Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. No additional restrictions — You may not apply 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":"Transnational"},{"word":"American Studies"},{"word":"Transpacific"},{"word":"Chicana/o Literature"}],"section":"Forward","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6842g1bw","frozenauthors":[{"first_name":"Jayson","middle_name":"Gonzales","last_name":"Sae-Saue","name_suffix":"","institution":"Dedman College, Southern Methodist University","department":"None"}],"date_submitted":"2017-10-05T02:57:18+11:00","date_accepted":"2017-10-05T02:57:18+11:00","date_published":"2017-10-05T02:57:50+11:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42842/galley/31942/download/"}]},{"pk":42841,"title":"A History That \"Dares Not Speak Its Name\"? Atlantic History, Global History and the Modern Atlantic Space","subtitle":null,"abstract":"Marco Mariano, “A History That ‘Dares Not Speak Its Name’? Atlantic History, Global History and the Modern Atlantic Space,” originally published as “Lo spazio atlantico contemporaneo: una storia ‘che non osa pronunciare il suo nome’?” in the journal \nPassato e Presente\n 100 (2017).","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. No additional restrictions — You may not apply 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":"Transnational"},{"word":"American Studies"},{"word":"History"},{"word":"Atlantic"}],"section":"Forward","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4k8891s9","frozenauthors":[{"first_name":"Marco","middle_name":"","last_name":"Mariano","name_suffix":"","institution":"Università del Piemonte Orientale","department":"None"}],"date_submitted":"2017-10-05T02:49:53+11:00","date_accepted":"2017-10-05T02:49:53+11:00","date_published":"2017-10-05T02:50:30+11:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42841/galley/31941/download/"}]},{"pk":42840,"title":"Introduction to \nThe Limits of Westernization: A Cultural History of America in Turkey","subtitle":null,"abstract":"Perin E. Gürel, introduction to \nThe Limits of Westernization: A Cultural History of America in Turkey\n (New York: Columbia University Press, 2017), 1–15.","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. No additional restrictions — You may not apply 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":"Transnational"},{"word":"American Studies"},{"word":"Westernization"},{"word":"Turkey"}],"section":"Forward","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6wd8d4bq","frozenauthors":[{"first_name":"Perin","middle_name":"E.","last_name":"Gürel","name_suffix":"","institution":"University of Notre Dame","department":"None"}],"date_submitted":"2017-10-05T02:41:42+11:00","date_accepted":"2017-10-05T02:41:42+11:00","date_published":"2017-10-05T02:41:53+11:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42840/galley/31940/download/"}]},{"pk":42839,"title":"Introduction to \nAmerican Literature in the World","subtitle":null,"abstract":"Wai Chee Dimock, introduction to \nAmerican Literature in the World: An Anthology from Anne Bradstreet to Octavia Butler\n, ed. Wai Chee Dimock et al. (New York: Columbia University Press, 2017), 1–18.","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. No additional restrictions — You may not apply 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":"Transnational"},{"word":"American Studies"},{"word":"American literature"}],"section":"Forward","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1936727c","frozenauthors":[{"first_name":"Wai Chee","middle_name":"","last_name":"Dimock","name_suffix":"","institution":"Yale University","department":"None"}],"date_submitted":"2017-10-05T02:33:41+11:00","date_accepted":"2017-10-05T02:33:41+11:00","date_published":"2017-10-05T02:33:58+11:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42839/galley/31939/download/"}]},{"pk":42838,"title":"Before Nation, Beyond Nation: The Place of \"Early\" in Transnational American Studies","subtitle":null,"abstract":"Kristina Bross and Laura M. Stevens, “Before Nation, Beyond Nation: The Place of ‘Early’ in Transnational American Studies,” in \nObama and Transnational American Studies\n, ed. Alfred Hornung (Heidelberg: Universitätsverlag Winter, 2016), 313–34.","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. No additional restrictions — You may not apply 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":"Transnational"},{"word":"American Studies"},{"word":"nation"},{"word":"Early American"}],"section":"Forward","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8nz211zp","frozenauthors":[{"first_name":"Kristina","middle_name":"","last_name":"Bross","name_suffix":"","institution":"Purdue University","department":"None"},{"first_name":"Laura","middle_name":"M.","last_name":"Stevens","name_suffix":"","institution":"University of Tulsa","department":"None"}],"date_submitted":"2017-10-05T02:22:43+11:00","date_accepted":"2017-10-05T02:22:43+11:00","date_published":"2017-10-05T02:23:17+11:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42838/galley/31938/download/"}]},{"pk":442,"title":"The Case of Ketamine Allergy","subtitle":null,"abstract":"Ketamine is often used for pediatric procedural sedation due to low rates of complications, with allergic reactions being rare. Immediately following intramuscular (IM) ketamine administration, a three-year-old female rapidly developed facial edema and diffuse urticarial rash, with associated wheezing and oxygen desaturation. Symptoms resolved following treatment with epinephrine, dexamethasone and diphenhydramine. This case presents a clinical reaction to ketamine consistent with anaphylaxis due to histamine release, but it is uncertain whether this was immuno globulin Emediated. This is the only case reported to date of allergic reaction to IM ketamine, without coadministration of other agents.","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/9ck8n7mm","frozenauthors":[{"first_name":"William","middle_name":"","last_name":"Bylund","name_suffix":"","institution":"Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia","department":"None"},{"first_name":"Liam","middle_name":"","last_name":"Delahanty","name_suffix":"","institution":"Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia","department":"None"},{"first_name":"Maxwell","middle_name":"","last_name":"Cooper","name_suffix":"","institution":"Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia","department":"None"}],"date_submitted":"2017-10-04T04:37:28+11:00","date_accepted":"2017-10-04T04:37:28+11:00","date_published":"2017-10-04T04:37:59+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/442/galley/206/download/"}]},{"pk":441,"title":"Thoracic Compression Fracture as a Result of Taser® Discharge","subtitle":null,"abstract":"A conducted electrical device (CED), usually Taser®, is commonly used by law enforcement officers to aid in the incapacitation of subjects. While CEDs are considered “safe” for use on subjects, adverse events may rarely occur. We report a case of a 23-year-old male presenting with severe back pain following deployment of a CED with resulting acute compression fractures of the thoracic sixth, seventh, and eighth vertebral bodies. To the best of our knowledge, this represents the third case of traumatic injury from CED discharge to be reported in the literature since 1995.","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/3r2863zx","frozenauthors":[{"first_name":"Aaron","middle_name":"C.","last_name":"Tyagi","name_suffix":"","institution":"Michigan State University, Sparrow Hospital, Department of Emergency Medicine, Lansing, Michigan","department":"None"},{"first_name":"Alex","middle_name":"","last_name":"Gill","name_suffix":"","institution":"Michigan State University, Sparrow Hospital, Department of Emergency Medicine, Lansing, Michigan","department":"None"},{"first_name":"Brent","middle_name":"","last_name":"Felton","name_suffix":"","institution":"Michigan State University, Sparrow Hospital, Department of Emergency Medicine, Lansing, Michigan","department":"None"}],"date_submitted":"2017-10-04T04:34:51+11:00","date_accepted":"2017-10-04T04:34:51+11:00","date_published":"2017-10-04T04:35:17+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/441/galley/205/download/"}]},{"pk":440,"title":"A Case of Syncope","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/65594969","frozenauthors":[{"first_name":"Kristin","middle_name":"H.","last_name":"Dwyer","name_suffix":"","institution":"Brown University, Warren Alpert School of Medicine, Department of Emergency Medicine, Providence, Rhode Island","department":"None"},{"first_name":"Joshua","middle_name":"S.","last_name":"Rempell","name_suffix":"","institution":"Cooper Medical School of Rowan University, Cooper University Hospital, Department\nof Emergency Medicine, Camden, New Jersey","department":"None"}],"date_submitted":"2017-10-04T04:31:56+11:00","date_accepted":"2017-10-04T04:31:56+11:00","date_published":"2017-10-04T04:32:16+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/440/galley/204/download/"}]},{"pk":439,"title":"An Unexpected Diagnosis Presenting as Hip Pain After a Fall","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/6m34x68q","frozenauthors":[{"first_name":"Jeremy","middle_name":"","last_name":"Sauer","name_suffix":"","institution":"Virginia Commonwealth University, Department of Emergency Medicine, Richmond, Virginia","department":"None"},{"first_name":"Eric","middle_name":"","last_name":"Morgan","name_suffix":"","institution":"Virginia Commonwealth University, Department of Emergency Medicine, Richmond, Virginia","department":"None"}],"date_submitted":"2017-10-04T04:29:03+11:00","date_accepted":"2017-10-04T04:29:03+11:00","date_published":"2017-10-04T04:29:30+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/439/galley/203/download/"}]},{"pk":438,"title":"Altered Mental Status Secondary to Extensive Pneumocephalus","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/4wn596v3","frozenauthors":[{"first_name":"Alexander","middle_name":"J.","last_name":"Scumpia","name_suffix":"","institution":"Broward Health, Imperial Point Hospital, Department of Emergency Medicine, Fort\nLauderdale, Florida","department":"None"},{"first_name":"Gary","middle_name":"","last_name":"Lai","name_suffix":"","institution":"Broward Health, Coral Springs Hospital, Department of Emergency Medicine, Coral\nSprings, Florida","department":"None"},{"first_name":"Maria","middle_name":"I.","last_name":"Rodriguez","name_suffix":"","institution":"Broward Health, Imperial Point Hospital, Department of Emergency Medicine, Fort\nLauderdale, Florida","department":"None"},{"first_name":"Daniel","middle_name":"M.","last_name":"Aronovich","name_suffix":"","institution":"Broward Health, Imperial Point Hospital, Department of Emergency Medicine, Fort\nLauderdale, Florida","department":"None"},{"first_name":"Gregory","middle_name":"","last_name":"Dubrovich","name_suffix":"","institution":"Broward Health, Imperial Point Hospital, Department of Emergency Medicine, Fort\nLauderdale, Florida","department":"None"},{"first_name":"Sopiko","middle_name":"","last_name":"Jimsheleishvili","name_suffix":"","institution":"University of California San Francisco, Department of Global Health Sciences, San\nFrancisco, California","department":"None"}],"date_submitted":"2017-10-04T04:20:31+11:00","date_accepted":"2017-10-04T04:20:31+11:00","date_published":"2017-10-04T04:20:51+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/438/galley/202/download/"}]},{"pk":437,"title":"Frontal Headache – An Unusual Presentation of Pneumomediastinum","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/6sk4t1kd","frozenauthors":[{"first_name":"Robert","middle_name":"","last_name":"Root","name_suffix":"","institution":"William Beaumont Army Medical Center, Department of Emergency Medicine, El Paso, Texas","department":"None"},{"first_name":"Bryant","middle_name":"","last_name":"Bullock","name_suffix":"","institution":"Madigan Army Medical Center, Fort Lewis, Washington","department":"None"},{"first_name":"Kevin","middle_name":"","last_name":"Schlicksup","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2017-10-04T04:14:10+11:00","date_accepted":"2017-10-04T04:14:10+11:00","date_published":"2017-10-04T04:14:30+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/437/galley/201/download/"}]},{"pk":436,"title":"Dead Legs: A Case of Bilateral Leg Paralysis","subtitle":null,"abstract":"Aortoiliac occlusive disease (AOD) is a rare presentation of thrombosis of the abdominal aorta. Also known as Leriche syndrome, its classic description entails claudication of the buttocks, thighs, and calves, absent femoral pulses, and impotence. AOD risk factors include smoking, hypertension, hyperlipidemia, diabetes, chronic renal insufficiency, and hypercoagulopathy. Ischemic complications of gastrointestinal malperfusion, renal infarction, and paralysis secondary to spinal cord ischemia are also noted. This case describes AOD complicated by a Stanford Type B aortic dissection leading to multi-system organ failure. A brief review of the literature further elucidates the key risk factors inidentifying and treating Leriche 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/3041r1nq","frozenauthors":[{"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":"Joel","middle_name":"","last_name":"Stillings","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California","department":"None"},{"first_name":"Jacqueline","middle_name":"","last_name":"Le","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California","department":"None"}],"date_submitted":"2017-10-04T04:11:17+11:00","date_accepted":"2017-10-04T04:11:17+11:00","date_published":"2017-10-04T04:11:39+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/436/galley/200/download/"}]},{"pk":435,"title":"Sternoclavicular Septic Arthritis Caused by Streptococcus pyogenes in a Child","subtitle":null,"abstract":"Septic arthritis can be a devastating condition that leads to further morbidity and potential mortality if not identified early in its course. Emergency providers must keep septic arthritis high on their differential of any joint-related pain in the pediatric population. We present a case of an eight-yearold female who initially presented with the chief complaint of chest pain and was subsequently diagnosed with septic arthritis of the left sternoclavicular joint in the emergency department.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6r60d2sj","frozenauthors":[{"first_name":"Yenisleidy","middle_name":"","last_name":"Paez-Perez","name_suffix":"","institution":"Department of Emergency Medicine, St. Joseph’s Regional Medical Center, Paterson, New Jersey","department":"None"},{"first_name":"Terrance","middle_name":"","last_name":"McGovern","name_suffix":"","institution":"Department of Emergency Medicine, St. Joseph’s Regional Medical Center, Paterson, New Jersey","department":"None"},{"first_name":"Ashley","middle_name":"","last_name":"Flannery","name_suffix":"","institution":"Department of Emergency Medicine, St. Joseph’s Regional Medical Center, Paterson, New Jersey","department":"None"},{"first_name":"Farid","middle_name":"","last_name":"Naim","name_suffix":"","institution":"Department of Emergency Medicine, St. Joseph’s Regional Medical Center, Paterson, New Jersey","department":"None"}],"date_submitted":"2017-10-04T04:08:08+11:00","date_accepted":"2017-10-04T04:08:08+11:00","date_published":"2017-10-04T04:08:45+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/435/galley/199/download/"}]},{"pk":434,"title":"Hiatal Hernia Mimicking Aortic Aneurysm on Point-of-care Echocardiography","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/9631f634","frozenauthors":[{"first_name":"Sam","middle_name":"","last_name":"Langberg","name_suffix":"","institution":"Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan\nDetroit Receiving Hospital, Department of Emergency Medicine, Detroit, Michigan","department":"None"},{"first_name":"Mark","middle_name":"","last_name":"Favot","name_suffix":"","institution":"Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan\nSinai Grace Hospital, Department of Emergency Medicine, Detroit, Michigan","department":"None"}],"date_submitted":"2017-10-04T03:52:12+11:00","date_accepted":"2017-10-04T03:52:12+11:00","date_published":"2017-10-04T03:52:44+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/434/galley/198/download/"}]},{"pk":433,"title":"Early Manifestations of Toxic Epidermal Necrolysis","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/6c94p0fw","frozenauthors":[{"first_name":"James","middle_name":"","last_name":"Chapman","name_suffix":"","institution":"Kent Hospital, Department of Emergency Medicine, Warwick, Rhode Island","department":"None"},{"first_name":"Katy","middle_name":"","last_name":"Deblois","name_suffix":"","institution":"Kent Hospital, Department of Emergency Medicine, Warwick, Rhode Island","department":"None"}],"date_submitted":"2017-10-04T03:43:22+11:00","date_accepted":"2017-10-04T03:43:22+11:00","date_published":"2017-10-04T03:43:45+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/433/galley/197/download/"}]},{"pk":432,"title":"Anterior Urethral Laceration from a Human Bite","subtitle":null,"abstract":"Isolated anterior urethral injuries in males related to sexual activity have rarely been reported. Human bites to the penis are also rarely discussed in the medical literature. We report an isolatedanterior urethral laceration in a male caused by a biting injury sustained during fellatio.","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/02z8p46s","frozenauthors":[{"first_name":"Chadwick","middle_name":"","last_name":"Shirk","name_suffix":"","institution":"University of Illinois at Chicago, College of Medicine, Department of Emergency\nMedicine, Chicago, Illinois","department":"None"},{"first_name":"Wesley","middle_name":"","last_name":"Eilbert","name_suffix":"","institution":"University of Illinois at Chicago, College of Medicine, Department of Emergency\nMedicine, Chicago, Illinois","department":"None"}],"date_submitted":"2017-10-04T03:36:19+11:00","date_accepted":"2017-10-04T03:36:19+11:00","date_published":"2017-10-04T03:40:22+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/432/galley/196/download/"}]},{"pk":431,"title":"Idiopathic Spinal Epidural Lipomatosis Causing Cauda Equina Syndrome","subtitle":null,"abstract":"Spinal epidural lipomatosis (SEL) is a rare condition defined by the hypertrophy of adipose tissue in the spinal epidural space, often resulting in compression of nerves in the region affected.1 This case describes a 64-year-old man who presented with cauda equina syndrome. Magnetic resonance imaging of the spine revealed extensive SEL of the lumbar spine. He underwent decompression and fusion with subsequent improvement of symptoms. This is one of the few cases reported of lumbar SEL in a non-obese patient in absence of long-term corticosteroid usage. We review possible etiologies.","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/71f5n7gj","frozenauthors":[{"first_name":"John","middle_name":"B.","last_name":"Bushkar","name_suffix":"","institution":"Medical University of South Carolina, Charleston, South Carolina","department":"None"},{"first_name":"Lacey","middle_name":"P.","last_name":"MenkinSmith","name_suffix":"","institution":"Medical University of South Carolina, Department of Emergency Medicine,\nCharleston, South Carolina","department":"None"},{"first_name":"Diann","middle_name":"M.","last_name":"Krywko","name_suffix":"","institution":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina","department":"None"}],"date_submitted":"2017-09-30T04:23:59+10:00","date_accepted":"2017-09-30T04:23:59+10:00","date_published":"2017-10-04T03:24:02+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/431/galley/195/download/"}]},{"pk":430,"title":"Man with Scrotal Rupture","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/5sd4d95f","frozenauthors":[{"first_name":"Andrew","middle_name":"","last_name":"Perechocky","name_suffix":"","institution":"Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Liam","middle_name":"","last_name":"Mahoney","name_suffix":"","institution":"Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Gina","middle_name":"","last_name":"Lopez","name_suffix":"","institution":"Boston Medical Center, Department of Emergency Medicine, Boston, Massachusetts","department":"None"}],"date_submitted":"2017-09-30T04:21:05+10:00","date_accepted":"2017-09-30T04:21:05+10:00","date_published":"2017-10-04T03:22:43+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/430/galley/194/download/"}]},{"pk":429,"title":"Reversible Acute Kidney Injury Associated with Chlorothalonil Ingestion","subtitle":null,"abstract":"A 43-year-old man ingested a chlorothalonil-containing fungicide in a suicide attempt. The patient was found to have acute kidney injury from acute tubular necrosis on hospital admission (serum creatinine 2.9 mg/dL), although his renal function recovered with hydration and supportive care. Acute toxicity from