null,"abstract":"N/A","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/64p9v8gh","frozenauthors":[{"first_name":"Kieron","middle_name":"","last_name":"Barkataki","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"Nathan","middle_name":"","last_name":"Wang","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"Daniel","middle_name":"","last_name":"Quesada","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California; LAC+USC Medical Center, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Rachell","middle_name":"","last_name":"O'Donnell","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"James","middle_name":"W.","last_name":"Rosbrugh","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"Phillip","middle_name":"","last_name":"Aguìñiga-Navarrete","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California","department":"None"}],"date_submitted":"2019-01-23T04:36:56+01:00","date_accepted":"2019-01-23T04:36:56+01:00","date_published":"2019-03-05T22:47:37+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/645/galley/405/download/"}]},{"pk":651,"title":"The Aquarium Sign: Another Opportunity for Detection of Perforated Viscus","subtitle":null,"abstract":"N/A","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4cv223tp","frozenauthors":[{"first_name":"Matthew","middle_name":"","last_name":"Gorgone","name_suffix":"","institution":"University of Rochester School of Medicine and Dentistry, Department of Emergency Medicine, Rochester, New York","department":"None"},{"first_name":"Timothy","middle_name":"P.","last_name":"O'Connor","name_suffix":"","institution":"University of Rochester Medical Center, Department of Emergency Medicine, Rochester, New York","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Lu","name_suffix":"","institution":"University of Rochester Medical Center, Department of Emergency Medicine, Rochester, New York","department":"None"}],"date_submitted":"2019-02-07T00:30:55+01:00","date_accepted":"2019-02-07T00:30:55+01:00","date_published":"2019-03-05T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/651/galley/411/download/"}]},{"pk":634,"title":"Perilymphatic Fistula After Penetrating Ear Trauma","subtitle":null,"abstract":"Pneumolabyrinth, defined as air within the labyrinth on high-resolution computed tomography, suggests that a perilymphatic fistula (PLF) is present. PLF describes an abnormal communication between the middle and inner ear, and can result in deafness, vertigo, and imbalance. In the setting of a penetrating injury to the temporal bone or inner ear, pneumolabyrinth should trigger prompt otolaryngology consultation and urgent surgical exploration. We describe a case in which a 49-year-old male presented with a traumatic PLF secondary to penetrating ear injury. Imaging demonstrated extensive pneumolabyrinth. Despite delay in diagnosis, expeditious surgical intervention resulted in successful preservation of inner ear function.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/12x0s580","frozenauthors":[{"first_name":"Ashley","middle_name":"E.","last_name":"Kita","name_suffix":"","institution":"David Geffen School of Medicine at the University of California Los Angeles, Department of Head and Neck Surgery, Los Angeles, California","department":"None"},{"first_name":"Irene","middle_name":"","last_name":"Kim","name_suffix":"","institution":"David Geffen School of Medicine at the University of California Los Angeles, Department of Head and Neck Surgery, Los Angeles, California","department":"None"},{"first_name":"Gail","middle_name":"","last_name":"Ishiyama","name_suffix":"","institution":"David Geffen School of Medicine at the University of California Los Angeles, Department of Head and Neck Surgery, Los Angeles, California; David Geffen School of Medicine at the University of California Los Angeles, Department of Neurology, Los Angeles, California","department":"None"},{"first_name":"Akira","middle_name":"","last_name":"Ishiyama","name_suffix":"","institution":"David Geffen School of Medicine at the University of California Los Angeles, Department of Head and Neck Surgery, Los Angeles, California","department":"None"}],"date_submitted":"2019-01-08T22:04:40+01:00","date_accepted":"2019-01-08T22:04:40+01:00","date_published":"2019-03-04T18:29:03+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/634/galley/394/download/"}]},{"pk":6174,"title":"Lady Anne Clifford: From Idealized Gender Warrior to Exceptional Literary Bureaucrat","subtitle":null,"abstract":"As the only child of her father, Lady Anne Clifford claimed she was entitled to his estates and titles upon his death as his sole appropriate heir. Because of conditions such as coverture, primogeniture, feme covert, etc. during early modern England, there has been, and still is, the general assumption that women were not only subordinate to men, but that they held only the most basic rights in regards to property. Due to this characterization, historians have perpetually viewed Clifford as a new-age feminist who defied the circumstances of her time and fought for rights that were uncommon for women to pursue.\n \nThis thesis proves that Clifford was not remarkable for what she has become so famously known for. Her struggle to gain her inheritance was not as unusual or noteworthy as it was initially thought; it was actually quite a common practice amongst women of her standing.\n \n \nWhile Anne may not have been extraordinary in regards to her legal battles, it must still be noted that Anne has stood the test of time and has remained a prominent historical figure over the past centuries. This thesis demonstrates that Anne was not in fact a gender warrior within the larger legal scene but rather an emerging bureaucrat and literary contributor. In the end, historians are able to understand Anne and other women of her stature because she chose to document her life, legal or not, and to thus make sure that she could and would be later studied.","language":"en","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2g3386k6","frozenauthors":[{"first_name":"Jenisha","middle_name":"","last_name":"Sabaratnam","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2019-03-02T00:44:22+01:00","date_accepted":"2019-03-02T00:44:22+01:00","date_published":"2019-03-01T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/our_buj/article/6174/galley/3712/download/"}]},{"pk":12553,"title":"Volume 20 Issue 2","subtitle":null,"abstract":"n/a","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"WestJEM Full-Text Issue","is_remote":true,"remote_url":"https://escholarship.org/uc/item/76v6b2mz","frozenauthors":[{"first_name":"Dana","middle_name":"H.","last_name":"Le","name_suffix":"","institution":"UC Irvine","department":"None"}],"date_submitted":"2019-02-28T21:55:00+01:00","date_accepted":"2019-02-28T21:55:00+01:00","date_published":"2019-02-28T22:05:21+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12553/galley/6654/download/"}]},{"pk":12465,"title":"A Case Report and Postulated Systematic Approach to the Evaluation of Emotionalism Post Stroke in a Crisis Unit","subtitle":null,"abstract":"Introduction:\n Emotionalism post stroke, when inadequately addressed, can cause distress to patients including embarrassment, confusion, possible caregiver complaints, and an overall decrease in health-related quality of life (Badhan, et al, 2014). Also known as pathological laughing and crying (PLC), emotionalism post stroke refers to the involuntary and neurologic pseudo-bulbar affect (PBA). It often leads to uncontrolled and exaggerated expressions of inappropriate, emotionally charged outbursts such as laughing and/or crying (Parvizi, et al, 2001).  This “emotional lability” is usually seen in patients with neurological disorders, in particular stroke, and was first described in the literature in 1872. While the exact mechanism can be debated, studies suggest a lesion in the upper brainstem leading to involuntary triggering of the facio-respiratory patterns associated with laughter and crying that involve the motor cortices (Parvizi, et al. 2001) or the cerebellum (Sak, Wilson, 1924). However, with recent studies reporting the prevalence of depression as high as 29% post stroke (Ayerbe, et al, 2013), identifying differences between post-stroke depression and PBA in the emergency setting is crucial for appropriate treatment and disposition. A critical component of patient history with regard to PLC is the lack of inciting stimulus in reports of numerous episodes of pathological crying. This study aims to outline a systematic approach to evaluate and manage patients with PLC in the emergency department (ED).\n \n \n \nCase Presentation\n: \nThe patient was a 74-year-old Caucasian male with no formal PPH and PMH of T2D, HLD, HTN, who was brought by his wife to the ED with complaints of excessive crying and a reported verbalization of suicidal ideation. Upon interview, patient stated that he had been having \"crying spells\" in excess of emotional stimulus for the prior three months, increasing in severity. He denied neuro-vegetative symptoms of depression. Patient also denied recent stressors. He admitted to a transient ischemic attack five months prior to his presentation. He stated there were no neurological deficits at the time of encounter except for a noted decreased sense of taste. The patient admitted to having suicidal ideations (SI) but without intent, plan, or means. He determined that he had intermittent SI in the context of observing, \"Doesn't everyone think about that sometimes?\" He did not report details of his SI as he determined they were passive and vague thoughts of what it would be like to be dead. He denied past or recent suicide attempts or self-injurious behavior. The patient reported he had met with his primary care physician who advised him to go to the ED for further evaluation. The patient and his wife, also in her 70s, reported they thought the ED could prescribe medications and were not seeking hospitalization.  His wife stated that the patient had been “crying at the drop of a hat.” She noted that this was not usual for him and denied any recent stressors, or past episodes. She further stated, “I was at my wit’s end and I feel like something is wrong with him.” Patient stated the breaking point was his inability to attend an important engagement due to a dis-inhibited “crying spell” that lasted &gt; 10 minutes. He and his wife reported frustration. The patient also reported, “I can’t take it. Please help me.” Patient affect was depressed, with intermittent “episodes of crying.” We placed him on hold and re-evaluate status.\n \n \n \nMethod:\n Patient consent for this study was obtained. A literature search was performed in PubMed and \nJAMA Psychiatry\n for articles published on pathological laughing and crying since 1900, using multiple combinations of the search terms, which included the following: \npost stroke crying syndrome\n, \nemotionalism post stroke\n, \ninvoluntary emotional expression\n, and \npost stroke neurological disorders\n. The development of evidence approach and drafting of systemic approach.\n \n \n \nResults:\n On observation, the patient had depressed affect and intermittent episodes of crying without provocation. He repeatedly denied being depressed and denied neuro-vegetative symptoms of depression despite his affect. Psychological review of systems was negative. Vital signs, complete blood count, and electrolytes were within normal limits. Collateral information was obtained and old chart review revealed mild to moderate small-vessel ischemic changes, including a semi-ovale infarct five months prior to presentation. His wife stated she wanted help for his presumed depression. Clinical pathway for the evaluation of emotionalism post stroke in the crisis unit includes performing the following: patient intake and triaging à medical clearance and laboratory work à patient history, and collateral information à If patient psychiatrically stable by negative psychological review of systems, consider past medical history for risk factors significant for stroke à consider ancillary tests to rule out differential diagnoses à Patient education and reassurance à Discharge with follow up as a key to diagnosis. Criteria for discharge can include lack of PPH, patient denial of neuro-vegetative depressive symptoms, access to immediate follow-up, social support, lack of social concerns, collateral comfortable with discharge plan and understanding of next steps regarding treatment and follow-up. Citalopram prescribed to patient resulted in decrease in incidence of crying spells. Studies show Citalopram, paroxetine, and sertraline provide &gt;90% efficacy and reduction in depressive affect and pathological crying in patients (Schiffer et al, 2005).\n \n \n \nConclusion:\n Post-stroke, neuro-psychiatric pathological crying syndrome is a disorder that results from lesions affecting the pseudo-bulbar aspects of the brain and can go unrecognized. Due diligence on the part of the physician can allow for appropriate disposition, and time and cost-effective steps for proper management of the patient presenting with PLC in the ED. Definitive treatment includes outpatient management with a selective serotonin re-uptake inhibition, in particular Citalopram, paroxetine, and sertraline.\n \n \n \nAcknowledgment:\n I would like to thank Dilys Ngu, MD, for her help in review of this report.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2zk2w5d9","frozenauthors":[{"first_name":"Antonia","middle_name":"LJ","last_name":"Phillip","name_suffix":"","institution":"Cooper Medical School of Rowan University – AtlantiCare Track, Psychiatry Residency Program, Department of Psychiatry, Camden, New Jersey","department":"None"}],"date_submitted":"2019-01-23T22:22:57+01:00","date_accepted":"2019-01-23T22:22:57+01:00","date_published":"2019-02-28T21:59:52+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12465/galley/6621/download/"}]},{"pk":12464,"title":"Heroin Abstinence: A Case Report of Kratom in the Emergency Department and Beyond","subtitle":null,"abstract":"Introduction\n: \nKratom, an herb that was traditionally used by Southeast Asians to boost energy, is increasingly being used in the United States. According to the American Kratom Association, an estimated two to three million chronic pain sufferers resort to kratom as a “safe,” natural alternative to prescription opioids. Some of the reported beneficial effects include analgesic effects, muscle relaxation, and anti-inflammatory properties. In the drug addiction world however, kratom is being propagated as a legal alternative to getting high that is undetectable on routine drug screen. Kratom, or mitragynine, is a major psychoactive alkaloid. Several studies have found that kratom has stimulant effects in small doses but sedative effects in large doses, binding to mu and kappa receptors (Yusoff et al. 2014). Kratom causes cravings and an array of opioid-like withdrawal symptoms when users attempt to decrease usage. Withdrawal symptoms include restlessness, severe bone pain, muscle aches, tearing or runny nose, gastrointestinal (GI) symptoms, blurred vision, depression, irritability, and changes in mood. This case report documents one patient who used kratom as an alternative to heroin use. We also describe its subsequent addictive potential and the successful management of his withdrawal symptoms with an opioid detoxification protocol.\n \nCase Presentation\n: Our \npatient was an adult Caucasian male with a past psychiatric history of depression and severe opioid use disorder identified by appropriate history- taking. The patient recounted that he had been using kratom for the prior two and a half years as a “legal alternative” to heroin, motivated by his partner. At the time of encounter, he reported “strong cravings” and withdrawal symptoms when he attempted to abstain from kratom. Urine drug screen was negative. A quick Clinical Opioid Withdrawal Scale (COWS) evaluation was noted to be 30, and inpatient detoxification was deemed appropriate. He admitted to using initially four capsules per day, which increased up to 30 capsules a day over the 30-month time period. He reported having spent a lot of money to feed his habit and noted weight loss and decreased appetite. He reported, “I felt high,” and maintained that he had abstained from illicit heroine use. The patient admitted that he had not known kratom had addictive properties and reported that the withdrawal symptoms were more protracted – as long as two months post his last use when compared to that of heroin after being “hard stopped” during a brief incarceration. We used a COWS assessment and scoring to determine management of his withdrawal symptoms at initial presentation and over a short period of time. We measured vital signs, hepatic function, and management of withdrawal symptoms daily two hours after the delivery of daily buprenorphine and naloxone (using tapering protocol) for five days. We also administered clonidine at a dose of 0.1 milligrams (mg) by mouth every six hours (PO q6h), baclofen 10 mg PO for muscle spasms, chlorproamazine/diphenhydramine 50mg as needed (PRN) for agitation, and ibuprofen 600mg PO q6h PRN for generalized joint pain. We monitored his symptomology by patient evaluation, daily vital signs, and a physician-guided questionnaire.\n \n \n \nResults\n: \nElectrolytes, renal function and liver studies were found to be within normal limits; however, his heart rate was elevated at 100 beats per minute on day of admission. Blood pressure was 122/75 millimeters of mercury and temperature was 97.5° Fahrenheit with a body mass index of 21.5. Urine toxicology was negative for all drugs of abuse including methadone and opiates. The patient’s pupils were constricted and there was profuse diaphoresis visible over his forehead. He also reported joint pain throughout his body, and he was unable to sit still. His eyes were tearing, he had uncontrollable yawning, and complained of “skin crawl.” The patient denied having any GI symptoms such as diarrhea or nausea, and he also denied having tremors. No tremors were observed, although muscle twitching of his forearm and biceps was noted. His COWS score was noted to be 30 on day one, and considered moderately severe. HIS COWS score reduced to five by day four. Of note, the COWs scale increased to 10 by day seven on 0mg of buprenorphine and naloxone.\n \n \n \nConclusion\n: \nKratom possesses properties that can be successfully used as an alternative to heroin use. Nonetheless, there is a potential for abuse, which results in severe opioid- like withdrawal symptoms when the user attempts abstinence. Patients require increasing amounts of kratom as they develop tolerance. Kratom withdrawal symptoms can be successfully managed with opioid detox protocol or buprenorphine/naloxone protocol over a period of five days, although symptoms noticeably last longer. Pharmaceutical companies should explore safe, physician-guided administration of kratom to reduce heroin use and add to our repertoire of methadone or buprenorphine in managing opioid use disorders.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/631314rk","frozenauthors":[{"first_name":"Antonia","middle_name":"LJ","last_name":"Phillip","name_suffix":"","institution":"Cooper Medical School of Rowan University – AtlantiCare Track, Psychiatry Residency Program, Department of Psychiatry, Camden, New Jersey","department":"None"}],"date_submitted":"2019-01-23T22:18:25+01:00","date_accepted":"2019-01-23T22:18:25+01:00","date_published":"2019-02-28T21:59:42+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12464/galley/6620/download/"}]},{"pk":12463,"title":"Development of a Precision Olfactory Delivery (POD®)-Olanzapine Drug-Device Product for Agitation","subtitle":null,"abstract":"Introduction:\n Agitation is a cluster of behaviors observed in multiple psychiatric diseases, which can increase the likelihood of violent behavior. Atypical antipsychotics, including oral and intramuscular (IM) olanzapine (OLZ), have been approved for chronic and acute agitation treatment, respectively, for schizophrenia and bipolar I disorder in the U.S. for over 20 years. During acute agitation episodes, IM OLZ is preferred over oral treatments due to a shorter Tmax. However, IM OLZ is invasive, predominantly administered in a hospital setting, and may require restraint if the patient is uncooperative, potentially reducing trust between patient and medical personnel and increasing the likelihood of injuries. When possible, non-injectable routes of administration are preferred during agitation events; however, slower-onset oral products often require labor-intensive observation of the medicated patient until adequate symptom resolution.\n \nImpel NeuroPharma is developing INP105, a drug-device combination product consisting of a novel OLZ powder formulation for upper nasal cavity administration using precision olfactory delivery (POD®) technology. This rescue therapy is designed to provide non-invasive, rapid relief of acute agitation comparable to IM injection, without excessively sedating the patient, in a reasonably safe and tolerable manner. POD technology is designed to deliver drug to the upper nasal mucosa with minimal effort or coordination for self or caregiver administration.\n \nMethods:\n OLZ formulations were designed and manufactured to optimize powder characteristics and device compatibility. Formulations were characterized by analytical methods to assess chemical and physical state as well as device compatibility. Lead formulations were evaluated in rat and non-human primate (NHP) pharmacokinetic (PK) studies, where dose was administered by species-specific POD devices, and plasma samples for PK analysis were analyzed by liquid chromatography mass spectrometry. Formulation selection for further evaluation was based on analytical and PK properties, and a single formulation was identified for inclusion in the INP105-101 proof-of-concept, clinical study.\n \nResults:\n Approximately 30 formulations designed for nasal delivery by POD technology were manufactured and then assessed using analytical chemistry techniques and device-compatibility testing. Twenty of the formulations were evaluated in rat and NHP PK models. Short-term stability tests and device compatibility testing were used to further narrow down formulations for additional PK studies. The lead formulation was tested to five months of stability with &gt;99% assay, &lt;1% total impurities, and positive device compatibility over the storage period. All formulations tested in NHP PK studies resulted in a Tmax of less than 53 minutes and a Cmax greater than 26 nanograms per milliliter (ng/mL). The lead formulation, selected for clinical development in the INP105-101 study, exhibited a Tmax of 17 minutes, similar to that reported for IM OLZ, and a Cmax of 71 ng/mL, approximately threefold higher than the reported Cmax in patients receiving 10 milligrams (mg) IM OLZ.\n \nConclusion:\n Impel NeuroPharma is developing a drug-device combination product that will administer powder OLZ to the vascular-rich, upper nasal space with a novel precision olfactory delivery (POD®) device. It is needle-free, easily administered by self or caregiver, and a potentially rapidly effective OLZ treatment to abort episodes of acute agitation in the low-intensity community clinic or emergency department setting. This series of preclinical development studies has led to the identification of a lead formulation to be tested in the INP105-101 proof-of-concept clinical study for further development.