Audience: This practice certifying exam case is intended for emergency medicine residents.
\nIntroduction: The American Board of Emergency Medicine (ABEM) certification process is currently undergoing a significant transformation, with the new ABEM Certifying Exam replacing the long-standing ABEM Oral Exam, which has been in place since 1980. The Certifying Exam will utilize a new exam format to evaluate different competencies compared to the Oral Exam, including high-stakes communication, managing difficult conversations, patient-centered communication, clinical decision-making, team management, leadership, procedural skills, ultrasound skills, reassessment, troubleshooting, task switching, and prioritization. This shift has understandably generated a degree of apprehension among Emergency Medicine (EM) residents preparing for their board exams. The new exam emphasizes several new cases and scenarios, including Clinical Decision-Making (CDM) cases. These structured discussions require residents to articulate their thought processes and justify their clinical choices while navigating simulated Emergency Department (ED) encounters with undifferentiated patients.
\nAlthough the CDM cases are similar in length (15 minutes) and format to the Structured Interview cases from the prior Oral Exam (structured discussion eliciting the steps necessary to diagnose and treat a patient with an undifferentiated presentation), ABEM has established new scoring criteria and objectives for the CDM cases. Therefore, to effectively prepare residents for this evolving assessment landscape, relevant and challenging example CDM case scenarios are essential. This CDM case focuses on eclampsia, defined as seizures occurring in a woman with pre-eclampsia or gestational hypertension during the peripartum period. This condition is a relatively rare, yet critical, emergency at the intersection of obstetrics and neurology that carries significant maternal and fetal risk and demands prompt recognition and decisive management. This case aligns directly with the exam's emphasis on high-acuity, low-occurrence presentations and provides a realistic and challenging opportunity to hone crucial clinical decision-making skills. It ensures that residents are not only well-prepared for the high-stakes Certifying Exam but are also capable of effectively managing this critical obstetric emergency in actual clinical practice.
\nEducational Objectives: By the end of this Mock Certifying Exam session, learners should be able to: 1) demonstrate familiarity with the Clinical Decision-Making case format and structure, 2) elicit relevant historical information and connect that information to the diagnosis of eclampsia, 3) describe and interpret physical exam findings and their significance in establishing a pertinent differential diagnosis, which includes eclampsia, 4) initiate appropriate diagnostic testing, interpret results accurately, and formulate a stabilization and treatment plan for a patient with eclamptic seizures, and 5) reassess the patient's condition, modify the management plan as needed, provide relevant anticipatory guidance for disposition, and articulate the clinical decision-making rationale at each stage of the encounter.
\nEducational Methods: This educational intervention employed a simulated ABEM Certifying Examination case. The initial case, focusing on the critical presentation of eclampsia, was developed collaboratively by a team of Emergency Medicine education faculty at a large, urban, three-year EM residency program. The structure and format were modeled after examples of the new CDM cases provided on the ABEM website. The CDM format involves a dynamic patient encounter in which the learner progresses through different phases of care, making diagnostic and therapeutic decisions and justifying their rationale to an examiner.
\nA pilot phase was conducted to ensure realism, educational value, and appropriate timing for the examination format. Four recent graduates of the EM residency program participated in this pilot: two fellows (in Emergency Medical Services and Medical Education, respectively) and two actively practicing attending physicians in community Emergency Department settings. These individuals engaged with the case as if they were taking the actual Certifying Examination, providing detailed feedback on the clarity of the scenario, the appropriateness of the clinical challenges presented, and the overall flow and timing of the case. Based on the insights gained from pilot testing, the case underwent refinement and adjustments to optimize its effectiveness as an assessment and learning tool.
\nThe finalized eclampsia CDM case was then implemented in a testing phase involving eighteen PGY-3 (Post Graduate Year-3) EM residents. These residents participated in a simulated certifying examination experience, with two faculty members acting as examiners for each resident physician in individual exam rooms, closely resembling the actual testing environment. The examiners sat across a table from the examinee, and a separate screen was utilized to display the case stimuli and task sheet during the case. The case sessions were limited to a maximum of 15 minutes. While this CDM case was incorporated into a Mock Certifying Exam session with multiple other cases and scenarios, it could also be employed in isolation using a virtual or in-person format. Following the Mock Certifying Exam, a group debrief was conducted in-person. This session provided collective feedback to resident examinees and faculty examiners regarding the eclampsia case, the CDM case format, and key clinical learning points.
\nResearch Methods: Following each simulated case encounter, faculty examiners evaluated resident performance using a standardized scoresheet. The scoresheet, derived from ABEM Certifying Exam Score Guidelines, assessed nine domains: focused history, physical exam interpretation, differential diagnosis, diagnostics, patient stabilization, reassessment, disposition, clinical reasoning, and pathophysiology.
\nThese nine domains were collated into the standard JETem scoring rubric, which includes 25 points spread among categories associated with the CDM format. In addition to the faculty assessment, residents anonymously completed a two-question post-case evaluation. This evaluation employed a 5-point Likert scale (1 = poor, 5 = excellent) to assess the overall quality of the case, characterized by how well the session met educational objectives and resident expectations, and the degree to which the case enhanced understanding of the certifying exam format (1 = strongly disagree, 5 = strongly agree).
\nResults: In total, 18 residents completed the case, and 17/18 residents (94.4%) completed the post-case evaluation. All residents identified eclampsia as one of the top three relevant differential diagnoses, administered intravenous magnesium as part of the treatment, and appropriately admitted the patient. However, antihypertensive medications were the most overlooked treatment modality.
\nThe mean quality rating of the case was 4.94/5, and 100% of resident respondents rated the overall quality of the case as “very good” or “excellent” on a 5-point Likert scale. Furthermore, 100% of respondents agreed or strongly agreed that the case enhanced their understanding of the certifying exam format.
\nDiscussion: The implementation of this CDM case proved highly effective in preparing EM residents for the complexities of clinical practice and the new challenge of understanding the Certifying Exam CDM format. The case was exceptionally well received, with a mean quality rating of 4.94 out of 5, and 100% of resident respondents rating its overall quality as \"very good\" or \"excellent.\" Furthermore, 100% of examinees agreed or strongly agreed that the case significantly enhanced their understanding of the certifying exam format, underscoring its utility as a preparatory tool for the newly formatted ABEM Certifying Exam.
\nFrom its implementation, we learned that high-fidelity mock cases, particularly those involving critical scenarios like eclampsia, are invaluable for assessing and refining clinical decision-making skills. Eclampsia is a high-yield case due to its critical nature, requiring a wide differential diagnosis for seizures, a deep understanding of pathophysiology, and the rapid initiation of diagnostic workup and treatment to mitigate significant morbidity and mortality. This type of simulation-based training provides a safe but realistic testing environment for residents to gain experience with rare or high-acuity situations they may not frequently encounter in clinical practice.