chlorothalonil ingestion has been described very rarely, and no previous cases have described clinically-significant renal effects.","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/8h07q644","frozenauthors":[{"first_name":"Jeffrey","middle_name":"R.","last_name":"Suchard","name_suffix":"","institution":"University of California Irvine Health School of Medicine, University of California Irvine Medical Center, Department of Emergency Medicine and Pharmacology, Orange, California","department":"None"}],"date_submitted":"2017-09-30T04:18:28+10:00","date_accepted":"2017-09-30T04:18:28+10:00","date_published":"2017-10-04T03:21:33+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/429/galley/193/download/"}]},{"pk":428,"title":"The Malingering Intussusception","subtitle":null,"abstract":"While intussusception is rarely seen in adults, it is typically obstructive in nature when it does occur. Even less commonly seen is transient intussusception, which occurs without a radiological lead point or any evidence of bowel obstruction. Such findings consist of a “target pattern” seen on computed tomography (CT) but are incidental and do not require any surgical intervention. We report the case of a 31-year-old female who presented to the emergency department with abdominal pain, vomiting, and diarrhea. CT imaging revealed transient intussusception, a benign finding that is not well established in emergency medicine literature.","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/4cj228rt","frozenauthors":[{"first_name":"Jacqueline","middle_name":"","last_name":"Le","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California","department":"None"},{"first_name":"Joel","middle_name":"","last_name":"Labha","name_suffix":"","institution":"Arrowhead Regional Medical Center, Department of Emergency Medicine, Colton, California","department":"None"},{"first_name":"Babak","middle_name":"","last_name":"Khazaeni","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California","department":"None"}],"date_submitted":"2017-09-30T04:16:20+10:00","date_accepted":"2017-09-30T04:16:20+10:00","date_published":"2017-10-04T03:20:18+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/428/galley/192/download/"}]},{"pk":427,"title":"Female with Abdominal Mass","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/2qr5s605","frozenauthors":[{"first_name":"Alex","middle_name":"","last_name":"Koo","name_suffix":"","institution":"Madigan Army Medical Center, Department of Emergency Medicine, Joint Base Lewis-McChord, Washington","department":"None"},{"first_name":"Scott","middle_name":"","last_name":"Young","name_suffix":"","institution":"Madigan Army Medical Center, Department of Emergency Medicine, Joint Base Lewis-McChord, Washington","department":"None"}],"date_submitted":"2017-09-30T04:13:24+10:00","date_accepted":"2017-09-30T04:13:24+10:00","date_published":"2017-10-04T03:18:47+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/427/galley/191/download/"}]},{"pk":426,"title":"A Toddler with Spontaneous Pneumomediastinum","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/6bq2g6s8","frozenauthors":[{"first_name":"Jessica","middle_name":"L.","last_name":"Chow","name_suffix":"","institution":"University of California, San Francisco, Zuckerberg San Francisco General\nHospital, Department of Emergency Medicine, San Francisco, California","department":"None"},{"first_name":"Israel","middle_name":"","last_name":"Green-Hopkins","name_suffix":"","institution":"University of California, San Francisco, Zuckerberg San Francisco General\nHospital, Department of Emergency Medicine, San Francisco, California\nUCSF Benioff Children’s Hospital, Department of Emergency Medicine, Division of Pediatric Emergency Medicine, San Francisco, California","department":"None"},{"first_name":"Christopher","middle_name":"R.","last_name":"Peabody","name_suffix":"","institution":"University of California, San Francisco, Zuckerberg San Francisco General\nHospital, Department of Emergency Medicine, San Francisco, California","department":"None"}],"date_submitted":"2017-09-30T04:11:02+10:00","date_accepted":"2017-09-30T04:11:02+10:00","date_published":"2017-10-04T03:17:31+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/426/galley/190/download/"}]},{"pk":425,"title":"25C-NBOMe Ingestion","subtitle":null,"abstract":"The popularity of recreational synthetic drug use has increased within the past several years. Emergency physicians, along with prehospital providers, are often the first to interact with patients who use these new drugs. We report the case of a 27-year-old male with two emergency department visits with confirmed ingestion of a relatively new synthetic drug of abuse. We discuss symptom management as well as the identification process of the ingestant.","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/0dh749xt","frozenauthors":[{"first_name":"Jonathan","middle_name":"","last_name":"Zygowiec","name_suffix":"","institution":"Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan","department":"None"},{"first_name":"Spencer","middle_name":"","last_name":"Solomon","name_suffix":"","institution":"Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan","department":"None"},{"first_name":"Anthony","middle_name":"","last_name":"Jaworski","name_suffix":"","institution":"Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Bloome","name_suffix":"","institution":"Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan","department":"None"},{"first_name":"Ari","middle_name":"","last_name":"Gotlib","name_suffix":"","institution":"Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan","department":"None"}],"date_submitted":"2017-09-30T04:04:41+10:00","date_accepted":"2017-09-30T04:04:41+10:00","date_published":"2017-10-04T03:16:10+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/425/galley/189/download/"}]},{"pk":424,"title":"Myasthenic Crisis In Pregnancy","subtitle":null,"abstract":"This case reviews the management of a 27-year-old pregnant female in myasthenic crisis. She presented to the emergency department in respiratory distress refractory to standard therapy, necessitating airway and ventilatory support and treatment with plasmapheresis. Myasthenic crisis in the setting of pregnancy is rare and presents unique management challenges for emergency physicians.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2dg4t81m","frozenauthors":[{"first_name":"David","middle_name":"M.","last_name":"French,","name_suffix":"","institution":"Medical University of South Carolina, Emergency Medicine, Charleston, South Carolina","department":"None"},{"first_name":"E.","middle_name":"Page","last_name":"Bridges","name_suffix":"","institution":"Greenville Health System, Emergency Medicine, Greenville, South Carolina","department":"None"},{"first_name":"Matthew","middle_name":"C.","last_name":"Hoskins","name_suffix":"","institution":"Medical University of South Carolina, Emergency Medicine, Charleston, South Carolina","department":"None"},{"first_name":"Charles","middle_name":"M.","last_name":"Andrews","name_suffix":"","institution":"Medical University of South Carolina, Emergency Medicine, Charleston, South Carolina\nMedical University of South Carolina, Neurocritical Care, Charleston, South Carolina","department":"None"},{"first_name":"Cecil","middle_name":"H.","last_name":"Nelson","name_suffix":"","institution":"Medical University of South Carolina, Department of Obstetrics and Gynecology,\nCharleston, South Carolina","department":"None"}],"date_submitted":"2017-09-30T04:02:07+10:00","date_accepted":"2017-09-30T04:02:07+10:00","date_published":"2017-10-04T03:12:21+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/424/galley/188/download/"}]},{"pk":423,"title":"Post-operative Appendix Specimen Retention Presenting as Small Bowel Obstruction","subtitle":null,"abstract":"One rare complication of appendectomy is a retained appendicolith, which can become a focal point for infection presenting hours to years after surgery. We present a case in which a 50-year-old male presented to the emergency department with a small bowel obstruction one week post appendectomy. A diagnostic laparoscopy was performed, and a necrotic appendiceal specimen containing a staple line across the base as well as an appendicolith was removed. It is crucial to include rare surgical complications in our differentials, alongside the more common pathologies when approaching and treating patients with abdominal pain.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5666c3ks","frozenauthors":[{"first_name":"Tiffany","middle_name":"","last_name":"Proffitt","name_suffix":"","institution":"UC IrvineLakeland Health, Department of Emergency Medicine, Saint Joseph, Michigan","department":"None"},{"first_name":"Kristen","middle_name":"","last_name":"Whitworth","name_suffix":"","institution":"Lakeland Health, Department of Emergency Medicine, Saint Joseph, Michigan","department":"None"},{"first_name":"Christopher","middle_name":"","last_name":"Trigger","name_suffix":"","institution":"Lakeland Health, Department of Emergency Medicine, Saint Joseph, Michigan","department":"None"}],"date_submitted":"2017-09-30T03:58:50+10:00","date_accepted":"2017-09-30T03:58:50+10:00","date_published":"2017-10-04T03:10:05+11:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/423/galley/187/download/"}]},{"pk":44408,"title":"Non Anion Gap Metabolic Acidosis Induced During L-arginine Therapy in a Patient with Mitochondrial Encephalopathy Lactic Acidosis and Stroke (MELAS)","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/4tx8f419","frozenauthors":[{"first_name":"Ramy","middle_name":"M.","last_name":"Hanna","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Reza","middle_name":"","last_name":"Khorsan","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-10-03T05:29:45+11:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44408/galley/33202/download/"}]},{"pk":422,"title":"Sulfur Mustard Exposure from Dredged Artillery Shell in a Commercial Clammer","subtitle":null,"abstract":"A 40-year-old commercial fisherman presented with a blistering second degree burn to the right arm after handling a dredged and undetonated World War I-era sulfur mustard artillery shell. He sustained isolated second degree cutaneous injury requiring wound care and skin grafting. Sulfur mustard, or dichlorethylsulphide, is a vesicant chemical warfare agent that causes significant cutaneous chemical burn and is managed with burn wound care. Long-term effects include cosmetic disfigurement and increased risk of developing cancer. Sulfur mustard exposure is a rare but devastating injury when discarded artillery shells are encountered in coastal waters.","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/54715267","frozenauthors":[{"first_name":"Jenna","middle_name":"","last_name":"Otter","name_suffix":"","institution":"*Temple University Hospital, Department of Emergency Medicine, Philadelphia, PA","department":"None"},{"first_name":"Alveena","middle_name":"","last_name":"Dawood","name_suffix":"","institution":"*Temple University Hospital, Department of Emergency Medicine, Philadelphia, PA","department":"None"},{"first_name":"Joseph","middle_name":"","last_name":"D’Orazio","name_suffix":"","institution":"*Temple University Hospital, Department of Emergency Medicine, Philadelphia, PA","department":"None"}],"date_submitted":"2017-09-30T03:56:37+10:00","date_accepted":"2017-09-30T03:56:37+10:00","date_published":"2017-09-30T04:58:48+10:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/422/galley/186/download/"}]},{"pk":421,"title":"Traumatic Facial Nerve Palsy","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/21x560wf","frozenauthors":[{"first_name":"Brenna","middle_name":"","last_name":"Derksen","name_suffix":"","institution":"University of California San Diego, Department of Emergency Medicine, San Diego, California","department":"None"},{"first_name":"Sherri","middle_name":"","last_name":"Rudinsky","name_suffix":"","institution":"Rady Children’s Hospital, Department of Emergency Medicine, San Diego, California","department":"None"}],"date_submitted":"2017-09-30T03:53:55+10:00","date_accepted":"2017-09-30T03:53:55+10:00","date_published":"2017-09-30T04:57:45+10:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/421/galley/185/download/"}]},{"pk":420,"title":"Not All Sore Throats Are Pharyngitis","subtitle":null,"abstract":"Presentations to the emergency department (ED) can often appear to be simple and common. Only when a physician begins to think outside the box when confronting what seems to be a simple condition can a life-threatening situation be avoided. This case provides insight into a common chief complaint seen everyday in the ED – “sore throat.” Not until the patient was seen on several subsequent encounters was a further work-up initiated and the diagnosis made.","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/0s42v2p2","frozenauthors":[{"first_name":"Adam","middle_name":"","last_name":"Sadowski","name_suffix":"","institution":"Ohio Valley Medical Center, Department of Emergency Medicine, Wheeling, West Virginia","department":"None"},{"first_name":"Joseph","middle_name":"","last_name":"Dougherty","name_suffix":"","institution":"Ohio Valley Medical Center, Department of Emergency Medicine, Wheeling, West Virginia","department":"None"}],"date_submitted":"2017-09-30T03:51:40+10:00","date_accepted":"2017-09-30T03:51:40+10:00","date_published":"2017-09-30T04:52:32+10:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/420/galley/184/download/"}]},{"pk":44407,"title":"Topical Management of Rosacea for Primary Care: What’s New","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/30q4v5w0","frozenauthors":[{"first_name":"Sean","middle_name":"","last_name":"Dreyer","name_suffix":"","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Paul","middle_name":"","last_name":"Levins","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-30T04:27:19+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44407/galley/33201/download/"}]},{"pk":42786,"title":"Fictions and Frictions of the \"Panama Roughneck\": Literary Depictions of White, US Labor in the Canal Zone","subtitle":null,"abstract":"This essay expands the critical conversation on race, labor, and literature in the Panama Canal Zone by foregrounding the portrayal of white, U.S. workers in two popular texts, Harry A. Franck’s \nZone Policeman \n(1913) and John Hall’s \nPanama Roughneck Ballads\n (1912). While existing scholarship has detailed the legal and economic policies that shaped the United States’ racialized form of labor management, the “gold and silver system,” in the Zone, it has largely ignored the literary discourse that emerged in response to the system’s incongruous values. This essay argues that literary depictions of white, American canal workers as hyper-masculine and hyper-productive “Panama roughnecks” rhetorically rationalized the gold and silver system’s privileging of white, US workers, while also producing narratives that destabilized its hierarchies of race, nationality, and skill set. These narratives also engendered new forms of identification that evaded or reimagined normative American understandings of race, genealogy, and national affiliation.","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. No additional restrictions — You may not apply 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":"panama canal zone"},{"word":"US Empire"},{"word":"Race"},{"word":"roughneck"},{"word":"gold and silver system"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2135q8gx","frozenauthors":[{"first_name":"Sunny","middle_name":"","last_name":"Yang","name_suffix":"","institution":"Louisiana State University","department":"None"}],"date_submitted":"2016-07-10T04:06:36+10:00","date_accepted":"2016-07-10T04:06:36+10:00","date_published":"2017-09-30T03:36:01+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42786/galley/31905/download/"}]},{"pk":42785,"title":"\"Strengthen the Bonds\": The United States on Display in 1938 France","subtitle":null,"abstract":"In 1938, curators from the Museum of Modern Art installed their first international exhibition, \nThree Centuries of American Art\n, in Paris. This article examines the powerful role that museums played in constructing national art-historical narratives during the 1930s. It argues that the intertwining of art, political diplomacy, and canon formation uncovered by an analysis of the exhibition reveals American art’s unique role in supporting shared 1930s cultural ideologies. It questions how \nThree Centuries of American Art\n located and presented the heterogeneity of American culture in the 1930s to an international audience grappling with political instability.\n \nMoMA’s curators created the most comprehensive exhibition to date of the history of American art with works from 1590 through 1938, and with over five hundred architectural models, drawings, films, paintings, photographs, prints, sculptures, and vernacular artworks. It argues that each of these successive actions—borrowing, display, canonization, publication, and reception—vested this artwork with additional, and at times, contradictory meanings that problematize our understanding of not just this exhibition’s artworks but also other exhibitions that create histories of American art. With World War II on the horizon, these artworks took on new meaning as the embodiment of the United 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. No additional restrictions — You may not apply 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":"internationalizing American art, 1930s material culture, Museum of Modern Art, Three Centuries of American Art"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1123r99s","frozenauthors":[{"first_name":"Caroline","middle_name":"M.","last_name":"Riley","name_suffix":"","institution":"San Jose State University","department":"None"}],"date_submitted":"2016-06-16T15:16:17+10:00","date_accepted":"2016-06-16T15:16:17+10:00","date_published":"2017-09-30T03:35:41+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42785/galley/31904/download/"}]},{"pk":42763,"title":"The Curious Case of Sick Keesar: Tracing the Roots of South Asian Presence in the Early Republic","subtitle":null,"abstract":"This article is part of a larger monograph on India in the American imaginary that seeks to trace Indo-American interactions as mediated by the triangulated relationship between India, Britain, and the US. In this article I perform a symptomatic reading of a petition for redress by a Bengali lascar, Sick Keesar, to Benjamin Franklin in 1785. Whilst most scholarship on lascars and their integral role in the transoceanic trade in the late eighteenth and nineteenth centuries has focused on Britain and Europe, Keesar’s petition illumines South Asian histories of mobility and labor formations forged against global networks of colonial capital and a maritime economy in the little-known context of the United States in the Early Republic. Read in conjunction with the many advertisements for runaway “East Indian” slaves found in newspapers of the times, Keesar’s petition presents an alternative genealogy of South Asian presence in America dating back to the colonial era. The petition sheds light on the unacknowledged and little-known presence and contributions of early South Asian settlers, as indentured servants, slaves, and lascars, in the seventeenth and eighteenth centuries. Mapping this hitherto little-known history not only radically reshapes the history of South Asian presence in America, but also illumines a tumultuous period in the making of the American nation that, as yet, was just beginning to define itself and how it related to its racial others.","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. No additional restrictions — You may not apply 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":"South Asian America, lascars, Early Republic, Petition, South Asian America, India"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/78w3x553","frozenauthors":[{"first_name":"Rajender","middle_name":"","last_name":"Kaur","name_suffix":"","institution":"William Paterson University of New Jersey","department":"None"}],"date_submitted":"2015-12-18T03:28:53+11:00","date_accepted":"2015-12-18T03:28:53+11:00","date_published":"2017-09-30T03:35:19+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42763/galley/31893/download/"}]},{"pk":42761,"title":"Dangerous Playgrounds: Hemispheric Imaginaries and Domestic Insecurity in Contemporary US Tourism Narratives","subtitle":null,"abstract":"This article explores a network of “dangerous playgrounds” narratives amid the backdrop of then President George W. Bush’s “War on Terror” and the revitalization of the “self-deportation movement” following the passage of SB1070. Tracing the journeys of young, white US American tourists traveling to Latin America to release their inhibitions, stories working in the dangerous playgrounds mode use figurations of insurrectionary violence to wed the narrative arc of the bildungsroman to the generic