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0gm7913k","frozenauthors":[{"first_name":"K","middle_name":"H","last_name":"Satterly","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"B","middle_name":"","last_name":"Gajera","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"G","middle_name":"J","last_name":"Davies","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"H","middle_name":"","last_name":"Lin","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"S","middle_name":"","last_name":"Muppaneni","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"J","middle_name":"","last_name":"Wright","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"K","middle_name":"","last_name":"To","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"S","middle_name":"B","last_name":"Shrewsbury","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"J","middle_name":"","last_name":"Hoekman","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"}],"date_submitted":"2019-01-23T22:16:14+01:00","date_accepted":"2019-01-23T22:16:14+01:00","date_published":"2019-02-28T21:59:35+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12463/galley/6619/download/"}]},{"pk":12462,"title":"Placebo/Active Controlled, Safety, Pharmaco-Kinetic/Dynamic Study of INP105 (POD® olanzapine) in Healthy Adults","subtitle":null,"abstract":"Introduction:\n A 2008 survey of emergency department staff (ED) found that 65% had witnessed physical attacks, 32% reported at least one verbal threat per day, and 18% had been assaulted at least once with a weapon. While many of the attacks were due to acute agitation, only 6% of the surveyed EDs had a protocol for medication selection and 40% provided training for staff. During acute agitation episodes – up to seven million/year in U.S. hospitals and EDs –  olanzapine (OLZ) intramuscular (IM) is favoured due to a shorter Tmax over oral tablets or oral disintegrating tablets (ODT); however, IM administration requires cooperation, is invasive and can be painful. Uncooperative patients require restraint for the administration of OLZ IM that may be viewed as an assault, thereby reducing trust in medical personnel and increasing the likelihood of staff injuries. When possible, non-injectable forms are preferred during agitation; however, currently approved oral products have slower onset of effect, often requiring labour-intensive observation of the medicated patient until resolved.\n \nINP105 is a drug-device combination product consisting of a powder form of OLZ delivered by a precision olfactory delivery (POD®) device to the vascular-rich, upper nasal space for rapid control of agitation in a cooperative or uncooperative patient (with a potentially caregiver‑administered dose). For this study a near-final formulation of OLZ was administered by the research embodiment of the POD (I231) device. For subsequent studies, INP105 will use the final commercial formulation adjustments and the commercial POD device. INP105 should provide faster onset of relief compared to oral therapy and be a more accessible dosage form compared to IM therapy without a needle. INP105 may also be suitable for early use by the patient who has insight into his or her condition and can recognize early symptoms of agitation before escalating, uncontrolled agitation leads to violence and injury to the patient, the caregiver and/or healthcare workers. The objectives of this SNAP 101 study were the following: 1) Establish safety and tolerability of three single, ascending doses of INP105; 2) compare pharmacokinetic (PK) data for OLZ)from three INP105 doses with OLZ IM (5 and 10 milligrams [mg]) and orally disintegrating tablets (OLZ-ODT) 10 mg; 3) establish and compare pharmacodynamic (PD) effects of INP105 to OLZ IM and OLZ-ODT; and 4) explore PK/PD and dose-response relationships for INP105.\n \nMethods:\n SNAP 101 was a randomized, double-blind, placebo- and active comparator-controlled, ascending-dose, 2-way, 2‑period, incomplete block, crossover Phase 1 trial to compare the safety, tolerability, PK and PD of three doses of INP105 (5 mg, 10 mg and 20 mg) with two doses of OLZ IM (5 mg and 10 mg) and one dose of OLZ-ODT (10 mg).\n \nPeriod 1 was open label; Period 2 was double-blind with at least 14 days between dosing in the two periods. Dose escalation was staggered across cohorts to allow a monitoring committee to assess safety and tolerability of INP105 between doses.\n \nFollowing all dosings in both periods, PD assessments were made by frequent and regular vital signs recordings as well as visual analogue scale for subjective assessment of sedation, the Agitation/Calmness Evaluation Scale, an objective assessment by the investigator, and the timed Digit Symbol Substitution Test. Blood was drawn at frequent timepoints over the 120 hours post dosing for PK evaluation.\n \nAll subjects were observed as inpatients for at least 72 hours post-dosing of reference therapy and IP. Follow-up occurred four, five and 14 days after dosing for each study period. The first two subjects receiving 10 mg OLZ IM had clinically significant hypotensive events following administration, and thus the study design was immediately changed with the remaining 36 subjects (12 per cohort) being randomized to OLZ 5 mg IM or OLZ ODT 10 mg. After each block of 12 subjects completed period 1 dosing, five days of observation and nine days of washout, they returned for period 2 dosing when they received INP105 (n=9) or placebo. After a further five days of observations and nine days of washout, a safety monitoring committee (SMC) reviewed the safety data before allowing dose to be escalated to the next level, ie, SMC 1 approved proceeding from INP105 5 mg to INP105 10 mg; but at SMC 2, the decision was made to reduce the dose for cohort 3 from INP105 20 mg (four capsules) to 15 mg (three capsules) due to the frequent but not substantial drops in blood pressure noted after cohort 2, period 2 dosing.\n \nConclusion:\n This SNAP 101 study (completed in 2018 with results expected in December), which administered OLZ to the vascular-rich, upper nasal space with the novel POD® device, should guide further clinical development for a needle-free, easy self- or caregiver-administered, rapidly effective OLZ treatment to abort episodes of acute agitation in low-intensity community or ED settings. Safety signals (blood pressure drops) suggestive of appreciable pharmacodynamic effects of OLZ were noted with OLZ IM 5 mg and with cohort 2 and 3, period 2 dosings (INP105 at 10 and 15 mg doses or placebo) at the SMCs. Their formal analysis, along with other PD measures and PK data, is anticipated.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/86f519rb","frozenauthors":[{"first_name":"SB","middle_name":"","last_name":"Shrewsbury","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"M","middle_name":"","last_name":"Swardstrom","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"KH","middle_name":"","last_name":"Satterly","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"J","middle_name":"","last_name":"Campbell","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"},{"first_name":"N","middle_name":"","last_name":"Tugiono","name_suffix":"","institution":"Nucleus Network, Melbourne, Australia","department":"None"},{"first_name":"JD","middle_name":"","last_name":"Gillies","name_suffix":"","institution":"Clinical Network Services, Brisbane, Australia","department":"None"},{"first_name":"J","middle_name":"","last_name":"Hoekman","name_suffix":"","institution":"Impel NeuroPharma, Seattle, Washington","department":"None"}],"date_submitted":"2019-01-23T22:12:05+01:00","date_accepted":"2019-01-23T22:12:05+01:00","date_published":"2019-02-28T21:59:28+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12462/galley/6618/download/"}]},{"pk":12461,"title":"Reducing Emergency Department Length of Stay and Wait Times for Psychiatric Patients","subtitle":null,"abstract":"Introduction: \nIn the past 20 years there has been a significant decline in the number of inpatient psychiatric beds in the United States, while the number of patients seeking psychiatric treatment in the emergency department (ED) has increased over the same time period. Given the increase in demand for psychiatric services and decrease in availability of inpatient treatment the ED is becoming the de facto place of treatment for the majority of psychiatric crises. Psychiatric patients experience longer lengths of stay (LOS) when compared to non-psychiatric patients, especially when transfer to another facility is required. Therefore, improvements in the efficiency of evaluation, treatment and disposition of psychiatric patients benefit both patients and the EDs that care for them.\n \n \n \nMethods:\n To improve throughput and reduce wait times in the ED at our Level I trauma center located in the Upstate region of South Carolina, we implemented several improvements. We then tracked pre- and post-intervention metrics, including LOS and the time from ED consultation order to the completion of psychiatric consultant documentation. The intervention consisted of several protocols with various checkpoints for required documentation necessary for progression through overall mental health evaluation and treatment. In addition, structured psychiatrist and social worker evaluation-note templates were standardized to improve documentation accuracy, consistency, efficiency and overall patient safety. A separate tracking system is monitored by a dedicated psychiatric advanced practice provider to ensure compliance on note completion and order set utilization. The time from ED consult order to completion of psychiatric consultant documentation and mean LOS (in hours +/-standard deviation [SD]) were measured for six months before (10/2016 to 03/2017) and eight months after (4/2017 to 11/2017) institution of these protocols. We then compared pre- and post-intervention measures using Student’s t-test (p&lt;0.05).\n \n \n \nResults\n: The number of ED patients seen by a psychiatrist were 3,331 and 4,482 in the pre- and post-intervention time frames, respectively. Overall mean LOS significantly decreased from 38.2 (SD+57.5) to 24.9 (SD+37.6) hours after institution of these new protocols. In addition, mean LOS for patients discharged to home or to a psychiatric facility also significantly decreased from 36.9 (SD+53.7) to 21.8 (SD+30.7) and 42.8 (SD+66.5) to 31.8 (SD+49.1) hours, respectively. Time from consult order to completion of ED psychiatrist documentation significantly decreased from 11.3 (SD+9.8) to 6.2 (SD+6.9) hours.  All four comparisons were significantly different with p-values ≤ 0.01.\n \n \n \nConclusion:\n The implementation of these protocols showed a rapid, sustained improvement in overall efficiency of evaluation and disposition of psychiatric patients in our ED. The decrease in time to evaluation for patients discharged home, as well as a decreased time to transfer to inpatient level of care for those requiring hospitalization made for greater throughput and decreased demand on ED resources. Of note, this improvement in efficiency was observed despite an increase in the volume of psychiatric patients seen by the ED over the course of the study. Our institution continues to track outcomes and has implemented further changes including hiring several dedicated ED psychiatrists, with a goal of providing 24/7 availability of in-house psychiatrists embedded in the ED in an effort to further decrease LOS and improve patient care.\n \nGiven the shortage of psychiatrists and declining numbers of psychiatric hospital beds, until an alternative solution for this difficulty of access to psychiatric services is implemented the demand for psychiatric services in the ED will remain high. While more study is needed to determine the generalizability of our findings, we believe that implementation of similar interventions would likely benefit other EDs struggling with delays in psychiatric evaluation and disposition.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3q94w2hf","frozenauthors":[{"first_name":"Joshua","middle_name":"D.","last_name":"Richter","name_suffix":"","institution":"Greenville Health System, Department of Emergency Medicine, Greenville, South Carolina","department":"None"},{"first_name":"Dawn","middle_name":"","last_name":"Blackhurst","name_suffix":"","institution":"Greenville Health System, Department of Emergency Medicine, Greenville, South Carolina","department":"None"},{"first_name":"Phillip","middle_name":"","last_name":"Moschella","name_suffix":"","institution":"Greenville Health System, Department of Emergency Medicine, Greenville, South Carolina","department":"None"},{"first_name":"Karen","middle_name":"M.","last_name":"Lommel","name_suffix":"","institution":"Greenville Health System, Department of Emergency Medicine, Greenville, South Carolina","department":"None"}],"date_submitted":"2019-01-23T22:07:40+01:00","date_accepted":"2019-01-23T22:07:40+01:00","date_published":"2019-02-28T21:59:21+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12461/galley/6617/download/"}]},{"pk":12460,"title":"Potentially Avoidable Transfers of Veterans with Mental Health Conditions in the Veterans Health Administration","subtitle":null,"abstract":"Objective:\n Over 40% of the 2.4 million emergency department (ED) visits to Veterans Health Administration (VHA) hospitals are from veterans who live in rural areas, a population at increased risk of interfacility transfer. Veterans may undergo interfacility transfer to obtain emergent or urgent access to specialized health services, particularly mental health care. However, such transfers raise questions regarding appropriate use of resources, travel burdens for patients and families, and logistical challenges for ED staff and providers that may delay timely care. We sought to describe ED-based, interfacility transfer rates within the VHA and to estimate the proportion of potentially avoidable transfers (PAT) of patients with mental health conditions relative to other diseases.\nMethods\n: This observational cohort included all patients who were transferred from a VHA ED to another VHA hospital between 2012 and 2014. We extracted data from Clinical Data Warehouse administrative data. PAT was defined as discharge from the receiving ED without a procedure, or hospital length of stay at the receiving hospital ≤ 1 day without having a procedure performed. We conducted facility-level and diagnosis-level analysis to identify conditions for which an alternative to transfer, such as telehealth access to specialty care, could be developed and implemented in low-volume or rural EDs.\nResults:\n Of 6,131,734 ED visits during the three-year study period, 18,875 (0.3%) were transferred from one VHA ED to another VHA facility. Rural residents were transferred three times as often as urban residents (0.6% vs. 0.2%, p&lt;0.001), and 23.6% of all VHA-to-VHA transfers met the PAT definition. Mental health conditions were the most common reason for interfacility transfer (34% of all interfacility transfers), followed by heart disease (12%). Of transfers that met PAT criteria, 11% were for mental health diagnoses whereas 21% were for heart disease. Geographic analysis suggested that overall PAT proportion ranged across regions from 8-53% with mental health PATs between 2-42%. \nConclusion:\n VHA interfacility transfer is commonly performed for mental health diagnoses, and there is substantial regional variation in potentially avoidable transfers in a national sample of transfers. A significant proportion of these transfers may be potentially avoidable. Future work should focus on improving capabilities to provide specialty evaluation locally for these conditions, possibly using telehealth solutions. Additional work should also focus on measuring the timeliness of these transfers.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7zs493xc","frozenauthors":[{"first_name":"Nicholas","middle_name":"M.","last_name":"Mohr","name_suffix":"","institution":"Center for Comprehensive Access Delivery Research & Evaluation (CADRE), VA Iowa City Healthcare System, Department of Emergency Medicine and Anesthesia, Iowa City, Iowa","department":"None"},{"first_name":"Chaorong","middle_name":"","last_name":"Wu","name_suffix":"","institution":"1Center for Comprehensive Access Delivery Research & Evaluation (CADRE), VA Iowa City Healthcare System, Iowa City, Iowa\n\nUniversity of Iowa, Institute for Clinical and Translational Sciences, Iowa City, Iowa","department":"None"},{"first_name":"Michael","middle_name":"J.","last_name":"Ward","name_suffix":"","institution":"Tennessee Valley Healthcare System VA Medical Center, Nashville, Tennessee\n\nVanderbilt University Medical Center, Department of Emergency Medicine, Nashville, Tennessee","department":"None"},{"first_name":"Candace","middle_name":"D.","last_name":"McNaughton","name_suffix":"","institution":"Tennessee Valley Healthcare System VA Medical Center, Nashville, Tennessee\n\nVanderbilt University Medical Center, Department of Emergency Medicine, Nashville, Tennessee","department":"None"},{"first_name":"Peter","middle_name":"J.","last_name":"Kaboli","name_suffix":"","institution":"Center for Comprehensive Access Delivery Research & Evaluation (CADRE), VA Iowa City Healthcare System, Iowa City, Iowa\n\nUniversity of Iowa Carver College of Medicine, Department of Internal Medicine, Iowa City, Iowa","department":"None"}],"date_submitted":"2019-01-23T21:52:51+01:00","date_accepted":"2019-01-23T21:52:51+01:00","date_published":"2019-02-28T21:57:31+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12460/galley/6616/download/"}]},{"pk":12458,"title":"Creating Elasticity and Improving Handoffs Increases Throughput on an Emergency Psychiatry Service","subtitle":null,"abstract":"Introduction:\n As the population of New Orleans continues to increase, psychiatric services at its main safety-net hospital, the relatively new University Medical Center New Orleans (UMCNO), have had to increase with it. At UMCNO, psychiatric patients in the emergency department (ED) are ideally managed in the behavioral health emergency room (BHER) until either admission, transfer, or discharge. The BHER holds 26 beds, but staffing limitations prevent all 26 from being open continuously. Historically, there are fewer discharges from inpatient psychiatric units citywide on weekends, which then causes overflow of the BHER into the main ED and slows throughput throughout the hospital. Because of this, elasticity in the system and effective reassessments by the emergency psychiatry consult service are key to minimizing lengths of stay and saturation events.\n \nMethods:\n In April 2018, efforts were undertaken to create more elasticity in the BHER as well as more effective handoffs to easily identify what is needed for each patient to ensure a safe discharge. Changes included the following: actively anticipating the need to expand to 26 beds starting Sunday evening; creating a mindset of “continuously seeking an inpatient bed” during peak times; and using the electronic health record (EHR) for handoffs between providers. Lengths of stay (LOS) for patients in the BHER as well as hours on psychiatric saturation were tracked monthly before and after the changes were made, as were the total number of emergency psychiatry consults, discharge rates, and transfer rates.\n \nResults: \nThe number of consults per day has been increasing by about 13.8% a month over the last few years and is now around 16-17 a day. The service discharges about 45% of the patients consulted to us; and of those requiring admission, about 35% are transferred to other psychiatric unit, with the rest being admitted to UMCNO’s 60-bed inpatient psychiatric unit. Looking at the seven months before and after the changes were made, the average LOS has decreased from 15.98 hours to 13.78 hours (a 17% decrease), and the number of hours on saturation decreased from 42.3 hours a month to 19.2 hours (a 55% decrease).\n \nDiscussion: \nWhile our goal of zero hours on saturation was not met, the data show that by planning for the increase in volume during the weekend with more staff starting Sunday evening to open all 26 beds, we were able to lower saturation hours, which helps throughput in the main ED and throughout the hospital. Furthermore, by increasing the hours of clerks on weekends (who are responsible for transferring patients when our inpatient unit is full), we were able to transfer more patients throughout the weekend than previously. And finally, by integrating our handoff within our EHR, we were able to quickly identify those patients who could potentially be discharged safely and what was needed to ensure that safe discharge. Combined, these efforts lowered the average of LOS in the BHER.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/56s2q6g4","frozenauthors":[{"first_name":"David","middle_name":"","last_name":"Fein","name_suffix":"","institution":"University Medical Center New Orleans, Department of Emergency Medicine, New Orleans, Louisiana","department":"None"}],"date_submitted":"2019-01-23T21:37:35+01:00","date_accepted":"2019-01-23T21:37:35+01:00","date_published":"2019-02-28T21:57:18+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12458/galley/6615/download/"}]},{"pk":12457,"title":"Pediatric Patients with Behavioral Emergencies: Who’s Coming in and What Happens While They’re Here?","subtitle":null,"abstract":"Introduction: \nChildren and adolescents evaluated in the emergency department (ED) represent a vulnerable population, especially when presenting for psychiatric symptoms. For these patients the ED environment may be stressful and lacking in needed resources. Data describing children seen within the ED are currently limited; this study aims to describe the pediatric patient population treated for mental health concerns within one ED, which may promote better-tailored treatment and support resources in the future.\n \nMethods: \nThe study describes 339 visits generated over two months in 2017 at LAC+USC Medical Center. We reviewed charts to determine each child’s stated age and gender, as well as whether the patient belonged to one or more vulnerable subpopulations. The factors of interest included involvement with the social services and legal systems, history of psychological trauma, diagnoses of post-traumatic stress disorder (PTSD) or autism spectrum disorder (ASD), and whether the patient required a “behavioral code” during his or her visit.\n \nResults: \nThe study determined that 76.1% of the charts included at least one risk factor assessed during our review. Males were more likely than females to present by the age of 11, while the opposite was true for patients age 12-17. We also determined that 38% of patients had been involved with child protective services, or a regional center (system for individuals with developmental disabilities), or the juvenile justice system, and that 5.6% were involved with multiple systems. Two hundred twenty-five patients had experienced psychological trauma, with 30 patients carrying an official diagnosis of PTSD. Of behavior codes called, 23% were for ASD patients, with these patients being far more likely to display dangerous behaviors in the ED compared with neurotypical children.\n \nConclusion: \nThis study demonstrates that a majority of children evaluated in our ED for psychiatric concerns also belonged to at least one vulnerable subpopulation. Especially striking was that behavioral codes were far more likely to be called for ASD patients than neurotypical patients, implying that EDs that work with this population may benefit from extra training in preventing and managing agitated behavior in children with ASD.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8b506481","frozenauthors":[{"first_name":"Anthony","middle_name":"R.","last_name":"Sanchez","name_suffix":"","institution":"Keck School of Medicine of University of Southern California, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Jason","middle_name":"","last_name":"Sterris","name_suffix":"","institution":"Keck School of Medicine of University of Southern California, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Erica","middle_name":"Z.","last_name":"Shoemaker","name_suffix":"","institution":"Keck School of Medicine of University of Southern California, Department of Emergency Medicine, Los Angeles, California","department":"None"}],"date_submitted":"2019-01-23T21:23:36+01:00","date_accepted":"2019-01-23T21:23:36+01:00","date_published":"2019-02-28T21:57:10+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12457/galley/6614/download/"}]},{"pk":12456,"title":"Evidence-based Care for Suspected Pediatric Somatic Symptom and Related Disorders in Emergent Settings","subtitle":null,"abstract":"Introduction:\n Somatic symptom and related disorders (SSRDs) are a group of diagnoses characterized by the presentation of one or more physical symptoms that are either inconsistent with physical disease based on a thorough medical evaluation or vastly disproportionate to findings on a thorough medical evaluation, and result in significant impairment. These symptoms are often significantly influenced by psychological factors including acute or chronic distress, as well as visceral hypersensitivity and habituation of maladaptive responses to somatic sensations. These conditions are common in pediatric medicine, accounting for up to 50% of primary care visits for abdominal pain, headache, and fatigue. There is a lack of a coordinated approach to SSRD care, often resulting in excessive and unnecessary healthcare utilization, miscommunications, missed opportunities to intervene, and considerable frustration from patients, families and providers.