\nThe main takeaway from this experience is the critical importance of proactive, targeted preparation for the evolving ABEM Certifying Exam. The overwhelmingly positive resident feedback and performance scores demonstrate that such simulated experiences are highly effective in enhancing understanding of the exam format. By providing a realistic, low-stakes environment for decision-making and targeted feedback, these mock cases directly contribute to residents' preparedness for board certification and, more importantly, for safe, high-quality independent practice in emergency medicine.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Clinical Decision-Making Case"},{"word":"Eclampsia"},{"word":"Seizure"},{"word":"post-partum"},{"word":"Certifying Exam"},{"word":"ABEM"}],"section":"Certifying Exam Practice","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6md873dm","frozenauthors":[{"first_name":"Samuel","middle_name":"","last_name":"Parnell","name_suffix":"","institution":"UT Southwestern Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Joshua","middle_name":"","last_name":"Ginsburg","name_suffix":"","institution":"UT Southwestern Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Brian","middle_name":"","last_name":"Milman","name_suffix":"","institution":"UT Southwestern Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Marshall","middle_name":"","last_name":"Howell","name_suffix":"","institution":"UT Southwestern Medical Center","department":"Department of Emergency Medicine"}],"date_submitted":"2025-06-24T21:34:41+05:30","date_accepted":"2025-11-25T01:58:20.445000+05:30","date_published":"2026-01-01T07:15:00+05:30","render_galley":{"label":"Parnell S, et al. Clinical Decision-Making Case Seizing the Diagnosis Eclampsia. JETem 2025. 10(5)CE186-211","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52338/galley/47805/download/"},"galleys":[{"label":"Parnell S, et al. Clinical Decision-Making Case Seizing the Diagnosis Eclampsia. JETem 2025. 10(5)CE186-211","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52338/galley/47805/download/"}]},{"pk":52335,"title":"Clinical Decision-Making Case: Pediatric Sexually Transmitted Infections and Consent","subtitle":null,"abstract":"Audience: This clinical decision-making case for the Certifying Board Exam is designed for emergency medicine residents at all training levels (PGY1 through PGY4).
\nIntroduction: Navigating consent for pediatric patients in the emergency department (ED) presents unique ethical and legal challenges. Physicians must understand parental consent requirements and the relevant exceptions that apply in the ED. Studies indicate that residents may lack confidence or knowledge in handling complex or nuanced consent scenarios, particularly regarding adolescents. We aimed to develop a structured educational intervention to address this gap. This clinical decision-making case aims to improve resident competency and comfort in managing these situations.
\nEducational Objectives: By the end of this case the learner will be able to: 1) demonstrate competency with the new ABEM Certifying Exam Clinical Decision-Making Case format, 2) manage a simulated pediatric care encounter that requires navigating the details of pediatric consent, 3) explain common exceptions to requiring parental consent in emergency situations according to established guidelines as well as state and local laws, 4) report increased comfort managing ethical dilemmas related to pediatric consent in the ED.
\nEducational Methods: This educational activity utilizes the new Clinical Decision-Making Case format for the American Board of Emergency Medicine Certifying Board Exam. This method simulates realistic ED encounters where residents must gather information, apply ethical and legal principles, and make decisions regarding pediatric consent under time constraints, similar to the new structure used in the board certification process for emergency medicine physicians. Additionally, a short presentation accompanied the debrief of this session to highlight the relevant clinical learning points.
\nResearch Methods: We administered pre- and post-intervention surveys assessing self-perceived comfort (using Likert scales) and objective knowledge (using multiple-choice questions) regarding pediatric consent, as well as comparing audience vs. participants experience. This study was approved by the Baylor Research Institute Institutional Review Board, approval number 025-322. Informed consent was obtained from all participants electronically.
\nResults: Thirteen EM residents (PGY1-PGY3) participated in this activity. In the presurvey, only 30.8% of residents reported to be somewhat or very comfortable, while in the post survey, 100% reported to be somewhat or very comfortable with pediatric consenting. When asked to evaluate the learning value of the case, 76.9% selected very valuable and 15.4% selected valuable.
\nDiscussion: This clinical decision-making case provides a standardized, active learning method to address emergency medicine residency training regarding pediatric consent, which has previously been identified as an area of difficulty for EM trainees. 1 The format allows for assessment of not just knowledge, but also application, communication, and ethical reasoning. Providing specific, constructive feedback immediately following the session is crucial for maximizing educational benefit.
\nTopics: Clinical decision-making case, board certification, pediatrics, ethics, legal.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"board certification"},{"word":"pediatrics"},{"word":"Ethics"},{"word":"Legal"},{"word":"Emergency Medicine"},{"word":"Clinical Decision-Making Case"}],"section":"Certifying Exam Practice","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4759d8gp","frozenauthors":[{"first_name":"Emily","middle_name":"","last_name":"Drone","name_suffix":"","institution":"John Peter Smith Hospital","department":"Department of Emergency Medicine"},{"first_name":"Andrew","middle_name":"","last_name":"Shedd","name_suffix":"","institution":"Baylor Scott and White All Saints Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Leslie","middle_name":"","last_name":"Rodriguez","name_suffix":"","institution":"Baylor Scott and White All Saints Medical Center","department":"Department of Graduate Medical Education"},{"first_name":"Chinmay","middle_name":"","last_name":"Patel","name_suffix":"","institution":"Baylor Scott and White All Saints Medical Center","department":"Department of Emergency Medicine"}],"date_submitted":"2025-06-18T00:44:09+05:30","date_accepted":"2025-12-05T03:26:42.106000+05:30","date_published":"2026-01-01T06:58:00+05:30","render_galley":{"label":"Drone E, et al. Clinical Decision-Making Case Pediatric Sexually Transmitted Infections and Consent. JETem 2025. 10(5)CE166-185","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52335/galley/47804/download/"},"galleys":[{"label":"Drone E, et al. Clinical Decision-Making Case Pediatric Sexually Transmitted Infections and Consent. JETem 2025. 10(5)CE166-185","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52335/galley/47804/download/"}]},{"pk":52171,"title":"Clinical Decision-Making Case: Intussusception","subtitle":null,"abstract":"Audience: This clinical decision making case is intended for emergency medicine residents of all levels.
\nIntroduction/Background:
\nTo become board certified in emergency medicine, graduates must pass both a qualifying exam and an oral exam. In 2026, the American Board of Emergency Medicine (ABEM) is transitioning to a Certifying Exam. Historically, the oral exam included two structured interview (now retitled clinical decision making [CDM]) cases and one pediatric case. Vomiting and abdominal pain are two of the top five reasons pediatric patients present to the emergency department. Being able to take a complete history and exam, regardless of age, and form an appropriate differential diagnosis is a critical skill for emergency physicians. There are many resources available to prepare for standardized single patient encounters, but there are very few resources available for candidates to prepare for the CDM cases. Here we present a CDM case of irritability and vomiting in an 18-month-old for learners to familiarize themselves with the CDM format and to demonstrate management of a pediatric patient.
\nEducational Objectives:
\nBy the end of this mock oral boards session, learners will (1) demonstrate familiarity with the CDM case format and case play, (2) model a problem-based history and physical exam, (3) generate a differential diagnosis for pediatric abdominal pain, and (4) demonstrate the ability to manage intussusception.
\nEducational Methods:
\nThis CDM case is based on the sample script available on the ABEM website. Individual residents were tested by a faculty member virtually via Zoom. After all residents completed the case, a group debrief was held virtually on Zoom.
\nResearch Methods:
\nThis case was originally tested with a pilot group of five learners who provided verbal feedback following the case. Adjustments were made to the case based on that feedback. The case was then tested with 36 second- and third-year emergency medicine residents from two residency programs. At the completion of each case, a faculty examiner scored each resident’s performance based on a standardized scoresheet. Residents received one-point for completing each task and the overall score was calculated out of 25 possible points. Residents were surveyed on prior experience with the CDM format and the educational value of this oral boards session. Educational value was evaluated on a 5-point Likert scale with 5 being excellent.
\nResults:
\nIn total, 36 residents completed this mock CDM case. The average score was 20.3/25. All examinees performed palpation on abdominal exam, ordered and provided justification for an abdominal ultrasound, ordered and provided justification for an air contrast enema, and stated the correct diagnosis of intussusception. Nearly all examinees provided an appropriate differential diagnosis for the patient. The most common items that examinees missed included asking about surgical history, asking about blood in the patient’s stool, listening for bowel sounds on exam, and providing at least one vital sign when the inpatient team was called for admission.