conventions of melodrama and horror, and so cast the Americas south of the US border as a source of danger to US American youth. By reading these narrative negotiations in relation to the legacies of US American hemispheric interventionism, post-9/11 immigration policy, and US American travel narratives, this article unpacks the ways Jessica Abel’s critically acclaimed comic \nLa Perdida \n(2006) and the films \nTuristas \n(2006), \nBorderland \n(2007), \nThe Ruins \n(2008), and \nIndigenous \n(2014) create slippages in meaning that project anxieties about terrorism and domestic security onto Latinx bodies and Latin American nations through figurations of imperiled white femininity. By using literary and cultural analysis to explore how popular sentiment, generic convention, and policy negotiations draw on, shape, and extend neo-Monroeist structures of feeling, this article ultimately finds that the emergence of domestic policies aimed at institutionalizing the surveillance of Latinx subjects arises in popular culture as a remarkably predictable narrative mode, which uses the conventions of adventure, melodrama, and horror to frame the nativist project of securing domestic borders and incarcerating and expelling undocumented Latinx subjects as one of the necessary compromises of a mature nation.","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. No additional restrictions — You may not apply 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":"media studies"},{"word":"Immigration"},{"word":"Hemispheric American Studies"},{"word":"La Perdida"},{"word":"Contemporary Literature"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7pm4m6t3","frozenauthors":[{"first_name":"Daniel","middle_name":"Lanza","last_name":"Rivers","name_suffix":"","institution":"Sonoma State University","department":"None"}],"date_submitted":"2015-11-13T05:57:19+11:00","date_accepted":"2015-11-13T05:57:19+11:00","date_published":"2017-09-30T03:35:03+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42761/galley/31892/download/"}]},{"pk":42756,"title":"Interzone’s a Riot: William S. Burroughs and Writing the Moroccan Revolution","subtitle":null,"abstract":"Naked Lunch\n, Burroughs’ breakthrough work, was written in scraps and fragments and is a hallucinatory tour through a realm he calls Interzone, closely modeled on the international zone of Tangier and that corresponds with Tangier in many ways: geographically, culturally, and politically. Much of the book’s content is inspired by or a direct transcription of events he witnessed there. Burroughs developed a fascination with Morocco’s anticolonial revolution and the violence surrounding the movement for independence. Scenes in \nNaked Lunch\n involving Islam Inc. and lengthy descriptions of Interzone’s political factions serve as satirical representations of the revolutionary organizations operating inside Morocco during the writing of the novel, many of which had a tendency to fight each other as often as they fought the French. With the publication of \nNaked Lunch\n in 1958, William S. Burroughs expressed both his admiration for the transformative potential of revolutionary violence and his dismay that this potential went unrealized in Morocco.","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. No additional restrictions — You may not apply 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":"William Burroughs"},{"word":"Naked Lunch"},{"word":"Red Night Trilogy"},{"word":"Tangier"},{"word":"International Zone"},{"word":"Colonialism"},{"word":"revolution"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3x68h6kb","frozenauthors":[{"first_name":"Stacey","middle_name":"Andrew","last_name":"Suver","name_suffix":"","institution":"Stony Brook University","department":"None"}],"date_submitted":"2015-09-16T01:55:30+10:00","date_accepted":"2015-09-16T01:55:30+10:00","date_published":"2017-09-30T03:34:48+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42756/galley/31890/download/"}]},{"pk":42753,"title":"Governable Travelers: International Comparison in American Tramp Ethnography","subtitle":null,"abstract":"Near the end of the nineteenth century, the “tramp” embodied the most extreme aspects of the boom-and-bust economy in the US. More than any other writer of his day, the ethnographer Josiah Flynt assisted both the public and government officials in visualizing the lives of tramps with the intent of rehabilitating this population. The key text in this effort, Flynt’s \nTramping with Tramps\n (1899) hinges on a comparison between US and European vagrancy. For reform-minded authors like Flynt, tramping in Europe provides a point of comparison for evaluating key areas of concern in the US—namely, the problem of idleness among sectors of the American population. The depiction of tramping abroad in Flynt’s work—as well as in accounts by writers like Mark Twain—ultimately reflects the international nexus shaping both the discourse surrounding vagrancy as well as antitramp legislation.","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. No additional restrictions — You may not apply 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":"vagrancy laws, 19th-century antitramp legislation, Josiah Flynt, Tramping with Tramps, Mark Twain, A Tramp Abroad"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5tb6b3g0","frozenauthors":[{"first_name":"Bryan","middle_name":"","last_name":"Yazell","name_suffix":"","institution":"University of Southern Denmark","department":"None"}],"date_submitted":"2015-08-14T10:26:35+10:00","date_accepted":"2015-08-14T10:26:35+10:00","date_published":"2017-09-30T03:34:24+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42753/galley/31889/download/"}]},{"pk":42750,"title":"Red Turbans in the Trinity Alps: Violence, Popular Religion, and Diasporic Memory in Nineteenth-Century Chinese America","subtitle":null,"abstract":"This article shows how social violence among Chinese in the mining districts of California during the 1850s was an extension of the Red Turban Rebellion and subsequent ethnic civil war between “local” and “guest peoples” in the Pearl River Delta of South China. In that context, I read a popular religious text, a secret society manual, and temple carvings to argue that Chinese workingmen in the Gold Rush imagined a moral economy that enabled the construction of a heroic diasporic identity.","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. No additional restrictions — You may not apply 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":"Chinese Americans, workingmen, Red Turban Rebellion, California, diaspora, popular religion, sites of memory"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4ws0q631","frozenauthors":[{"first_name":"Robert","middle_name":"G.","last_name":"Lee","name_suffix":"","institution":"Brown University","department":"None"}],"date_submitted":"2015-06-30T05:03:26+10:00","date_accepted":"2015-06-30T05:03:26+10:00","date_published":"2017-09-30T03:33:51+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42750/galley/31888/download/"}]},{"pk":42714,"title":"“Suppose for a moment, that Keanu had reasoned thus”: Contagious Debts and Prisoner–Patient Consent in Nineteenth-Century Hawai‘i","subtitle":null,"abstract":"This article considers the 1884 criminal case and medical archive of Keanu, a Native Hawaiian prisoner sentenced to death in the Hawaiian courts for murder. Keanu’s sentence was commuted to “life in prison” after he consented to experimental leprosy (Hansen’s disease) inoculations. The article examines the tensions between Keanu’s prisoner–patient value and US imperialism as a discourse of social debt in nineteenth-century Hawai‘i. It argues that the figure of the prisoner–patient raises broad questions about the historical function of racialization, criminalization, and disease across medical discourse at that time. More specifically, it interrogates how those discourses were constructed around the figure of Keanu and reveals a transformation in his status from devalued social death to that of valuable social debt.","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. No additional restrictions — You may not apply 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":"prisoner–patients"},{"word":"Hawai'i"},{"word":"Nineteenth Century Transnational Medicine"},{"word":"Leprosy"},{"word":"empire"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3mp7p2dv","frozenauthors":[{"first_name":"Christopher","middle_name":"","last_name":"Perreira","name_suffix":"","institution":"University of Kansas","department":"None"}],"date_submitted":"2014-09-12T09:12:14+10:00","date_accepted":"2014-09-12T09:12:14+10:00","date_published":"2017-09-30T03:33:16+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/42714/galley/31866/download/"}]},{"pk":62759,"title":"Distribution and Genetic Structure of \nFucus distichus\n Linnaeus 1953 (formerly \nF. gardneri\n) within Central San Francisco Bay","subtitle":null,"abstract":"Fucus distichus\n, a rockweed common to the mid-intertidal shoreline within the San Francisco Estuary (previously known as \nF. gardneri\n), was injured during the Cosco Busan oil spill in November 2007 and subsequent clean-up actions. Restoration planning activities are underway to help recover\n F. distichus\n at sites within central San Francisco Bay where damage occurred. As a first step, we conducted shoreline surveys during the summers of 2012–2013 to map the occurrence of this rockweed. Of the 151.73 km of rocky shoreline within the central bay, \nF. distichus\n covered 32.16 km of shoreline. The alga generally occurred in narrow bands but formed expansive beds at locations with natural, flat bedrock benches. We also observed \nF. distichus\n on artificial substrata such as seawalls and riprap, but not on pilings. Samples of \nF. distichus\n from 11 sites throughout the central / east San Francisco Bay were genetically analyzed (microsatellite genotyping). The populations analyzed (1) had low genetic diversity, (2) the frequency of homozygotes was higher than expected (suggesting high inbreeding), and (3) also displayed geographic population structure, in part driven by very small differences in the midst of extremely low within-population genetic diversity. However, these genetic data do not raise concerns for restoration methods in terms of choosing donor populations and mixing \nF. distichus\n from different sites within the central bay. The choice of donor populations should be based on practical criteria for effective restoration; individuals will nonetheless be taken from locations as nearby to donor sites as possible. Various locations throughout the central San Francisco Bay are composed of cobble or small riprap that are populated with \nF. distichus\n, which could provide efficient means of translocating rockweed for future restoration 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":[{"word":"Cosco Busan, San Francisco Bay, Fucus distichus, oil spill, rockweed, riprap, bedrock, cobble, genetic structure, restoration, rocky intertidal, re-establishment"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8jt3v8mk","frozenauthors":[{"first_name":"Stephen","middle_name":"G.","last_name":"Whitaker","name_suffix":"","institution":"Channel Islands National Park","department":""},{"first_name":"Darren","middle_name":"R.","last_name":"Fong","name_suffix":"","institution":"Golden Gate National Recreation Area","department":""},{"first_name":"João","middle_name":"","last_name":"Neiva","name_suffix":"","institution":"Centro de Ciências do Mar\nUniversity of Algarve","department":""},{"first_name":"Ester","middle_name":"A.","last_name":"Serrão","name_suffix":"","institution":"Centro de Ciências do Mar\nUniversity of Algarve","department":""},{"first_name":"Laura","middle_name":"M.","last_name":"Anderson","name_suffix":"","institution":"University of California, Santa Cruz","department":""},{"first_name":"Peter","middle_name":"T.","last_name":"Raimondi","name_suffix":"","institution":"University of California, Santa Cruz","department":""}],"date_submitted":"2017-09-22T20:24:04+10:00","date_accepted":"2017-09-22T20:24:04+10:00","date_published":"2017-09-29T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62759/galley/48440/download/"}]},{"pk":62758,"title":"Implications for Greenhouse Gas Emission Reductions and Economics of a Changing Agricultural Mosaic in the Sacramento–San Joaquin Delta","subtitle":null,"abstract":"We quantified the greenhouse-gas (GHG) emission and economic implications of alternative crop and wetland mosaics on a Sacramento–San Joaquin Delta island: Staten Island. Using existing GHG fluxes measurements for the Delta and biogeochemical models, we estimated GHG emissions for a range of scenarios, including the status quo, modified groundwater management, and incorporating rice and managed wetlands. For current land uses, emissions were predicted to vary greatly (48,000 to 105,000 t CO2-e yr−1) with varying groundwater depth. GHG emissions were highest when water depth was 120 cm, the typical depth for a Delta island, and lowest if water table depth was shallowest (60 cm). In the alternate land-use scenarios, we simulated wetlands and rice cultivation in areas of highest organic-matter soils, greatest subsidence, and GHG emissions. For each scenario, we analyzed economic implications for the land-owner by determining profit changes relative to the status quo. We spatially assigned areas for rice and wetlands, and then allowed the Delta Agricultural Production (DAP) model to optimize the allocation of other crops to maximize profit. The scenario that included wetlands decreased profits 79% relative to the status quo but reduced GHG emissions by 43,000 t CO2-e yr−1 (57% reduction). When mixtures of rice and wetlands were introduced, farm profits decreased 16%, and the GHG emission reduction was 33,000 t CO2-e yr−1 (44% reduction). When rice was cultivated on 38% of the island, profit increased 12% and emissions were 22,000 t CO2-e yr−1 lower than baseline emissions (30% reduction). Conversion to a mosaic of wetlands and crops including rice could substantially reduce overall GHG emissions of cultivated lands in the Delta without greatly affecting profitability.","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":"greeenhouse-gas (GHG) emission, Sacramento–San Joaquin Delta, GHG emission reduction, wetland, rice, carbon dioxide fluxes, methane fluxes, nitrous oxide fluxes, carbon offset, carbon cycle, agricul.."}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/99z2z7hb","frozenauthors":[{"first_name":"Steven","middle_name":"","last_name":"Deverel","name_suffix":"","institution":"HydroFocus, Inc.","department":""},{"first_name":"Paul","middle_name":"","last_name":"Jacobs","name_suffix":"","institution":"University of California, Davis","department":""},{"first_name":"Christina","middle_name":"","last_name":"Lucero","name_suffix":"","institution":"HydroFocus, Inc.","department":""},{"first_name":"Sabina","middle_name":"","last_name":"Dore","name_suffix":"","institution":"HydroFocus, Inc.","department":""},{"first_name":"T. Rodd","middle_name":"","last_name":"Kelsey","name_suffix":"","institution":"The Nature Conservancy","department":""}],"date_submitted":"2017-09-22T20:08:28+10:00","date_accepted":"2017-09-22T20:08:28+10:00","date_published":"2017-09-29T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62758/galley/48439/download/"}]},{"pk":62757,"title":"Inhabiting the Delta: A Landscape Approach to Transformative Socio-Ecological Restoration","subtitle":null,"abstract":"Current legislation and plans for the Sacramento–San Joaquin Delta (Delta) call for large-scale restoration of aquatic and terrestrial habitats, which will require significant changes in waterways, land uses, and cultural patterns. These re-made landscapes will be subject to a variety of new human uses, which Delta planning and adaptive management literature has yet to adequately consider. Failing to account for human uses and evolving place values can lead to diminished performance and public support for Delta restoration efforts.\n \nOur empirical study examined restored and naturalized Delta landscapes using an integrative landscape approach that seeks to reconcile multiple goals and land-use agendas that span ecological, social, economic, and political domains. The research design consisted of six overlapping methods that included a planning, policy, and law review specific to the Delta; surveys and interviews with approximately 100 land managers, scientists, land-owners, law-enforcement personnel, agency representatives, and Delta residents; nine case studies of restored and naturalized delta landscapes; GIS mapping; and extensive field work. \n \nFindings derived from the synthesis of these methods show that human uses of the Delta’s re-wilded landscapes are diverse and pervasive. Given the infrastructural and urbanized context of the region, these environments are subject to multiple and sometimes conflicting uses, perceptions, and place values. Though these myriad uses cannot be fully predicted or controlled (nor should they be), findings showed that more proactive and inclusive planning for human uses can encourage or discourage particular uses while also building constituency, support, and active engagement in ecological restoration efforts. We conclude that reconciling human uses with ecological recovery in the Delta will require a more localized, multi-functional, and creative approach to designing and adaptively managing these emergent landscapes. We recommend that more resources and experimental prototyping be dedicated to such work.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Sacramento–San Joaquin Delta, landscape approach, landscape planning, conservation, adaptive management, socio-ecological systems, evolving place, reconciliation ecology, infrastructure, Anthropocene"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9352n7cn","frozenauthors":[{"first_name":"Brett","middle_name":"","last_name":"Milligan","name_suffix":"","institution":"Landscape Architecture, Dept. of Human Ecology\nUniversity of California, Davis","department":""},{"first_name":"Alejo","middle_name":"","last_name":"Kraus–Polk","name_suffix":"","institution":"Geography Graduate Group\nUniversity of California, Davis","department":""}],"date_submitted":"2017-09-22T20:04:03+10:00","date_accepted":"2017-09-22T20:04:03+10:00","date_published":"2017-09-29T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62757/galley/48438/download/"}]},{"pk":62760,"title":"Science Advancements Key to Increasing Management Value of Life Stage Monitoring Networks for Endangered Sacramento River Winter-Run Chinook Salmon in California","subtitle":null,"abstract":"A robust monitoring network that provides quantitative information about the status of imperiled species at key life stages and geographic locations over time is fundamental for sustainable management of fisheries resources. For anadromous species, management actions in one geographic domain can substantially affect abundance of subsequent life stages that span broad geographic regions. Quantitative metrics (e.g., abundance, movement, survival, life history diversity, and condition) at multiple life stages are needed to inform how management actions (e.g., hatcheries, harvest, hydrology, and habitat restoration) influence salmon population dynamics. The existing monitoring network for endangered Sacramento River winter-run Chinook Salmon (SRWRC, \nOncorhynchus tshawytscha\n) in California’s Central Valley was compared to conceptual models developed for each life stage and geographic region of the life cycle to identify relevant SRWRC metrics. We concluded that the current monitoring network was insufficient to diagnose when (life stage) and where (geographic domain) chronic or episodic reductions in SRWRC cohorts occur, precluding within- and among-year comparisons. The strongest quantitative data exist in the Upper Sacramento River, where abundance estimates are generated for adult spawners and emigrating juveniles. However, once SRWRC leave the upper river, our knowledge of their identity, abundance, and condition diminishes, despite the juvenile monitoring enterprise. We identified six system-wide recommended actions to strengthen the value of data generated from the existing monitoring network to assess resource management actions: (1) incorporate genetic run identification; (2) develop juvenile abundance estimates; (3) collect data for life history diversity metrics at multiple life stages; (4) expand and enhance real-time fish survival and movement monitoring; (5) collect fish condition data; and (6) provide timely public access to monitoring data in open data formats. To illustrate how updated technologies can enhance the existing monitoring to provide quantitative data on SRWRC, we provide examples of how each recommendation can address specific management issues","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":"Chinook Salmon, monitoring, conceptual models, life stage