\n \n \n \nMethods:\n There is limited information in the literature for how to provide SSRD care in practice and no current consensus guidelines for SSRD care in youth. At our institution, we convened a multidisciplinary group of providers, used LEAN methodology to assess problematic areas, including areas of inefficiency or disruption in work flow, gathered data from primary care providers statewide to inform understanding, and developed an evidence-based, institutional clinical practice guideline for management of SSRD care within the emergency department (ED) and inpatient setting. In addition, we have integrated education on SSRDs into our pediatric and psychiatric trainee curriculum.\n \n \n \nResults:\n We will present the consensus-building process and multidisciplinary group formation used at our institution to develop standardized tools, resources, a clinical protocol and a clinical practice guideline. This includes a review of our value stream map as part of incorporating LEAN methodology in our process. We will review current evidence in SSRD practice, including data gathered from a statewide survey on practice. We will share our clinical protocol that outlines a detailed approach to suspect and confirm diagnoses of SSRD starting in the ED setting, as well as principles and contents from an interdisciplinary, hospital-wide clinical practice guideline with several associated clinical resources for practical application of the practice guideline and protocol. \n \nConclusion: \nOur institutional and statewide data align closely with existing evidence that indicates SSRDs are common, that providers, both medical and psychiatric, have little training or education on these conditions, that these conditions often present in emergent settings, and that patients and families often seek an overly physical conceptualization to their symptoms that is devoid of mental health involvement, which often leads to unnecessary and significant healthcare utilization. Initial results from our institutional approach, resulting in consensus-based practice guidelines, protocol and resources, suggest a model that can be used in ED and inpatient settings to address the needs of this pediatric population.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1xs899q6","frozenauthors":[{"first_name":"Nasuh","middle_name":"","last_name":"Malas","name_suffix":"","institution":"C.S. Mott Children's Hospital, Michigan Medicine, Department of Psychiatry and Pediatrics, Ann Arbor, Michigan","department":"None"}],"date_submitted":"2019-01-23T21:20:18+01:00","date_accepted":"2019-01-23T21:20:18+01:00","date_published":"2019-02-28T21:57:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12456/galley/6613/download/"}]},{"pk":12455,"title":"Management of Pediatric Agitation and Aggression: Lessons Learned from the National Consensus Pediatric BETA Guidelines","subtitle":null,"abstract":"Introduction: \nAgitation in pediatric acute care settings is common and disruptive. We begin with a case example of an agitated patient on a pediatric medical unit. Using data from a survey of 38 North American children’s hospitals we will outline the prevalence, screening methods, clinical guidelines, and physician training in the management of agitation. We will describe hospital practice in the comprehensive evaluation and management of pediatric agitation and aggression at one institution, followed by a summary of the literature on medications for agitation. We conclude with the National Consensus Pediatric BETA Guidelines for the management of pediatric agitation and aggression in emergent settings.\n \n \n \nMethods: \nA case presentation will be followed by data from a national survey of pediatric hospitalists and consultation/liaison psychiatrists.  A clinical pathway for management of agitation will be described. Using a \nMedline\n and \nPsycINFO\n search from 01/01/1996-01/01/2017, we will summarize the literature on psychopharmacological management of agitation in pediatric patients. Using the Delphi method for consensus guideline development, a team of emergency department-based child and adolescent psychiatrists from across the United States created the Consensus Guidelines.\n \n \n \nResults: \nResults of the survey of 38 North American academic children’s hospitals revealed 85.5% of the respondents encountered agitation in pediatric patients at least once a month. Most viewed agitation in pediatric patients as highly important, yet 55.1% do not screen for risk factors of agitation, 65.3% reported no clinical guidelines for agitation, and 57.1% indicated no physician training in pediatric agitation. A multidisciplinary clinical pathway for agitation in pediatric patients will be outlined. Evidence for the following medication classes will be described: antihistamines, benzodiazepines, typical antipsychotics, atypical antipsychotics, mood stabilizers, anti-depressants, and stimulants. The Consensus Guidelines outline standardized recommendations for medications.\n \n \n \nConclusion: \nAgitation in pediatrics patients is a concern continent-wide, but there is little training or standardization of care. Clinical pathways exist and can ensure identification and early management. Data about psychopharmacological management of agitation exists and updated Consensus Guidelines provide standardized guidelines for the management of agitation.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Abstracts","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1wq391qz","frozenauthors":[{"first_name":"Nasuh","middle_name":"","last_name":"Malas","name_suffix":"","institution":"C.S. Mott Children's Hospital, Michigan Medicine, Ann Arbor, Michigan","department":"None"}],"date_submitted":"2019-01-23T21:18:07+01:00","date_accepted":"2019-01-23T21:18:07+01:00","date_published":"2019-02-28T21:56:49+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12455/galley/6612/download/"}]},{"pk":11924,"title":"Assessment of Physician Well-being, Part Two: Beyond Burnout","subtitle":null,"abstract":"Part One of this two-article series reviews assessment tools to measure burnout and other negative states. Physician well-being goes beyond merely the absence of burnout. Transient episodes of burnout are to be expected. Measuring burnout alone is shortsighted. Well-being includes being challenged, thriving, and achieving success in various aspects of personal and professional life. In this second part of the series, we identify and describe assessment tools related to wellness, quality of life, resilience, coping skills, and other positive states.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Physician Well-being"},{"word":"Assessment Tools"},{"word":"resilience"}],"section":"Provider Workforce","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3260s32v","frozenauthors":[{"first_name":"Michelle","middle_name":"","last_name":"Lall","name_suffix":"","institution":"Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia","department":"None"},{"first_name":"Theodore","middle_name":"J.","last_name":"Gaeta","name_suffix":"","institution":"New York-Presbyterian Brooklyn Methodist Hospital, Department of Emergency Medicine, Brooklyn, New York\nWeill Cornell Medicine, Department of Emergency Medicine in Clinical Medicine, New York, New York","department":"None"},{"first_name":"Arlene","middle_name":"S.","last_name":"Chung","name_suffix":"","institution":"Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York","department":"None"},{"first_name":"Sneha","middle_name":"A.","last_name":"Chinai","name_suffix":"","institution":"University of Massachusetts Medical School, Department of Emergency Medicine, Worcester, Massachusetts","department":"None"},{"first_name":"Manish","middle_name":"","last_name":"Garg","name_suffix":"","institution":"Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania\nTemple University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":"None"},{"first_name":"Abbas","middle_name":"","last_name":"Husain","name_suffix":"","institution":"Staten Island University Hospital Zucker School of Medicine at Hofstra/Northwell, Department of Emergency Medicine, Staten Island, New York","department":"None"},{"first_name":"Carolyn","middle_name":"","last_name":"Kanter","name_suffix":"","institution":"Temple University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":"None"},{"first_name":"Sorabh","middle_name":"","last_name":"Khandelwal","name_suffix":"","institution":"The Ohio State University, Department of Emergency Medicine, Columbus, Ohio","department":"None"},{"first_name":"Caitlin","middle_name":"S.","last_name":"Rublee","name_suffix":"","institution":"The Ohio State University, Department of Emergency Medicine, Columbus, Ohio","department":"None"},{"first_name":"Ramin","middle_name":"R.","last_name":"Tabatabai","name_suffix":"","institution":"Keck School of Medicine of USC, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"James","middle_name":"","last_name":"Kimo Takayesu","name_suffix":"","institution":"Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Mohammad","middle_name":"","last_name":"Zaher","name_suffix":"","institution":"Prince Mohammed Bin Abdulaziz Hospital, Consultant of Emergency Medicine, Riyadh, Saudi Arabia","department":"None"},{"first_name":"Nadine","middle_name":"T.","last_name":"Himelfarb","name_suffix":"","institution":"Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island","department":"None"}],"date_submitted":"2018-07-10T17:47:32+02:00","date_accepted":"2018-07-10T17:47:32+02:00","date_published":"2019-02-28T21:39:20+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11924/galley/6374/download/"}]},{"pk":11923,"title":"Assessment of Physician Well-being, Part One: Burnout and Other Negative States","subtitle":null,"abstract":"Physician well-being is a complex and multifactorial issue. A large number of tools have been developed in an attempt to measure the nature, severity, and impact of both burnout and well-being in a range of clinical populations. This two-article series provides a review of relevant tools and offers guidance to clinical mentors and researchers in choosing the appropriate instrument to suit their needs, whether assessing mentees or testing interventions in the research setting. Part One begins with a discussion of burnout and focuses on assessment tools to measure burnout and other negative states. Part Two of the series examines the assessment of well-being, coping skills, and other positive states.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"physician"},{"word":"Well-Being"},{"word":"Assessment Tools"}],"section":"Provider Workforce","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9623x0gd","frozenauthors":[{"first_name":"Michelle","middle_name":"D.","last_name":"Lall","name_suffix":"","institution":"Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia","department":"None"},{"first_name":"Theodore","middle_name":"J.","last_name":"Gaeta","name_suffix":"","institution":"New York-Presbyterian Brooklyn Methodist Hospital, Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Arlene","middle_name":"S.","last_name":"Chung","name_suffix":"","institution":"Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York","department":"None"},{"first_name":"Erin","middle_name":"","last_name":"Dehon","name_suffix":"","institution":"University of Mississippi Medical Center, Department of Emergency Medicine, Jackson, Mississippi","department":"None"},{"first_name":"William","middle_name":"","last_name":"Malcolm","name_suffix":"","institution":"Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia","department":"None"},{"first_name":"Adam","middle_name":"","last_name":"Ross","name_suffix":"","institution":"University of Louisville School of Medicine, Department of Emergency Medicine, Louisville, Kentucky","department":"None"},{"first_name":"David","middle_name":"P.","last_name":"Way","name_suffix":"","institution":"The Ohio State University College of Medicine, Department of Emergency Medicine, Columbus, Ohio","department":"None"},{"first_name":"Lori","middle_name":"","last_name":"Weichenthal","name_suffix":"","institution":"University of San Francisco-Fresno, Department of Emergency Medicine, Fresno, California","department":"None"},{"first_name":"Nadine","middle_name":"T.","last_name":"Himelfarb","name_suffix":"","institution":"Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island","department":"None"}],"date_submitted":"2018-07-10T17:35:14+02:00","date_accepted":"2018-07-10T17:35:14+02:00","date_published":"2019-02-28T21:31:47+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11923/galley/6373/download/"}]},{"pk":11518,"title":"Approach to the Diagnosis and Management of Subarachnoid Hemorrhage","subtitle":null,"abstract":"Headache is one of the most common reasons for presentation to the emergency department (ED), seen in up to 2% of patients.1 Most are benign, but it is imperative to understand and discern the life-threatening causes of headache when they present. Headache caused by a subarachnoid hemorrhage (SAH) from a ruptured aneurysm is one of the most deadly, with a median case-fatality of 27-44%.2 Fortunately, it is also rare, comprising only 1% of all headaches presenting to the ED.3 On initial presentation, the one-year mortality of untreated SAH is up to 65%.4 With appropriate diagnosis and treatment, mortality can be reduced to 18%.5 The implications are profound: Our careful assessment leading to the detection of a SAH as the cause of headache can significantly decrease our patients’ mortality. If this were an easy task, the 12% reported rate of missed diagnosis would not exist.6 We have multiple tools and strategies to evaluate the patient with severe headache and must understand the strengths and limitations of each tool. Herein we will describe the available strategies, as well as the ED management of the patient with SAH.","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":"Headache, subarachnoid hemorrhage, cat scan, emergency department"}],"section":"Medical Decision Making","is_remote":true,"remote_url":"https://escholarship.org/uc/item/50p8m76m","frozenauthors":[{"first_name":"Evie","middle_name":"","last_name":"Marcolini","name_suffix":"","institution":"University of Vermont Medical Center, Department of Emergency Medicine, Burlington, Vermont","department":"None"},{"first_name":"Jason","middle_name":"","last_name":"Hine","name_suffix":"","institution":"Tufts University School of Medicine, Department of Emergency Medicine, Boston, Massachusetts","department":"None"}],"date_submitted":"2017-12-20T00:40:50+01:00","date_accepted":"2017-12-20T00:40:50+01:00","date_published":"2019-02-28T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11518/galley/6214/download/"}]},{"pk":650,"title":"A Man with Severe Right Knee Pain","subtitle":null,"abstract":"N/A","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3cm3k46s","frozenauthors":[{"first_name":"Shinsuke","middle_name":"","last_name":"Takeda","name_suffix":"","institution":"Anjo Kosei Hospital, Emergency and Critical Care Center, Anjo, Japan; Anjo Kosei Hospital, Department of Orthopaedic Surgery, Anjo, Japan; Nagoya University Graduate School of Medicine, Department of Hand Surgery,\nNagoya, Japan","department":"None"},{"first_name":"Katsuyuki","middle_name":"","last_name":"Iwatsuki","name_suffix":"","institution":"Nagoya University Graduate School of Medicine, Department of Hand Surgery, Nagoya, Japan","department":"None"},{"first_name":"Yosuke","middle_name":"","last_name":"Takeichi","name_suffix":"","institution":"Anjo Kosei Hospital, Department of Orthopaedic Surgery, Anjo, Japan","department":"None"},{"first_name":"Tomohiro","middle_name":"","last_name":"Kano","name_suffix":"","institution":"Anjo Kosei Hospital, Department of Orthopaedic Surgery, Anjo, Japan","department":"None"},{"first_name":"Akihiko","middle_name":"","last_name":"Tabuchi","name_suffix":"","institution":"Anjo Kosei Hospital, Emergency and Critical Care Center, Anjo, Japan","department":"None"},{"first_name":"Hitoshi","middle_name":"","last_name":"Hirata","name_suffix":"","institution":"Nagoya University Graduate School of Medicine, Department of Hand Surgery, Nagoya, Japan","department":"None"}],"date_submitted":"2019-01-29T22:52:38+01:00","date_accepted":"2019-01-29T22:52:38+01:00","date_published":"2019-02-26T21:22:58+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/650/galley/410/download/"}]},{"pk":649,"title":"Ruptured Visceral Artery Aneurysms: A Deadly Cause of Epigastric Pain","subtitle":null,"abstract":"Visceral artery aneurysms (VAA) are rare, life-threatening disease processes that often affect the celiac, superior mesenteric, or inferior mesenteric arteries and their respective branches. The splenic, hepatic, superior mesenteric, and tripod celiac arteries are most commonly affected and have high rupture and mortality rates. This case describes splenic and celiac artery aneurysms ina patient that led to hemorrhagic shock and multisystem organ failure despite timely diagnosis and ligation. A brief review of the literature further elucidates the key risk factors in identifying patients with VAAs and their treatment course.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3jj101ft","frozenauthors":[{"first_name":"Sara","middle_name":"","last_name":"Bradley","name_suffix":"","institution":"Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, California","department":"None"},{"first_name":"Faith","middle_name":"","last_name":"Quenzer","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California","department":"None"},{"first_name":"Micah","middle_name":"","last_name":"Wittler","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California","department":"None"}],"date_submitted":"2019-01-29T22:24:07+01:00","date_accepted":"2019-01-29T22:24:07+01:00","date_published":"2019-02-26T21:22:14+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/649/galley/409/download/"}]},{"pk":648,"title":"Evans Syndrome","subtitle":null,"abstract":"A 22-year-old man presented to the emergency department with facial swelling, rash, and fatigue. Hehad a past medical history of pericarditis and pericardial effusion. His evaluation showed anemia and thrombocytopenia. He was admitted for intravenous administration of steroids, plasmapheresis, and workup of his anemia and thrombocytopenia. He was ultimately diagnosed with Evans syndrome as a presenting feature of systemic lupus erythematosus. Plasmapheresis was stopped but administration of steroids continued. His blood counts improved, and the facial swelling and rash subsided. Evans syndrome is an immunologic conundrum that requires early recognition and 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":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/63d4s1d9","frozenauthors":[{"first_name":"Ahmed","middle_name":"","last_name":"Al Hazmi","name_suffix":"","institution":"University of Maryland Medical Center, Department of Emergency Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Michael","middle_name":"E.","last_name":"Winters","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland","department":"None"}],"date_submitted":"2019-01-29T22:18:57+01:00","date_accepted":"2019-01-29T22:18:57+01:00","date_published":"2019-02-26T21:21:26+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/648/galley/408/download/"}]},{"pk":646,"title":"Anterior Loculated Pericardial Effusion Misinterpreted as Right Heart Dilation Suggesting Pulmonary Embolism","subtitle":null,"abstract":"We report a case of anterior loculated pericardial effusion misinterpreted on point-of-care ultrasound as a dilated right ventricle, and suggesting diagnosis of pulmonary embolism (PE), in a patient with renal failure. The compressed right ventricle from tamponade physiology appeared to be a thickened intraventricular septum. Heparin was given empirically for presumed PE. Later the same day, computed tomography of the chest showed the effusion, as did formal echocardiogram. The patient had drainage of 630 milliliters of fluid and recovered from tamponade. Loculated effusions comprise 15% of all pericardial effusions, and misdiagnosis of PE with heparin therapy could be fatal.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0hc5q6nz","frozenauthors":[{"first_name":"Sari","middle_name":"","last_name":"Lahham","name_suffix":"","institution":"University of California, Irvine, Department of Emergency Medicine, Orange","department":"None"},{"first_name":"Emily","middle_name":"","last_name":"Frisch","name_suffix":"","institution":"University of California, Irvine, Department of Emergency Medicine, Orange","department":"None"},{"first_name":"Mark","middle_name":"","last_name":"Langdorf","name_suffix":"","institution":"University of California, Irvine, Department of Emergency Medicine, Orange","department":"None"}],"date_submitted":"2019-01-29T22:10:45+01:00","date_accepted":"2019-01-29T22:10:45+01:00","date_published":"2019-02-26T21:20:48+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/646/galley/406/download/"}]},{"pk":643,"title":"Emergency Physician Reduction of Pediatric Hip Dislocation","subtitle":null,"abstract":"Traumatic hip dislocation in children is relatively rare but presents a true emergency, as a delay in reduction can result in avascular necrosis of the femoral head and long-term morbidity. After sustaining a traumatic posterolateral hip dislocation, a seven-year-old boy presented to an outside facility where no attempt was made at reduction. The patient was transferred to our emergency department (ED) where he was promptly sedated and the dislocation was reduced in a timely manner. Emergency physicians have demonstrated high success rates with dislocation reduction. ED reduction should occur immediately to reduce the likelihood of long-term complications. While timely consultation with a pediatric orthopedist is recommended, that should not delay reduction. The reduction should ideally be performed before the patient leaves the department or is transferred to another facility.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/24t7p7g4","frozenauthors":[{"first_name":"Seth","middle_name":"","last_name":"Capehart","name_suffix":"","institution":"West Virginia University School of Medicine, Morgantown, West Virginia","department":"None"},{"first_name":"Brenden","middle_name":"J.","last_name":"Balcik","name_suffix":"","institution":"West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia","department":"None"},{"first_name":"Rosanna","middle_name":"","last_name":"Sikora","name_suffix":"","institution":"West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia","department":"None"},{"first_name":"Melinda","middle_name":"","last_name":"Sharon","name_suffix":"","institution":"West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia","department":"None"},{"first_name":"Joseph","middle_name":"","last_name":"Minardi","name_suffix":"","institution":"West Virginia University School of Medicine, Department of Emergency Medicine, Morgantown, West Virginia; West Virginia University School of Medicine, Department of Medical Education, Morgantown, West Virginia","department":"None"}],"date_submitted":"2019-01-23T04:32:22+01:00","date_accepted":"2019-01-23T04:32:22+01:00","date_published":"2019-02-26T21:20:06+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/643/galley/403/download/"}]},{"pk":644,"title":"Aortic Dissection with Subsequent Hemorrhagic Tamponade Diagnosed with Point-of-care Ultrasound in a Patient Presenting with STEMI","subtitle":null,"abstract":"A 58-year-old male with no past medical history presented to the emergency department with sudden onset left lower extremity weakness and central chest pain with radiation to his back. Electrocardiogram revealed an acute inferior and posterior ST-segment elevation myocardial infarction(STEMI). Point-of-care ultrasound (POCUS) demonstrated right ventricular akinesis consistent with infarction, and an intimal defect consistent with an aortic dissection. We determined that cardiothoracic surgery was indicated rather than left-heart catheterization and anticoagulation. Using POCUS we were able to immediately diagnose a dissection of the aortic arch and considerably alter treatment in a patient presenting with STEMI.