\nTwenty residents responded to the post-case survey (55.6%). When asked if they had previous knowledge of the CDM format, only 30% of respondents were aware of this case format, and only 10% of respondents had previously participated in a CDM practice case. The learners rated the educational value of this case a 4.7/5 with 95% “agreeing” or “strongly agreeing” that the case was helpful in preparing for their oral board exam and 90% feeling like the educational value was “very good” or “excellent.”
\nDiscussion:
\nWe present a CDM case of intussusception that allows the resident to become familiar with this type of case while demonstrating their ability to obtain a history from, examine, and treat a pediatric patient. Through this case, residents are asked specific questions about the thought process behind the history and physical exam they perform. They are also required to provide a differential diagnosis, treatment plan, and disposition for the patient. Through this clinical decision-making process, our residents felt that the case was of high educational value and was helpful in preparing for the certifying exam.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Structured Interview"},{"word":"pediatric abdominal pain"},{"word":"Intussusception"},{"word":"Oral Board Exam"}],"section":"Certifying Exam Practice","is_remote":true,"remote_url":"https://escholarship.org/uc/item/87r081x4","frozenauthors":[{"first_name":"Brian","middle_name":"","last_name":"Milman","name_suffix":"","institution":"UT Southwestern Medical Center","department":""},{"first_name":"Samuel","middle_name":"","last_name":"Parnell","name_suffix":"","institution":"UT Southwestern Medical Center","department":"Department of Emergency Medicine"}],"date_submitted":"2024-07-29T23:03:16+05:30","date_accepted":"2025-11-18T21:36:40.984000+05:30","date_published":"2026-01-01T06:45:00+05:30","render_galley":{"label":"Milman B, et al. Clinical Decision-Making Case Intussusception. JETem 2025. 10(5)CE148-165","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52171/galley/47803/download/"},"galleys":[{"label":"Milman B, et al. Clinical Decision-Making Case Intussusception. JETem 2025. 10(5)CE148-165","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52171/galley/47803/download/"}]},{"pk":52365,"title":"Ultrasound Case: Syncope in PE","subtitle":null,"abstract":"Audience: This certifying exam practice ultrasound case is intended for emergency physicians (EP) in training.
\nIntroduction: Point-of-care ultrasound (POCUS) has become an essential tool in the practice of Emergency Medicine (EM). EM physicians routinely use POCUS to expedite diagnostic evaluations, guide resuscitative efforts, enhance the safety and success of bedside procedures, and reassess critically ill patients in real-time. Furthermore, POCUS is listed in the Model of the Clinical Practice of Emergency Medicine from ABEM, including diagnostic, resuscitative, and procedural components. Training during residency, however, remains variable while POCUS continues to grow in importance. Incorporating structured, competency-based ultrasound education into EM training has the potential to standardize skill with image acquisition, enhance image interpretation, improve confidence with clinical integration, and ultimately lead to better patient care in the acute setting.
\nEducational Objectives: By the end of the session, learners will be able to: 1) obtain and interpret the parasternal short-axis view of the heart to assess right ventricular size and function, 2) identify ultrasound findings suggestive of pulmonary embolism (PE) on cardiac short-axis view, including right ventricular dilation and septal bowing, 3) demonstrate appropriate probe selection and positioning to obtain optimal images of the heart and inferior vena cava (IVC), 4) evaluate the IVC using a subxiphoid or longitudinal view to assess distension and lack of respiratory collapse as supportive findings for elevated right heart pressures, 5) identify the anatomy of the neck vasculature, differentiate between the internal jugular vein and carotid artery, and select the appropriate puncture site, 6) describe ultrasound-guided central venous catheterization via the right internal jugular vein, using a sterile technique and real-time guidance
\nEducational Methods: We developed a single-station Objective Structured Clinical Examination (OSCE) focused on point-of-care ultrasound (POCUS) in the evaluation of a patient with syncope and suspected pulmonary embolism (PE). This format aligns with the American Board of Emergency Medicine’s (ABEM) newly implemented certification examination, emphasizing real-time clinical reasoning and ultrasound skills in a simulated encounter. The OSCE features a simulated participant and a standardized examiner script mirroring the ABEM certification exam format to ensure realism and consistency. ABEM has not released specific scoring elements to our knowledge. As a result, a novel set of grading criteria was developed based on patient-centered care, image acquisition, and image interpretation. The case was co-developed by experts in emergency ultrasound and simulation-based education, and then peer-reviewed to ensure clinical accuracy, clarity, and educational value.
\nDuring the station, the examinee is presented with a focused clinical case involving a patient with syncope and is expected to demonstrate foundational POCUS knowledge, including image acquisition, optimization, and interpretation to assess for signs of PE, such as right ventricular strain or plethoric inferior vena cava. The examiner follows a structured and standardized script that evaluates the participant using a checklist, including de-identified images and clips of pathology. This tool assesses image acquisition, interpretation, and the integration of ultrasound findings into clinical decision-making. This OSCE provides a standardized method to assess diagnostic and procedural competence in a common application of ultrasound.
\nResearch Methods: This simulation case can be used as a standalone scenario or part of an ABEM Certifying Exam practice. For best results, residents should complete it individually, with some assigned as facilitators to better understand the examiner's role. The case runs for about 10 minutes, followed by a 10-minute debrief. Optimal setup includes examiner control over room lighting and ultrasound display. The case was trialed with EM residents across multiple sites using an iterative process. Feedback was collected via anonymous Qualtrics surveys using Likert scales and open-ended comments. The Boston University Institutional Review Board reviewed the project and deemed it exempt.
\nResults: Initial testing with two residents and a facilitator showed the case was clear, easy to use, and valuable for exam prep. A second round at the 2025 SAEM Annual Meeting included four learners and one facilitator. Feedback led to case revisions. Survey scores were consistently positive, with high ratings for clarity, usability, and relevance to ABEM exam preparation.
\nDiscussion: The development and implementation of a syncope-focused ultrasound case for ABEM certification preparation highlights the growing integration of POCUS into emergency medicine training and assessment. Syncope is a high-yield chief complaint in the emergency department and serves as a common clinical context in which critical diagnoses like PE may be encountered. In this case, the use of bedside ultrasound to identify right heart strain consistent with PE not only mirrors real-world clinical practice but also reinforces the diagnostic reasoning and image interpretation skills essential for contemporary emergency physicians. The favorable reception from learners underscores the value of ultrasound-based cases in exam preparation and supports the continued development of high-quality, board-style ultrasound assessments in emergency medicine training programs.
\nTopics: Ultrasound, cardiac, inferior vena cava, vascular, pulmonary embolism.