survival, migration, diversity"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6751j957","frozenauthors":[{"first_name":"Rachel","middle_name":"C.","last_name":"Johnson","name_suffix":"","institution":"National Marine Fisheries Service, National Oceanic and Atmospheric Administration & Center for Watershed Sciences, University of California, Davis","department":""},{"first_name":"Sean","middle_name":"","last_name":"Windell","name_suffix":"","institution":"California Sea Grant Fellowship, Delta Stewardship Council","department":""},{"first_name":"Patricia","middle_name":"L.","last_name":"Brandes","name_suffix":"","institution":"U.S. Fish and Wildlife Service","department":""},{"first_name":"J. Louise","middle_name":"","last_name":"Conrad","name_suffix":"","institution":"California Department of Water Resources","department":""},{"first_name":"John","middle_name":"","last_name":"Ferguson","name_suffix":"","institution":"Anchor QEA","department":""},{"first_name":"Pascale","middle_name":"A. L.","last_name":"Goertler","name_suffix":"","institution":"California Department of Water Resources","department":""},{"first_name":"Brett","middle_name":"N.","last_name":"Harvey","name_suffix":"","institution":"California Department of Water Resources","department":""},{"first_name":"Joseph","middle_name":"","last_name":"Heublein","name_suffix":"","institution":"National Marine Fisheries Service, National Oceanic and Atmospheric Administration","department":""},{"first_name":"Joshua","middle_name":"A.","last_name":"Israel","name_suffix":"","institution":"U.S. Bureau of Reclamation","department":""},{"first_name":"Daniel","middle_name":"W.","last_name":"Kratville","name_suffix":"","institution":"California Department of Fish and Wildlife","department":""},{"first_name":"Joseph","middle_name":"E.","last_name":"Kirsch","name_suffix":"","institution":"U.S. Fish and Wildlife Service","department":""},{"first_name":"Russell","middle_name":"W.","last_name":"Perry","name_suffix":"","institution":"U.S Geological Survey","department":""},{"first_name":"Joseph","middle_name":"","last_name":"Pisciooto","name_suffix":"","institution":"California Department of Fish and Wildlife","department":""},{"first_name":"William","middle_name":"R.","last_name":"Poytress","name_suffix":"","institution":"U.S. Fish and Wildlife Service","department":""},{"first_name":"Kevin","middle_name":"","last_name":"Reece","name_suffix":"","institution":"California Department of Water Resources","department":""},{"first_name":"Brycen","middle_name":"G.","last_name":"Swart","name_suffix":"","institution":"National Marine Fisheries Service, National Oceanic and Atmospheric Administration","department":""}],"date_submitted":"2017-09-22T20:51:20+10:00","date_accepted":"2017-09-22T20:51:20+10:00","date_published":"2017-09-29T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62760/galley/48441/download/"}]},{"pk":44406,"title":"Adult Still’s Disease Complicated by Macrophage Activation Syndrome","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/4t80d9p1","frozenauthors":[{"first_name":"Ashley","middle_name":"","last_name":"Saito","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Jason","middle_name":"","last_name":"Williams","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-27T04:25:12+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44406/galley/33200/download/"}]},{"pk":10808,"title":"ALiEM Blog and Podcast Watch: Procedures in Emergency Medicine","subtitle":null,"abstract":"Introduction:\n The WestJEM Blog and Podcast Watch presents high-quality, open-accesseducational blogs and podcasts in emergency medicine (EM) based on the ongoing Academic Lifein EM (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional series. Both seriescritically appraise resources using an objective scoring rubric. This installment of the Blog andPodcast Watch highlights the topic of procedure emergencies from the AIR Series.\nMethods:\n The AIR Series is a continuously building curriculum that follows the Council ofEmergency Medicine Residency Directors’ (CORD) annual testing schedule. For each module,relevant content is collected from the top 50 Social Media Index sites published within the previous12 months, and scored by eight AIR board members using five equally weighted measurementoutcomes: Best Evidence in Emergency Medicine (BEEM) score, accuracy, educational utility,evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIRlabel. Resources scoring 27-29 receive an “honorable mention” label if the executive board agreesthat the post is accurate and educationally valuable.\nResults:\n A total of 85 blog posts and podcasts were evaluated in June 2016. This report summarizeskey educational pearls from the three AIR posts and the 10 Honorable Mentions.\nConclusion:\n The WestJEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series,which attempts to identify high-quality educational content on open-access blogs and podcasts. Thisseries provides an expert-based, post-publication curation of educational social media content forEM clinicians, with this installment focusing on procedure emergencies within the AIR series.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Emergency Medicine, Procedures"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4qv6m1k8","frozenauthors":[{"first_name":"Nikita","middle_name":"","last_name":"Joshi","name_suffix":"","institution":"Stanford University, Department of Emergency Medicine, Stanford, California","department":"None"},{"first_name":"Eric","middle_name":"J.","last_name":"Morley","name_suffix":"","institution":"Stony Brook School of Medicine, Department of Emergency Medicine, Stony Brook, New York","department":"None"},{"first_name":"Taku","middle_name":"","last_name":"Taira","name_suffix":"","institution":"LAC + USC Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Jeremy","middle_name":"","last_name":"Branzetti","name_suffix":"","institution":"NYU/Bellevue Hospital, Ronald O. Perelman Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Andrew","middle_name":"","last_name":"Grock","name_suffix":"","institution":"LAC + USC Department of Emergency Medicine, Los Angeles, California\nAnd\nUniversity of California, Los Angeles, Department of Emergency Medicine, Los Angeles, California","department":"None"}],"date_submitted":"2017-05-13T16:53:42+10:00","date_accepted":"2017-05-13T16:53:42+10:00","date_published":"2017-09-26T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10808/galley/5883/download/"}]},{"pk":10793,"title":"A Sepsis-related Diagnosis Impacts Interventions and Predicts Outcomes for Emergency Patients with Severe Sepsis","subtitle":null,"abstract":"Introduction:\n Many patients meeting criteria for severe sepsis are not given a sepsis-relateddiagnosis by emergency physicians (EP). This study 1) compares emergency department (ED)interventions and in-hospital outcomes among patients with severe sepsis, based on the presenceor absence of sepsis-related diagnosis, and 2) assesses how adverse outcomes relate to three-hoursepsis bundle completion among patients fulfilling severe sepsis criteria but not given a sepsisrelateddiagnosis.\nMethods:\n We performed a retrospective cohort study using patients meeting criteria for severesepsis at two urban, academic tertiary care centers from March 2015 through May 2015. Weincluded all ED patients with the following: 1) the 1992 Consensus definition of severe sepsis,including two or more systemic inflammatory response syndrome criteria and evidence of organdysfunction; or 2) physician diagnosis of severe sepsis or septic shock. We excluded patientstransferred to or from another hospital and those <18 years old. Patients with an EP-assignedsepsis diagnosis created the “Physician Diagnosis” group; the remaining patients composed the“Consensus Criteria” group. The primary outcome was in-hospital mortality. Secondary outcomesincluded completed elements of the current three-hour sepsis bundle; non-elective intubation;vasopressor administration; intensive care unit (ICU) admission from the ED; and transfer to theICU in < 24 hours. We compared proportions of each outcome between groups using the chi-squaretest, and we also performed a stratified analysis using chi square to assess the association betweenfailure to complete the three-hour bundle and adverse outcomes in each group.\nResults:\n Of 418 patients identified with severe sepsis we excluded 54, leaving 364 patients foranalysis: 121 “Physician Diagnosis” and 243 “Consensus Criteria.” The “Physician Diagnosis” grouphad a higher in-hospital mortality (12.4% vs 3.3%, P < 0.01) and compliance with the three-hour sepsisbundle (52.1% vs 20.2%, P < 0.01) compared with the “Consensus Criteria” group. An incompletethree-hour sepsis bundle was not associated with a higher incidence of death, intubation, vasopressoruse, ICU admission or transfer to the ICU in <24 hours in patients without a sepsis diagnosis.\nConclusion:\n “Physician Diagnosis” patients more frequently received sepsis-specific interventionsand had a higher incidence of mortality. “Consensus Criteria” patients had infrequent adverseoutcomes regardless of three-hour bundle compliance. EPs’ sepsis diagnoses reflect riskstratificationbeyond the severe sepsis criteria.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Severe Sepsis"},{"word":"sepsis"},{"word":"bundled care"},{"word":"Diagnosis"}],"section":"Patient Safety","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9975s2fs","frozenauthors":[{"first_name":"Mitchell","middle_name":"","last_name":"Kim","name_suffix":"","institution":"University of Washington, Division of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Taketo","middle_name":"","last_name":"Watase","name_suffix":"","institution":"University of Washington, Division of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Karl","middle_name":"D.","last_name":"Jablonowski","name_suffix":"","institution":"University of Washington, Division of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Medley","middle_name":"O.","last_name":"Gatewood","name_suffix":"","institution":"University of Washington, Division of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Daniel","middle_name":"J.","last_name":"Henning","name_suffix":"","institution":"University of Washington, Division of Emergency Medicine, Seattle, Washington","department":"None"}],"date_submitted":"2017-05-06T09:58:46+10:00","date_accepted":"2017-05-06T09:58:46+10:00","date_published":"2017-09-26T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10793/galley/5875/download/"}]},{"pk":10581,"title":"Emergency Department Utilization by Children in the USA, 2010-2011","subtitle":null,"abstract":"Introduction:\n Epidemiological surveillance data for emergency department (ED) visits by children areimperative to guide resource allocation and to develop health policies that advance pediatric emergencycare. However, there are sparse population-based data on patient-level information (e.g., the number ofchildren who present to the emergency department [ED]). In this context, we aimed to investigate boththe patient- and visit-level rates of ED utilization by children.\nMethods:\n This was a retrospective cohort study using population-based multipayer data – state EDdatabases (SEDD) and state inpatient databases (SID) – from six geographically-dispersed U.S. states(California, Florida, Iowa, Nebraska, New York, and Utah) in 2010 and 2011. We identified all childrenaged <18 years who presented to the ED and described the patient-level ED visit rate, visit-level ED visitrate, and proportion of all ED visits made by children. We conducted the analysis using the 2011 SEDDand SID data. We also repeated the analysis using the 2010 data to determine the consistency of theresults across different years.\nResults:\n In 2011, 2.9 million children with a patient identifier presented to EDs in the six U.S. states.At the patient-level, 15 out of every 100 children presented to an ED at least once per year. Of thesechildren, 25% presented to EDs 2-3 times per year with an approximately 1.5-fold variation across thestates (e.g., 19% in Utah vs. 28% in Florida). In addition, 5% presented to EDs ≥4 times per year. At thevisit-level, 6.7 million ED visits were made by children in 2011 – 34 ED visits per 100 children annually.ED visits by children accounted for 22% of all ED visits (including both adults and children), with arelatively small variation across the states (e.g., 20% in New York vs. 24% in Nebraska). Analysis of the2010 data gave similar results for the ED utilization by children.\nConclusion:\n By using large population-based data, we found a substantial burden of ED visits at bothpatient- and visit-levels. These findings provide a strong foundation for policy makers and professionalorganizations to strengthen emergency care for children.","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":"Children, emergency medicine, emergency department, healthcare utilization"}],"section":"Emergency Department Access","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1zc4d95j","frozenauthors":[{"first_name":"Tadahiro","middle_name":"","last_name":"Goto","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Kohei","middle_name":"","last_name":"Hasegawa","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Mohammad","middle_name":"K.","last_name":"Faridi","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Ashley","middle_name":"F.","last_name":"Sullivan","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Carlos","middle_name":"A.","last_name":"Camargo","name_suffix":"","institution":"Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"}],"date_submitted":"2017-01-26T17:06:45+11:00","date_accepted":"2017-01-26T17:06:45+11:00","date_published":"2017-09-26T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10581/galley/5805/download/"}]},{"pk":39489,"title":"Developing Leaders Through Mentoring in Environmental Education","subtitle":null,"abstract":"Abstract\n \nThis article is geared towards substantiating the claim on the importance of environmental education in building leaders for the present and future generation. Emphasis was laid on the integral role mentorship program plays in developing effective environmental leaders. These leaders are expected to contribute to building environmentally friendly and sustainable societies in the future. Hence the researchers elaborated on these through the following subheading: overview of environmental education; concept of environmental leader; improving environmental education leadership skill and mentoring of leaders in environmental education.\n \nKeywords: Environmental Education, Mentorship, Environmental leader.","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":"environmental education, mentorship and environmental leader"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0gz4d58m","frozenauthors":[{"first_name":"Norris","middle_name":"Igbinosa","last_name":"Erhabor","name_suffix":"","institution":"Other","department":"None"}],"date_submitted":"2017-04-07T08:54:48+10:00","date_accepted":"2017-04-07T08:54:48+10:00","date_published":"2017-09-23T09:41:26+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/egj/article/39489/galley/29805/download/"}]},{"pk":63257,"title":"Homophobic Expression in K-12 Public Schools: Legal and Policy Considerations Involving Speech that Denigrates Others","subtitle":null,"abstract":"This article examines an education policy matter that involves homophobic speech in public schools. Using legal research methods, two federal circuit court opinions that have examined the tension surrounding anti-LGBTQ student expression are analyzed. This legal analysis provides non-lawyers some insight into the current realities of student speech jurisprudence in public schools and offers school leaders guidance about how they might address speech that denigrates other students. It also proposes how courts might reconsider analyzing homophobic expression in public schools under existing precedent.","language":"en","license":null,"keywords":[{"word":"LGBTQ"},{"word":"Law"},{"word":"Educational Policy"},{"word":"Speech"},{"word":"First Amendment"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7t3982rc","frozenauthors":[{"first_name":"Suzanne","middle_name":"E","last_name":"Eckes","name_suffix":"","institution":"Indiana University","department":""}],"date_submitted":"2015-12-07T00:20:17+11:00","date_accepted":"2015-12-07T00:20:17+11:00","date_published":"2017-09-23T07:33:54+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/bre/article/63257/galley/48800/download/"}]},{"pk":44393,"title":"Unilateral Mydriasis: Emergent or Benign","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/9w19h0tc","frozenauthors":[{"first_name":"Mina","middle_name":"","last_name":"Ma","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Jessica","middle_name":"","last_name":"Liao","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-23T04:29:04+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44393/galley/33188/download/"}]},{"pk":44389,"title":"New Anabolic Treatment of Osteoporosis","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/7n29d46j","frozenauthors":[{"first_name":"Aarthi","middle_name":"","last_name":"Arasu","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Jennifer","middle_name":"","last_name":"Han","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-23T04:13:56+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44389/galley/33184/download/"}]},{"pk":44388,"title":"An Unusual Course of PMR","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/67w29788","frozenauthors":[{"first_name":"Rania","middle_name":"","last_name":"Shammas","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-23T04:09:40+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44388/galley/33183/download/"}]},{"pk":10679,"title":"Injuries Associated with Hoverboard Use: A Case Series of Emergency Department Patients","subtitle":null,"abstract":"Introduction: Since hoverboards became available in 2015, 2.5 million have been sold in theUS. An increasing number of injuries related to their use have been reported, with limited data onassociated injury patterns. We describe a case series of emergency department (ED) visits forhoverboard-related injuries.\nMethods: We performed a retrospective chart review on patients presenting to 10 EDs insoutheastern Virginia from December 24, 2015, through June 30, 2016. We used a free-textsearch feature of the electronic medical record to identify patients documented to have the word“hoverboard” in the record. We reported descriptive statistics for patient demographics, types ofinjuries, body injury location, documented helmet use, injury severity score (ISS), length of stay inthe ED, and ED charges.\nResults: We identified 83 patients in our study. The average age was 26 years old ( 18 months to 78years). Of these patients, 53% were adults; the majority were female (61.4%) and African American(56.6%). The primary cause of injury was falls (91%), with an average ISS of 5.4 (0-10). The majorityof injuries were contusions (37.3%) and fractures (36.1%). Pediatric patients tended to have morefractures than adults (46.2% vs 27.3%). Though 20% of patients had head injuries, only one patientreported using a helmet. The mean and median ED charges were $2,292.00 (SD $1,363.64) and$1,808.00, respectively. Head injuries resulted in a significantly higher cost when compared to otherinjuries; median cost was $2,846.00.\nConclusion: While the overall ISS was low, more pediatric patients suffered fractures comparedto adults. Documented helmet use was low, yet 20% of our population had head injuries.Further investigation into proper protective gear and training is warranted.","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":"Hoverboard, Injury"}],"section":"Injury Prevention and Population Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/74j4h1b9","frozenauthors":[{"first_name":"Gregory","middle_name":"S.","last_name":"Weingart","name_suffix":"","institution":"Eastern Virginia Medical School, Department of Emergency Medicine, Norfolk, Virginia","department":"None"},{"first_name":"Lindsey","middle_name":"","last_name":"Glueckert","name_suffix":"","institution":"Eastern Virginia Medical School, Department of Emergency Medicine, Norfolk, Virginia","department":"None"},{"first_name":"Girlyn","middle_name":"A.","last_name":"Cachaper","name_suffix":"","institution":"Sentara Healthcare Quality Research Institute, Norfolk, Virginia","department":"None"},{"first_name":"Kathie","middle_name":"S.","last_name":"Zimbro","name_suffix":"","institution":"Sentara Healthcare Quality Research Institute, Norfolk, Virginia","department":"None"},{"first_name":"Ralitsa","middle_name":"S.","last_name":"Maduro","name_suffix":"","institution":"Sentara Healthcare Quality Research Institute, Norfolk, Virginia","department":"None"},{"first_name":"Francis","middle_name":"","last_name":"Counselman","name_suffix":"","institution":"Eastern Virginia Medical School, Department of Emergency Medicine, Norfolk, Virginia","department":"None"}],"date_submitted":"2017-03-20T13:26:34+11:00","date_accepted":"2017-03-20T13:26:34+11:00","date_published":"2017-09-22T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10679/galley/5839/download/"}]},{"pk":10567,"title":"The Impact of an Emergency Department Front-End Redesign on Patient-Reported Satisfaction Survey Results","subtitle":null,"abstract":"Introduction: For emergency department (ED) patients, delays in care are associated withdecreased satisfaction. Our department focused on implementing a front-end vertical patient flowmodel aimed to decrease delays in care, especially care initiation. The physical space for this newmodel was termed the Flexible Care Area (FCA). The purpose of this study was to quantify theimpact of this intervention on patient satisfaction.