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/28q995kw","frozenauthors":[{"first_name":"Eric","middle_name":"","last_name":"Abrams","name_suffix":"","institution":"University of California, Irvine, Department of Emergency Medicine, Orange, California","department":"None"},{"first_name":"Angela","middle_name":"","last_name":"Allen","name_suffix":"","institution":"University of California, Irvine, School of Medicine, Irvine, California","department":"None"},{"first_name":"Shadi","middle_name":"","last_name":"Lahham","name_suffix":"","institution":"University of California, Irvine, Department of Emergency Medicine, Orange, California","department":"None"}],"date_submitted":"2019-01-23T04:33:36+01:00","date_accepted":"2019-01-23T04:33:36+01:00","date_published":"2019-02-26T21:19:17+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/644/galley/404/download/"}]},{"pk":642,"title":"De Garengeot Hernia Diagnosed with Point-of-care Ultrasound","subtitle":null,"abstract":"De Garengeot hernias, defined as a femoral hernia containing the appendix, are rare. It is even uncommon to have an incarcerated de Garengeot hernia with associated acute appendicitis. We report a case of a 76-year-old female presenting to the emergency department for a right lower quadrant abdominal mass for four days. Physical exam was consistent with an incarcerated hernia. A point-of-care ultrasound revealed a non-compressible, blind-ended loop of bowel within the hernia sac, concerning for acute appendicitis within the mass. Computed tomography of the abdomen and pelvis confirmed the diagnosis of acute appendicitis within a femoral hernia.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4jr9918s","frozenauthors":[{"first_name":"Lindsey","middle_name":"","last_name":"Jennings","name_suffix":"","institution":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina","department":"None"},{"first_name":"Brad","middle_name":"","last_name":"Presley","name_suffix":"","institution":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina","department":"None"},{"first_name":"Edward","middle_name":"","last_name":"Jauch","name_suffix":"","institution":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina","department":"None"}],"date_submitted":"2019-01-23T04:29:51+01:00","date_accepted":"2019-01-23T04:29:51+01:00","date_published":"2019-02-26T21:09:50+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/642/galley/402/download/"}]},{"pk":641,"title":"Atypical Fungal Rash","subtitle":null,"abstract":"N/A","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2vs4998z","frozenauthors":[{"first_name":"Fadi","middle_name":"W.M.","last_name":"Adel","name_suffix":"","institution":"Mayo Clinic, Department of Internal Medicine, Rochester, Minnesota","department":"None"},{"first_name":"Venkatesh","middle_name":"","last_name":"Bellamkonda","name_suffix":"","institution":"Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota","department":"None"}],"date_submitted":"2019-01-23T04:27:23+01:00","date_accepted":"2019-01-23T04:27:23+01:00","date_published":"2019-02-26T21:08:24+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/641/galley/401/download/"}]},{"pk":633,"title":"A Desquamating Skin Rash in a Pediatric Patient","subtitle":null,"abstract":"Prompt identification and treatment of true dermatologic emergencies is essential in emergency medicine, especially in vulnerable populations such as pediatric patients. This is a case of a three year-old female who presented with significant dehydration in the setting of a desquamating skin rash diagnosed in our emergency department as staphylococcal scalded skin syndrome.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6fd1c1j2","frozenauthors":[{"first_name":"John","middle_name":"","last_name":"Haggerty","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":"2019-01-08T22:02:42+01:00","date_accepted":"2019-01-08T22:02:42+01:00","date_published":"2019-02-26T21:06:52+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/633/galley/393/download/"}]},{"pk":637,"title":"Apparent Pacer Spikes in a Patient with Back and Chest Pain","subtitle":null,"abstract":"N/A","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1rg346c1","frozenauthors":[{"first_name":"Al","middle_name":"","last_name":"Lulla","name_suffix":"","institution":"Washington University School of Medicine, Division of Emergency Medicine, St.\nLouis, Missouri","department":"None"},{"first_name":"Richard","middle_name":"T.","last_name":"Griffey","name_suffix":"","institution":"Washington University School of Medicine, Division of Emergency Medicine, St.\nLouis, Missouri","department":"None"}],"date_submitted":"2019-01-08T22:15:51+01:00","date_accepted":"2019-01-08T22:15:51+01:00","date_published":"2019-02-26T21:05:39+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/637/galley/397/download/"}]},{"pk":640,"title":"Early Diagnosis of Heterotopic Pregnancy in a Primigravid Without Risk Factors in the Emergency Department","subtitle":null,"abstract":"N/A","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/54h2k0gz","frozenauthors":[{"first_name":"Rachel","middle_name":"","last_name":"O'Donnell","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"Elizabeth","middle_name":"","last_name":"Siacunco","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"Daniel","middle_name":"","last_name":"Quesada","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California; LAC+USC Medical Center, Los Angeles, California","department":"None"},{"first_name":"Kieron","middle_name":"","last_name":"Barkataki","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California; UCLA Health Sciences, Department of Emergency Medicine, Bakersfield, California","department":"None"},{"first_name":"Phillip","middle_name":"","last_name":"Aguìñiga-Navarrete","name_suffix":"","institution":"Kern Medical, Department of Emergency Medicine, Bakersfield, California","department":"None"}],"date_submitted":"2019-01-08T22:23:34+01:00","date_accepted":"2019-01-08T22:23:34+01:00","date_published":"2019-02-26T20:58:04+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/640/galley/400/download/"}]},{"pk":612,"title":"Pediatric Ingestion of Multiple Button Batteries","subtitle":null,"abstract":"N/A","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7w65p5jn","frozenauthors":[{"first_name":"Johnny","middle_name":"","last_name":"Fong","name_suffix":"","institution":"University of Nevada, Las Vegas School of Medicine, University Medical Center of Southern Nevada, Department of Emergency Medicine, Las Vegas, Nevada","department":"None"},{"first_name":"Tony","middle_name":"","last_name":"Zitek","name_suffix":"","institution":"University of Nevada, Las Vegas School of Medicine, University Medical Center of Southern Nevada, Department of Emergency Medicine, Las Vegas, Nevada; Kendall Regional Medical Center, Department of Emergency Medicine, Miami, Florida.","department":"None"}],"date_submitted":"2018-11-16T01:05:52+01:00","date_accepted":"2018-11-16T01:05:52+01:00","date_published":"2019-02-20T23:26:59+01:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/612/galley/372/download/"}]},{"pk":11828,"title":"A Research Agenda for Assessment and Management of Psychosis in Emergency Department Patients","subtitle":null,"abstract":"Introduction:\n Emergency departments (ED) manage a wide variety of critical medical presentations. Traumatic, neurologic, and cardiac crises are among the most prevalent types of emergencies treated in an ED setting. The high volume of presentations has led to collaborative partnerships in research and process development between experts in emergency medicine (EM) and other disciplines. While psychosis is a medical emergency frequently treated in the ED, there remains a paucity of evidence-based literature highlighting best practices for management of psychotic presentations in the ED. In the absence of collaborative research, development of best practice guidelines cannot begin. A working group convened to develop a set of high-priority research questions to address the knowledge gaps in the care of psychotic patients in the ED. This article is the product of a subgroup considering “Special Populations: Psychotic Spectrum Disorders,” from the 2016 Coalition on Psychiatric Emergencies first Research Consensus Conference on Acute Mental Illness.\nMethods: \nParticipants were identified with expertise in psychosis from EM, emergency psychiatry, emergency psychology, clinical research, governmental agencies, and patient advocacy groups. Background literature reviews were performed prior to the in-person meeting. A nominal group technique was employed to develop group consensus on the highest priority research gaps. Following the nominal group technique, input was solicited from all participants during the meeting, questions were iteratively focused and revised, voted on, and then ranked by importance.\nResults:\n The group developed 28 separate questions. After clarification and voting, the group identified six high-priority research areas. These questions signify the perceived gaps in psychosis research in emergency settings. Questions were further grouped into two topic areas: screening and identification; and intervention and management strategies.\nConclusion:\n While psychosis has become a more common presentation in the ED, standardized screening, intervention, and outcome measurement for psychosis has not moved beyond attention to agitation management. As improved outpatient-intervention protocols are developed for treatment of psychosis, it is imperative that parallel protocols are developed for delivery in the ED setting.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Mental Health"},{"word":"psychosis"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7qh1b1r8","frozenauthors":[{"first_name":"Jennifer","middle_name":"","last_name":"Peltzer-Jones","name_suffix":"","institution":"Henry Ford Health System, Department of Emergency Medicine, Detroit, Michigan","department":"None"},{"first_name":"Kimberly","middle_name":"","last_name":"Nordstrom","name_suffix":"","institution":"University of Colorado School of Medicine, Department of Psychiatry, Denver, Colorado","department":"None"},{"first_name":"Glenn","middle_name":"","last_name":"Currier","name_suffix":"","institution":"University of South Florida, Morsani College of Medicine, Department of Psychiatry, Tampa, Florida","department":"None"},{"first_name":"Jon","middle_name":"S.","last_name":"Berlin","name_suffix":"","institution":"Medical College of Wisconsin, Department of Psychiatry and Behavioral Medicine, Department of Emergency Medicine, Milwaukee, Wisconsin","department":"None"},{"first_name":"Cynthia","middle_name":"","last_name":"Singh","name_suffix":"","institution":"American College of Emergency Physicians, Irving, Texas","department":"None"},{"first_name":"Sandra","middle_name":"","last_name":"Schneider","name_suffix":"","institution":"American College of Emergency Physicians, Irving, Texas; John Peter Smith Hospital, Department of Emergency Medicine, Fort Worth, Texas; Hofstra Northwell School of Medicine, Hempstead, New York","department":"None"}],"date_submitted":"2018-06-05T01:48:40+02:00","date_accepted":"2018-06-05T01:48:40+02:00","date_published":"2019-02-19T19:47:19+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11828/galley/6333/download/"}]},{"pk":11827,"title":"A Research Agenda for the Assessment and Management of Acute Behavioral Changes in Elderly Emergency Department Patients","subtitle":null,"abstract":"Introduction: \nAgitation, mental illness, and delirium are common reasons for older adults to seek care in the emergency department (ED). There are significant knowledge gaps in understanding how to best screen older adults for these conditions and how to manage them. In addition, in areas where research has been performed, implementation has been slow. A working group convened to develop a set of high-priority research questions that would advance the understanding of optimal management of older adults with acute behavioral changes in the ED. This manuscript is the product of a breakout session on “Special Populations: Agitation in the Elderly” from the 2016 Coalition on Psychiatric Emergencies’ first Research Consensus Conference on Acute Mental Illness.\nMethods:\n Participants were identified with expertise in emergency medicine (EM), geriatric EM, and psychiatry. Background literature reviews were performed prior to the in-person meeting in four key areas: delirium; dementia; substance abuse or withdrawal; and mental illness in older adults. Input was solicited from all participants during the meeting, and questions were iteratively focused and revised, voted on, and ranked by importance.\nResults:\n Fourteen questions were identified by the group with high consensus for their importance related to the care of older adults with agitation in the ED. The questions were grouped into three topic areas: screening and identification; management strategies; and the approach to delirium. \nConclusion:\n It is important for emergency physicians to recognize the spectrum of underlying causes of behavioral changes, have the tools to screen older adults for those causes, and employ methods to treat the underlying causes and ameliorate their symptoms. Answers to the identified research questions have great potential to improve the care of older adults presenting with behavioral changes.","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":"Mental Health"},{"word":"Geriatrics"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6k81t1bm","frozenauthors":[{"first_name":"Christina","middle_name":"","last_name":"Shenvi","name_suffix":"","institution":"University of North Carolina, Department of Emergency Medicine, Chapel Hill, North Carolina","department":"None"},{"first_name":"Michael","middle_name":"P.","last_name":"Wilson","name_suffix":"","institution":"University of Arkansas for Medical Sciences, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"},{"first_name":"Alessandra","middle_name":"","last_name":"Aldai","name_suffix":"","institution":"University of California, San Diego Medical Center, Department of Emergency Medicine San Diego, California","department":"None"},{"first_name":"David","middle_name":"","last_name":"Pepper","name_suffix":"","institution":"Hartford Hospital/Institute of Living, Department of Psychiatry, Hartford, Connecticut","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Gerardi","name_suffix":"","institution":"Morristown Medical Center, Department of Emergency Medicine, Morristown, New Jersey","department":"None"}],"date_submitted":"2018-06-05T01:45:08+02:00","date_accepted":"2018-06-05T01:45:08+02:00","date_published":"2019-02-19T19:36:24+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11827/galley/6332/download/"}]},{"pk":11826,"title":"Emergency Medicine Research Priorities for Early Intervention for Substance Use Disorders","subtitle":null,"abstract":"Introduction: \nPatients with substance use disorders (SUDs) frequently seek emergency care, and the emergency department (ED) may be their only point of contact with the healthcare system. While the ED visit has been increasingly recognized as providing opportunity for interventions around substance use, many questions remain. \nMethods:\n In December 2016 the Coalition on Psychiatric Emergencies (CPE) convened the first Research Consensus Conference on Acute Mental Illness, which consisted of clinical researchers, clinicians from emergency medicine, emergency psychiatry, emergency psychology, representatives from governmental agencies and patient advocacy groups. Background literature review was conducted prior to the meeting, and questions were iteratively focused, revised, voted on and ranked by perceived importance using nominal group method. \nResults:\n The main goal of the SUD workgroup was to identify research priorities and develop a research agenda to improve the early identification of and management of emergency department (ED) patients with SUDs with the goal of improving outcomes. This article is the product of a breakout session on “Special Populations: Substance Use Disorder.” The workgroup identified with high consensus six research priorities for their importance related to the care of ED patients with SUDs in these overall domains: screening; ED interventions; the role of peer navigators; initiation of SUD management in the ED; specific patient populations that may impact the effectiveness of interventions including sociogenerational and cultural factors; and the management of the acutely intoxicated patient.\nConclusion:\n Emergency providers are increasingly recognizing the important role of the ED in reducing adverse outcomes associated with untreated SUDs. Additional research is required to close identified knowledge gaps and improve care of ED patients with SUD.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Substance use"},{"word":"Mental Health"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2806d7kc","frozenauthors":[{"first_name":"Kathryn","middle_name":"F.","last_name":"Hawk","name_suffix":"","institution":"Yale University, Department of Emergency Medicine, New Haven, Connecticut","department":"None"},{"first_name":"Rachel","middle_name":"L.","last_name":"Glick","name_suffix":"","institution":"University of Michigan, Department of Psychiatry, Ann Arbor, Michigan","department":"None"},{"first_name":"Aurthur","middle_name":"R.","last_name":"Jey","name_suffix":"","institution":"Sutter Medical Center, Department of Emergency Medicine, Sacramento, California","department":"None"},{"first_name":"Sydney","middle_name":"","last_name":"Gaylor","name_suffix":"","institution":"University of California- San Diego, Department of Emergency Medicine, San Diego, California","department":"None"},{"first_name":"Jamie","middle_name":"","last_name":"Doucet","name_suffix":"","institution":"Rosalind Franklin University, Chicago, Illinois","department":"None"},{"first_name":"Michael","middle_name":"P.","last_name":"Wilson","name_suffix":"","institution":"University of Arkansas for Medical Sciences, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"},{"first_name":"John","middle_name":"S.","last_name":"Rozel","name_suffix":"","institution":"University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania","department":"None"}],"date_submitted":"2018-06-05T01:41:27+02:00","date_accepted":"2018-06-05T01:41:27+02:00","date_published":"2019-02-19T19:26:25+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11826/galley/6331/download/"}]},{"pk":11825,"title":"Opportunities for Research in Mental Health Emergencies: Executive Summary and Methodology","subtitle":null,"abstract":"Introduction:\n Despite the ever-increasing numbers of mental health patients presenting to United States emergency departments, there are large gaps in knowledge about acute care of the behavioral health patient. To address this important problem, the Coalition on Psychiatric Emergencies convened a research consensus conference in December 2016 consisting of clinical researchers, clinicians from emergency medicine, psychiatry and psychology, and representatives from governmental agencies and patient advocacy groups.\n \nMethods: \nParticipants used a standardized methodology to select and rank research questions in the order of importance to both researchers and patients.\nResults:\n Three working groups (geriatrics, substance use disorders, and psychosis) reached consensus on 26 questions within their respective domains. These questions are summarized in this document.\nConclusion:\n The research consensus conference is the first of its kind to include non-clinicians in helping identify knowledge gaps in behavioral emergencies. It is hoped that these questions will prove useful to prioritize future research within the specialty.","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":"Mental Health"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/19r336nj","frozenauthors":[{"first_name":"Michael","middle_name":"P.","last_name":"Wilson","name_suffix":"","institution":"University of Arkansas for Medical Sciences, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"},{"first_name":"Christina","middle_name":"","last_name":"Shenvi","name_suffix":"","institution":"University of North Carolina, Department of Emergency Medicine, Chapel Hill, North Carolina","department":"None"},{"first_name":"Loren","middle_name":"","last_name":"Rives","name_suffix":"","institution":"American College of Emergency Physicians, Irving, Texas","department":"None"},{"first_name":"Kimberly","middle_name":"","last_name":"Nordstrom","name_suffix":"","institution":"University of Colorado School of Medicine, Department of Psychiatry, Denver, Colorado","department":"None"},{"first_name":"Sandra","middle_name":"","last_name":"Schneider","name_suffix":"","institution":"American College of Emergency Physicians, Irving, Texas; John Peter Smith Hospital, Department of Emergency Medicine, Fort Worth, Texas; Hofstra Northwell School of Medicine, Hempstead, New York","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Gerardi","name_suffix":"","institution":"Morristown Memorial Hospital, Morristown, New Jersey","department":"None"}],"date_submitted":"2018-06-05T01:35:54+02:00","date_accepted":"2018-06-05T01:35:54+02:00","date_published":"2019-02-19T19:21:44+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11825/galley/6330/download/"}]},{"pk":12277,"title":"Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry","subtitle":null,"abstract":"Introduction:\n Agitation in children and adolescents in the emergency department (ED) can be dangerous and distressing for patients, family and staff. We present consensus guidelines for management of agitation among pediatric patients in the ED, including non-pharmacologic methods and the use of immediate and as-needed medications.\n \nMethods: \nUsing the Delphi method of consensus, a workgroup comprised of 17 experts in emergency child and adolescent psychiatry and psychopharmacology from the the American Association for Emergency Psychiatry and the American Academy of Child and Adolescent Psychiatry Emergency Child Psychiatry Committee sought to create consensus guidelines for the management of acute agitation in children and adolescents in the ED.\nResults:\n Consensus found that there should be a multimodal approach to managing agitation in the ED, and that etiology of agitation should drive choice of treatment. We describe general and specific recommendations for medication use.