\n","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"ultrasound"},{"word":"Cardiac"},{"word":"Inferior Vena Cava"},{"word":"vascular"},{"word":"pulmonary embolism"}],"section":"Certifying Exam Practice","is_remote":false,"remote_url":"https://jetem.org/us_case_pe/","frozenauthors":[{"first_name":"Neil","middle_name":"","last_name":"Wallace","name_suffix":"","institution":"University of Arizona/Banner Medical Center","department":""},{"first_name":"Andrew","middle_name":"","last_name":"Melendez","name_suffix":"","institution":"Yale University","department":""},{"first_name":"Lars","middle_name":"K","last_name":"Beattie","name_suffix":"","institution":"University of Florida","department":""},{"first_name":"Tina","middle_name":"H","last_name":"Chen","name_suffix":"","institution":"St. Louis University","department":""},{"first_name":"David","middle_name":"","last_name":"Fernandez","name_suffix":"","institution":"Mount Sinai Hospital","department":""},{"first_name":"Amrita","middle_name":"","last_name":"Vempati","name_suffix":"","institution":"Creighton School of Medicine Phoenix","department":"Department of Emergency Medicine"},{"first_name":"Kelly","middle_name":"","last_name":"Roszczynialski","name_suffix":"","institution":"Stanford University","department":""},{"first_name":"Stephanie","middle_name":"","last_name":"Cohen","name_suffix":"","institution":"University of Central Florida","department":""},{"first_name":"Stephanie","middle_name":"","last_name":"Stapleton","name_suffix":"","institution":"Boston University/Boston Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Tiffany","middle_name":"","last_name":"Moadel","name_suffix":"","institution":"Zucker School of Medicine at Hofstra/Northwell Health","department":""}],"date_submitted":"2025-08-01T23:48:58+05:30","date_accepted":"2025-12-09T01:28:38.279000+05:30","date_published":"2026-01-01T06:33:00+05:30","render_galley":{"label":"Wallace N, et al. Ultrasound Case Syncope in PE. JETem 2025. 10(5)CE126-147","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52365/galley/47802/download/"},"galleys":[{"label":"Wallace N, et al. Ultrasound Case Syncope in PE. JETem 2025. 10(5)CE126-147","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52365/galley/47802/download/"}]},{"pk":61927,"title":"Introduction: Yoga in Global Muslim Contexts: Cultural Representations and Spiritual Practices","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Introduction","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4pr2x2sv","frozenauthors":[{"first_name":"Narin","middle_name":"","last_name":"Hassan","name_suffix":"","institution":"None","department":""},{"first_name":"Farha","middle_name":"","last_name":"Ternikar","name_suffix":"","institution":"Other","department":""}],"date_submitted":"2025-12-31T23:42:46.075000+05:30","date_accepted":"2026-01-01T01:52:30.340000+05:30","date_published":"2026-01-01T02:59:00+05:30","render_galley":{"label":"GalleyFinal_Intro","type":"pdf","path":"https://journalpub.escholarship.org/raceandyoga/article/61927/galley/47943/download/"},"galleys":[{"label":"Galley2Final_Intro","type":"pdf","path":"https://journalpub.escholarship.org/raceandyoga/article/61927/galley/47942/download/"},{"label":"GalleyFinal_Intro","type":"pdf","path":"https://journalpub.escholarship.org/raceandyoga/article/61927/galley/47943/download/"}]},{"pk":53004,"title":"Yoga in Gaza: A Conversation Featuring Hadeel Al-Gharbawi of Al-Jawad Camp","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"ceasefire"},{"word":"Gaza"},{"word":"Genocide"},{"word":"hope"},{"word":"Islam"},{"word":"Occupation"},{"word":"Palestine"},{"word":"trauma-informed yoga"}],"section":"Interviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/25n1c174","frozenauthors":[{"first_name":"Sheena","middle_name":"","last_name":"Sood","name_suffix":"","institution":"Delaware Valley University","department":"Sociology"}],"date_submitted":"2025-10-02T07:19:59.525000+05:30","date_accepted":"2025-12-19T02:57:41.617000+05:30","date_published":"2026-01-01T02:06:00+05:30","render_galley":{"label":"Galley_Sood","type":"pdf","path":"https://journalpub.escholarship.org/raceandyoga/article/53004/galley/47813/download/"},"galleys":[{"label":"Galley_Sood","type":"pdf","path":"https://journalpub.escholarship.org/raceandyoga/article/53004/galley/47813/download/"}]},{"pk":52364,"title":"Procedural Case: Neonatal Lumbar Puncture","subtitle":null,"abstract":"
ABSTRACT:
Audience: This case was specifically designed for senior emergency medicine (EM) resident physicians as a preparatory tool for the American Board of Emergency Medicine (ABEM) Certifying Exam. However, it is applicable for EM residents at all levels of training.
Introduction: Lumbar puncture (LP) is a critical diagnostic procedure in evaluating for central nervous system infections in febrile neonates. Recognizing its significance, ABEM has identified LP as a procedure that is integral to the practice of emergency medicine. Additionally, ABEM’s new Certifying Exam, launching in 2026, will include LP among the procedural skills that examinees may encounter. Despite its importance, neonatal LP can be technically challenging, with reported success rates of only 50-60%. Many EM clinicians hesitate to perform the procedure due to concerns about complications and limited hands-on experience during residency training. Furthermore, the American Academy of Pediatrics’ updated clinical practice guideline for the evaluation and management of febrile infants has led to a substantial decline in the number of LPs performed in this patient population, further reducing opportunities for trainees to gain clinical experience. This simulation case was designed to allow learners to practice and demonstrate the cognitive and technical skills necessary for performing a neonatal LP in a structured, risk-free environment.
\nEducational Objectives: This is a Procedure case involving a neonatal LP. The overarching educational goal of this case is to assess learners’ clinical decision-making, technical proficiency, and communication skills when performing a neonatal LP. Participants will be evaluated on their ability to identify indications and contraindications, obtain informed consent, prepare for and perform the procedure with sterile technique, and implement appropriate post-procedure care. By the end of the session, learners should be able to: 1) describe the indications and contraindications associated with performing a neonatal LP, 2) obtain informed consent for a neonatal LP, using clear, patient-centered language to explain the procedure and to discuss risks, benefits, and alternative options, 3) demonstrate proper preparation for a neonatal LP, including equipment setup, patient positioning, patient monitoring, use of sterile technique, and analgesia, 4) perform a neonatal LP on a procedural task trainer with technical proficiency, demonstrating proper needle insertion, cerebrospinal (CSF) collection, and adherence to sterile technique, and 5) outline appropriate post-procedure management for the patient, including interpreting CSF results, initiating appropriate treatment, monitoring for complications, and providing caregivers with clear follow-up guidance.
\nEducational Methods: We developed a single-station Objective Structured Clinical Examination (OSCE) centered on the neonatal LP procedure. This format aligns with the Procedures module of the new ABEM Certifying Exam, which emphasizes real-time procedural performance within simulated clinical encounters. This OSCE station incorporates a neonatal LP procedural task trainer and a standardized examiner script modeled after the ABEM Certifying Exam format to promote realism, consistency, and educational relevance. The case was collaboratively developed by experts in EM and simulation-based education and was externally peer-reviewed to ensure clinical accuracy, scenario clarity, and educational value.
\nDuring the OSCE, the learner is presented with a brief case summary describing a febrile neonate requiring a lumbar puncture and is expected to demonstrate the essential cognitive and technical skills for performing the procedure. The examiner follows a structured script to deliver standardized prompts, offer procedural cues, and evaluate performance using a detailed, behaviorally anchored checklist that captures both procedural steps and critical decision-making elements.
\nResearch Methods: The simulation case was originally developed by three experts in simulation-based education and EM. To enhance accuracy, realism, and educational value, the case underwent a structured peer review process involving a panel of three additional experts. Reviewers used the Simulation Scenario Evaluation Tool (SSET) to provide standardized feedback on key elements, including scenario flow, realism, clarity of learning objectives, and alignment with assessment criteria.
\nThe case was subsequently piloted at two academic institutions and a national EM conference to assess its feasibility, clarity, and instructional design in real-world educational settings. During these pilot sessions, faculty facilitators and participating learners interacted with the case using a standardized examiner script and procedural checklist. Feedback and observations from this testing informed refinements to case logistics, examiner prompts, and assessment criteria to enhance usability and educational effectiveness.