\nMethods: We conducted a retrospective study of patients discharged from our academic ED over aone-year period (7/1/2013-6/30/2014). Of the 34,083 patients discharged during that period, 14,075were sent a Press-Ganey survey and 2,358 (16.8%) returned the survey. We subsequently comparedthese survey responses with clinical information available through our electronic health record(EHR). Responses from the Press-Ganey surveys were dichotomized as being “Very Good” (VG, thehighest rating) or “Other” (for all other ratings). Data abstracted from the EHR included demographicinformation (age, gender) and operational information (e.g. – emergency severity index, length of stay,whether care was delivered entirely in the FCA, utilization of labs or radiology testing, or administrationof opioid pain medications). We used Fisher’s exact test to calculate statistical differences inproportions, while the Mantel-Haenszel method was used to report odds ratios.\nResults: Of the returned surveys, 62% rated overall care for the visit as VG. However, fewerpatients reported their care as VG if they were seen in FCA (53.4% versus 63.2%, p=0.027). Patientsseen in FCA were less likely to have advanced imaging performed (12% versus 23.8%, p=0.001) orlabs drawn (24.8% vs. 59.1%, p=0.001). Length of stay (FCA mean 159 ±103.5 minutes versus non-FCA 223 ±117 minutes) and acuity were lower for FCA patients than non-FCA patients (p=0.001).There was no statistically significant difference between patient-reported ratings of physicians ornurses when comparing patients seen in FCA vs. those not seen in FCA.\nConclusion: Patients seen through the FCA reported a lower overall rating of care comparedto patients not seen in the FCA. This occurred despite a shorter overall length of stay for thesepatients, suggesting that other factors have a meaningful impact on patient satisfaction.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"emergency department, crowding, lean process improvement, patient satisfaction"}],"section":"Patient Satisfaction","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8d16z2qd","frozenauthors":[{"first_name":"Michael","middle_name":"D.","last_name":"Repplinger","name_suffix":"","institution":"University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin\nUniversity of Wisconsin, Madison, Department of Radiology, Madison, Wisconsin","department":"None"},{"first_name":"Shashank","middle_name":"","last_name":"Ravi","name_suffix":"","institution":"University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin","department":"None"},{"first_name":"Andrew","middle_name":"W.","last_name":"Lee","name_suffix":"","institution":"University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin","department":"None"},{"first_name":"James","middle_name":"E.","last_name":"Svenson","name_suffix":"","institution":"University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin","department":"None"},{"first_name":"Brian","middle_name":"","last_name":"Sharp","name_suffix":"","institution":"University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin","department":"None"},{"first_name":"Matt","middle_name":"","last_name":"Bauer","name_suffix":"","institution":"University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin","department":"None"},{"first_name":"Azita","middle_name":"G.","last_name":"Hamedani","name_suffix":"","institution":"University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin","department":"None"}],"date_submitted":"2017-01-20T07:44:23+11:00","date_accepted":"2017-01-20T07:44:23+11:00","date_published":"2017-09-22T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10567/galley/5801/download/"}]},{"pk":11126,"title":"Why Emergency Physicians Should Care About the Salton Sea","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":"salmon sea"},{"word":"california"},{"word":"Public health"},{"word":"asthma"}],"section":"Societal Impact on Emergency Care","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3097p098","frozenauthors":[{"first_name":"John","middle_name":"R.","last_name":"Marshall","name_suffix":"","institution":"University of California, Irvine, Department of Emergency Medicine, Irvine, California","department":"None"}],"date_submitted":"2017-08-22T06:12:14+10:00","date_accepted":"2017-08-22T06:12:14+10:00","date_published":"2017-09-22T06:33:59+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11126/galley/5983/download/"}]},{"pk":44390,"title":"Subacute Thyroiditis Following Group A Streptococcus Pharyngitis","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/5vh1f444","frozenauthors":[{"first_name":"Jeff","middle_name":"E.","last_name":"Borenstein","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Jelena","middle_name":"","last_name":"Maletkovic","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-22T04:20:11+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44390/galley/33185/download/"}]},{"pk":44387,"title":"A Curious Case of Amlodipine Induced Hyponatremia","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/67p7p5mp","frozenauthors":[{"first_name":"Jennifer","middle_name":"","last_name":"Han","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Aarthi","middle_name":"","last_name":"Arasu","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-22T04:06:26+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44387/galley/33182/download/"}]},{"pk":10704,"title":"Effectiveness of SBIRT for Alcohol Use Disorders in the Emergency Department: A Systematic Review","subtitle":null,"abstract":"Introduction: Alcohol use disorders (AUD) place a significant burden on individuals and society. Theemergency department (ED) offers a unique opportunity to address AUD with brief screening tools andearly intervention. We undertook a systematic review of the effectiveness of ED brief interventions forpatients identified through screening who are at risk for AUD, and the effectiveness of these interventionsat reducing alcohol intake and preventing alcohol-related injuries.\nMethods: We conducted systematic electronic database searches to include randomized controlled trialsof AUD screening, brief intervention, referral, and treatment (SBIRT), from January 1966 to April 2016. Twoauthors graded and abstracted data from each included paper.\nResults: We found 35 articles that had direct relevance to the ED with enrolled patients ranging from12 to 70 years of age. Multiple alcohol screening tools were used to identify patients at risk for AUD.Brief intervention (BI) and brief motivational intervention (BMI) strategies were compared to a controlintervention or usual care. Thirteen studies enrolling a total of 5,261 participants reported significantdifferences between control and intervention groups in their main alcohol-outcome criteria of number ofdrink days and number of units per drink day. Sixteen studies showed a reduction of alcohol consumptionin both the control and intervention groups; of those, seven studies did not identify a significant interventioneffect for the main outcome criteria, but nine observed some significant differences between BI and controlconditions for specific subgroups (i.e., adolescents and adolescents with prior history of drinking anddriving; women 22 years old or younger; low or moderate drinkers); or secondary outcome criteria (e.g.reduction in driving while intoxicated).\nConclusion: Moderate-quality evidence of targeted use of BI/BMI in the ED showed a small reduction inalcohol use in low or moderate drinkers, a reduction in the negative consequences of use (such as injury),and a decline in ED repeat visits for adults and children 12 years of age and older. BI delivered in the EDappears to have a short-term effect in reducing at-risk drinking.","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":"alcohol consumption (related terms)"},{"word":"alcohol reduction"},{"word":"alcohol dependence"},{"word":"alcohol screening"},{"word":"brief intervention"},{"word":"brief negotiated interview"},{"word":"computerized intervention"},{"word":"motivational interviewing"},{"word":"tailored feedback"},{"word":"Injury"},{"word":"and emergency department"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/60s175hz","frozenauthors":[{"first_name":"Isabel","middle_name":"A.","last_name":"Barata","name_suffix":"","institution":"North Shore University Hospital, Department of Emergency Medicine, Manhasset, New York\nDonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York","department":"None"},{"first_name":"Jamie","middle_name":"","last_name":"Shandro","name_suffix":"","institution":"Harborview Medical Center, University of Washington Medical Center, Department of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Margaret","middle_name":"","last_name":"Montgomery","name_suffix":"","institution":"American College of Emergency Physicians, Dallas, Texas","department":"None"},{"first_name":"Robin","middle_name":"","last_name":"Polansky","name_suffix":"","institution":"Cedars-Sinai Medical Center, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Carolyn","middle_name":"J.","last_name":"Sachs","name_suffix":"","institution":"UCLA David Geffen School of Medicine, Emergency Medicine Center, Los Angeles, California","department":"None"},{"first_name":"Herbert","middle_name":"C.","last_name":"Duber","name_suffix":"","institution":"Harborview Medical Center, University of Washington Medical Center, Department of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Lindsay","middle_name":"","last_name":"Weaver","name_suffix":"","institution":"Indiana University School of Medicine, Department of Emergency Medicine, Indianapolis, Indiana","department":"None"},{"first_name":"Alan","middle_name":"","last_name":"Heins","name_suffix":"","institution":"Cullman Regional Medical Center, Department of Emergency Medicine, Cullman, Alabama","department":"None"},{"first_name":"Heather","middle_name":"S.","last_name":"Owen","name_suffix":"","institution":"Parkland Memorial Hospital, Department of Emergency Medicine, Dallas, Texas","department":"None"},{"first_name":"Elaine","middle_name":"B.","last_name":"Josephson","name_suffix":"","institution":"Lincoln Medical and Mental Health Center, Department of Emergency Medicine, Bronx, New York","department":"None"},{"first_name":"Wendy","middle_name":"","last_name":"Macias-Konstantopoulos,","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"}],"date_submitted":"2017-03-30T08:12:10+11:00","date_accepted":"2017-03-30T08:12:10+11:00","date_published":"2017-09-21T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10704/galley/5847/download/"}]},{"pk":10663,"title":"GLASS Clinical Decision Rule Applied to Thoracolumbar Spinal Fractures in Patients Involved in Motor Vehicle Crashes","subtitle":null,"abstract":"Introduction: There are established and validated clinical decision tools for cervical spineclearance. Almost all the rules include spinal tenderness on exam as an indication for imaging. Ourgoal was to apply GLASS, a previously derived clinical decision tool for cervical spine clearance, tothoracolumbar injuries. GLass intact Assures Safe Spine (GLASS) is a simple, objective method toevaluate those patients involved in motor vehicle collisions and determine which are at low risk forthoracolumbar injuries.\nMethods: We performed a retrospective cohort study using the National Accident Sampling System-Crashworthiness Data System (NASS-CDS) over an 11-year period (1998-2008). Sampled occupantcases selected in this study included patients age 16-60 who were belt-restrained, front- seatoccupants involved in a crash with no airbag deployment, and no glass damage prior to the crash.\nResults: We evaluated 14,191 occupants involved in motor vehicle collisions in this analysis.GLASS had a sensitivity of 94.4% (95% CI [86.3-98.4%]), specificity of 54.1% (95% CI [53.2-54.9%]), and negative predictive value of 99.9% (95% CI [99.8-99.9%]) for thoracic injuries, and asensitivity of 90.3% (95% CI [82.8-95.2%]), specificity of 54.2% (95% CI [53.3-54.9%]), and negativepredictive value of 99.9% (95% CI [99.7-99.9%]) for lumbar injuries.\nConclusion: The GLASS rule represents the possibility of a novel, more-objective thoracolumbarspine clearance tool. Prospective evaluation would be required to further evaluate the validity of thisclinical decision rule.","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":"Spine, Trauma, Clinical Decision Tool"}],"section":"Patient Safety","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1vw323zs","frozenauthors":[{"first_name":"Seth","middle_name":"","last_name":"Althoff","name_suffix":"","institution":"Einstein Medical Center","department":"None"},{"first_name":"Ryan","middle_name":"","last_name":"Overberger","name_suffix":"","institution":"Einstein Medical Center, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":"None"},{"first_name":"Mark","middle_name":"","last_name":"Sochor","name_suffix":"","institution":"University of Virginia, Department of Emergency Medicine, Charlottesville, Virginia","department":"None"},{"first_name":"Dipan","middle_name":"","last_name":"Bose","name_suffix":"","institution":"Einstein Medical Center, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":"None"},{"first_name":"Joshua","middle_name":"","last_name":"Werner","name_suffix":"","institution":"World Bank, Transport Specialist, Washington, DC","department":"None"}],"date_submitted":"2017-03-09T04:42:29+11:00","date_accepted":"2017-03-09T04:42:29+11:00","date_published":"2017-09-21T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10663/galley/5834/download/"}]},{"pk":10784,"title":"Impact of Superstorm Sandy on Medicare Patients’ Utilization of Hospitals and Emergency Departments","subtitle":null,"abstract":"Introduction: National health security requires that healthcare facilities be prepared to provide rapid,effective emergency and trauma care to all patients affected by a catastrophic event. We sought toquantify changes in healthcare utilization patterns for an at-risk Medicare population before, during,and after Superstorm Sandy’s 2012 landfall in New Jersey (NJ).\nMethods: This study is a retrospective cohort study of Medicare beneficiaries impacted bySuperstorm Sandy. We compared hospital emergency department (ED) and healthcare facilityinpatient utilization in the weeks before and after Superstorm Sandy landfall using a 20%random sample of Medicare fee-for-service beneficiaries continuously enrolled in 2011 and 2012(N=224,116). Outcome measures were pre-storm discharges (or transfers), average length of stay,service intensity weight, and post-storm ED visits resulting in either discharge or hospital admission.\nResults: In the pre-storm week, hospital transfers from skilled nursing facilities (SNF) increased by39% and inpatient discharges had a 0.3 day decreased mean length of stay compared to the prioryear. In the post-storm week, ED visits increased by 14% statewide; of these additional “surge”patients, 20% were admitted to the hospital. The increase in ED demand was more than double thestatewide average in the most highly impacted coastal regions (35% versus 14%).\nConclusion: Superstorm Sandy impacted both pre- and post-storm patient movement in NewJersey; post-landfall ED surge was associated with overall storm impact, which was greatest incoastal counties. A significant increase in the number and severity of pre-storm transfer patients,in particular from SNF, as well as in post-storm ED visits and inpatient admissions, draws attentionto the importance of collaborative regional approaches to healthcare in large-scale events.","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 Care Preparedness"},{"word":"Public Health Emergencies"},{"word":"Medical Surge"},{"word":"Surge Capacity"},{"word":"Medicare"}],"section":"Emergency Department Access","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8t61v46p","frozenauthors":[{"first_name":"Benoit","middle_name":"","last_name":"Stryckman","name_suffix":"","institution":"U.S. Department of Health and Human Services, Washington, D.C.","department":"None"},{"first_name":"Lauren","middle_name":"","last_name":"Walsh","name_suffix":"","institution":"U.S. Department of Health and Human Services, Washington, D.C.","department":"None"},{"first_name":"Brendan","middle_name":"","last_name":"Carr","name_suffix":"","institution":"U.S. Department of Health and Human Services, Washington, D.C.\nThomas Jefferson University, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":"None"},{"first_name":"Nathaniel","middle_name":"","last_name":"Hupert","name_suffix":"","institution":"U.S. Department of Health and Human Services, Washington, D.C.\nWeill Cornell Medical College, Department of Healthcare Policy and Research, Department of Medicine, New York, New York","department":"None"},{"first_name":"Nicole","middle_name":"","last_name":"Lurie","name_suffix":"","institution":"U.S. Department of Health and Human Services, Washington, D.C.","department":"None"}],"date_submitted":"2017-05-02T03:26:57+10:00","date_accepted":"2017-05-02T03:26:57+10:00","date_published":"2017-09-21T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10784/galley/5874/download/"}]},{"pk":44392,"title":"Unilateral Eye Redness and Pulsatile Tinnitus One Year after Head Trauma","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/8pc5k3x0","frozenauthors":[{"first_name":"Giselle","middle_name":"","last_name":"Namazie","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-21T04:26:34+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44392/galley/33187/download/"}]},{"pk":44391,"title":"Two Distinct Genetic Mutations Leading to Hypercoagulability In a Patient Presenting with Pulmonary Emboli","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/1218q7j8","frozenauthors":[{"first_name":"Steven","middle_name":"","last_name":"Applebaum","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-21T04:22:30+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44391/galley/33186/download/"}]},{"pk":44363,"title":"A Case of Hand Sanitizer Intoxication","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/84k7z7r4","frozenauthors":[{"first_name":"Timothy","middle_name":"","last_name":"Ellis-Caleo","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Samuel","middle_name":"","last_name":"Burstein","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-21T04:18:29+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44363/galley/33159/download/"}]},{"pk":44378,"title":"A Case of Hyperprolactinemia and Pituitary Microadenoma in a Schizophrenic Patient on Antipsychotic Therapy","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/5c58438s","frozenauthors":[{"first_name":"Eva","middle_name":"C.","last_name":"Pessegueiro","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Antonio","middle_name":"M. ","last_name":"Pessegueiro","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-20T05:25:33+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44378/galley/33174/download/"}]},{"pk":44377,"title":"Using I-PASS to Improve Multidisciplinary Handoffs in a Large, Level IV Neonatal Intensive Care Unit","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Original Research"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4840g85z","frozenauthors":[{"first_name":"Margaret","middle_name":"","last_name":"Nguyen","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Chaim","middle_name":"","last_name":"Aron","name_suffix":"DO","institution":"","department":""},{"first_name":"Julia","middle_name":"","last_name":"Shelburne","name_suffix":"MD","institution":"","department":""},{"first_name":"Cynthia","middle_name":"","last_name":"Bell","name_suffix":"MS","institution":"","department":""},{"first_name":"Suzanne","middle_name":"","last_name":"Lopez","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-19T05:20:29+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44377/galley/33173/download/"}]},{"pk":44376,"title":"Encouraging Long-Term Volunteerism in Medical Professionals: Is it Our Duty to Serve?","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Commentary"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0bg8x5cd","frozenauthors":[{"first_name":"Henry","middle_name":"","last_name":"Kirolos","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-19T05:16:53+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44376/galley/33172/download/"}]},{"pk":44375,"title":"Modern Poppy Seed Tea: An Un-Healthy Recipe","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/7s42p5bk","frozenauthors":[{"first_name":"Henry","middle_name":"","last_name":"Kirolos","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-19T05:15:06+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44375/galley/33171/download/"}]},{"pk":10809,"title":"Case-controlled Analysis of Patient-based Risk Factors for Assault in the Healthcare Workplace","subtitle":null,"abstract":"Introduction: Violence against healthcare workers in the medical setting is common and associatedwith both physical and psychological adversity. The objective of this study was to identify featuresassociated with assailants to allow early identification of patients at risk for committing an assault inthe healthcare setting.