\n \nConclusion:\n These guidelines describing child and adolescent psychiatry expert consensus for the management of agitation in the ED may be of use to pediatricians and emergency physicians who are without immediate access to psychiatry consultation.","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":"Pediatrics, Agitation, Emergency Department, Management"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9253b2hz","frozenauthors":[{"first_name":"Ruth","middle_name":"","last_name":"Gerson","name_suffix":"","institution":"Bellevue Hospital/New York University, Department of Psychiatry, New York, New York","department":"None"},{"first_name":"Nasuh","middle_name":"","last_name":"Malas","name_suffix":"","institution":"University of Michigan, Departments of Psychiatry and Pediatrics, Ann Arbor, Michigan","department":"None"},{"first_name":"Vera","middle_name":"","last_name":"Feuer","name_suffix":"","institution":"Northwell Health, Department of Psychiatry, New Hyde Park, New York","department":"None"},{"first_name":"Gabrielle","middle_name":"H.","last_name":"Silver","name_suffix":"","institution":"Weill Cornell Medical College, Department of Psychiatry, New York, New York","department":"None"},{"first_name":"Raghuram","middle_name":"","last_name":"Prasad","name_suffix":"","institution":"Children’s Hospital of Philadelphia, Department of Psychiatry, Philadelphia, Pennsylvania","department":"None"},{"first_name":"Megan","middle_name":"M.","last_name":"Mroczkowski","name_suffix":"","institution":"Columbia University Medical Center","department":"None"}],"date_submitted":"2018-10-21T21:34:45+02:00","date_accepted":"2018-10-21T21:34:45+02:00","date_published":"2019-02-19T19:15:49+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12277/galley/6551/download/"}]},{"pk":40731,"title":"Bringing the Empire Home: Italian Fascism’s Mediterranean Tour of Rhodes","subtitle":null,"abstract":"From 1912 until World War II, Italy occupied Rhodes and thirteen other islands in the Southeast Aegean as part of its territorial expansion. In comparison with Italian colonies in Africa the islands have received significantly less historical and critical attention. This article brings the Southeast Aegean into the light and into dialogue with ongoing debates about Italy’s colonial past. I argue that the islands offer an important lens onto the relationship between overseas expansion and the remaking of Italian national identity at home. The essay reconstructs a massive project to reinvent the port of Rhodes as an upscale resort town of cultural attraction for Italian and European tourists. It describes how the urban renovation of Rhodes was marked simultaneously by the desire to modernize the island and by the desire to preserve, embellish and celebrate the exotic setting of the island. Analyzing architecture, urban planning, touring propaganda, and representations of the local community in photography and film, the article illuminates Italian fantasies of recuperating cosmopolitan histories through Mediterranean colonial tourism. At the same time, these fantasies evolved over time. The articles tracks an unresolvable ambivalence about whether the islands were “Western” or “Eastern”—part of  metropolitan Italy or part of its overseas expansion—and its ideological challenge to the Fascist ideas about nation and race.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Colonialism, Postcolonialism, Italy, Mediterranean, Aegean, Rhodes"}],"section":"Italian Culture: Transnational Perspectives","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9kd9m5tk","frozenauthors":[{"first_name":"Valerie","middle_name":"","last_name":"McGuire","name_suffix":"","institution":"UC Berkeley","department":"None"}],"date_submitted":"2018-04-22T03:50:53+02:00","date_accepted":"2018-04-22T03:50:53+02:00","date_published":"2019-02-17T16:47:11+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40731/galley/30542/download/"}]},{"pk":40790,"title":"40 Italian Poets on Their Ends","subtitle":null,"abstract":"","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"FORTY ITALIAN POETS ON THEIR ENDS","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8k730054","frozenauthors":[{"first_name":"Aa.","middle_name":"","last_name":"Vv.","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2019-02-16T17:29:57+01:00","date_accepted":"2019-02-16T17:29:57+01:00","date_published":"2019-02-16T17:32:14+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40790/galley/30567/download/"}]},{"pk":40789,"title":"Poetry, Between Alpha and Omega","subtitle":null,"abstract":"","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"∞","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7sz3j2r6","frozenauthors":[{"first_name":"Thomas","middle_name":"","last_name":"Harrison","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2019-02-16T17:09:33+01:00","date_accepted":"2019-02-16T17:09:33+01:00","date_published":"2019-02-16T17:11:06+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40789/galley/30566/download/"}]},{"pk":39499,"title":"Do generations differ when it comes  to green values and products?","subtitle":null,"abstract":"Purpose: This study investigates the environmental beliefs of three generations to discover whether their stated beliefs match their actions in regards to green purchases.\n \nDesign/methodology/approach: 1,215 participants across three generations (Millennials, Generation Xers, and Baby Boomers) answered survey questions regarding their environmental beliefs and were assigned a \"Green\" score. They also answered questions regarding the types and quantities of past green purchases. Analyses were performed to determine if there were statically significant differences among the generations.\n \nFindings: Baby Boomers were the most environmentally friendly generation. However, there was no statistically significant difference in the types of items purchased by the three generations, and Baby Boomers only slightly outpaced the other two generations in the quantity of green items purchased.\n \nResearch limitations/implications:\n \nMarketers can use this research to market environmentally friendly products differently to the three generations.\n \nOriginality/value:\n \nThis research expands on existing work in the areas of generational cohorts and green products.\n \nKeywords:\n generational cohorts, green products, GREEN Consumer Values Scale\n Paper type: Research paper","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"green marketing, generations"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6f91213q","frozenauthors":[{"first_name":"Scot","middle_name":"","last_name":"Squires","name_suffix":"","institution":"Ferris State University","department":"None"}],"date_submitted":"2018-06-20T03:30:53+02:00","date_accepted":"2018-06-20T03:30:53+02:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39499/galley/29813/download/"}]},{"pk":39483,"title":"Eco-labels: A tool for green marketing or just a blind mirror for consumers","subtitle":null,"abstract":"Studies show that greening the business is not only helpful in getting the green products to the consumers, which may be better for their health and environment, but it also helps the business as a kind of strategy for enjoying a competitive advantage and strengthening brand image. Green marketing practices are now days gaining wide acceptance among various marketing practices. Green marketing is the set of marketing activities which start from the procurement of the product to the delivery of the product to the end user in a greener way. On the other hand, eco-labeling is one of the important tools for the green marketing as it helps to differentiate the green products from non-green products. But it has been seen that many times these eco-labels fail to attain their objectives. The objective of this paper is to establish a relationship of eco-labels with consumer knowledge, information communication, consumer trust and its impact on green purchase intention. Further, all these relationships have been verified with the help of structural equation modeling (SEM), performed by using SmartPLS 3.0. The study reveals that eco-labeling is a significant criterion for consumer trust and green purchase intention via consumer information and knowledge.","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":"Eco-labels"},{"word":"Green marketing, Environment"},{"word":"Consumer knowledge"},{"word":"Green Purchase Intention."}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6k83s5mv","frozenauthors":[{"first_name":"Nagendra","middle_name":"Kumar","last_name":"Sharma","name_suffix":"","institution":"Assistant Professor, Faculty of Management Studies, Shri Ram Murti Smarak College of Engineering and Technology, Bareilly, Uttar Pradesh, India.","department":"None"},{"first_name":"Gyaneshwar","middle_name":"Singh","last_name":"Kushwaha","name_suffix":"","institution":"Assistant Professor, Department of Management Studies, Maulana Azad National Institute of Technology, Bhopal,India","department":"None"}],"date_submitted":"2017-01-24T09:18:42+01:00","date_accepted":"2017-01-24T09:18:42+01:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39483/galley/29801/download/"}]},{"pk":39493,"title":"Learning from Greenpeace: Activist Habitus in a Local Struggle","subtitle":null,"abstract":"This paper traces the onto-genesis of a specific environmental campaign in Indonesia. A highly effective struggle to save the local city forest was instigated by young activists in Bandung who had previously been involved with Greenpeace Indonesia. The data comes from interviews, a focus group and ethnographic fieldwork. The paper illustrates the point that when youth get involved in a highly structured environmental protest movement like Greenpeace, the skills, network resources and confidence they gain there can later be deployed to great advantage in a local conservation campaign. That phenomenon can be understood using the notion of radical habitus derived from the theoretical work of Pierre Bourdieu.\n \n \n \nKeywords:\n \nyouth, activism, radical habitus, Greenpeace","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":"youth, activism, radical habitus, Greenpeace"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/41s879p5","frozenauthors":[{"first_name":"Meredian","middle_name":"","last_name":"Alam","name_suffix":"","institution":"School of Humanities and Social Sciences, University of Newcastle, Callaghan NSW 2308.","department":"None"},{"first_name":"Pam","middle_name":"","last_name":"Nilan","name_suffix":"","institution":"School of Humanities and Social Sciences, University of Newcastle, Callaghan NSW 2308. \nPhone: +61249215912","department":"None"},{"first_name":"Terry","middle_name":"","last_name":"Leahy","name_suffix":"","institution":"School of Humanities and Social Sciences, University of Newcastle, Callaghan NSW 2308. \nPhone: +61419418841","department":"None"}],"date_submitted":"2018-02-09T03:37:29+01:00","date_accepted":"2018-02-09T03:37:29+01:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39493/galley/29807/download/"}]},{"pk":39506,"title":"Review: A Hole in the Wind: A Climate Scientist’s Bicycle Journey Across the United States","subtitle":null,"abstract":"Review","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/09p7p1n4","frozenauthors":[{"first_name":"Lia","middle_name":"","last_name":"Vella","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2018-10-27T00:16:22+02:00","date_accepted":"2018-10-27T00:16:22+02:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39506/galley/29818/download/"}]},{"pk":39508,"title":"Review: A Primer for Teaching Environmental History: Ten Design Principles","subtitle":null,"abstract":"Review","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2dc431j7","frozenauthors":[{"first_name":"Abbey","middle_name":"","last_name":"Lewis","name_suffix":"","institution":"University of Colorado Boulder","department":"None"}],"date_submitted":"2018-10-27T00:19:20+02:00","date_accepted":"2018-10-27T00:19:20+02:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39508/galley/29820/download/"}]},{"pk":39509,"title":"REVIEW: Beasts at Bedtime: Revealing the Environmental Wisdom in Children’s Literature","subtitle":null,"abstract":"Review","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6cc882v6","frozenauthors":[{"first_name":"Yves","middle_name":"","last_name":"Laberge","name_suffix":"","institution":"University of Ottowa","department":"None"}],"date_submitted":"2018-11-09T21:50:45+01:00","date_accepted":"2018-11-09T21:50:45+01:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39509/galley/29821/download/"}]},{"pk":39503,"title":"Review: Creating a Transformational Community, The Fundamentals of Stewardship Activities","subtitle":null,"abstract":"Review: C\nreating a Transformational Community, The Fundamentals of Stewardship Activities","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1j19h6c5","frozenauthors":[{"first_name":"Ryder","middle_name":"","last_name":"Miller","name_suffix":"","institution":"New York, NY","department":"None"}],"date_submitted":"2018-09-23T21:31:19+02:00","date_accepted":"2018-09-23T21:31:19+02:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39503/galley/29815/download/"}]},{"pk":39504,"title":"Review:  Energy and Civilization: A History","subtitle":null,"abstract":"Review:  \nEnergy and Civilization: A History","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8bq7q0tz","frozenauthors":[{"first_name":"Byron","middle_name":"","last_name":"Anderson","name_suffix":"","institution":"Retired/Northern Illinois University","department":"None"}],"date_submitted":"2018-09-23T21:39:50+02:00","date_accepted":"2018-09-23T21:39:50+02:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39504/galley/29816/download/"}]},{"pk":39502,"title":"Review: Grassroots to Global","subtitle":null,"abstract":"Book review","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7nz8r22f","frozenauthors":[{"first_name":"Byron","middle_name":"P.","last_name":"Anderson","name_suffix":"","institution":"Retired/Northern Illinois University","department":"None"}],"date_submitted":"2018-09-22T16:48:40+02:00","date_accepted":"2018-09-22T16:48:40+02:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39502/galley/29814/download/"}]},{"pk":39512,"title":"Review: Handbook of Gentrification Studies","subtitle":null,"abstract":"Review","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4n83j234","frozenauthors":[{"first_name":"Yves","middle_name":"","last_name":"Laberge","name_suffix":"","institution":"University of Ottawa","department":"None"}],"date_submitted":"2018-11-21T23:46:17+01:00","date_accepted":"2018-11-21T23:46:17+01:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39512/galley/29824/download/"}]},{"pk":39505,"title":"Review:  Nature’s Allies: Eight Conservationists Who Changed Our World","subtitle":null,"abstract":"Review","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0j62b756","frozenauthors":[{"first_name":"Byron","middle_name":"","last_name":"Anderson","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2018-10-27T00:13:26+02:00","date_accepted":"2018-10-27T00:13:26+02:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39505/galley/29817/download/"}]},{"pk":39511,"title":"Review: Recomposing Ecopoetics: North American Poetry of the Self-Conscious Anthropocene","subtitle":null,"abstract":"Review","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7wf4x96r","frozenauthors":[{"first_name":"Daniel","middle_name":"S.","last_name":"Helman","name_suffix":"","institution":"Ton Duc Thang University","department":"None"}],"date_submitted":"2018-11-21T18:59:11+01:00","date_accepted":"2018-11-21T18:59:11+01:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39511/galley/29823/download/"}]},{"pk":39513,"title":"Review: Should We Control World Population?","subtitle":null,"abstract":"Review","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8j64v801","frozenauthors":[{"first_name":"Yves","middle_name":"","last_name":"Laberge","name_suffix":"","institution":"University of Ottawa","department":"None"}],"date_submitted":"2018-11-21T23:52:22+01:00","date_accepted":"2018-11-21T23:52:22+01:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39513/galley/29825/download/"}]},{"pk":39510,"title":"Review: Sustainabilty","subtitle":null,"abstract":"Review","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4w2993h3","frozenauthors":[{"first_name":"Yves","middle_name":"","last_name":"Laberge","name_suffix":"","institution":"University of Ottowa","department":"None"}],"date_submitted":"2018-11-10T23:54:56+01:00","date_accepted":"2018-11-10T23:54:56+01:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39510/galley/29822/download/"}]},{"pk":39515,"title":"Review: The Great Acceleration – An Environmental History of the Anthropocene since 1945","subtitle":null,"abstract":"Despite my criticisms, I would recommend this book for anyone who needs a short introduction to the Great Acceleration, the escalation of human impacts on the “Earth system” since 1945.","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":"The Great Acceleration"},{"word":"Anthropocene, Environmental History"}],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5f05v4zj","frozenauthors":[{"first_name":"Jan","middle_name":"","last_name":"Kunnas","name_suffix":"","institution":"Independent scholar","department":"None"}],"date_submitted":"2018-12-29T12:24:41+01:00","date_accepted":"2018-12-29T12:24:41+01:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39515/galley/29826/download/"}]},{"pk":39507,"title":"Review: Watering the Revolution: An Environmental and Technological History of Agrarian Reform in Mexico","subtitle":null,"abstract":"Review","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8zk3c1jw","frozenauthors":[{"first_name":"Lia","middle_name":"","last_name":"Vella","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2018-10-27T00:18:03+02:00","date_accepted":"2018-10-27T00:18:03+02:00","date_published":"2019-02-15T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39507/galley/29819/download/"}]},{"pk":12262,"title":"Machine Learning in Relation to Emergency Medicine  Clinical and Operational Scenarios: An Overview","subtitle":null,"abstract":"Health informatics is a vital technology that holds great promise in the healthcare setting. We describe two prominent health informatics tools relevant to emergency care, as well as the historical background and the current state of informatics. We also identify recent research findings and practice changes. The recent advances in machine learning and natural language processing (NLP) are a prominent development in health informatics overall and relevant in emergency medicine (EM). A basic comprehension of machine-learning algorithms is the key to understand the recent usage of artificial intelligence in healthcare. We are using NLP more in clinical use for documentation. NLP has started to be used in research to identify clinically important diseases and conditions. Health informatics has the potential to benefit both healthcare providers and patients. We cover two powerful tools from health informatics for EM clinicians and researchers by describing the previous successes and challenges and conclude with their implications to emergency 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":"Health Informatics, Machine Learning, Natural Language Processing"}],"section":"Emergency Department Operations","is_remote":true,"remote_url":"https://escholarship.org/uc/item/71f2f15r","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"},{"first_name":"Nicholas","middle_name":"M.","last_name":"Mohr","name_suffix":"","institution":"University of Iowa Carver College of Medicine, Department of Emergency Medicine, Anesthesia and Critical Care, Iowa City, Iowa","department":"None"},{"first_name":"W.","middle_name":"Nicholas","last_name":"Street","name_suffix":"","institution":"University of Iowa Tippie College of Business, Department of Management Sciences, Iowa City, Iowa","department":"None"},{"first_name":"Prakash","middle_name":"","last_name":"Nadkarni","name_suffix":"","institution":"University of Iowa Carver College of Medicine, Department of Internal Medicine, Iowa City, Iowa","department":"None"}],"date_submitted":"2018-10-12T20:37:12+02:00","date_accepted":"2018-10-12T20:37:12+02:00","date_published":"2019-02-14T22:49:47+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12262/galley/6542/download/"}]},{"pk":12433,"title":"Response to “Creating Consensus: Revisiting the Emergency Medicine Scholarly Activity Requirement”","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":"Scholarly Activity, Consensus, Emergency Medicine, Residency, Resident"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0n79j8g2","frozenauthors":[{"first_name":"Scott","middle_name":"H.","last_name":"Pasichow","name_suffix":"","institution":"Brown University, Department of Emergency Medicine, Providence, Rhode Island","department":"None"},{"first_name":"Zachary","middle_name":"J.","last_name":"Jarou","name_suffix":"","institution":"University of Chicago, Department of Medicine, Section of Emergency Medicine, Chicago, Illinois","department":"None"},{"first_name":"Dhimitri","middle_name":"A.","last_name":"Nikolla","name_suffix":"","institution":"Saint Vincent Hospital, Allegheny Health Network, Department of Emergency Medicine, Erie, Pennsylvania","department":"None"},{"first_name":"Mohammed","middle_name":"M.","last_name":"Qureshi","name_suffix":"","institution":"Penn State Milton S. Hershey Medical Center,Department of Emergency Medicine, Hershey, Pennsylvania","department":"None"},{"first_name":"Michael","middle_name":"L","last_name":"Epter","name_suffix":"","institution":"","department":"None"},{"first_name":"Bryan","middle_name":"G.","last_name":"Kane","name_suffix":"","institution":"Lehigh Valley Hospital, Department of Emergency Medicine and Hospital Medicine, Allentown, Pennsylvania \nUniversity of South Florida, Morsani College of Medicine, Lehigh Valley Campus, Allentown, Pennsylvania","department":"None"},{"first_name":"Vicken","middle_name":"Y.","last_name":"Totten","name_suffix":"","institution":"Kaweah Delta Medical Center, Department of Emergency Medicine, Visalia, California","department":"None"},{"first_name":"Chadd","middle_name":"K.","last_name":"Kraus","name_suffix":"","institution":"Geisinger Health System, Department of Emergency Medicine, Danville, Pennsylvania","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Allswede","name_suffix":"","institution":"Mountainview Hospital, Department of Emergency Medicine, Las Vegas, Nevada","department":"None"},{"first_name":"Deborah","middle_name":"B.","last_name":"Diercks","name_suffix":"","institution":"University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, Texas","department":"None"},{"first_name":"Nidhi","middle_name":"","last_name":"Garg","name_suffix":"","institution":"Long Island Jewish Medical Center, Northwell Health, Department of Emergency Medicine, New Hyde Park, New York","department":"None"},{"first_name":"Louis","middle_name":"","last_name":"Ling","name_suffix":"","institution":"Accreditation Council for Graduate Medical Education, Chicago, Illinois\nUniversity of Minnesota, Department of Emergency Medicine, Minneapolis, Minnesota","department":"None"},{"first_name":"Eric","middle_name":"N.","last_name":"McDonald","name_suffix":"","institution":"University of Mississippi, Department of Emergency Medicine, Oxford, Mississippi","department":"None"},{"first_name":"Alex","middle_name":"M.","last_name":"Rosenau","name_suffix":"","institution":"Lehigh Valley Hospital, Department of Emergency Medicine and Hospital Medicine, Allentown, Pennsylvania \nUniversity of South Florida, Morsani College of Medicine, Lehigh Valley Campus, Allentown, Pennsylvania","department":"None"},{"first_name":"Mike","middle_name":"","last_name":"Wilk","name_suffix":"","institution":"Brown University, Department of Emergency Medicine, Providence, Rhode Island","department":"None"},{"first_name":"Alexandria","middle_name":"D.","last_name":"Holmes","name_suffix":"","institution":"Lehigh Valley Hospital, Department of Emergency Medicine and Hospital Medicine, Allentown, Pennsylvania \nUniversity of South Florida, Morsani College of Medicine, Lehigh Valley Campus, Allentown, Pennsylvania","department":"None"},{"first_name":"Adam","middle_name":"","last_name":"Hemminger","name_suffix":"","institution":"Lehigh Valley Hospital, Department of Emergency Medicine and Hospital Medicine, Allentown, Pennsylvania \nUniversity of South Florida, Morsani College of Medicine, Lehigh Valley Campus, Allentown, Pennsylvania","department":"None"},{"first_name":"Marna","middle_name":"Rayl","last_name":"Greenberg","name_suffix":"","institution":"Lehigh Valley Hospital, Department of Emergency Medicine and Hospital Medicine, Allentown, Pennsylvania \nUniversity of South Florida, Morsani College of Medicine, Lehigh Valley Campus, Allentown, Pennsylvania","department":"None"}],"date_submitted":"2019-01-14T20:26:30+01:00","date_accepted":"2019-01-14T20:26:30+01:00","date_published":"2019-02-14T21:50:26+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12433/galley/6607/download/"}]},{"pk":12306,"title":"Reconsidering the “Classic” Clinical History Associated with Subluxations of the Radial Head","subtitle":null,"abstract":"Introduction:\n The national burden of radial head subluxations in the United States (U.S.) population is poorly defined, and non-classical injury mechanisms have been increasingly reported in recent years. The purpose of this study is to report historical national estimates and demographic characteristics of patients presenting to U.S. emergency departments (ED) with subluxations of the radial head.