\nResults: Our expert reviewers, using the SSET survey, strongly agreed that the simulation case’s learning objectives were specific, action-oriented, relevant, and appropriately tailored to the target audience’s skill level and knowledge base. They also strongly agreed that the clinical context, embedded critical actions, and patient states effectively supported these learning objectives. Faculty facilitators reported that the scenario materials and resources provided sufficient information to enable independent facilitation of the case at their own institutions. Participating learners indicated that the written materials and verbal instructions were clear and that the experience was valuable for preparing for the ABEM Certifying Exam.
\nDiscussion: This neonatal LP simulation case was effective in achieving its educational objectives and served as a valuable tool for preparing learners for the Procedures module of the ABEM Certifying Exam. Facilitators rated the case highly across key domains, highlighting the clarity, usability, and cohesiveness of the provided materials. Learners consistently reported that the scenario provided meaningful opportunities to practice both procedural skills and clinical reasoning. These findings support the incorporation of structured procedural OSCEs into EM training programs. By leveraging simulation, this case helps address educational gaps, promote consistency in training, and enhance learner preparedness for board certification.
\nTopics: Lumbar puncture, meningitis, procedure, American Board of Emergency Medicine, Certifying Exam.
\n","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"lumbar puncture"},{"word":"meningitis"},{"word":"procedure"},{"word":"American Board of Emergency Medicine"},{"word":"Certifying Exam"}],"section":"Certifying Exam Practice","is_remote":false,"remote_url":"https://jetem.org/neonatal_lp/","frozenauthors":[{"first_name":"Charles","middle_name":"","last_name":"Lei","name_suffix":"","institution":"Hennepin County Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Stephanie","middle_name":"","last_name":"Cohen","name_suffix":"","institution":"University of Central Florida","department":"Department of Emergency Medicine"},{"first_name":"Alaa","middle_name":"","last_name":"Aldalati","name_suffix":"","institution":"University of Kansas School of Medicine-Wichita","department":"Wesley Medical Center Emergency Department"},{"first_name":"Andrew","middle_name":"","last_name":"Melendez","name_suffix":"","institution":"Yale University","department":"Department of Emergency Medicine"},{"first_name":"Neil","middle_name":"","last_name":"Wallace","name_suffix":"","institution":"University of Arizona/Banner Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Tiffany","middle_name":"","last_name":"Moadel","name_suffix":"","institution":"Zucker School of Medicine at Hofstra/Northwell","department":"Department of Emergency Medicine"},{"first_name":"Lars","middle_name":"K","last_name":"Beattie","name_suffix":"","institution":"University of Florida","department":"Department of Emergency Medicine"},{"first_name":"Tina","middle_name":"H","last_name":"Chen","name_suffix":"","institution":"St. Louis University","department":"Department of Emergency Medicine"},{"first_name":"David","middle_name":"","last_name":"Fernandez","name_suffix":"","institution":"Mount Sinai Hospital","department":"Department of Emergency Medicine"},{"first_name":"Stephanie","middle_name":"","last_name":"Stapleton","name_suffix":"","institution":"Boston University/Boston Medical Center","department":"Department of Emergency Medicine"}],"date_submitted":"2025-07-30T23:56:37+05:30","date_accepted":"2025-12-02T03:03:48.067000+05:30","date_published":"2026-01-01T02:03:00+05:30","render_galley":{"label":"Lei C, et al. Procedural Case Neonatal Lumbar Puncture. JETem 2025. 10(5)CE106-125","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52364/galley/47801/download/"},"galleys":[{"label":"Lei C, et al. Procedural Case Neonatal Lumbar Puncture. JETem 2025. 10(5)CE106-125","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52364/galley/47801/download/"}]},{"pk":52354,"title":"Difficult Conversation Case: Death Notification","subtitle":null,"abstract":"
Audience: This case is meant for senior emergency medicine (EM) resident physicians as a preparatory tool for the American Board of Emergency Medicine Certifying Exam. However, it is applicable for EM residents at all levels of training.
\nIntroduction: Difficult conversations are an integral part of the practice of emergency medicine. Competent EM physicians routinely engage in challenging conversations with patients and their families (eg, delivering bad news, disclosing medical errors, providing death notifications). Despite their importance, communication skills are often not formally taught in residency training. Instead, learners frequently rely on role modeling to develop the skills necessary to navigate these difficult situations. Incorporating structured education and training around these challenging encounters has the potential to significantly enhance both learner preparedness and patient care.
\nEducational Objectives: This Observed Structured Clinical Examination (OSCE) is intended to cover the topic of Difficult Conversations. The overarching educational goal of this case is to assess learners’ communication skills, emotional responsiveness, and ability to facilitate a death notification conversation. Participants will be evaluated on their ability to communicate in an empathic, patient-centered manner while leading a difficult discussion. Successful participants will establish rapport, actively listen, disclose sensitive information clearly and compassionately, and respond appropriately to emotional reactions. By the end of the session, learners should be able to: (1) establish rapport with the patient’s family by initiating introductions and creating a supportive environment, (2) assess the family’s baseline understanding of the patient’s condition by using open-ended questions and active listening to elicit their perspective, (3) communicate the patient’s death clearly and compassionately, using concise, non-technical language, (4) demonstrate empathy by responding appropriately to emotional reactions, validating concerns, and addressing questions thoughtfully, and (5) provide closure to the conversation by summarizing key points, offering emotional support, and clarifying the next steps in the patient’s care.
\nEducational Methods: We designed a single-station OSCE focused on the delivery of a death notification. This format is aligned with the Difficult Conversations module of the newly implemented ABEM Certifying Exam, which emphasizes communication skills and emotional responsiveness in a challenging simulated clinical encounter. In this OSCE, the learner is presented with a brief case summary describing the unsuccessful resuscitation of a patient in cardiac arrest and is tasked with delivering the bad news to the patient’s family. The family member is portrayed by a standardized participant who follows a structured script and provides standardized emotional and verbal cues. The examiner assesses learner performance using a detailed, behaviorally anchored checklist that includes both verbal and nonverbal communication skills. This OSCE structure mirrors the ABEM Certifying Exam to promote realism, consistency, and educational relevance.
\nResearch Methods: This simulation case was initially developed by three subject matter experts with backgrounds in EM and simulation-based education. To ensure clinical accuracy, coherence, and educational relevance, the case underwent a structured peer review process. Using the Simulation Scenario Evaluation Tool (SSET), a panel of three external reviewers evaluated the case and provided targeted feedback on elements such as case realism, scenario progression, clarity of learning objectives, and alignment with assessment metrics. Following peer review, the case was pilot-tested at two EM residency programs and a national EM academic conference. These pilot implementations aimed to evaluate the case’s clarity, feasibility, and instructional design within authentic educational environments. During these sessions, faculty facilitators and learners engaged with case materials, including a standardized participant script, examiner overview, and critical actions checklist. Feedback from this beta testing phase guided revisions to enhance standardized actor prompts, case logistics, and assessment materials.
\nResults: Expert reviewers reported strong agreement that the learning objectives of the simulation case were specific, measurable, action-oriented, relevant, time-bound, and appropriately aligned with the experience level of the intended learners. They also noted that the clinical context, scenario progression, and integrated critical actions effectively supported these learning objectives. Faculty facilitators expressed strong agreement that the accompanying case materials and resources offered adequate guidance to support independent implementation of the case at their own institutions. Learner feedback indicated that both the written and verbal instructions were easy to follow and that the experience was valuable for preparing them for the ABEM Certifying Exam.