\nMethods: We used the hospital database for reporting assaults to identify cases from July 2011through June 2013. Medical records were reviewed for the assailant’s (patient’s) past medical andsocial history, primary medical complaints, ED diagnoses, medications prescribed, presence ofan involuntary psychiatric hold, prior assaultive behavior, history of reported illicit drug use, andfrequency of visits to same hospital requesting prescription for pain medications. We selectedmatched controls at random for comparison. The primary outcome measure(s) reported are featuresof patients committing an assault while undergoing medical or psychiatric treatment within themedical center.\nResults: We identified 92 novel visits associated with an assault. History of an involuntarypsychiatric hold was noted in 52%, history of psychosis in 49%, a history of violence in the ED ona prior visit in 45%, aggression at index visit noted in the ED chart in 64%, an involuntary hold (orconsideration of) for danger to others in 61%, repeat visits for pain medication in 9%, and history ofillicit drug use in 33%. Compared with matched controls, all these factors were significantly different.\nConclusion: Patients with obvious risk factors for assault, such as history of assault, psychosis, andinvoluntary psychiatric holds, have a substantially greater chance of committing an assault in thehealthcare setting. These risk factors can easily be identified and greater security attention given tothe patient.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Emergency Department, Health Care Worker, Assault"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/94h4t0th","frozenauthors":[{"first_name":"Ilene","middle_name":"","last_name":"Claudius","name_suffix":"","institution":"University of Southern California, Keck School of Medicine, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Shoma","middle_name":"","last_name":"Desai","name_suffix":"","institution":"University of Southern California, Keck School of Medicine, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Sean","middle_name":"","last_name":"Henderson","name_suffix":"","institution":"University of Southern California, Keck School of Medicine, Department of Emergency Medicine, Los Angeles, California","department":"None"}],"date_submitted":"2017-05-13T15:26:59+10:00","date_accepted":"2017-05-13T15:26:59+10:00","date_published":"2017-09-18T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10809/galley/5884/download/"}]},{"pk":10761,"title":"Characteristics of Emergency Medicine Residency Programs in Colombia","subtitle":null,"abstract":"Introduction: Emergency medicine (EM) is in different stages of development around the world.Colombia has made significant strides in EM development in the last two decades and recognized it as amedical specialty in 2005. The country now has seven EM residency programs: three in the capital city ofBogotá, two in Medellin, one in Manizales, and one in Cali. The seven residency programs are in differentstages of maturity, with the oldest founded 20 years ago and two founded in the last two years. Theobjective of this study was to characterize these seven residency programs.\nMethods: We conducted semi-structured interviews with faculty and residents from all the existingprograms in 2013-2016. Topics included program characteristics and curricula.\nResults: Colombian EM residencies are three-year programs, with the exception of one four-yearprogram. Programs accept 3-10 applicants yearly. Only one program has free tuition and the rest chargetuition. The number of EM faculty ranges from 2-15. EM rotation requirements range from 11-33% oftotal clinical time. One program does not have a pediatric rotation. The other programs require 1-2months of pediatrics or pediatric EM. Critical care requirements range from 4-7 months. Other commonrotations include anesthesia, general surgery, internal medicine, obstetrics, gynecology, orthopedics,ophthalmology, radiology, toxicology, psychiatry, neurology, cardiology, pulmonology, and trauma. Allprograms offer 4-6 hours of protected didactic time each week. Some programs require AdvancedCardiac Life Support, Pediatric Advanced Life Support and Advanced Trauma Life Support, with someprograms providing these trainings in-house or subsidizing the cost. Most programs require one researchproject for graduation. Resident evaluations consist of written tests and oral exams several times per year.Point-of-care ultrasound training is provided in four of the seven programs.\nConclusion: As emergency medicine continues to develop in Colombia, more residency programsare expected to emerge. Faculty development and sustainability of academic pursuits will be criticallyimportant. In the long term, the specialty will need to move toward certifying board exams andprofessional development through a national EM organization to promote standardization acrossprograms.","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":"Colombia, Latin America, Emergency Medicine, residency programs, medical education, Emergency Medicine Development"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3h09q77k","frozenauthors":[{"first_name":"Andres","middle_name":"M.","last_name":"Patiño","name_suffix":"","institution":"Harvard Affiliated Emergency Medicine Residency, Massachusetts General\nHospital / Brigham and Women’s Hospital, Boston, Massachusetts","department":"None"},{"first_name":"Victor","middle_name":"","last_name":"Alcalde","name_suffix":"","institution":"Aria Health Emergency Medicine, Philadelphia, Pennsylvania","department":"None"},{"first_name":"Camilo","middle_name":"","last_name":"Gutierrez","name_suffix":"","institution":"Boston Medical Center, Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Mauricio","middle_name":"","last_name":"Garcia Romero","name_suffix":"","institution":"Asociación Colombiana de Especialistas en Urgencias y Emergencias, Barranquilla, Colombia","department":"None"},{"first_name":"Atilio","middle_name":"","last_name":"Moreno Carrillo","name_suffix":"","institution":"Pontificia Universidad Javeriana, Facultad de Medicina, Emergency Medicine Residency, Bogota, Colombia","department":"None"},{"first_name":"Luis","middle_name":"E.","last_name":"Vargas","name_suffix":"","institution":"Universidad del Rosario, Facultad de Medicina, Emergency Medicine Residency, Bogota, Colombia","department":"None"},{"first_name":"Carlos","middle_name":"E.","last_name":"Vallejo","name_suffix":"","institution":"Universidad de Antioquia, Facultad de Medicina, Emergency Medicine Residency, Medellin, Colombia","department":"None"},{"first_name":"Virginia","middle_name":"","last_name":"Zarama","name_suffix":"","institution":"Universidad ICESI, Facultad de Medicina, Emergency Medicine Residency, Fundacion Valle del Lili, Cali, Colombia","department":"None"},{"first_name":"Jose","middle_name":"L.","last_name":"Mora Rodriguez","name_suffix":"","institution":"Universidad de Caldas, Facultad de Medicina, Emergency Medicine Residency, Manizales, Colombia","department":"None"},{"first_name":"Yury","middle_name":"","last_name":"Bustos","name_suffix":"","institution":"Universidad del Rosario, Facultad de Medicina, Emergency Medicine Residency, Bogota, Colombia","department":"None"},{"first_name":"Juliana","middle_name":"","last_name":"Granada","name_suffix":"","institution":"Pontificia Universidad Javeriana, Facultad de Medicina, Emergency Medicine Residency, Bogota, Colombia","department":"None"},{"first_name":"Leonar","middle_name":"G.","last_name":"Aguiar","name_suffix":"","institution":"Pontificia Universidad Javeriana, Facultad de Medicina, Emergency Medicine Residency, Bogota, Colombia","department":"None"},{"first_name":"Salvador","middle_name":"","last_name":"Menendez","name_suffix":"","institution":"Universidad del Rosario, Facultad de Medicina, Emergency Medicine Residency, Bogota, Colombia","department":"None"},{"first_name":"Jorge","middle_name":"I.","last_name":"Cohen","name_suffix":"","institution":"Universidad CES, Facultad de Medicina, Emergency Medicine Residency, Medellin, Colombia","department":"None"},{"first_name":"Miguel","middle_name":"A.","last_name":"Saavedra","name_suffix":"","institution":"Fundación Universitaria de Ciencias de la Salud, Facultad de Medicina, Emergency Medicine Residency, Bogota, Colombia","department":"None"},{"first_name":"Juan","middle_name":"M.","last_name":"Rodriguez","name_suffix":"","institution":"Fundación Universitaria de Ciencias de la Salud, Facultad de Medicina, Emergency Medicine Residency, Bogota, Colombia","department":"None"},{"first_name":"Tatiana","middle_name":"","last_name":"Roldan","name_suffix":"","institution":"Universidad del Rosario, Facultad de Medicina, Emergency Medicine Residency, Bogota, Colombia","department":"None"},{"first_name":"Christian","middle_name":"","last_name":"Arbelaez","name_suffix":"","institution":"Harvard Medical School, Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts","department":"None"}],"date_submitted":"2017-04-22T11:00:27+10:00","date_accepted":"2017-04-22T11:00:27+10:00","date_published":"2017-09-18T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10761/galley/5867/download/"}]},{"pk":10758,"title":"Decreasing Emergency Department Walkout Rate and Boarding Hours by Improving Inpatient Length of Stay","subtitle":null,"abstract":"Introduction: Patient progress, the movement of patients through a hospital system from admission todischarge, is a foundational component of operational effectiveness in healthcare institutions. Optimalpatient progress is a key to delivering safe, high-quality and high-value clinical care. The Baystate PatientProgress Initiative (BPPI), a cross-disciplinary, multifaceted quality and process improvement project, waslaunched on March 1, 2014, with the primary goal of optimizing patient progress for adult patients.\nMethods: The BPPI was implemented at our system’s tertiary care, academic medical center, a highvolume,high-acuity hospital that serves as a regional referral center for western Massachusetts. TheBPPI was structured as a 24-month initiative with an oversight group that ensured collaborative goalalignment and communication of operational teams. It was organized to address critical aspects ofa patient’s progress through his hospital stay and to create additional inpatient capacity. The specificgoal of the BPPI was to decrease length of stay (LOS) on the inpatient adult Hospital Medicine serviceby optimizing an interdisciplinary plan of care and promoting earlier departure of discharged patients.Concurrently, we measured the effects on emergency department (ED) boarding hours per patient andwalkout rates.\nResults: The BPPI engaged over 300 employed clinicians and non-clinicians in the work. We createdincreased inpatient capacity by implementing daily interdisciplinary bedside rounds to proactively addresspatient progress; during the 24 months, this resulted in a sustained rate of discharge orders writtenbefore noon of more than 50% and a decrease in inpatient LOS of 0.30 days (coefficient: -0.014, 95%CI [-0.023, -0.005] P< 0.005). Despite the increase in ED patient volumes and severity of illness overthe same time period, ED boarding hours per patient decreased by approximately 2.1 hours (coefficient:-0.09; 95% CI [-0.15, -0.02] P = 0.007). Concurrently, ED walkout rates decreased by nearly 32% to amonthly mean of 0.4 patients (coefficient: 0.4; 95% CI [-0.7, -0.1] P= 0.01).\nConclusion: The BPPI realized significant gains in patient progress for adult patients by promotingearlier discharges before noon and decreasing overall inpatient LOS. Concurrently, ED boarding hoursper patient and walkout rates decreased.","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":"ED Crowding"},{"word":"Length of Stay"},{"word":"Walkouts. ED Boarding"}],"section":"Emergency Department Operations","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9hh3r9vb","frozenauthors":[{"first_name":"Andrew","middle_name":"W.","last_name":"Artenstein","name_suffix":"","institution":"University of Massachusetts Medical School-Baystate, Department of Medicine, Division of Infectious Disease, Springfield, Massachusetts","department":"None"},{"first_name":"Niels","middle_name":"K.","last_name":"Rathlev","name_suffix":"","institution":"University of Massachusetts Medical School-Department of Emergency Medicine, Baystate, Springfield, Massachusetts","department":"None"},{"first_name":"Douglas","middle_name":"","last_name":"Neal","name_suffix":"","institution":"Baystate Health, Healthcare Quality and Process Improvement, Springfield, Massachusetts","department":"None"},{"first_name":"Vernette","middle_name":"","last_name":"Townsend","name_suffix":"","institution":"Baystate Health, Baystate Medical Center, Springfield, Massachusetts","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Vemula","name_suffix":"","institution":"Baystate Health, Department of Emergency Medicine, Springfield, Massachusetts","department":"None"},{"first_name":"Sheila","middle_name":"","last_name":"Goldlust","name_suffix":"","institution":"Baystate Health, Baystate Medical Center, Springfield, Massachusetts","department":"None"},{"first_name":"Joseph","middle_name":"","last_name":"Schmidt","name_suffix":"","institution":"University of Massachusetts Medical School-Department of Emergency Medicine, Baystate, Springfield, Massachusetts","department":"None"},{"first_name":"Paul","middle_name":"","last_name":"Visintainer","name_suffix":"","institution":"University of Massachusetts Medical School-Baystate, Office of Research, Springfield, Massachusetts","department":"None"}],"date_submitted":"2017-04-22T06:15:35+10:00","date_accepted":"2017-04-22T06:15:35+10:00","date_published":"2017-09-18T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10758/galley/5866/download/"}]},{"pk":10492,"title":"Emergency Department Attending Physician Variation in Opioid Prescribing in Low Acuity Back Pain","subtitle":null,"abstract":"Introduction:\n Despite treatment guidelines suggesting alternatives, as well as evidence of a lackof benefit and evidence of poor long-term outcomes, opioid analgesics are commonly prescribedfor back pain from the emergency department (ED). Variability in opioid prescribing suggests a lackof consensus and an opportunity to standardize and improve care. We evaluated the variation inattending emergency physician (EP) opioid prescribing for patients with uncomplicated, low acuityback pain (LABP).\nMethods: \nThis retrospective study evaluated the provider-specific proportion of LABP patientsdischarged from an urban academic ED over a seven-month period with a prescription for opioids.LABP was strictly defined as (1) back pain chief complaint, (2) discharged from ED with nointerventions, and (3) predefined discharge diagnosis of back pain. We excluded providers if theyhad less than 25 LABP patients in the study period. The primary outcome was the physician-specificproportion of LABP patients discharged with an opioid analgesic prescription. We performed adescriptive analysis and then risk standardized prescribing proportion by adjusting for patient andclinical characteristics using hierarchical logistic regression.\nResults:\n During the seven-month study period, 23 EPs treated and discharged at least 25 LABPpatients and were included. Eight (34.8%) were female, and six (26.1%) were junior attendings (< 5years after residency graduation). There were 943 LABP patients included in the analysis. Providerspecificproportions ranged from 3.7% to 88.1% (mean 58.4% [SD +/- 22.2]), and we found a 22-foldvariation in prescribing proportions. There was a six-fold variation in the adjusted, risk-standardizedprescribing proportion with a range from 12.0% to 78.2% [mean 50.4% (SD +/-16.4)].\nConclusion:\n We found large variability in opioid prescribing practices for LABP that persistedafter adjustment for patient and clinical characteristics. Our findings support the need to furtherstandardize and improve adherence to treatment guidelines and evidence suggesting alternatives toopioids.","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":"opioid prescribing, decision-making"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7v6867t3","frozenauthors":[{"first_name":"Jason","middle_name":"A.","last_name":"Hoppe","name_suffix":"","institution":"University of Colorado, Department of Emergency Medicine, Aurora, Colorado","department":"None"},{"first_name":"Christopher","middle_name":"","last_name":"McStay","name_suffix":"","institution":"University of Colorado, Department of Emergency Medicine, Aurora, Colorado","department":"None"},{"first_name":"Benjamin","middle_name":"","last_name":"Sun","name_suffix":"","institution":"Oregon Health and Sciences University, Department of Emergency Medicine, Portland, Oegon","department":"None"},{"first_name":"Roberta","middle_name":"","last_name":"Capp","name_suffix":"","institution":"University of Colorado, Department of Emergency Medicine, Aurora, Colorado","department":"None"}],"date_submitted":"2016-12-10T04:19:00+11:00","date_accepted":"2016-12-10T04:19:00+11:00","date_published":"2017-09-18T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10492/galley/5768/download/"}]},{"pk":10880,"title":"Involuntary Psychiatric Holds in Preadolescent Children","subtitle":null,"abstract":"Introduction: Little is known about the use of involuntary psychiatric holds in preadolescentchildren. The primary objective was to characterize patients under the age of 10 years on involuntarypsychiatric holds.\nMethods: This was a two-year retrospective study from April 2013 – April 2015 in one urbanpediatric emergency department (ED). Subjects were all children under the age of 10 years whowere on an involuntary psychiatric hold at any point during their ED visit. We collected demographicdata including age, gender, ethnicity and details about living situation, child protective servicesinvolvement and prior mental health treatment, as well as ED disposition.\nResults: There were 308 visits by 265 patients in a two-year period. Ninety percent of involuntarypsychiatric holds were initiated in the prehospital setting. The following were common characteristics:male (75%), in custody of child protective services (23%), child protective services involvement(42%), and a prior psychiatric hospitalization (32%). Fifty-six percent of visits resulted in dischargefrom the ED, 42% in transfer to a psychiatric hospital and 1% in admission to the pediatric medicalward. Median length of stay was 4.7 hours for discharged patients and 11.7 hours for patientstransferred to psychiatric hospitals.