\n \nMethods:\n This cross-sectional, retrospective study analyzes the National Electronic Injury Surveillance System (NEISS) database (2001-2017) to identify patients ≤ 7 years of age presenting to U.S. EDs with subluxations of the radial head.\nResults:\n Linear regression (R2 = 0.65; P &lt; 0.01) demonstrated that the annual number of patients presenting to U.S. EDs with subluxations of the radial head increased significantly (P &lt; 0.001) between 2001 (N=13,247; confidence interval [CI], 9,492-17,001) and 2010 (N=21,723; CI, 18,762-24,685), but did not change significantly between 2010 and 2017 (R2 &lt; 0.01; P = 0.85). It also demonstrated that 51.0% (CI, 45.3%-56.6%) of injuries were either self-induced or spontaneous, whereas 36.8% (CI, 31.6%-42.0%) and 9.4% (CI, 8.0%-10.7%) were associated with parents/guardians or siblings, respectively. The majority of injuries occurred in patients who were the age of one (33.5%; CI, 32.1%-35.0%) and two (35.1%; CI, 33.7%-36.6%); females (57.8%; CI, 56.8%-58.9%) were more commonly injured than males.\nConclusion:\n Although the national burden of radial head subluxations may be less than previously reported, it still results in over 20,000 ED visits annually in the U.S. Given that over half of such injuries are actually self-induced or spontaneous, caretakers should be taught to recognize the clinical presentation of radial head subluxation, since the classically described history of a patient being lifted or pulled by the arm may simply have never occurred.","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":"nursemaid’s elbow"},{"word":"pulled elbow"},{"word":"Radial Head Subluxation"},{"word":"nonclassical"},{"word":"Epidemiology"}],"section":"Pediatrics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/17k2n2wx","frozenauthors":[{"first_name":"Kevin","middle_name":"","last_name":"Pirruccio","name_suffix":"","institution":"University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania","department":"None"},{"first_name":"Daniel","middle_name":"","last_name":"Weltsch","name_suffix":"","institution":"The Children’s Hospital of Philadelphia, Division of Orthopaedic Surgery, Philadelphia, Pennsylvania; Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv-Yafo, Israel; The Chaim Sheba Medical Center at Tel Hashomer, Department of Orthopaedic Surgery, Tel HaShomer, Ramat Gan, Israel","department":"None"},{"first_name":"Keith","middle_name":"D.","last_name":"Baldwin","name_suffix":"","institution":"The Children’s Hospital of Philadelphia, Division of Orthopaedic Surgery, Philadelphia, Pennsylvania","department":"None"}],"date_submitted":"2018-11-06T00:28:09+01:00","date_accepted":"2018-11-06T00:28:09+01:00","date_published":"2019-02-14T21:37:43+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12306/galley/6564/download/"}]},{"pk":11515,"title":"Diagnosis and Management of Oncologic Emergencies","subtitle":null,"abstract":"Oncologic emergencies may be seen in any emergency department and will become more frequent as our population ages and more patients receive chemotherapy. Life-saving interventions are available for certain oncologic emergencies if the diagnosis is made in a timely fashion. In this article we will cover neutropenic fever, tumor lysis syndrome, hypercalcemia of malignancy, and hyperviscosity syndrome. After reading this article the reader should be much more confident in the diagnosis, evaluation, and management of these oncologic emergencies.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"oncologic emergency, malignancy"}],"section":"Health Outcomes","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3x84z2bq","frozenauthors":[{"first_name":"Sarah","middle_name":"","last_name":"Klemencic","name_suffix":"","institution":"Virginia Tech Carilion School of Medicine, Department of Emergency Medicine, Roanoke, Virginia","department":"None"},{"first_name":"Jack","middle_name":"","last_name":"Perkins","name_suffix":"","institution":"Virginia Tech Carilion School of Medicine, Department of Emergency Medicine, Roanoke, Virginia","department":"None"}],"date_submitted":"2017-12-19T17:46:32+01:00","date_accepted":"2017-12-19T17:46:32+01:00","date_published":"2019-02-14T21:34:27+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11515/galley/6212/download/"}]},{"pk":12488,"title":"This Article Corrects: “Behind the Curtain: The Nurse’s Voice in Assessment of Residents in the Emergency Department”","subtitle":null,"abstract":"Introduction:\n Feedback provides valuable input for improving physician performance. Conventionally, feedback is obtained from attending physicians; however, residents work in close contact with other members of the care team, especially nurses. Nurses may have more opportunity to directly observe trainees. In addition, they may value different behaviors and provide unique feedback. The objective of this study was to examine the nurse’s perspective of resident performance in the emergency department.\nMethods:\n This was a retrospective, mixed-methods study of nursing assessments of residents using a  five-point scale from 1 (unsatisfactory) to 5 (outstanding) and providing comments. Analysis included descriptive statistics of the quantitative assessments and content analysis of the nursing comments by a group of attendings, residents, and nurses. \nResults: \nNurses assessed residents as above expectation or outstanding, especially for the categories of “How would you rate this resident’s attitude?” (65%) and “Is this resident a team player?” (64%). Content analysis of the comments yielded nine themes including being kind, communication with nurses, being a team player, work ethic and efficiency, and respect for other team members. Of the comments made, 50% provided positive feedback, and the majority of comments (80%) were determined to be actionable.\nConclusion:\n Our data indicate that nurses provide feedback on residents’ kindness, efficiency and communication. These two aspects of interacting in the healthcare setting may not be highlighted in conventional, attending provider feedback, yet they are clearly noted by the nurse’s voice.","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":"Erratum","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1z66x7wc","frozenauthors":[{"first_name":"Ashley","middle_name":"","last_name":"Pavlic","name_suffix":"","institution":"University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan","department":"None"},{"first_name":"Dana","middle_name":"","last_name":"Liu","name_suffix":"","institution":"University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan\nWake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina","department":"None"},{"first_name":"Kara","middle_name":"","last_name":"Baker","name_suffix":"","institution":"University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan\nNorth Shore University Hospital, Department of Emergency Medicine, Manhasset, New York","department":"None"},{"first_name":"Joseph","middle_name":"","last_name":"House","name_suffix":"","institution":"University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Byrd","name_suffix":"","institution":"University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan","department":"None"},{"first_name":"Tina","middle_name":"","last_name":"Martinek","name_suffix":"","institution":"University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan","department":"None"},{"first_name":"Diana","middle_name":"","last_name":"O’Leary","name_suffix":"","institution":"University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan","department":"None"},{"first_name":"Sally","middle_name":"A.","last_name":"Santen","name_suffix":"","institution":"University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan\nVirginia Commonwealth University School of Medicine, Department of Emergency Medicine, Richmond, Virginia","department":"None"}],"date_submitted":"2019-01-31T20:07:36+01:00","date_accepted":"2019-01-31T20:07:36+01:00","date_published":"2019-02-14T21:31:34+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12488/galley/6630/download/"}]},{"pk":12133,"title":"End-tidal CO2 Monitoring is Available in Most Community Hospitals in a Rural State: A Health System Survey","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":"Hospitals, Community"},{"word":"Capnography"},{"word":"Rural Health Services"},{"word":"Emergency Medicine"},{"word":"Personnel Staffing and Scheduling"}],"section":"Patient Safety","is_remote":true,"remote_url":"https://escholarship.org/uc/item/55s1g9j5","frozenauthors":[{"first_name":"Steven","middle_name":"A.","last_name":"Ilko","name_suffix":"","institution":"University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa","department":"None"},{"first_name":"J.","middle_name":"Priyanka","last_name":"Vakkalanka","name_suffix":"","institution":"University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa College of Public Health, Department of Epidemiology, Iowa City, Iowa","department":"None"},{"first_name":"Azeemuddin","middle_name":"","last_name":"Ahmed","name_suffix":"","institution":"University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa Tippie College of Business, Iowa City, Iowa","department":"None"},{"first_name":"Daniel","middle_name":"A.","last_name":"Evans","name_suffix":"","institution":"Indiana University, Department of Emergency Medicine, Indianapolis, Indiana","department":"None"},{"first_name":"Hans","middle_name":"R.","last_name":"House","name_suffix":"","institution":"University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa","department":"None"},{"first_name":"Nicholas","middle_name":"M.","last_name":"Mohr","name_suffix":"","institution":"University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa College of Public Health, Department of Epidemiology, Iowa City, Iowa; University of Iowa Carver College of Medicine, Division of Critical Care, Department of Anesthesia, Iowa City, Iowa","department":"None"}],"date_submitted":"2018-08-07T18:55:01+02:00","date_accepted":"2018-08-07T18:55:01+02:00","date_published":"2019-02-14T21:29:51+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12133/galley/6492/download/"}]},{"pk":44652,"title":"Cancer-Related Microangiopathic Hemolytic 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/43q1f9xb","frozenauthors":[{"first_name":"David","middle_name":"D.","last_name":"Kim","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Sheldon","middle_name":"","last_name":"Davidson","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2019-02-14T20:58:50+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44652/galley/33445/download/"}]},{"pk":44651,"title":"A Case of Urosepsis due to Staphylococcus simulans Infection in a Pediatric Patient","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8km164zs","frozenauthors":[{"first_name":"Jonathan","middle_name":"","last_name":"Warren","name_suffix":"BS","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"John","middle_name":"D.","last_name":"Petersen","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2019-02-14T20:56:36+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44651/galley/33444/download/"}]},{"pk":44650,"title":"Prematurity and Postoperative Apnea: Modern Anesthetics Meet Old Recommendations","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/6pc426p1","frozenauthors":[{"first_name":"Kenneth","middle_name":"","last_name":"Liu","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Diana","middle_name":"","last_name":"Phan","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2019-02-14T20:53:59+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44650/galley/33443/download/"}]},{"pk":44649,"title":"Anemia and Worsening Renal Failure in an Immunocompromised Patient with Mechanical Valves","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/1kx8410s","frozenauthors":[{"first_name":"Aileen","middle_name":"","last_name":"Bui","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Samuel","middle_name":"","last_name":"Burstein","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2019-02-14T20:51:38+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44649/galley/33442/download/"}]},{"pk":40698,"title":"Making News: the Sonzogno Affair (1875) and the Print Networks in Liberal Italy","subtitle":null,"abstract":"In this essay I discuss the murder of journalist Raffaele Sonzogno, the director of the Rome-based daily \nLa capitale\n, in February 1875, and the trial of his murderers which took place the same year. I explore how the events were presented in the press at the time, in particular the democratic newspaper \nIl secolo\n, and more broadly how the Sonzogno murder and his assassins’ trial can help us understand the print networks of the time. I offer two main readings, one ideological and one more material: on the one hand, I discuss the presence and shadow of Giuseppe Garibaldi and his Risorgimento legacy over these events (a rhetorical presence, but also a very literal one). On the other, I consider the role that the written-word networks (newspapers, books, periodicals) played in the construction of Raffaele Sonzogno as a democratic hero, a modern mediatized victim, and an object of commercial exploitation. Lastly, I consider the dynamics of the murder and the figure of Sonzogno’s material assassin, Pio Frezza, as he emerges from the trial depositions, to argue that his brief moment of political visibility does not enable him to intervene critically in Garibaldianism, and in the political discourse of Unified Italy. Rather, Frezza’s patriotism is exploited against him – forcing him to wordlessly, violently make his way into the printed world.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Italian Risorgimento"},{"word":"Italian Journalism"},{"word":"print culture"},{"word":"Raffaele Sonzogno"},{"word":"Giuseppe Garibaldi"},{"word":"La capitale"},{"word":"Il secolo"},{"word":"La Perseveranza"},{"word":"Sonzogno family"},{"word":"Giuseppe Luciani"},{"word":"Pio Frezza"},{"word":"Fake News"},{"word":"nationalism"}],"section":"Culture, Body, Politics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3f8449v2","frozenauthors":[{"first_name":"Silvia","middle_name":"","last_name":"Valisa","name_suffix":"","institution":"Florida State University","department":"None"}],"date_submitted":"2017-08-11T22:17:28+02:00","date_accepted":"2017-08-11T22:17:28+02:00","date_published":"2019-02-13T21:23:36+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40698/galley/30527/download/"}]},{"pk":40723,"title":"Embodied Voice and the Body Politic: The Dialoghi of Leone de’ Sommi","subtitle":null,"abstract":"Leone de’ Sommi’s sixteenth-century treatise on stagecraft, \nQuattro dialoghi in materia di rappresentazioni sceniche, \ndefines drama as a mirror of human life and society. For Leone, dramatic form is patterned on the human body, its meaning conveyed through gesture and vocalization. While Leone’s theatrical worldview seems to embrace civic unity, I argue that it also reflects the anxieties of a period of aggressive marginalization of Italian Jewish communities due to the rise of ghettos. The \nDialoghi\n develop a counter-argument to the dominant humanist (Christian) narrative of theater’s origins and de-center the Aristotelian model, citing Hebrew scripture as drama’s highest ancient authority. Moreover, de’ Sommi’s prescriptions for actors’ uses of voice and body in performance dramatize the politically and socially charged relationships of Mantua’s Jewish artists and artisans to the Gonzaga court. Through his dramatic theory, Leone de’ Sommi enacts a challenge to the structural and ideological confines of the ghetto.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Italy"},{"word":"Theater History"},{"word":"Mantua"}],"section":"Culture, Body, Politics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3vj0v2wd","frozenauthors":[{"first_name":"Ariane","middle_name":"","last_name":"Helou","name_suffix":"","institution":"UCLA","department":"None"}],"date_submitted":"2018-03-31T02:22:50+02:00","date_accepted":"2018-03-31T02:22:50+02:00","date_published":"2019-02-13T21:23:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40723/galley/30539/download/"}]},{"pk":40725,"title":"Resisting Monologue: Alba de Céspedes' Nessuno torna indietro and the Subversion of Paternal Authority","subtitle":null,"abstract":"Through the lens of Foucauldian theories of docile bodies, discursive and discoursing subjectivities, and heterotopias, along with theories of the voice drawn from the film criticism of Michel Chion and Kaja Silverman, this essay examines the ways in which de Céspedes’s novel resists the monologic discourse characteristic of paternalistic authority and the fascist regime. It is argued that, by presenting alternative mother types and corresponding alternative matrilineal genealogies, the protagonists of \nNessuno torna indietro\n subvert traditional paternal authority and cultural conceptions of fathers and mothers, proposing different models of female (pro)creativity and self-determination more in line with women’s individual and varied aspirations. The role and expression of the voice, in multiple modes and registers, and the continual tension toward dialogue and conversation, as opposed to monologue, is central to my analysis and allows for a more multifaceted understanding of discursive and discoursing subjectivities, particularly in relation to conventional gender roles within the family during the fascist period in Italy.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Alba de Céspedes, Nessuno torna indietro, mothers, fathers, daughters, paternal authority, voice"}],"section":"Culture, Body, Politics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8px8m3hn","frozenauthors":[{"first_name":"Lindsay","middle_name":"","last_name":"Eufusia","name_suffix":"","institution":"Northwestern University","department":"None"}],"date_submitted":"2018-03-31T04:41:15+02:00","date_accepted":"2018-03-31T04:41:15+02:00","date_published":"2019-02-13T21:20:32+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40725/galley/30540/download/"}]},{"pk":40707,"title":"What Did Annarella See? “Il bisogno di conoscere con ogni medium” and the Hermeneutics of the Gaze in Carlo Damasco’s “Un paio di occhiali”","subtitle":null,"abstract":"\"What did Annarella See?\"analyzes Carlo Damasco's cinematic adaptation of Anna Maria Ortese's short story \"Un paio di occhiali\" and argues that the trope of the \"insopportabilita' della realta'\" constitutes the connective tissue between Ortese's story and Damasco's film.  This trope generates different options of \"being in the world\" for Eugenia and Annarella, the respective protagonists of short story and film. it is upon this contextualized and historicized notion of \"being in the world\" that Damasco's adaptation generates a powerful reflection of Ortese's estranged and estranging gaze, and the revolutionalty, if veiled, knowledge it envisioned.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"adaptation"},{"word":"Annarella"},{"word":"Eugenia"},{"word":"Gaze"},{"word":"telefoni bianchi"},{"word":"Ortese"},{"word":"Damasco"}],"section":"Culture, Body, Politics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5t46k2w7","frozenauthors":[{"first_name":"Cristina","middle_name":"","last_name":"Della Coletta","name_suffix":"","institution":"UC San Diego","department":"None"}],"date_submitted":"2017-11-20T22:34:44+01:00","date_accepted":"2017-11-20T22:34:44+01:00","date_published":"2019-02-13T21:19:53+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40707/galley/30529/download/"}]},{"pk":40701,"title":"Are Italians White? The Perspective from the Pacific","subtitle":null,"abstract":"By reviewing a wide variety of works pertaining to the racialization of European immigrants in the United States and the history of race relations and of individual ethnic groups in California, this article outlines some reflections arising from addressing the issue of Italians’ “whiteness” within the West Coast’s historically distinct multiracial context. Californian journalist Chester Harvey Rowell’s 1909 view of North America Pacific Coast as the “frontier of the white man” is adopted as a paradigm highlighting how California’s racial dynamic, centered around a white/Asian polarity, supported Italians’ being included among “whites”, with all the symbolic and material privileges this implied.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Whiteness"},{"word":"race relations California"},{"word":"Italian immigration"}],"section":"Italian Culture: Transnational Perspectives","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3zw016sg","frozenauthors":[{"first_name":"Tommaso","middle_name":"","last_name":"Caiazza","name_suffix":"","institution":"Other","department":"None"}],"date_submitted":"2017-09-11T18:19:28+02:00","date_accepted":"2017-09-11T18:19:28+02:00","date_published":"2019-02-13T21:17:36+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40701/galley/30528/download/"}]},{"pk":40732,"title":"Mapping Transnational Subjecthood: Space, Affects and Relationality in Recent Transnational Italian Fictions","subtitle":null,"abstract":"This article addresses the construction of transnational subjects in contemporary literary narratives, focusing on two recent novels in Italian by Gabriella Kuruvilla and by Shirin Ramzanali Fazel. Exploring the construction and the experience of the individual subject as spatial, relational, embodied, and linguistic practice in everyday life, the analysis draws upon theory in human and social geography, as well as in literary and cultural studies, to uncover the complexity of the human subject in mobility.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Transnational"},{"word":"Italian migration literature"},{"word":"postcolonial literature"},{"word":"subjectivity"},{"word":"Space"},{"word":"Affect"}],"section":"Italian Culture: Transnational Perspectives","is_remote":true,"remote_url":"https://escholarship.org/uc/item/60z4v30p","frozenauthors":[{"first_name":"Jennifer","middle_name":"","last_name":"Burns","name_suffix":"","institution":"University of Warwick","department":"None"}],"date_submitted":"2018-04-25T14:51:05+02:00","date_accepted":"2018-04-25T14:51:05+02:00","date_published":"2019-02-13T21:14:39+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40732/galley/30543/download/"}]},{"pk":40714,"title":"Rhino / Rhinoceros: Experimental Cinema and the Migrant Condition","subtitle":null,"abstract":"This essay examines two films by Kevin Jerome Everson: \nRhinoceros \n(2013) and \nRhino \n(2017). \nRhinoceros \nis an imagined staging of the last speech of the first Duke of Florence, Alessandro de’ Medici (1510-1537), also known as the first black European head of state due to his mixed Italian and African ancestry. For de’ Medici’s speech, \nRhinoceros\n uses one of the last communiqués of Mummar al-Gaddafi, then recently deposed as head of the Libyan state by the Arab Spring. Once staunchly anti-imperialist, Gaddafi’s last years were marked by new political and economic relations with Western nations, notably the 2008 “friendship treaty” orchestrated with then Prime Minister Silvio Berlusconi. By having de’ Medici speak the words of one of the most polarizing African leaders of the last forty years, \nRhinoceros \nmerges the politics of early modern Italy with the country’s colonial legacies in north and east Africa. \nRhino\n imagines the final days leading up to Duke Alessandro’s 1537 assassination, with de’ Medici’s narrative told alongside interviews with African migrants in present-day Florence. In \nRhino, \nthe historic presence of Africans within the Italian peninsula is paralleled to contemporary African migration to Italy. I argue \nRhinoceros \nand \nRhino\n not only reveal the ironies of postcolonial Italy at the beginning of the 21st century, but also participates in the construction of the archive of Black Italy.