\nDiscussion: This simulation case effectively met its educational goals and proved to be a useful resource for preparing learners for the Difficult Conversations module of the ABEM Certifying Exam. Facilitators gave high ratings across key areas, emphasizing the clarity and quality of the learning objectives, scenario flow, and supporting materials. Learners consistently noted that the case offered valuable practice in communication skills and emotional engagement. These results support the use of structured OSCEs within EM residency curricula. Through simulation, this case contributes to closing educational gaps, fostering standardization, and improving learner readiness for board certification.
\n","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Death notification"},{"word":"delivering bad news"},{"word":"Communication"},{"word":"difficult conversations"},{"word":"American Board of Emergency Medicine"},{"word":"Certifying Exam"}],"section":"Certifying Exam Practice","is_remote":false,"remote_url":"https://jetem.org/difficult_conversation_death_notification/","frozenauthors":[{"first_name":"Charles","middle_name":"","last_name":"Lei","name_suffix":"","institution":"Hennepin County Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Tiffany","middle_name":"","last_name":"Moadel","name_suffix":"","institution":"Zucker School of Medicine at Hofstra/Northwell","department":"Department of Emergency Medicine"},{"first_name":"Suzanne","middle_name":"","last_name":"Bentley","name_suffix":"","institution":"NYC Health + Hospitals/Elmhurst; Icahn SOM at Mount Sinai","department":"Department of Emergency Medicine"},{"first_name":"Amrita","middle_name":"","last_name":"Vempati","name_suffix":"","institution":"Creighton School of Medicine Phoenix","department":"Department of Emergency Medicine"},{"first_name":"David","middle_name":"","last_name":"Fernandez","name_suffix":"","institution":"Mount Sinai Hospital","department":"Department of Emergency Medicine"},{"first_name":"Daniela","middle_name":"","last_name":"Ortiz","name_suffix":"","institution":"Baylor College of Medicine","department":"Department of Emergency Medicine,"},{"first_name":"Anita","middle_name":"","last_name":"Rohra","name_suffix":"","institution":"Baylor College of Medicine","department":"Department of Emergency Medicine"},{"first_name":"Stephanie","middle_name":"","last_name":"Stapleton","name_suffix":"","institution":"Boston University/Boston Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Hillary","middle_name":"","last_name":"Moss","name_suffix":"","institution":"Montefiore Medical Center","department":"Department of Emergency Medicine"}],"date_submitted":"2025-07-18T07:52:57+05:30","date_accepted":"2025-12-02T02:48:58.708000+05:30","date_published":"2026-01-01T02:02:00+05:30","render_galley":{"label":"Lei C, et al. Difficult Conversation Case Death Notification. JETem 2025. 10(5)CE14-29","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52354/galley/47796/download/"},"galleys":[{"label":"Lei C, et al. Difficult Conversation Case Death Notification. JETem 2025. 10(5)CE14-29","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52354/galley/47796/download/"}]},{"pk":52353,"title":"Reassessment Case: Acute Pulmonary Edema in a Boarding Patient","subtitle":null,"abstract":"
Audience: The target audience for this communication case is senior residents and junior faculty preparing for the American Board of Emergency Medicine (ABEM) Certifying Exam. Secondary audiences include junior emergency medicine (EM) residents.
\nIntroduction: Rapid identification of clinical changes, reassessment of previous diagnoses, and appropriate adjustment of interventions are critical skills in EM. This case highlights the skills needed to recognize and manage a change in condition with acute pulmonary edema, a life-threatening condition that requires prompt intervention.
\nEducational Objectives: By the end of the case, the learner should will be able to: 1) demonstrate competency with the new ABEM Certifying Exam Reassessment case format, 2) demonstrate the ability to evaluate new information and integrate it into an existing care plan, 3) recognize signs and symptoms of pulmonary edema, 4) review possible etiologies of acute respiratory distress and the evaluation/work up to differentiate and diagnose those causes, and 5) manage pulmonary edema including implementing afterload reduction, positive pressure ventilation, and diuresis.
\nEducational Method: This is a standardized patient scenario, in alignment with the expected reassessment case format of the ABEM Certifying Exam. This educational modality is advantageous for assessing the learner’s ability to acquire history and physical examination data in a clinical environment, as well as to communicate with a patient using clear, understandable, and appropriate language.
\nResearch Methods: This case was iteratively evaluated using facilitator and learner surveys at three sites: an academic EM residency program, the 2025 Society for Academic Emergency Medicine Annual Meeting, and a second academic EM residency program. Feedback at each site informed further refinements. A total of 11 senior resident learners and four facilitators tested the case, providing feedback on its quality and usefulness.
\nResults: Learners and facilitators found the case well-written and effective. All 11 learners felt that the case was helpful practice for the ABEM Certifying Examination. Additionally, all facilitators felt the case materials were easy to use and would use the case again in the future.
\nDiscussion: The case was well-received by both learners and facilitators and appears to be a good preparatory tool for the Reassessment case format of the ABEM Certifying Exam.
\n","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"pulmonary edema"},{"word":"Sign-out"},{"word":"reassessment"},{"word":"Certifying Exam"}],"section":"Certifying Exam Practice","is_remote":false,"remote_url":"https://jetem.org/pulm_edema_reassessment/","frozenauthors":[{"first_name":"Tina","middle_name":"H","last_name":"Chen","name_suffix":"","institution":"St. Louis University","department":"Department of Emergency Medicine"},{"first_name":"David","middle_name":"","last_name":"Fernandez","name_suffix":"","institution":"Mount Sinai Hospital","department":""},{"first_name":"Amrita","middle_name":"","last_name":"Vempati","name_suffix":"","institution":"Creighton University School of Medicine in Phoenix","department":""},{"first_name":"Kelly","middle_name":"","last_name":"Roszczynialski","name_suffix":"","institution":"Stanford University","department":""},{"first_name":"Stephanie","middle_name":"","last_name":"Cohen","name_suffix":"","institution":"University of Central Florida","department":""},{"first_name":"Charles","middle_name":"","last_name":"Lei","name_suffix":"","institution":"Hennepin County Medical Center","department":""},{"first_name":"Hillary","middle_name":"","last_name":"Moss","name_suffix":"","institution":"Montefiore Medical Center","department":""},{"first_name":"Tiffany","middle_name":"","last_name":"Moadel","name_suffix":"","institution":"Zucker School of Medicine at Hofstra/Northwell Health","department":""},{"first_name":"Stephanie","middle_name":"","last_name":"Stapleton","name_suffix":"","institution":"Boston University/Boston Medical Center","department":""},{"first_name":"Lars","middle_name":"K","last_name":"Beattie","name_suffix":"","institution":"University of Florida","department":""}],"date_submitted":"2025-07-18T07:17:08+05:30","date_accepted":"2025-12-23T09:37:56.791000+05:30","date_published":"2026-01-01T01:42:00+05:30","render_galley":{"label":"Chen T, et al. Reassessment Case Acute Pulmonary Edema in a Boarding Patient. JETem 2025. 10(5)CE77-105","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52353/galley/47800/download/"},"galleys":[{"label":"Chen T, et al. Reassessment Case Acute Pulmonary Edema in a Boarding Patient. JETem 2025. 10(5)CE77-105","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52353/galley/47800/download/"}]},{"pk":52360,"title":"Patient-Centered Communication Case: Threatened Miscarriage","subtitle":null,"abstract":"
Audience: This communication case is intended for EM residents of all levels.
\nIntroduction: Patient-centered communication is a necessary skill in the practice of emergency medicine. This style of communication is crucial for promoting high-quality healthcare by prioritizing patient needs, perspectives, and values. This patient-centered communication case centers on miscarriage, a diagnosis where patient-centered communication is requisite. Approximately one in six or 17.1% of patients with a final diagnosis of miscarriage, also known as early pregnancy loss, present initially to the emergency department. Advising a patient of the diagnosis of miscarriage requires excellent communication skills including facile rapport building, empathy, nonverbal communication, and explanation of management options.