\nConclusion: To our knowledge, this study presents the first characterization of preadolescentchildren on involuntary psychiatric holds. Ideally, mental health screening and services could beinitiated in children with similar high-risk characteristics before escalation results in placement ofan involuntary psychiatric hold. Furthermore, given that many patients were discharged from theED, the current pattern of utilization of involuntary psychiatric holds in young children should bereconsidered.","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":"psychiatric emergency, pediatric, pediatric psychiatry, behavioral emergency"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8vc737vg","frozenauthors":[{"first_name":"Genevieve","middle_name":"","last_name":"Santillanes","name_suffix":"","institution":"University of Southern California, Keck School of Medicine, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Y","middle_name":"L.","last_name":"Kearl","name_suffix":"","institution":"University of Southern California, Keck School of Medicine, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Chun","middle_name":"N.","last_name":"Lam","name_suffix":"","institution":"University of Southern California, Keck School of Medicine, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Ilene","middle_name":"A.","last_name":"Claudius","name_suffix":"","institution":"University of Southern California, Keck School of Medicine, Department of Emergency Medicine, Los Angeles, California","department":"None"}],"date_submitted":"2017-06-07T07:17:07+10:00","date_accepted":"2017-06-07T07:17:07+10:00","date_published":"2017-09-18T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10880/galley/5903/download/"}]},{"pk":10751,"title":"Knowledge Translation of the PERC Rule for Suspected Pulmonary Embolism: A Blueprint for Reducing the Number of CT Pulmonary Angiograms","subtitle":null,"abstract":"Introduction: Computerized decision support decreases the number of computed tomography pulmonary angiograms (CTPA) for pulmonary embolism (PE) ordered in emergency departments, but it is not always well accepted by emergency physicians. We studied a department-endorsed, evidence-based clinical protocol that included the PE rule-out criteria (PERC) rule, multi-modal education using principles of knowledge translation (KT), and clinical decision support embedded in our order entry system, to decrease the number of unnecessary CTPA ordered. Methods: We performed a historically controlled observational before-after study for one year pre- and post-implementation of a departmentally-endorsed protocol. We included patients > 18 in whom providers suspected PE and who did not have a contraindication to CTPA. Providers entered clinical information into a diagnostic pathway via computerized order entry. Prior to protocol implementation, we provided education to ordering providers. The primary outcome measure was the number of CTPA ordered per 1,000 visits one year before vs. after implementation. Results: CTPA declined from 1,033 scans for 98,028 annual visits (10.53 per 1,000 patient visits (95% CI [9.9-11.2]) to 892 scans for 101,172 annual visits (8.81 per 1,000 patient visits (95% CI [8.3-9.4]) p<0.001. The absolute reduction in PACT ordered was 1.72 per 1,000 visits (a 16% reduction). Patient characteristics were similar for both periods.Conclusion: Knowledge translation clinical decision support using the PERC rule significantly reduced the number of CTPA ordered.","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":"Patient Safety","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2fg1b2pz","frozenauthors":[{"first_name":"Michael","middle_name":"J.","last_name":"Drescher","name_suffix":"","institution":"Hartford Hospital, Department of Emergency Medicine, Hartford, Connecticut\nUniversity of Connecticut School of Medicine, Department of Emergency Medicine,\nFarmington, Connecticut\nRabin Medical Center, Department of Emergency Medicine, Petah Tikvah, Israel","department":"None"},{"first_name":"Jeremy","middle_name":"","last_name":"Fried","name_suffix":"","institution":"Charlotte Hungerford Hospital, Department of Emergency Medicine, Torrington, Connecticut","department":"None"},{"first_name":"Ryan","middle_name":"","last_name":"Brass","name_suffix":"","institution":"Rutland Regional Medical Center, Department of Emergency Medicine, Rutland, Vermont\nUniversity of New Mexico, Department of Emergency Medicine, Albuquerque, New Mexico","department":"None"},{"first_name":"Amanda","middle_name":"","last_name":"Medoro","name_suffix":"","institution":"University of Cincinnati College of Medicine, Department of Emergency Medicine, Cincinnati, Ohio","department":"None"},{"first_name":"Timothy","middle_name":"","last_name":"Murphy","name_suffix":"","institution":"University of Connecticut School of Medicine, Department of Emergency Medicine, Farmington, Connecticut","department":"None"},{"first_name":"Joao","middle_name":"","last_name":"Delgado","name_suffix":"","institution":"Hartford Hospital, Department of Emergency Medicine, Hartford, Connecticut \nUniversity of Connecticut School of Medicine, Department of Emergency Medicine, Farmington, Connecticut","department":"None"}],"date_submitted":"2017-04-18T04:12:29+10:00","date_accepted":"2017-04-18T04:12:29+10:00","date_published":"2017-09-18T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10751/galley/5862/download/"}]},{"pk":11114,"title":"Understanding the Intention-to-treat Principle in Randomized Controlled Trials","subtitle":null,"abstract":"Clinicians, institutions, and policy makers use results from randomized controlled trials to makedecisions regarding therapeutic interventions for their patients and populations. Knowing the effectthe intervention has on patients in clinical trials is critical for making both individual patient as well aspopulation-based decisions. However, patients in clinical trials do not always adhere to the protocol.Excluding patients from the analysis who violated the research protocol (did not get their intendedtreatment) can have significant implications that impact the results and analysis of a study.\nIntention-to-treat analysis is a method for analyzing results in a prospective randomized studywhere all participants who are randomized are included in the statistical analysis and analyzedaccording to the group they were originally assigned, regardless of what treatment (if any) theyreceived. This method allows the investigator (or consumer of the medical literature) to draw accurate(unbiased) conclusions regarding the effectiveness of an intervention. This method preserves thebenefits of randomization, which cannot be assumed when using other methods of analysis.\nThe risk of bias is increased whenever treatment groups are not analyzed according to the groupto which they were originally assigned. If an intervention is truly effective (truth), an intention-to-treatanalysis will provide an unbiased estimate of the efficacy of the intervention at the level of adherencein the study. This article will review the “intention-to-treat” principle and its converse, “per-protocol”analysis, and illustrate how using the wrong method of analysis can lead to a significantly biasedassessment of the effectiveness of an intervention.","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":"Population Health Research Design","is_remote":true,"remote_url":"https://escholarship.org/uc/item/83j2g4hq","frozenauthors":[{"first_name":"C.","middle_name":"Eric","last_name":"McCoy","name_suffix":"","institution":"University of California, Irvine, School of Medicine and Medical Center, Department of\nEmergency Medicine, Orange, California","department":"None"}],"date_submitted":"2017-08-17T08:55:41+10:00","date_accepted":"2017-08-17T08:55:41+10:00","date_published":"2017-09-18T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11114/galley/5977/download/"}]},{"pk":4756,"title":"Radjedef to the Eighth Dynasty","subtitle":null,"abstract":"Our sources for the chronology of the Old Kingdom comprise a mere handful of contemporary written documents, supplemented by radiocarbon dates, some of which have recently been recalibrated by Oxford University. The bulk of historical evidence, deriving primarily from residential cemeteries of the ruling kings and the elite, as well as from provincial sites, shows that during large portions of the Old Kingdom Egypt represented a relatively centralized state with a well-structured administrative system. Until the end of the Fourth Dynasty Egypt’s royal family exercised a role of complete authority, exemplified in the monumental construction of pyramids, such as those on the Giza Plateau. Fourth-Dynasty king Radjedef broke with tradition, building his pyramid at Abu Rawash, nearer the major cult center of Heliopolis. Evident from the Fifth Dynasty onward is a steady decline in the royal family’s dominant role in the state administration, concomitant with the rising importance and authority of non-royal officials and provincial administrators. Tomb motifs accompanied by various proxy data, particularly from the reign of Niuserra, are suggestive of changing environmental conditions and climatic stress, supported today by scientific data. The so-called “status race” became yet more explicit in the Sixth Dynasty, which was marked by instability and court intrigue, the provincial nomarchs ultimately succeeding in combining powers of both the administration and priesthood. The Seventh Dynasty represents a fleeting period of political upheaval wherein, according to the historian Manetho, 70 kings reigned during a period of 70 days. By the Eighth Dynasty—the ultimate closing stage of the Old Kingdom—the powers of the formerly centralized government had become territorial and personal.","language":"en","license":null,"keywords":[{"word":"History"},{"word":"Near Eastern Languages and Societies"}],"section":"Time and History","is_remote":true,"remote_url":"https://escholarship.org/uc/item/67n4m4c4","frozenauthors":[{"first_name":"Miroslav","middle_name":"","last_name":"Bárta","name_suffix":"","institution":"Czech Institute of Egyptology, Charles University Prague","department":"None"}],"date_submitted":"2009-12-12T10:48:50+11:00","date_accepted":"2009-12-12T10:48:50+11:00","date_published":"2017-09-17T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/nelc_uee/article/4756/galley/2673/download/"}]},{"pk":44374,"title":"Critical Hypomagnesemia Exacerbated by Alcohol and Thiazides Presenting with Weakness with a Probable Underlying Genetic Basis","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/8hb2s8wc","frozenauthors":[{"first_name":"Gopi","middle_name":"","last_name":"Manthripragada","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Ramy","middle_name":"M.","last_name":"Hanna","name_suffix":"MD, FASN, FACP","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-16T05:11:23+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44374/galley/33170/download/"}]},{"pk":44373,"title":"Ipilimumab Induced Hypopituitarism","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/478967nc","frozenauthors":[{"first_name":"Amy","middle_name":"","last_name":"Chow","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Na","middle_name":"","last_name":"Shen","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-16T04:59:05+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44373/galley/33169/download/"}]},{"pk":44346,"title":"Methemoglobinemia: A Case from Primary Care","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/2rk1302q","frozenauthors":[{"first_name":"Samuel","middle_name":"","last_name":"Burstein","name_suffix":"","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Sondra","middle_name":"","last_name":"Vazirani","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-14T07:18:23+10:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44346/galley/33142/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44346/galley/33142/download/"}]},{"pk":44372,"title":"Epstein Barr Virus Associated Acalculous Cholecystitis","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/4008f964","frozenauthors":[{"first_name":"Geoffrey","middle_name":"L.","last_name":"Graham","name_suffix":"MD, MBA","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Hamed","middle_name":"","last_name":"Nayeb-Hashemi","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-13T04:54:21+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44372/galley/33168/download/"}]},{"pk":10755,"title":"Ultrasound-Guided Peripheral Intravenous Line Placement: A Narrative Review of Evidence-based Best Practices","subtitle":null,"abstract":"Peripheral intravenous line placement is a common procedure in emergency medicine. Ultrasoundguidance has been demonstrated to improve success rates, as well as decrease complicationsand pain. This paper provides a narrative review of the literature focusing on best practices andtechniques to improve performance with this procedure. We provide an evidence-based discussionof preparation for the procedure, vein and catheter selection, multiple techniques for placement, andline confirmation.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"ultrasound"},{"word":"ultrasonography"},{"word":"piv"},{"word":"peripheral line"},{"word":"intravenous"}],"section":"Technology in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8bx2p13k","frozenauthors":[{"first_name":"Michael","middle_name":"","last_name":"Gottlieb","name_suffix":"","institution":"Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois","department":"None"},{"first_name":"Tina","middle_name":"","last_name":"Sundaram","name_suffix":"","institution":"Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois","department":"None"},{"first_name":"Dallas","middle_name":"","last_name":"Holladay","name_suffix":"","institution":"Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois","department":"None"},{"first_name":"Damali","middle_name":"","last_name":"Nakitende","name_suffix":"","institution":"Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois","department":"None"}],"date_submitted":"2017-04-19T09:05:17+10:00","date_accepted":"2017-04-19T09:05:17+10:00","date_published":"2017-09-12T06:51:31+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10755/galley/5864/download/"}]},{"pk":10622,"title":"ALiEM Blog and Podcast Watch: Toxicology","subtitle":null,"abstract":"Introduction:\n The WestJEM Blog and Podcast Watch presents high-quality open-access educationalblogs and podcasts in emergency medicine based on the ongoing Academic Life in Emergency Medicine(ALiEM) Approved Instructional Resources (AIR) and AIR-Professional (Pro) series. Both series criticallyappraise open-access educational blogs and podcasts in EM using an objective scoring instrument. Thisinstallment of the blog and podcast watch series curated and scored relevant posts in the specific topic oftoxicology emergencies from the AIR-Pro Series.\nMethods\n: The AIR-Pro Series is a continuously building curriculum covering a new subject area everytwo months. For each area, eight EM chief residents identify 3-5 advanced clinical questions. UsingFOAMsearch.net and FOAMSearcher to search blogs and podcasts, relevant posts are scored byeight reviewers from the AIR-Pro editorial board, which is comprised of EM faculty and chief residentsat various institutions across North America. The scoring instrument contains five measurementoutcomes based on seven-point Likert scales: recency, accuracy, educational utility, evidence based,and references. The AIR-Pro label is awarded to posts with a score of ≥28 (out of 35) points. An“honorable mention” label is awarded if board members collectively felt that the blogs were valuableand the scores were > 25.\nResults: \nA total of 31 blog posts and podcasts were included. Key educational pearls from the six highqualityAIR-Pro posts and four honorable mentions are summarized.\nConclusion:\n The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-ProSeries, which attempts to identify high-quality educational content on open-access blogs and podcasts.This series provides an expert-based, crowdsourced approach towards critically appraising educationalsocial media content for EM clinicians. This installment focuses on toxicology 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":[],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/933722tt","frozenauthors":[{"first_name":"Fareen","middle_name":"","last_name":"Zaver","name_suffix":"","institution":"University of Calgary, Department of Emergency Medicine, Calgary, AB","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Craddick","name_suffix":"","institution":"University of Illinois College of Medicine at Peoria, Department of Emergency Medicine, Peoria, Illinois","department":"None"},{"first_name":"Audrey","middle_name":"","last_name":"Sanford","name_suffix":"","institution":"University of Illinois at Chicago, Department of Emergency Medicine, Chicago, Illinois","department":"None"},{"first_name":"Nana","middle_name":"","last_name":"Sefa","name_suffix":"","institution":"William Beaumont Hospital, Department of Emergency Medicine, El Paso Texas","department":"None"},{"first_name":"George","middle_name":"","last_name":"Hughes","name_suffix":"","institution":"University of Illinois at Chicago, Department of Emergency Medicine, Chicago, Illinois","department":"None"},{"first_name":"Michelle","middle_name":"","last_name":"Lin","name_suffix":"","institution":"University of California San Francisco, Department of Emergency Medicine, San\nFrancisco, California","department":"None"}],"date_submitted":"2017-02-16T07:25:43+11:00","date_accepted":"2017-02-16T07:25:43+11:00","date_published":"2017-09-12T06:44:54+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10622/galley/5822/download/"}]},{"pk":44371,"title":"Hemophagocytic Lymphohistiocytosis: A Rare and Rapid Cause of End-Organ Failure","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/7136m320","frozenauthors":[{"first_name":"Lisa","middle_name":"Nguy","last_name":"Quach ","name_suffix":"","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Aashini","middle_name":"","last_name":"Master","name_suffix":"DO","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-12T04:51:01+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44371/galley/33167/download/"}]},{"pk":10818,"title":"Characterizing New England Emergency Departments by Telemedicine Use","subtitle":null,"abstract":"Introduction: Telemedicine connects emergency departments (ED) with resources necessaryfor patient care; its use has not been characterized nationally, or even regionally. Our primaryobjective was to describe the prevalence of telemedicine use in New England EDs and theclinical applications of use. Secondarily, we aimed to determine if telemedicine use wasassociated with consultant availability and to identify ED characteristics associated withtelemedicine use.\nMethods: We analyzed data from the National Emergency Department Inventory-New Englandsurvey, which assessed basic ED characteristics in 2014. The survey queried directors of everyED (n=195) in the six New England states (excluding federal hospitals and college infirmaries).Descriptive statistics characterized ED telemedicine use; multivariable logistic regressionidentified independent predictors of use.\nResults: Of the 169 responding EDs (87% response rate), 82 (49%) reported usingtelemedicine. Telemedicine EDs were more likely to be rural (18% of users vs. 7% of nonusers,p=0.03); less likely to be academic (1% of users vs. 11% of non-users, p=0.01); andless likely to have 24/7 access to neurology (p<0.001), neurosurgery (p<0.001), orthopedics(p=0.01), plastic surgery (p=0.01), psychiatry (p<0.001), and hand surgery (p<0.001)consultants. Neuro/stroke (68%), pediatrics (11%), psychiatry (11%), and trauma (10%) were themost commonly reported applications. On multivariable analysis, telemedicine was more likely inrural EDs (odds ratio [OR] 4.39, 95% confidence interval [CI] 1. 30-14.86), and less likely in EDswith 24/7 neurologist availability (OR 0.21, 95% CI [0.09-0.49] ), and annual volume <20,000 (OR0.24, 95% CI [0.08-0.68]).\nConclusion: Telemedicine is commonly used in New England EDs. In 2014, use was morecommon among rural EDs and EDs with limited neurology consultant availability. In contrast,telemedicine use was less common among very low-volume EDs.","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":"Technology in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6n78g1j0","frozenauthors":[{"first_name":"Kori","middle_name":"S.","last_name":"Zachrison","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Emily","middle_name":"M.","last_name":"Hayden","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Lee","middle_name":"H.","last_name":"Schwamm","name_suffix":"","institution":"Massachusetts General Hospital, Department of Neurology, Boston, Massachusetts","department":"None"},{"first_name":"Janice","middle_name":"A.","last_name":"Espinola","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Ashley","middle_name":"F.","last_name":"Sullivan","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Krislyn","middle_name":"M.","last_name":"Boggs","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Ali","middle_name":"S.","last_name":"Raja","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Carlos","middle_name":"A.","last_name":"Camargo","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"}],"date_submitted":"2017-05-19T00:32:05+10:00","date_accepted":"2017-05-19T00:32:05+10:00","date_published":"2017-09-11T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10818/galley/5889/download/"}]},{"pk":11057,"title":"Heated Ultrasound Gel and Patient Satisfaction with Bedside Ultrasound Studies: The HUGS Trial","subtitle":null,"abstract":"Introduction: Our goal was to determine if heated gel for emergency department (ED) bedsideultrasonography improves patient satisfaction compared to room-temperature gel.\nMethods: We randomized a convenience sample of ED patients determined by their treating physicianto require a bedside ultrasound (US) study to either heated gel (102.0° F) or room-temperature gel(82.3° F). Investigators performed all US examinations. We informed all subjects that the study entailedinvestigation into various measures to improve patient satisfaction with ED US examinations but didnot inform them of our specific focus on gel temperature. Investigators wore heat-resistant gloves whileperforming the examinations to blind themselves to the gel temperature. After completion of the US,subjects completed a survey including the primary outcome measure of patient satisfaction as measuredon a 100-mm visual analogue scale (VAS). A secondary outcome was patient perceptions of sonographerprofessionalism measured by an ordinal scale (1-5).