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Alessandro de’ Medici"},{"word":"Early Modern Italy"},{"word":"Florence"},{"word":"Kevin Jerome Everson"},{"word":"Experimental Film"},{"word":"African American Studies"},{"word":"Afro-Surrealism"},{"word":"Italian Colonialism"},{"word":"Libya"},{"word":"post-colonialism"}],"section":"Italian Culture: Transnational Perspectives","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5628t5vx","frozenauthors":[{"first_name":"Shelleen","middle_name":"","last_name":"Greene","name_suffix":"","institution":"UCLA","department":"None"}],"date_submitted":"2018-02-22T00:32:19+01:00","date_accepted":"2018-02-22T00:32:19+01:00","date_published":"2019-02-13T21:05:43+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40714/galley/30533/download/"}]},{"pk":40727,"title":"L’inizio, la fine, il deserto, la forma, la poesia, la “zona incerta.” Sereni traduce e trasforma The Desert Music di W.C. Williams","subtitle":null,"abstract":"The essay aims to underline the various strategies by which Sereni, in 1961, translates a poem very far and different from his own tastes and inclinations like The Desert Music.","language":"ita","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"translation"},{"word":"Poetry"},{"word":"stellar friendhip"}],"section":"ITALIAN POETRY AND TRANSLATION","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0gq3t4f4","frozenauthors":[{"first_name":"Federico","middle_name":"","last_name":"Francucci","name_suffix":"","institution":"Università degli Studi di Pavia. Dipartimento di Studi Umanistici","department":"None"}],"date_submitted":"2018-04-02T04:15:34+02:00","date_accepted":"2018-04-02T04:15:34+02:00","date_published":"2019-02-13T20:58:06+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40727/galley/30541/download/"}]},{"pk":40733,"title":"Heaney, Pascoli and the Ends of Poetry","subtitle":null,"abstract":"What are the ends of poetry in times when humanity has to face up to the possibility of nature’s finitude and our own lethal capacity to bring about its end? The Northern Irish poet Seamus Heaney has been invoked as an example of an environmentalist poet whose later writing addresses issues of climate change and ecological disaster. I would like to argue for a more nuanced approach to Heaney’s late poetry which, I believe, does powerfully address our relation to the natural world, but it does so on its own, internally generated terms. Heaney invites us to think more broadly about the ends—or the good, or \ntelos\n—of poetry, and its ability to align us with our fundamental, rhythmic, patterned, human, and natural senses of being. His conviction of the serious purpose of poetry, in my view, transcends the current, in-house divisions of ecocriticism. It also restores a sense of poetry as playful, pleasurable, and health-enhancing to the individual reader or poet. To advance this argument, I will analyse a little-discussed late work: \nThe Last Walk \n(2013), which is Heaney’s posthumously published translation of Pascoli’s “L’ultima passeggiata.” This sequence of slight, finely turned poems, while celebrating the rhythms of rural life, are far removed from any explicitly political or environmentalist agenda. Yet they reveal much about Heaney’s aesthetics and ethics as he faced his own end, preparing this translation in the last months of his life.  The second part of the essay considers the translation in the light of other writing by the Irish poet, and suggests how, without locking him into an explicit political or theoretical agenda, we might read his poetry from an environmental perspective.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Heaney Pascoli ends environment"}],"section":"ITALIAN POETRY AND TRANSLATION","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9cf9h0qc","frozenauthors":[{"first_name":"Rachel","middle_name":"","last_name":"Falconer","name_suffix":"","institution":"University of Lausanne","department":"None"}],"date_submitted":"2018-05-06T02:17:16+02:00","date_accepted":"2018-05-06T02:17:16+02:00","date_published":"2019-02-13T20:57:30+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40733/galley/30544/download/"}]},{"pk":40751,"title":"Una previsione sbagliata: gli ultimi poeti dopo il diluvio","subtitle":null,"abstract":"The article aims to investigate the contemporary poetic scene, in particular the heritage of Neoavanguardia in the so-called research area. Denying the prophecy of “diluvio” that Gruppo 63 formulated in the forty years of birth, new poetic tendencies and contests were born, following French and American poets and theorists. The main place of meeting and exchanges for the new textuality is internet, which is at the same time a tool for the evolution of languages and poetical practices.  Instead of ending after “diluvio”, a stream of poets born between the sixties and the nineties enriched the poetic scene with new possibilities, re-discussing the same form and conception of traditional poetry.","language":"ita","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"ITALIAN POETRY TODAY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/181638r2","frozenauthors":[{"first_name":"Gilda","middle_name":"","last_name":"Policastro","name_suffix":"","institution":"Other","department":"None"}],"date_submitted":"2018-08-17T15:16:31+02:00","date_accepted":"2018-08-17T15:16:31+02:00","date_published":"2019-02-13T20:55:25+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40751/galley/30549/download/"}]},{"pk":40710,"title":"“La poesia dopo la fine della poesia”: Visionary Realism and the Ethics of Playful Care in Aldo Nove's Twenty-First Century Poetry","subtitle":null,"abstract":"This article examines the experimental realism that Aldo Nove has adopted in two recent poetry collections, \nA schemi di costellazioni\n (2010) and \nAddio mio Novecento\n (2014).\nThese works similarly feature a time in which personal memories intertwine with geological elements. In doing so, they seemingly mark a break with Nove’s previous poetry and prose, concerned with a disturbing representation of late-capitalist lifestyle. I argue, though, that Nove’s cosmological poetry ushers in a new stage of the author’s material and visionary realism. His recent poetry represents the “material complexity” of the Anthropocene, while suggesting playful ethics of non-hierarchical coexistence with nonhuman agents. Nove retraces these perspectives of co-survival to the oft-forgotten origin of western thought, which—beginning with the Milesian School—is surprisingly rooted in the recognition of nature as the generative principle of life and meaning.\nAt a metaliterary level, Nove’s twenty-first century realism marks a farewell to the twentieth-century tradition, while foreseeing new stylistic and thematic possibilities for Italian poetry. The author repurposes the polemic materialism of the avant-gardes and the anti-realist poetics of the “parola innamorata” into a thought-provoking reflection on the meaning of playful care in the troubled epoch of the Anthropocene.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Aldo Nove"},{"word":"Realism"},{"word":"twenty-first century poetry"},{"word":"Anthropocene"},{"word":"childhood"},{"word":"playfulness"}],"section":"ITALIAN POETRY TODAY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5p5669r3","frozenauthors":[{"first_name":"Danila","middle_name":"","last_name":"Cannamela","name_suffix":"","institution":"University of St. Thomas (MN)","department":"None"}],"date_submitted":"2018-01-22T20:28:04+01:00","date_accepted":"2018-01-22T20:28:04+01:00","date_published":"2019-02-13T20:48:32+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40710/galley/30532/download/"}]},{"pk":40759,"title":"Expanded Poetry: Otto Iconopoemi 2006–2018","subtitle":null,"abstract":"","language":"It","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"ITALIAN POETRY TODAY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9726v2fz","frozenauthors":[{"first_name":"Andrea","middle_name":"","last_name":"Cortellessa","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2018-11-10T15:46:32+01:00","date_accepted":"2018-11-10T15:46:32+01:00","date_published":"2019-02-13T20:46:54+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40759/galley/30553/download/"}]},{"pk":40716,"title":"Sounding Ends and Endings: Non-Closure in Modern and Contemporary Poetry","subtitle":null,"abstract":"This article examines the ends of lyric poetry in the teleological sense (\nil\n fine) by investigating the end (\nla\n fine) of certain poems—the textual endings and instances of closure (or lack thereof), i.e., the final strophe, the final verse. In particular, it analyzes some exemplary instances of non-closure in modern and contemporary (mostly Italian) poetry. Drawing on Giorgio Agamben and Timothy Bahti, it explores a peculiar form of non-closure, namely, endings of poems that, by means of self-reflexivity, repetition, and chiastic structures, re-direct the text and its reader back towards its beginning, toward a new reading.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Contemporary Poetry"},{"word":"literary theory"},{"word":"lyric"},{"word":"Poetic Forms"},{"word":"Non-closure"},{"word":"Ending"},{"word":"Teleology"},{"word":"Chiasmus"}],"section":"NINETEENTH- AND TWENTIETH-CENTURY ITALIAN POETRY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/63k3j1m5","frozenauthors":[{"first_name":"Federico","middle_name":"","last_name":"Italiano","name_suffix":"","institution":"Austrian Academy of Sciences","department":"None"}],"date_submitted":"2018-03-19T21:12:10+01:00","date_accepted":"2018-03-19T21:12:10+01:00","date_published":"2019-02-13T20:43:19+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40716/galley/30535/download/"}]},{"pk":40750,"title":"Autenticità e conoscenza. Il pensiero emotivo e la funzione della lirica","subtitle":null,"abstract":"La lirica è il genere che ha prodotto la forma simbolica con cui è stata letta più frequentemente la poesia italiana del Novecento. Tuttavia, soprattutto da un certo momento in poi, questa maniera di concepire la lirica diventa uno stereotipo, che ingabbia non solo la scrittura in versi, ma anche la presenza della soggettività nella scrittura. Questo cliché ha fossilizzato la lirica in un’espressione sterile, che a mano a mano non è sembrata più in grado di generare un pensiero produttivo e di raccontare il presente. Conferma la deriva della poesia che avrebbe perso progressivamente sempre più lettori e supporto istituzionale. Tuttavia, se il genere si è cristallizzato in uno stereotipo, le riflessioni sulla soggettività hanno seguito uno sviluppo ben più articolato e differenziato. Così come la filosofia del soggetto ha attraversato molte trasformazioni, è cambiata la funzione della lirica e della soggettività nella scrittura. Il saggio si propone di mettere a fuoco questi problemi a partire da un'analisi della poetica di Vittorio Sereni. Propone, infine, un'idea di rifunzionalizzazione della lirica che pone l'accento sull'importanza del rapporto tra la poesia e il pensiero emotivo come pensiero produttivo.","language":"it","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Lirica"},{"word":"Poesia del Novecento"},{"word":"Poesia italiana"},{"word":"Vittorio Sereni"},{"word":"teoria della letteratura"}],"section":"NINETEENTH- AND TWENTIETH-CENTURY ITALIAN POETRY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/56g143rb","frozenauthors":[{"first_name":"Maria","middle_name":"","last_name":"Borio","name_suffix":"","institution":"Other","department":"None"}],"date_submitted":"2018-07-28T02:42:19+02:00","date_accepted":"2018-07-28T02:42:19+02:00","date_published":"2019-02-13T20:41:32+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40750/galley/30548/download/"}]},{"pk":40717,"title":"“Trasposizioni”: I due mestieri di Amelia Rosselli","subtitle":null,"abstract":"My aim is to reconstruct a phase of the intellectual biography of Amelia Rosselli from 1950 to 1965, in order to highlight her transition from music to poetry. I touch on some of her intellectual relationships such as those with Bartók, Dallapiccola, Carpitella, Berio, Maderna, Cage and Tudor. Her “end”, music, turned into a “beginning”: the “beginning” of a poetic oeuvre regarded as one of the greatest of XX century. As a possible title for her arduous theoretical essay “Spazi metrici”, Amelia proposed to Pasolini the title “Trasposizioni”. Musicians transform poetry into music in many ways, from the Renaissance madrigals to Luigi Nono's experimentalism. Amelia, on the contrary, transposes musical structures into a metrical system.  Her powerful metrical rhythm, added to her abnormal lexicon, creates a strong emotional impact, which is felt even if it is not completely understood. Yet we still will try to understand it.","language":"it","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"amelia rosselli musica poesia"}],"section":"NINETEENTH- AND TWENTIETH-CENTURY ITALIAN POETRY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/22n084xb","frozenauthors":[{"first_name":"Laura","middle_name":"","last_name":"Barile","name_suffix":"","institution":"Other\nUniversità degli studi di Siena","department":"None"}],"date_submitted":"2018-03-14T14:51:01+01:00","date_accepted":"2018-03-14T14:51:01+01:00","date_published":"2019-02-13T20:37:38+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40717/galley/30536/download/"}]},{"pk":40735,"title":"Rethinking the Ends of Poetry:  Elegy and ‘Demi-deuil’ in Eugenio Montale’s “La casa dei doganieri”","subtitle":null,"abstract":"Focusing on Eugenio Montale’s “La casa dei doganieri” (\nLe occasioni\n, 1939), this article explores the nature of the poet’s mourning for Arletta and how it challenges traditional views on elegy. Although this poem displays several of the conventions  of classical elegy, Montale ultimately disregards what Jahan Ramazani calls the “consolatory machinery” common to that genre, a post-loss experience aiming to achieve complete forgetfulness and replacement of the lost object of love. Furthermore, Montale’s mourning for Arletta deviates from the traditional binary distinction between “healthy” finite mourning and “unhealthy” melancholia as initially presented by Freud in his “Mourning and Melancholia” (1917). Mourning in Montale’s poetry is intermittent, but nevertheless unending.\n \nBy considering the relationship between Montale’s poetry and mourning from the Derridean perspective of “demi-deuil” I contribute an original viewpoint to the study of Montale’s “care ombre” (“Proda di Versilia,” \nLa bufera e altro\n, 1956), whereby subjects of mourning are no longer considered to be negatively dominated by the Other’s death, but rather devoted to preserving the affect relationship with the dead, as opposed to the Freudian notion of “moving on” after loss. From this standpoint, elegiac poetry, in Montale’s rendition of it, assumes the key responsibility of passing on traumatic knowledge and, in so doing, affirms its centrality in the creation of a space where death and the experience of mourning can be framed and processed.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Eugenio Montale"},{"word":"Lyric Poetry"},{"word":"Jacque Derrida"},{"word":"Demi-deuil"},{"word":"Mourning"}],"section":"NINETEENTH- AND TWENTIETH-CENTURY ITALIAN POETRY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/33k049ft","frozenauthors":[{"first_name":"Adele","middle_name":"","last_name":"Bardazzi","name_suffix":"","institution":"The Queen’s College, University of Oxford","department":"None"}],"date_submitted":"2018-05-17T14:41:14+02:00","date_accepted":"2018-05-17T14:41:14+02:00","date_published":"2019-02-13T20:12:25+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40735/galley/30545/download/"}]},{"pk":40719,"title":"Temporalità liriche. Ripetizione e incompiutezza tra Dante e Caproni, Montale e Sanguineti","subtitle":null,"abstract":"Looking at lyric poetry from the perspective of temporality, this paper intends to address a crucial and often overlooked issue for a theoretical approach to the lyric: how the crystallized moment of the single poem encapsulates iteration. One side of this issue is at the centre of Jonathan Culler’s \nTheory of the Lyric\n (2015): the lyric poem as a script to be actualized as event in the ‘now’ of each act of reading. I want to focus instead on the other side of the issue, namely on the strategies by which the poem itself singularizes what it presents as a recurrent event. This ancient phenomenon can be traced back, for instance, to Sappho’s fragment 31 and its famous translation, Catullus’ \ncarmen\n 51, but the point of departure here will be a much clearer case: Dante’s sonnet “Tanto gentile e tanto onesta pare”. Indeed, it is Dante himself who makes these dynamics clear in the narrative prose that precedes the poem and provides its scene of enunciation. Moving to the twentieth century, I will discuss first an evident case of retrieval of Dante’s and Cavalcanti’s poetics by focusing on one of the poems that Giorgio Caproni collects in the section “Versi livornesi” of his 1959 book \nIl seme del piangere\n. Then I will expand the analysis to other poems by poets as different as Montale and Sanguineti. The discussion will address also issues of open referentiality, the re-enactment of lyric gestures, and the trans-historical dimension of the lyric in the context of Giorgio Agamben’s notion of \npoetica dell’inoperosità\n as a potential critique of teleology.","language":"it","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"lyric"},{"word":"time"},{"word":"Trans-historicism"},{"word":"Repetition"},{"word":"incompleteness"},{"word":"Lyric gestures"},{"word":"Singularity"},{"word":"performance"},{"word":"Community"}],"section":"NINETEENTH- AND TWENTIETH-CENTURY ITALIAN POETRY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/87x199p7","frozenauthors":[{"first_name":"Francesco","middle_name":"","last_name":"Giusti","name_suffix":"","institution":"ICI Berlin Institute for Cultural Inquiry","department":"None"}],"date_submitted":"2018-03-15T20:44:50+01:00","date_accepted":"2018-03-15T20:44:50+01:00","date_published":"2019-02-13T20:11:19+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40719/galley/30538/download/"}]},{"pk":40736,"title":"Thinking the Future in Giacomo Leopardi’s Zibaldone","subtitle":null,"abstract":"This essay examines Giacomo Leopardi’s reflections on the future in the \nZibaldone\n, his encyclopedic miscellany of notes and thoughts. Leopardi (1798-1837) is one of Europe’s greatest poets and thinkers, yet his reception outside of Italy has been relatively limited. The article aims to situate Leopardi’s ideas in the context of modern European thought and to frame his vision of futurity by examining a series of interconnected issues: the question of the modern individual’s experience of time and relationship with the future; the nature of society’s responsibility toward the generations to come; and the question of literature’s engagement with future readers. It shows how Leopardi’s philosophy of the future provided both a critique of European modernity and a response to its challenges. It also draws out the parallel issue of an author’s contemporaneity, that is her capacity to belong to her period and, at the same time, to transcend it. Thus, while resituating Leopardi’s temporal reflection within the epochal changes that took place between the eighteenth and nineteenth centuries, the article also attempts to decouple the texts and their message from their historical period, in order to investigate Leopardi’s relevance beyond the limits of his present.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Leopardi"},{"word":"Zibaldone"},{"word":"Modernity"},{"word":"future"},{"word":"contemporaneity"}],"section":"NINETEENTH- AND TWENTIETH-CENTURY ITALIAN POETRY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0h43q19k","frozenauthors":[{"first_name":"Sabrina","middle_name":"","last_name":"Ferri","name_suffix":"","institution":"University of Notre Dame","department":"None"}],"date_submitted":"2018-05-21T19:47:23+02:00","date_accepted":"2018-05-21T19:47:23+02:00","date_published":"2019-02-13T20:10:10+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40736/galley/30546/download/"}]},{"pk":40715,"title":"Poetry Without End: Reiterating Desire in Petrarch’s Rvf 70 and 23","subtitle":null,"abstract":"This paper proposes a new reading of Petrarch’s \nRVF\n 70, an intertextual \ncanzone\n (and part-\ncento\n)\n \nthat ends with an explicit textual return to the poet’s own \nRVF\n 23, the so-called \ncanzone delle metamorfosi \n[canzone of the metamorphoses]. The \nincipit\n of \ncanzone \n23, ‘Nel dolce tempo de la prima etade’ [In the sweet time of my first age] forms the final line of \ncanzone \n70 and is the last in a series of quotations of the \nincipits\n of earlier poems (by the pseudo-Arnaut Daniel, Cavalcanti, Dante, and Cino da Pistoia), each of which closes one of the stanzas of Petrarch’s poem. The trend has been to read \nRVF\n 70 teleologically and as a palinode, in which the poet renounces errant desire and arrives at a new mode of loving and speaking by moving beyond the limitations of the previous tradition and his own earlier poetics, including the sensually-directed eros expounded in canzone 23. Instead this paper explores what happens if we take \nRVF\n 70 as a more literal return to \nRVF \n23, which unsettles or resists the resolution of change proposed in the poem by keeping the question of desire more open and expressing a form of poetic subjectivity that paradoxically seeks to have it both ways – to recognize a fault in desire without renouncing it and to take pleasure in repeatedly giving itself over to what harms it. In this reading, the poet’s decision to end \nRVF\n 70 with a return to the beginning of his own \nRVF\n 23 not only destabilizes the narrative of conversion on which critics usually insist, but leads the poems to reenter themselves endlessly, making repetition and deferral the blueprint of Petrarch’s poetics.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"MEDIEVAL AND EARLY MODERN ITALIAN POETRY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5996x6qn","frozenauthors":[{"first_name":"Manuele","middle_name":"","last_name":"Gragnolati","name_suffix":"","institution":"Sorbonne Universite","department":"None"},{"first_name":"Francesca","middle_name":"","last_name":"Southerden","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2018-02-24T02:22:36+01:00","date_accepted":"2018-02-24T02:22:36+01:00","date_published":"2019-02-13T20:09:26+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40715/galley/30534/download/"}]},{"pk":40757,"title":"Boccaccio’s Cartography of Poetry, or the Geocritical Navigation of the Genealogy of the Pagan Gods","subtitle":null,"abstract":"This essay offers a geocritical reading of \nBoccaccio’s Genealogie deorum gentilium\n for its unique combination of poetry and geography. The \nGenealogy\n features the poet’s journey through the Mediterranean Sea, and in particular through the Archipelago, the Aegean Sea, to describe places where the myths of the pagan gods and their progeny unfolded, with the end goal of establishing the veracity of poetry. In so doing, he adopts an empirical approach to the search of the truth of the myths, thereby making a cartography of the poetry, a unique humanistic space in which he rescues the relics of a shipwrecked past by mapping spaces and places of civilization.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"MEDIEVAL AND EARLY MODERN ITALIAN POETRY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3bf722mr","frozenauthors":[{"first_name":"Roberta","middle_name":"","last_name":"Morosini","name_suffix":"","institution":"Wake Forest University (NC)","department":"None"}],"date_submitted":"2018-11-08T17:07:33+01:00","date_accepted":"2018-11-08T17:07:33+01:00","date_published":"2019-02-13T20:08:33+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40757/galley/30552/download/"}]},{"pk":40718,"title":"“Ché non finire so cominciare”: Orality's Role in Shaping the Circular Poetics of Guittone's ballate-laude","subtitle":null,"abstract":"The relationship between the ballata (a secular, popular poetic form with a refrain, often performed orally) and the lauda (a religious musical composition that gained popularity in Tuscany and Umbria in the 1260s) have long been contested by historians of Italian literature. The case of Siculo-Tuscan poet Guittone d'Arezzo's five ballate-laude demonstrate the high level of cross-fertilization between the ballata and the lauda, as he uses the secular poem's refrain form in creating his poetics of praise. More specifically, Guittone uses the refrain form to enact, with an extraordinary level of poetic self-awareness, an anti-sequential, circular, never-ending poetics of praise for the divine. A close examination of these poems, then, provides new perspectives on orality and textuality in the early Italian lyric, as well as pointing to new poetic possibilities resulting from the fusion of the two. These possibilities would prove fruitful in later Italian lyric, even contributing to Dante's attempts at out-of-time poetics in the Paradiso.