\nEducational Objectives: By the end of this certifying exam practice case, learners will be able to: 1) establish a supportive and compassionate environment through verbal and non-verbal communication when engaging with a patient experiencing distress, anxiety, or grief related to potential pregnancy loss, 2) actively explore the patient’s understanding, concerns, values, and goals related to their pregnancy and presenting symptoms, 3) recognize and normalize a range of emotional reactions, offering validation and support regardless of the patient’s obstetric history or desired pregnancy outcomes, 4) clearly explain the diagnosis of a “threatened miscarriage,” outlining its clinical implications, inherent uncertainty, and potential outcomes, 5) review the results of any imaging or lab studies succinctly and empathetically, while verifying the patient's understanding, 6) collaborate with the patient to develop a mutually agreeable care plan, including medical recommendations, appropriate follow-up, monitoring, and return precautions.
\nEducational Methods: This standardized patient case provides an opportunity to practice patient-centered communication and debrief on areas for improvement for the learner. The case was co-developed by experts in simulation-based education and emergency medicine resident leadership.
\nResearch Methods: Facilitators evaluated the standardized patient case via a survey for efficacy, while learners evaluated it via a survey from the learner perspective. This case was tested in a serial fashion with incremental improvements based on feedback at each step: initially, both learners and facilitators at the case writer’s institution, then learners and facilitators at the annual SAEM meeting, and finally with both at an institution outside of the case writer’s institution. Three unique learners and three unique facilitators tested the case throughout the entire process.
\nResults: The case was reviewed favorably with minor recommendations noted, such as additional notes for the facilitator and stronger alignment between objectives and critical actions expected. Both surveys asked for demographic information and an evaluation of the case on a scale of 1-5, with 5 being the highest rating. Learners ranked the case 4.5, and then 4.8 on iterative trialing sessions. Facilitators ranked the case above 4 out of 5 for all questions. Comments centered on clarifying verbal prompts and debriefing plan.
\nDiscussion: Overall, this standardized patient case for patient communication was received positively and is recommended for use in preparation for the ABEM certifying examination.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Patient-centered communication"},{"word":"threatened miscarriage"},{"word":"Health Communication"}],"section":"Certifying Exam Practice","is_remote":false,"remote_url":"https://jetem.org/pcc_miscarriage/","frozenauthors":[{"first_name":"Anita","middle_name":"","last_name":"Rohra","name_suffix":"","institution":"Baylor College of Medicine","department":"Department of Emergency Medicine"},{"first_name":"Daniela","middle_name":"","last_name":"Ortiz","name_suffix":"","institution":"Baylor College of Medicine","department":"Department of Emergency Medicine"},{"first_name":"Shagun","middle_name":"","last_name":"Berry","name_suffix":"","institution":"Rush University Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Colleen","middle_name":"","last_name":"Donovan","name_suffix":"","institution":"Rutgers Robert Wood Johnson Medical School","department":"Department of Emergency Medicine"},{"first_name":"Nicole","middle_name":"","last_name":"Novotny","name_suffix":"","institution":"Ochnser Health System","department":"Department of Emergency Medicine"},{"first_name":"Stephanie","middle_name":"","last_name":"Cohen","name_suffix":"","institution":"University of Central Florida","department":"Department of Emergency Medicine"},{"first_name":"Charles","middle_name":"","last_name":"Lei","name_suffix":"","institution":"Hennepin County Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Alaa","middle_name":"","last_name":"Aldalati","name_suffix":"","institution":"University of Kansas School of Medicine-Wichita","department":"Wesley Medical Center Emergency Department"},{"first_name":"Stephanie","middle_name":"","last_name":"Stapleton","name_suffix":"","institution":"Boston University/Boston Medical Center","department":"Department of Emergency Medicine"},{"first_name":"David","middle_name":"","last_name":"Fernandez","name_suffix":"","institution":"Mount Sinai Hospital","department":"Department of Emergency Medicine"}],"date_submitted":"2025-07-23T00:31:28+05:30","date_accepted":"2025-12-09T01:28:28.559000+05:30","date_published":"2026-01-01T01:38:00+05:30","render_galley":{"label":"Rohra A, et al. Patient Centered Communication Case Threatened Miscarriage. JETem 2025. 10(5)CE58-76","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52360/galley/47799/download/"},"galleys":[{"label":"Rohra A, et al. Patient Centered Communication Case Threatened Miscarriage. JETem 2025. 10(5)CE58-76","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52360/galley/47799/download/"}]},{"pk":47233,"title":"Returning to Fitra: Teaching Yogic Mindfulness to Children through Meddy Teddy","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Articles and Personal Narratives","is_remote":true,"remote_url":"https://escholarship.org/uc/item/92v8r2sb","frozenauthors":[{"first_name":"Neda","middle_name":"","last_name":"Ahson","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-04-15T04:28:51.649000+05:30","date_accepted":"2025-12-01T21:27:44.293000+05:30","date_published":"2026-01-01T00:42:00+05:30","render_galley":{"label":"New Galley_Ahson","type":"pdf","path":"https://journalpub.escholarship.org/raceandyoga/article/47233/galley/47817/download/"},"galleys":[{"label":"Galley_Ahson","type":"pdf","path":"https://journalpub.escholarship.org/raceandyoga/article/47233/galley/47806/download/"},{"label":"New Galley_Ahson","type":"pdf","path":"https://journalpub.escholarship.org/raceandyoga/article/47233/galley/47817/download/"}]},{"pk":53815,"title":"Managing Conflict Case: The Difficult Consultant","subtitle":null,"abstract":"Audience: This communication case is intended for emergency medicine (EM) resident physicians and junior faculty preparing for the ABEM Certifying Exam.
\nIntroduction: Conflict management is a common and significant challenge in the emergency department (ED), with potential negative impact on both physicians and patients. At the individual level, hospital-based conflicts can lead to emotional stress, impaired concentration, decreased trust among providers, and feelings of dehumanization.¹ For patients, conflicts between physicians can compromise the quality of care and contribute to delays in treatment.¹ In the ED, conflict often arises between emergency physicians (EPs) and various stakeholders, including patients, family members, nursing staff, hospitalists, and consultants.² Recognizing its importance, the American Board of Emergency Medicine (ABEM) has identified conflict management as a core competency for emergency medicine residents and has incorporated it into the oral certification examination.³ This oral examination case was developed to help train EM residents in managing conflict—specifically between an emergency physician and a consultant—in a structured environment.
\nEducational Objectives: By the end of the session, the learner should be able to: 1) review format and have become familiar with an ABEM Certifying Exam conflict management communication case, 2) demonstrate the ability to initiate the consultation call, establish rapport, and present a concise, evidence-based summary of the patient’s STEMI findings, 3) recognize concerns raised by the cardiologist and respond with an empathetic acknowledgment (eg, validating workload, uncertainty, or resource constraints) to support a collaborative tone, 4) articulate differing viewpoint by referencing objective clinical data (eg, ST-segment elevations, ongoing chest pain, risk from delays) when conflict is encountered and justify why urgent catheterization lab activation is indicated, and 5) identify shared goals in optimizing patient care (reducing myocardial damage and preventing deterioration) and use these to negotiate a mutually acceptable plan.
\nEducational Methods: This is a standardized patient scenario in alignment with the expected Managing Conflict case format of the ABEM Certifying Exam. The benefits of this educational modality are that it allows for direct observation and assessment of a learner’s ability to communicate with a consultant and to observe the use of conflict resolution strategies.