\nResults: We enrolled 124 subjects; 120 completed all outcome measures. Of these, 59 underwentrandomization to US studies with room-temperature gel and 61 underwent randomization to heated USgel. Patient 100-mm VAS satisfaction scores were 83.9 among patients undergoing studies with roomtemperaturegel versus 87.6 among subjects undergoing studies with heated gel (effect size 3.7, 95%confidence interval -1.3-8.6). There were similarly no differences between the two arms with regard topatient perceptions of sonographer professionalism.\nConclusion: The use of heated ultrasound gel appears to have no material impact on the satisfaction ofED patients undergoing bedside ultrasound studies.","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":"ultrasonography"},{"word":"patient satisfaction"},{"word":"Heated Gel"},{"word":"Diagnostic Imaging"},{"word":"Randomized Controlled Trial"}],"section":"Patient Satisfaction","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0g85q1kh","frozenauthors":[{"first_name":"Benjamin","middle_name":"M.","last_name":"Krainin","name_suffix":"","institution":"San Antonio Uniformed Services Health Education Consortium, Department of Emergency Medicine, San Antonio, Texas","department":"None"},{"first_name":"Lane","middle_name":"C.","last_name":"Thaut","name_suffix":"","institution":"San Antonio Uniformed Services Health Education Consortium, Department of\nEmergency Medicine, San Antonio, Texas","department":"None"},{"first_name":"Michael","middle_name":"D.","last_name":"April","name_suffix":"","institution":"San Antonio Uniformed Services Health Education Consortium, Department of Emergency Medicine, San Antonio, TX","department":"None"},{"first_name":"Ryan","middle_name":"A.","last_name":"Curtis","name_suffix":"","institution":"San Antonio Uniformed Services Health Education Consortium, Department of\nEmergency Medicine, San Antonio, Texas","department":"None"},{"first_name":"Andrea","middle_name":"L.","last_name":"Kaelin","name_suffix":"","institution":"San Antonio Uniformed Services Health Education Consortium, Department of\nEmergency Medicine, San Antonio, Texas","department":"None"},{"first_name":"Garrett","middle_name":"B.","last_name":"Hardy","name_suffix":"","institution":"San Antonio Uniformed Services Health Education Consortium, Department of\nEmergency Medicine, San Antonio, Texas","department":"None"},{"first_name":"Wells","middle_name":"L.","last_name":"Weymouth","name_suffix":"","institution":"San Antonio Uniformed Services Health Education Consortium, Department of\nEmergency Medicine, San Antonio, Texas","department":"None"},{"first_name":"Jonathan","middle_name":"","last_name":"Srichandra","name_suffix":"","institution":"San Antonio Uniformed Services Health Education Consortium, Department of\nEmergency Medicine, San Antonio, Texas","department":"None"},{"first_name":"Eric","middle_name":"J.","last_name":"Chin","name_suffix":"","institution":"San Antonio Uniformed Services Health Education Consortium, Department of\nEmergency Medicine, San Antonio, Texas","department":"None"},{"first_name":"Shane","middle_name":"M.","last_name":"Summers","name_suffix":"","institution":"San Antonio Uniformed Services Health Education Consortium, Department of\nEmergency Medicine, San Antonio, Texas","department":"None"}],"date_submitted":"2017-07-07T08:23:08+10:00","date_accepted":"2017-07-07T08:23:08+10:00","date_published":"2017-09-11T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/11057/galley/5955/download/"}]},{"pk":10829,"title":"Poor Access for African Researchers to African Emergency Care Publications: A Cross-sectional Study","subtitle":null,"abstract":"Introduction: Based on relative population size and burden of disease, emergency care publicationoutputs from low- and middle-income regions are disproportionately lower than those of high-incomeregions. Ironically, outputs from regions with higher publication rates are often less relevant in the Africancontext. As a result, the dissemination of and access to local research is essential to local researchers,but the cost of this access (actual and cost-wise) remains unknown. The aim of this study was to describeaccess to African emergency care publications in terms of publisher-based access (open access orsubscription) and alternate access (self-archived or author provided), as well as the cost of access.\nMethods: We conducted a retrospective, cross-sectional study using all emergency medicinepublications included in Scopus between 2011 and 2015. A sequential search strategy describedaccess to each article, and we calculated mean article charges against the purchasing power parityindex (used to describe out-of-pocket expense).\nResults: We included 666 publications from 49 journals, of which 395 (59.3%) were open access. Forsubscription-based articles, 106 (39.1%) were self-archived, 60 (22.1%) were author-provided, and105 (38.8%) were inaccessible. Mean article access cost was $36.44, and mean processing chargewas $2,319.34. Using the purchasing power parity index it was calculated that equivalent out-ofpocketexpenditure for South African, Ghanaian and Tanzanian authors would respectively be $15.77,$10.44 and $13.04 for access, and $1,004.02, $664.36 and $830.27 for processing. Based on this,the corrected cost of a single-unit article access or process charge for South African, Ghanaian andTanzanian authors, respectively, was 2.3, 3.5 and 2.8 times higher than the standard rate.\nConclusion: One in six African emergency care publications are inaccessible outside institutional librarysubscriptions; additionally, the cost of access to publications in low- and middle-income countries appearsprohibitive. Publishers should strongly consider revising pricing for more equitable access for researchersfrom low- and middle-income countries.","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":"publication"},{"word":"access"},{"word":"Emergency Medicine"},{"word":"Africa"}],"section":"Global Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7bz9638t","frozenauthors":[{"first_name":"Stevan","middle_name":"R.","last_name":"Bruijns","name_suffix":"","institution":"University of Cape Town, Division of Emergency Medicine, Cape Town, South Africa","department":"None"},{"first_name":"Mmapeladi","middle_name":"","last_name":"Maesela","name_suffix":"","institution":"University of Cape Town, Faculty of Health Sciences, Cape Town, South Africa","department":"None"},{"first_name":"Suniti","middle_name":"","last_name":"Sinha","name_suffix":"","institution":"University of Cape Town, Faculty of Health Sciences, Cape Town, South Africa","department":"None"},{"first_name":"Megan","middle_name":"","last_name":"Banner","name_suffix":"","institution":"African Federation for Emergency Medicine, Cape Town, South Africa","department":"None"}],"date_submitted":"2017-05-23T04:52:33+10:00","date_accepted":"2017-05-23T04:52:33+10:00","date_published":"2017-09-11T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10829/galley/5893/download/"}]},{"pk":10675,"title":"Team Size and Stretching-Exercise Effects on Simulated Chest Compression Performance and Exertion","subtitle":null,"abstract":"Introduction: Investigators conducted a prospective experimental study to evaluate the effectof team size and recovery exercises on individual providers’ compression quality and exertion.Investigators hypothesized that 1) larger teams would perform higher quality compressions withless exertion per provider when compared to smaller teams; and 2) brief stretching and breathingexercises during rest periods would sustain compressor performance and mitigate fatigue.\nMethods: In Phase I, a volunteer cohort of pre-clinical medical students performed four minutesof continuous compressions on a Resusci-Anne manikin to gauge the spectrum of compressorperformance in the subject population. Compression rate, depth, and chest recoil weremeasured. In Phase II, the highest-performing Phase I subjects were placed into 2-, 3-, and/or4-compressor teams; 2-compressor teams were assigned either to control group (no recoveryexercises) or intervention group (recovery exercises during rest). All Phase II teams participatedin 20-minute simulations with compressor rotation every two minutes. Investigators recordedcompression quality and real-time heart rate data, and calculated caloric expenditure fromcontact heart rate monitor measurements using validated physiologic formulas.\nResults: Phase I subjects delivered compressions that were 24.9% (IQR1-3: [0.5%-74.1%])correct with a median rate of 112.0 (IQR1-3: [103.5-124.9]) compressions per minute anddepth of 47.2 (IQR1-3: [35.7-55.2]) mm. In their first rotations , all Phase II subjects deliveredcompressions of similar quality and correctness (p=0.09). Bivariate analyses of 2-, 3-, and4-compressor teams’ subject compression characteristics by subsequent rotation did notidentify significant differences within or across teams. On multivariate analyses, only subjects in2-compressor teams exhibited significantly lower compression rat es (control subjects; p<0.01),diminished chest release (intervention subjects; p=0.03), and greater exertion over successiverotations (both control [p≤0.03] and intervention [p≤0.02] subj ects).\nConclusion: During simulated resuscitations, 2-compressor teams exhibited increased levels ofexertion relative to 3- and 4-compressor teams for comparable compression delivery. Stretchingand breathing exercises intended to assist with compressor recovery exhibited mixed effects oncompression performance and subject exertion.","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":"cardiopulmonary resuscitation"},{"word":"emergency treatment"},{"word":"human engineering"},{"word":"patient simulation"},{"word":"task performance and analysis"}],"section":"Critical Care","is_remote":true,"remote_url":"https://escholarship.org/uc/item/47h8z844","frozenauthors":[{"first_name":"Jessica","middle_name":"C.","last_name":"Schoen","name_suffix":"","institution":"Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island\nLifespan Medical Simulation Center, Providence, Rhode Island\nMayo Clinic Rochester, Department of Emergency Medicine, Rochester, Minnesota","department":"None"},{"first_name":"Jason","middle_name":"T.","last_name":"Machan","name_suffix":"","institution":"Rhode Island Hospital, Biostatistics Core, Providence, Rhode Island","department":"None"},{"first_name":"Max","middle_name":"","last_name":"Dannecker","name_suffix":"","institution":"Lifespan Medical Simulation Center, Providence, Rhode Island","department":"None"},{"first_name":"Leo","middle_name":"","last_name":"Kobayashi","name_suffix":"","institution":"Alpert Medical School of Brown University, Department of Emergency Medicine,\nProvidence, Rhode Island\nLifespan Medical Simulation Center, Providence, Rhode Island","department":"None"}],"date_submitted":"2017-03-17T08:36:38+11:00","date_accepted":"2017-03-17T08:36:38+11:00","date_published":"2017-09-11T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10675/galley/5838/download/"}]},{"pk":10752,"title":"Trends in Regionalization of Care for ST-Segment Elevation Myocardial Infarction","subtitle":null,"abstract":"Introduction: California has led successful regionalized efforts for several time-critical medicalconditions, including ST-segment elevation myocardial infarction (STEMI), but no specific mandatedprotocols exist to define regionalization of care. We aimed to study the trends in regionalizationof care for STEMI patients in the state of California and to examine the differences in patientdemographic, hospital, and county trends.\nMethods: Using survey responses collected from all California emergency medical services (EMS)agencies, we developed four categories – no, partial, substantial, and complete regionalization– to capture prehospital and inter-hospital components of regionalization in each EMS agency’sjurisdiction between 2005-2014. We linked the survey responses to 2006 California non-publichospital discharge data to study the patient distribution at baseline.\nResults: STEMI regionalization-of-care networks steadily developed across California. Only 14%of counties were regionalized in 2006, accounting for 42% of California’s STEMI patient population,but over half of these counties, representing 86% of California’s STEMI patient population, reachedcomplete regionalization in 2014. We did not find any dramatic differences in underlying patientcharacteristics based on regionalization status; however, differences in hospital characteristics wererelatively substantial.\nConclusion: Potential barriers to achieving regionalization included competition, hospital ownership,population density, and financial challenges. Minimal differences in patient characteristics canestablish that patient differences unlikely played any role in influencing earlier or later regionalizationand can provide a framework for future analyses evaluating the impact of regionalization on patientoutcomes.","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, regionalization of care, EMS, pre-hospital care"}],"section":"Disaster Medicine/ Emergency Medical Services","is_remote":true,"remote_url":"https://escholarship.org/uc/item/56q516fc","frozenauthors":[{"first_name":"Renee","middle_name":"Y.","last_name":"Hsia","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San\nFrancisco, California\nUniversity of California, San Francisco, Philip R. Lee Institute for Health Policy Studies, San Francisco, California","department":"None"},{"first_name":"Sarah","middle_name":"","last_name":"Sabbagh","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San\nFrancisco, California","department":"None"},{"first_name":"Nandita","middle_name":"","last_name":"Sarkar","name_suffix":"","institution":"National Bureau of Economic Research, Cambridge, Massachusetts","department":"None"},{"first_name":"Karl","middle_name":"","last_name":"Sporer","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San\nFrancisco, California\nAlameda County Emergency Medical Services Agency, Oakland, California","department":"None"},{"first_name":"Ivan","middle_name":"C.","last_name":"Rokos","name_suffix":"","institution":"University of California, Los Angeles-Olive View Medical Center; Geffen School of Medicine, Los Angeles, California","department":"None"},{"first_name":"John","middle_name":"F.","last_name":"Brown","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San\nFrancisco, California\nSan Francisco Emergency Medical Services Agency, San Francisco, California","department":"None"},{"first_name":"Ralph","middle_name":"G.","last_name":"Brindis","name_suffix":"","institution":"University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies, San Francisco, California\nUniversity of California, San Francisco, Department of Medicine, San Francisco,\nCalifornia","department":"None"},{"first_name":"Joanna","middle_name":"","last_name":"Guo","name_suffix":"","institution":"University of California, San Francisco, Department of Emergency Medicine, San\nFrancisco, California","department":"None"},{"first_name":"Yu-Chu","middle_name":"","last_name":"Shen","name_suffix":"","institution":"National Bureau of Economic Research, Cambridge, Massachusetts\nNaval Postgraduate School, Graduate School of Business and Public Policy, Monterey, California","department":"None"}],"date_submitted":"2017-04-18T06:20:15+10:00","date_accepted":"2017-04-18T06:20:15+10:00","date_published":"2017-09-11T17:00:00+10:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10752/galley/5863/download/"}]},{"pk":44370,"title":"Unexpected Diagnosis of Type 1 Diabetes in Toddler","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/1m654062","frozenauthors":[{"first_name":"Gifty-Maria","middle_name":"","last_name":"Ntim","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-10T04:48:53+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44370/galley/33166/download/"}]},{"pk":44369,"title":"Peripheral Neuropathy","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/4cj5n2rq","frozenauthors":[{"first_name":"Felicia","middle_name":"","last_name":"Yu","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Edward .","middle_name":"K","last_name":"Hui","name_suffix":"MD","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2017-09-09T04:41:36+10:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/44369/galley/33165/download/"}]},{"pk":6752,"title":"Ethical Issues for Applying Linguistics: Introduction and Prologue","subtitle":null,"abstract":"N.2","language":"en","license":null,"keywords":[],"section":"Articles","is_remote":false,"remote_url":null,"frozenauthors":[{"first_name":"Carol","middle_name":"Temple","last_name":"Adger","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2016-05-05T18:06:49+10:00","date_accepted":"2016-05-05T18:06:49+10:00","date_published":"2017-09-07T09:06:03+10:00","render_galley":null,"galleys":[]},{"pk":6141,"title":"\"In Sondry Forms\": Dreams and Truth in Chaucer's Troilus and Criseyde","subtitle":null,"abstract":"The desire to understand a literary text often translates into a desire to neatly categorize meaning; and by consequence, to flatten the complexity of the work through oversimplification. This is true for both casual readers and literary critics—and, as demonstrated in this paper, for interpreters of dream visions. Yet some elusive texts slip out of reach, instead mystifying and elevating the literary genre. Geoffrey Chaucer's work \nTroilus and Criseyde\n, an exquisite retelling of the Troy myth, subverts the formal employment of dream visions common to medieval writing. This paper attempts to illuminate the genius of the two major dream scenes in this work through the analytic frameworks of Stephen Kruger and Valerie Ross. To offer a more comprehensive picture of Chaucer’s career, this paper also explores how he incorporates dreams in other key works. By way of this investigation, I find that the natural obscurities surrounding unconscious dreamspace allows Chaucer to access—and challenge—readers' conceptions of narrative epistemology, thereby achieving both authorial agency and critical liberation. Understanding Chaucer's stylistic legacy within his oeuvre and the larger English canon grants unique insight to even a contemporary reader’s personal relationship to liminality.","language":"en","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[{"word":"Dreams, Dream Vision, Medieval Dream Theory, Troilus and Criseyde, Chaucer"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4gq7s8kn","frozenauthors":[{"first_name":"Madeleine","middle_name":"","last_name":"Karydes","name_suffix":"","institution":"UC Berkeley","department":"None"}],"date_submitted":"2017-03-11T19:16:15+11:00","date_accepted":"2017-03-11T19:16:15+11:00","date_published":"2017-09-07T04:08:37+10:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/our_buj/article/6141/galley/3707/download/"}]},{"pk":6138,"title":"Disposing of Racial Injustice: An Analysis of Kettleman City’s Hazardous Waste Facility","subtitle":null,"abstract":"This paper will identify current health concerns inflicting Kettleman City and its corollary between race and hazardous waste, a comparison that has shown to disproportionately affect low-income communities of color. California reigns as the state with the nation’s highest concentration of minorities living near hazardous waste facilities, a correlation that generates concern in the public over racial targeting, particularly in Kettleman City, home of the largest hazardous waste plant west of the Mississippi. Kettleman City has been under scrutiny for hazardous waste violations, sparking conversations amidst the public regarding birth defects, infant mortality, increased cancer risk, and environmental racism, as the community comprises of primarily low-income farming families. Residents have actively mobilized since the 1990s, accompanying the establishment of the Kettleman Hill Hazardous Waste landfill within three miles of the City’s residential district, and have meaningfully publicized increased occurrence of cleft palate and infant mortality. Through implementation of quantitative analysis, this paper will provide an overview on the intersectionality between waste, race, and class, addressing alleged health effects, as well as identifying sociopolitical impacts affecting frontline communities of hazardous waste operations.","language":"en","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[{"word":"Environmental Justice, Hazardous Waste, Public Health, Kettleman City"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6z86m739","frozenauthors":[{"first_name":"Shruti","middle_name":"","last_name":"Patrachari","name_suffix":"","institution":"UC Berkeley","department":"None"}],"date_submitted":"2017-03-10T14:07:15+11:00","date_accepted":"2017-03-10T14:07:15+11:00","date_published":"2017-09-07T04:07:22+10:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/our_buj/article/6138/galley/3706/download/"}]}]}