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Ballata"},{"word":"Lauda"},{"word":"Medieval Italian Lyric"},{"word":"Orality"},{"word":"Circularity"},{"word":"Sequentiality"}],"section":"MEDIEVAL AND EARLY MODERN ITALIAN POETRY","is_remote":true,"remote_url":"https://escholarship.org/uc/item/990165rr","frozenauthors":[{"first_name":"Isabella","middle_name":"M","last_name":"Livorni","name_suffix":"","institution":"Columbia University","department":"None"}],"date_submitted":"2018-03-14T19:45:23+01:00","date_accepted":"2018-03-14T19:45:23+01:00","date_published":"2019-02-13T20:07:25+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cisj/article/40718/galley/30537/download/"}]},{"pk":48205,"title":"Integrating the Arts into Science Teaching and Learning: a Literature Review","subtitle":null,"abstract":"Combining arts with science builds on children’s interests in nature while allowing artistic expression.  Although educators often discuss integrating the arts into science learning, empirical support is relatively recent.  This thorough review of the education research literature on arts integration synthesizes previous empirical studies and theoretical literature published on arts integration, how the arts are integrated into science teaching, and the efficacy of arts integration for science learning.  It provides evidence that arts integration provides positive outcomes in important areas such as learning, school climate, and teacher collaboration.  This review also discusses evidence regarding obstacles to arts integration such as time, professional development, and ongoing support for teachers.  Finally, we offer implications for future research, including the need for more rigorous empirical studies on integrating the arts into science teaching and learning.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Arts Integration"},{"word":"science education"},{"word":"K-12 education"}],"section":"Arts and Sciences","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7bz8d6bz","frozenauthors":[{"first_name":"Kathryn","middle_name":"","last_name":"Green","name_suffix":"","institution":"North Carolina State University","department":"None"},{"first_name":"Kathy","middle_name":"Cabe","last_name":"Trundle","name_suffix":"","institution":"Utah State University","department":"None"},{"first_name":"Maria","middle_name":"","last_name":"Shaheen","name_suffix":"","institution":"Primrose Schools","department":"None"}],"date_submitted":"2018-09-02T15:53:37+02:00","date_accepted":"2018-09-02T15:53:37+02:00","date_published":"2019-02-13T17:55:09+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/cla_jlta/article/48205/galley/36311/download/"}]},{"pk":12110,"title":"Push Notifications Reduce Emergency Department Response Times to Prehospital ST-segment Elevation Myocardial Infarction","subtitle":null,"abstract":"Introduction:\n Prehospital acquisition of electrocardiograms (ECG) has been consistently associated with reduced door-to-balloon times in the treatment of ST-segment myocardial infarction (STEMI). There is little evidence establishing best hospital practices once the ECG has been received by the emergency department (ED). This study evaluates the use of a push notification system to reduce delays in cardiac catheterization lab (CCL) activation for prehospital STEMI.\nMethods:\n In this prospective before-and-after study, we collected prehospital ECGs with computer interpretation of STEMI from May 2012 to October 2013. Push notifications were implemented June 1, 2013. During the study period, we collected timestamps of when the prehospital ECG was received (email timestamp of receiving account), CCL team activation (timestamp in paging system), and patient arrival (timestamp in ED tracking board). When prehospital ECGs were received in the ED, an audible alert was played via the Vocera WiFi communication system, notifying nursing staff that an ECG was available for physician interpretation. We compared the time from receiving the ECG to activation of the CCL before and after the audible notification was implemented. \nResults:\n Of the 56 cases received, we included 45 in our analysis (20 cases with pre-arrival CCL activation and 25 with post-arrival activation). For the pre-arrival group, the interval from ECG received to CCL activation prior to implementation was 9.1 minutes with a standard deviation (SD) of 5.7 minutes. After implementation, the interval was reduced to 3.33 minutes with a SD of 1.63 minutes. Delay was decreased by 5.8 minutes (p &lt; 0.01). Post-implementation activation times were more consistent, demonstrated by a decrease in SD from 5.75 to 1.63 min (p &lt; 0.01). For patients with CCL activation after arrival, there was no significant change in mean delay after implementation.\nConclusion:\n In this small, single-center observational study, we demonstrated that the use of push notifications to ED staff alerting that a prehospital STEMI ECG was received correlated with a small reduction in, and increased consistency of, ED CCL activation.","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":"STEMI"},{"word":"paramedic"},{"word":"push notification"}],"section":"Emergency Medical Services","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5kk5j0qx","frozenauthors":[{"first_name":"Mathew","middle_name":"","last_name":"Goebel","name_suffix":"","institution":"University of California San Diego School of Medicine, Department of Emergency Medicine, San Diego, California","department":"None"},{"first_name":"Joseph","middle_name":"","last_name":"Bledsoe","name_suffix":"","institution":"Intermountain Medical Center, Department of Emergency Medicine, Murray, Utah","department":"None"}],"date_submitted":"2018-08-01T06:55:25+02:00","date_accepted":"2018-08-01T06:55:25+02:00","date_published":"2019-02-11T21:59:19+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12110/galley/6486/download/"}]},{"pk":12193,"title":"The Prevalence of Modifiable Parental Behaviors Associated with Inadvertent Pediatric Medication Ingestions","subtitle":null,"abstract":"Introduction:\n Our aim was to examine potential risk factors and modifiable behaviors that could lead to pediatric poisonings. Our secondary objectives were to explore socioeconomic factors associated with caregiver (parent/guardian) safe medication storage and knowledge of poison control contact information. \nMethods:\n We conducted a prospective, cross-sectional survey of caregivers of patients 2-10 years old presenting to an inner city pediatric emergency department. Caregiver and patient demographic data, prescription and nonprescription medication type, storage and when and where taken, were recorded. We used multivariable regression to explore factors associated with secure prescription medication storage and knowledge of poison control center contact information.\nResults:\n Of 1457 caregivers, 29% took daily prescription and 17% took daily non-prescription medications. Only 25% of caregivers stored their prescription medications in a secure place, and &lt;3% stored medications in a locked drawer or safe. Of demographic and socioeconomic factors, only income ≥$80,000 was associated with storage of prescription medication in a secure place (odds ratio [OR], 2.47; 95% confidence interval [CI], 1.27-4.81). When asked how they would access poison control in case of an ingestion, the majority, 86%, had an appropriate plan. In multivariable regression, the only factor associated with knowledge of poison control center contact information was college education in the caregiver (OR 1.6; 95% CI, 1.10-2.32). \nConclusion:\n A minority of caregivers store medications in a safe place and even fewer keep prescription medications under lock and key. The majority, however, were aware of how to contact a poison control center in case of ingestion.","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":"Poisoning, toxicology, child"}],"section":"Pediatrics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1mz1b03s","frozenauthors":[{"first_name":"Matthew","middle_name":"","last_name":"Salzman","name_suffix":"","institution":"Cooper Medical School of Rowan University, Department of Emergency Medicine, Camden, New Jersey","department":"None"},{"first_name":"Lia","middle_name":"","last_name":"Cruz","name_suffix":"","institution":"Cooper Medical School of Rowan University, Department of Pediatrics, Camden, New Jersey","department":"None"},{"first_name":"Sandra","middle_name":"","last_name":"Nairn","name_suffix":"","institution":"Cooper Medical School of Rowan University, Department of Emergency Medicine, Camden, New Jersey","department":"None"},{"first_name":"Samuel","middle_name":"","last_name":"Bechmann","name_suffix":"","institution":"Cooper Medical School of Rowan University, Department of Emergency Medicine, Camden, New Jersey","department":"None"},{"first_name":"Rupa","middle_name":"","last_name":"Gupta","name_suffix":"","institution":"Cooper Medical School of Rowan University, Department of Emergency Medicine, Camden, New Jersey","department":"None"},{"first_name":"Brigitte","middle_name":"M.","last_name":"Bauman","name_suffix":"","institution":"Cooper Medical School of Rowan University, Department of Emergency Medicine, Camden, New Jersey","department":"None"}],"date_submitted":"2018-09-21T21:21:07+02:00","date_accepted":"2018-09-21T21:21:07+02:00","date_published":"2019-02-11T21:55:32+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12193/galley/6515/download/"}]},{"pk":12101,"title":"Individualized Interactive Instruction: A Guide to Best Practices from the Council of Emergency Medicine Residency Directors","subtitle":null,"abstract":"Over the last several years, there has been increasing interest in transitioning a portion of residency education from traditional, lecture-based format to more learner-centered asynchronous opportunities. These asynchronous learning activities were renamed in 2012 by the Accreditation Council for Graduate Medical Education (ACGME) as individualized interactive instruction (III). The effectiveness and applicability of III in residency education has been proven by multiple studies, and its routine use has been made officially acceptable as per the ACGME. This article provides a review of the current literature on the implementation and utilization of III in emergency medicine residency education. It provides examples of currently implemented and studied III curricula, identifies those III learning modalities that can be considered best practice, and provides suggestions for program directors to consider when choosing how to incorporate III into their residency teaching.","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":"Individualized Interactive Instruction, asynchronous learning, emergency medicine, residency, curriculum"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5pj6j9q0","frozenauthors":[{"first_name":"Molly","middle_name":"","last_name":"Estes","name_suffix":"","institution":"Loma Linda University, Department of Emergency Medicine, Loma Linda, California","department":"None"},{"first_name":"Puja","middle_name":"","last_name":"Gopal","name_suffix":"","institution":"University of Chicago, Department of Emergency Medicine, Chicago, Illinois","department":"None"},{"first_name":"Jeffrey","middle_name":"N.","last_name":"Siegelman","name_suffix":"","institution":"Emory University, Department of Emergency Medicine, Atlanta, Georgia","department":"None"},{"first_name":"John","middle_name":"","last_name":"Bailitz","name_suffix":"","institution":"Northwestern University Emergency Medicine, Feinberg School of Medicine, Chicago, Illinois","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":"2018-07-25T00:35:39+02:00","date_accepted":"2018-07-25T00:35:39+02:00","date_published":"2019-02-11T21:52:51+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12101/galley/6483/download/"}]},{"pk":12223,"title":"Emergency Medicine Physician Assistant (EMPA) Postgraduate Training Programs: Program Characteristics and Training Curricula","subtitle":null,"abstract":"n/a","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Provider Workforce","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7sz4j9td","frozenauthors":[{"first_name":"Fred","middle_name":"","last_name":"Wu","name_suffix":"","institution":"Society of Emergency Medicine Physician Assistants (SEMPA), Irving, Texas","department":"None"}],"date_submitted":"2018-09-27T06:40:15+02:00","date_accepted":"2018-09-27T06:40:15+02:00","date_published":"2019-02-11T21:49:42+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12223/galley/6530/download/"}]},{"pk":12117,"title":"Why Residents Quit: National Rates of and Reasons for Attrition Among Emergency Medicine Physicians in Training","subtitle":null,"abstract":"Introduction: \nRecruiting and retaining residents who will complete their emergency medicine (EM) training is vital, not only because residency positions are a limited and costly resource, but also to prevent the significant disruptions, increased workload, and low morale that may arise when a resident prematurely leaves a program. We investigated national rates of EM resident attrition and examined the reasons and factors associated with their attrition. \nMethods:\n In this retrospective, observational study we used national data from the American Medical Association National Graduate Medical Education Census for all residents who entered Accreditation Council for Graduate Medical Education-accredited EM programs between academic years 2006-2007 and 2015-2016. Our main outcome was the annual national rate of EM resident attrition. Secondary outcomes included the main reason for attrition as well as resident factors associated with attrition. \nResults:\n Compared to the other 10 largest specialties, EM had the lowest rate of attrition (0.8%, 95% confidence interval [CI] [0.7-0.9]), or approximately 51.6 (95% CI [44.7-58.5]) residents per year. In the attrition population, 44.2% of the residents were women, a significantly higher proportion when compared to the proportion of female EM residents overall (38.8%, p=0.011). A greater proportion of Hispanic/Latino (1.8%) residents also left their programs when compared to their White (0.9%) counterparts (p&lt;0.001). In examining reasons for attrition as reported by the program director, female residents were significantly more likely than male residents to leave due to “health/family reasons” (21.5% vs 9.6%, p=0.019). \nConclusion:\n While the overall rate of attrition among EM residents is low, women and some under-represented minorities in medicine had a higher than expected rate of attrition. Future studies that qualitatively investigate the factors contributing to greater attrition among female and some ethnic minority residents are necessary to inform efforts promoting inclusion and diversity within the specialty.","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":"Education, Medical, Graduate"},{"word":"Internship and Residency"},{"word":"Female"},{"word":"Minority Groups"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9g62v2qf","frozenauthors":[{"first_name":"Dave","middle_name":"W.","last_name":"Lu","name_suffix":"","institution":"Tufts University School of Medicine, Department of Emergency Medicine, Medford, Massachusetts\nMaine Medical Center, Department of Emergency Medicine, Portland, Maine","department":"None"},{"first_name":"Nicholas","middle_name":"D.","last_name":"Hartman","name_suffix":"","institution":"Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina","department":"None"},{"first_name":"Jeffrey","middle_name":"","last_name":"Druck","name_suffix":"","institution":"The University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado","department":"None"},{"first_name":"Jennifer","middle_name":"","last_name":"Mitzman","name_suffix":"","institution":"The Ohio State University College of Medicine, Department of Emergency Medicine, Columbus, Ohio","department":"None"},{"first_name":"Tania","middle_name":"D.","last_name":"Strout","name_suffix":"","institution":"Tufts University School of Medicine, Department of Emergency Medicine, Medford, Massachusetts\nMaine Medical Center, Department of Emergency Medicine, Portland, Maine","department":"None"}],"date_submitted":"2018-08-02T19:08:27+02:00","date_accepted":"2018-08-02T19:08:27+02:00","date_published":"2019-02-11T21:45:58+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12117/galley/6490/download/"}]},{"pk":11846,"title":"Rapid Discharge After Interfacility Transfer for Mild Traumatic Intracranial Hemorrhage: Frequency and Associated Factors","subtitle":null,"abstract":"Introduction:\n Traumatic intracranial hemorrhage (TIH), brain injury with radiographic hemorrhage, is a common emergency department (ED) presentation, and encompasses a wide range of clinical syndromes. Patients with moderate and severe neurotrauma (Glasgow Coma Scale [GCS] &lt; 13) with intracranial hemorrhage require care at a trauma center with neurosurgical capabilities. However, many patients with mild traumatic intracranial hemorrhage (mTIH), defined as radiographic bleeding and GCS ≥ 13, do not require operative intervention or intensive care unit monitoring, but are still routinely transferred to tertiary care centers. We hypothesized that a significant proportion of patients are managed non-operatively and are discharged within 24 hours of admission.\nMethods:\n This was a retrospective, observational study of consecutive patients age ≥ 16 years, GCS ≥ 13 who were transferred to an urban, medical school-affiliated, 100,000 annual visit ED over a seven-year period with blunt isolated mTIH. The primary outcome was discharge within 24 hours of admission. We measured rates of neurosurgical intervention, computed tomography hemorrhage progression, and neurologic deterioration as well as other demographic and clinical variables.\nResults:\n There were 1079 transferred patients with isolated mTIH. Of these, 92.4% were treated non-operatively and 35.8% were discharged within 24 hours of presentation to the tertiary ED. Patient characteristics associated with rapid discharge after transfer include a GCS of 15 (odds ratio [OR] 2.9, 95% confidence interval [CI], 1.9 – 4.4), subdural hematoma ≤ 6mm (OR 3.1, 95% CI, 2.2 – 4.5) or the presence of an isolated subarachnoid hemorrhage (OR 1.7, 95% CI, 1.3 – 2.4). Of patients with length of stay &lt; 24 hours, 79.8% were discharged directly from the ED or ED observation unit. \nConclusion:\n Patients transferred to tertiary care centers are frequently discharged after brief observation without intervention. Risk can be predicted by clinical and radiographic data. Further prospective research is required to determine a safe cohort of patients who could be managed at community sites.","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":"mild head trauma, traumatic intracranial hemorrhage, inter-facility transfer, head injury"}],"section":"Health Outcomes","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0tq9v87d","frozenauthors":[{"first_name":"Pierre","middle_name":"","last_name":"Borczuk","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Jonathan","middle_name":"Van","last_name":"Ornam","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"},{"first_name":"Joshua","middle_name":"","last_name":"Penn","name_suffix":"","institution":"Winchester Hospital, Emergency Services, Winchester, Massachusetts","department":"None"},{"first_name":"Peter","middle_name":"","last_name":"Pruitt","name_suffix":"","institution":"Northwestern University, Department of Emergency Medicine, Chicago, Illinois","department":"None"}],"date_submitted":"2018-06-11T19:10:26+02:00","date_accepted":"2018-06-11T19:10:26+02:00","date_published":"2019-02-11T21:40:44+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11846/galley/6342/download/"}]},{"pk":44648,"title":"Severe Pharyngitis due to Primary Acute Epstein-Barr Virus (EBV) and Cytomegalovirus (CMV) Coinfection","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/2vk5m5nd","frozenauthors":[{"first_name":"Adam","middle_name":"","last_name":"Braun","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Reece","middle_name":"","last_name":"Doughy","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2019-02-08T16:56:55+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44648/galley/33441/download/"}]},{"pk":41692,"title":"Puercolestes\n and \nBetonnia\n (Cimolestidae, Mammalia) from the early Paleocene (Puercan 3 Interval Zone) of northeastern Montana, U.S.A.","subtitle":null,"abstract":"In northeastern Montana, fossil localities in the Garbani Channel Complex and other early Paleocene (Puercan 3 Interval Zone) localities are preserved in the Tullock Member of the Fort Union Formation. They document an early phase in the recovery of the terrestrial fauna of the North American Western Interior after the mass extinction marking the Cretaceous-Paleogene (K-Pg) boundary. The cimolestids \nPuercolestes simpsoni\n and \nBetonnia tsosia\n were typified on fragmentary jaws and isolated teeth found in Puercan 2 and 3 Interval Zones (Pu2, Pu3) in the Nacimiento Formation, San Juan Basin, New Mexico. The available samples of these genera from both New Mexico and Montana are small and dominantly consist of isolated teeth. Characters of upper cheek teeth, P4 and M1–M3, justify provisional recognition of \nPuercolestes\n sp. cf. \nPu. simpsoni\n and the somewhat smaller \nBetonnia\n sp. cf. \nBe. tsosia\n in Pu3 local faunas in the Tullock Member. In contrast, discovery of characters distinguishing the isolated lower cheek teeth, p4s and m1–m3s, of these species must await recovery of dentulous dentaries documenting the patterns of morphological variation of their lower dentitions. Fossils from the Tullock Member add support to the current interpretation that cimolestids were taxonomically diverse and geographically widespread but relatively rare members of the faunas of the North American Western Interior during approximately the first million years of the Paleocene.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-ShareAlike 4.0","short_name":"CC BY-NC-SA 4.0","text":"<p><!-- x-tinymce/html --></p>\n<p>Readers are free to:</p>\n<ul>\n<li><strong>Share</strong> — copy and redistribute the material in any medium or format</li>\n<li><strong>Adapt</strong> — remix, transform, and build upon the material<br><br>The licensor cannot revoke these freedoms as long as you follow the license terms.</li>\n</ul>\n<p>Under the following terms:</p>\n<ul>\n<li><strong>Attribution</strong> — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.</li>\n<li><strong>NonCommercial</strong> — You may not use the material for commercial purposes .</li>\n<li><strong>ShareAlike</strong> — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br><br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</li>\n</ul>\n<p>Notices:</p>\n<p>You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.</p>\n<p>No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.</p>","url":"https://creativecommons.org/licenses/by-nc-sa/4.0"},"keywords":[{"word":"<i>Puercolestes</i>, <i>Betonnia</i>, Cimolestidae, Puercan, Tullock Member, Fort Union Formation, Montana"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/04r4f1wk","frozenauthors":[{"first_name":"William","middle_name":"A.","last_name":"Clemens","name_suffix":"","institution":"University of California Museum of Paleontology, 1101 Valley Life Sciences Building, \nBerkeley, California 94720-4780","department":"None"}],"date_submitted":"2019-02-08T20:42:37+01:00","date_accepted":"2019-02-08T20:42:37+01:00","date_published":"2019-02-08T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/ucmp_paleobios/article/41692/galley/31190/download/"}]}]}