\nResearch Methods: We used an iterative case trialing process with a convenience sample of EM residents. Feedback from each site was used to make iterative changes to the case material. Facilitators completed a Simulation Scenario Evaluation Tool4 (SSET) survey during the written and alpha trials to evaluate the quality of key simulation elements. Facilitators and learners used modified usability surveys to evaluate cases during the beta trials. All surveys were completed anonymously using 5-point Likert scales and free text responses. All data were collected using Qualtrics (https://www.qualtrics.com) and analyzed using Excel (Microsoft, Redmond, WA). The Boston University Institutional Review Board reviewed the project and deemed it exempt.
\nResults: A total of 14 senior resident learners and 4 facilitators evaluated the case. The SSET data were largely positive; case objectives, key actions and materials were clear. The facilitators found the case was easy to use, and thought others would feel similarly. They felt confident using the case and would like to use this case for ABEM certifying exam practice. Over 90% of residents found both the written and verbal case materials to be clear. Ninety percent of residents reported that the experience was helpful practice for the ABEM certifying exam.
\nDiscussion: The case was well-received by both learners and facilitators due to its realism and similarity to real-life encounters and appears to be a useful preparatory tool for the ABEM Certifying Exam’s Managing Conflict case because it allows learners to practice conflict resolution skills.
\n","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Conflict Resolution"},{"word":"Communication"},{"word":"ABEM Certifying Exam"}],"section":"Certifying Exam Practice","is_remote":false,"remote_url":"https://jetem.org/managing_conflict_difficult_consultant/","frozenauthors":[{"first_name":"Amrita","middle_name":"","last_name":"Vempati","name_suffix":"","institution":"Creighton School of Medicine Phoenix","department":"Department of Emergency Medicine"},{"first_name":"Suzanne","middle_name":"","last_name":"Bentley","name_suffix":"","institution":"NYC Health + Hospitals/Elmhurst; Icahn SOM at Mount Sinai","department":"Department of Emergency Medicine"},{"first_name":"Anita","middle_name":"","last_name":"Rohra","name_suffix":"","institution":"Baylor College of Medicine","department":"Department of Emergency Medicine"},{"first_name":"Daniela","middle_name":"","last_name":"Ortiz","name_suffix":"","institution":"Baylor College of Medicine","department":"Department of Emergency Medicine"},{"first_name":"David","middle_name":"","last_name":"Fernandez","name_suffix":"","institution":"Mount Sinai Hospital","department":"Department of Emergency Medicine"},{"first_name":"Shagun","middle_name":"","last_name":"Berry","name_suffix":"","institution":"Rush University Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Colleen","middle_name":"","last_name":"Donovan","name_suffix":"","institution":"Rutgers Robert Wood Johnson Medical School","department":"Department of Emergency Medicine"},{"first_name":"Nicole","middle_name":"","last_name":"Novotny","name_suffix":"","institution":"Ochnser Health System","department":"Department of Emergency Medicine"},{"first_name":"Stephanie","middle_name":"","last_name":"Cohen","name_suffix":"","institution":"University of Central Florida","department":"Department of Emergency Medicine"},{"first_name":"Stephanie","middle_name":"","last_name":"Stapleton","name_suffix":"","institution":"Boston University/Boston Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Tiffany","middle_name":"","last_name":"Moadel","name_suffix":"","institution":"Zucker School of Medicine at Hofstra/Northwell","department":"Department of Emergency Medicine"}],"date_submitted":"2025-11-08T09:16:40.151000+05:30","date_accepted":"2025-12-23T09:39:51.936000+05:30","date_published":"2026-01-01T00:27:00+05:30","render_galley":{"label":"Vempati A, et al. Managing Conflict Case The Difficult Consultant. JETem 2025. 10(5)CE43-57.pdf","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/53815/galley/47798/download/"},"galleys":[{"label":"Vempati A, et al. Managing Conflict Case The Difficult Consultant. JETem 2025. 10(5)CE43-57.pdf","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/53815/galley/47798/download/"}]},{"pk":52341,"title":"Managing Conflict Case: Admission of a Patient with Decompensated Schizophrenia, Hypertension, and Diabetes","subtitle":null,"abstract":"
Audience: This practice Certifying Exam Communication case is intended for emergency medicine resident physicians (both junior and senior).
\nIntroduction: Conflict is the result of two parties who differ in their expectations, agendas, personal needs, backgrounds, and/or communication styles. Emergency medicine physicians are faced with conflict in various forms in the workplace on a regular basis related to task content, interpersonal differences, and processes. When conflict is not managed appropriately, it can result in subpar patient care and poor team morale. Thus, conflict management is an important skill for all emergency medicine physicians. With this in mind, ABEM (the American Board of Emergency Medicine) has now chosen to assess candidates’ conflict management proficiency as part of its new Certifying Exam. As educators, we must prepare trainees for both the certification exam and the clinical setting by creating opportunities for practice, focused evaluation, and formative feedback. To strengthen our certifying exam preparation curriculum, we designed a certifying exam practice case to help residents learn how to manage conflict.
\nEducational Objectives: The following objectives, which align with ABEM’s recommended objectives, address the nuances of managing conflict. By the end of the session, learners should be able to: 1) demonstrate familiarity with the ABEM Managing Conflict case format and structure, 2) establish rapport by developing connection and trust with the admitting physicians, 3) demonstrate understanding of the other party's position by verbalizing thoughtful and specific questions about his/her concerns, 4) explain his/her own position clearly and insightfully, 5) acknowledge divergent positions with thoughtfulness and insight, 6) identify interests shared by both the psychiatrist and hospitalist as well as what is in the best interest of the patient, and 7) propose a path forward which accounts for the interests of all parties involved.
\nEducational Methods: We developed a 10-minute OSCE (Objective Structured Clinical Examination)-style case requiring the resident examinee to manage a conflict with consulting physicians. The ABEM certifying exam will utilize standardized patient actors. For our case, the faculty examiner served as the actor who alternated between the two roles required by the case.
\nResearch Methods: We piloted this case with 18 PGY-3 emergency medicine residents. We developed a grading rubric based on ABEM’s six published conflict-management case learning objectives. To pass the case, learners had to score 12 or more of the 18 available points (67%). Each learner was also asked to complete a post-case evaluation associated with a 5-point Likert scale.
\nResults: When asked whether the case increased their understanding of the new ABEM certifying exam format, 18/18 (100%) of the participants replied “agree” or “strongly agree.\" When asked to assess the overall quality of the case, 16/18 (88.89%) of the participants stated that it was “very good” or “excellent.” The case received a mean score of 4.61/5. The mean critical action completion score was 17.61/18.
\nDiscussion: We sought to create a practice certifying exam case that provided learners with a high-fidelity opportunity to both understand ABEM’s new certifying exam requirements and to be evaluated on how well they managed conflict. Our results reflect that most learners felt we addressed these aims, and that overall, our educational assessment was effective.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"conflict management"},{"word":"Communication"},{"word":"Certifying Exam"}],"section":"Certifying Exam Practice","is_remote":false,"remote_url":"https://jetem.org/managing_conflict_psych_admit/","frozenauthors":[{"first_name":"Monique","middle_name":"","last_name":"Graf","name_suffix":"","institution":"Baylor Scott & White All Saints Medical Center-Fort Worth","department":"Department of Emergency Medicine"},{"first_name":"Sonika","middle_name":"","last_name":"Raj","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Jedidiah","middle_name":"","last_name":"Leaf","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Marshall","middle_name":"","last_name":"Howell","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine,"},{"first_name":"Joshua","middle_name":"","last_name":"Ginsburg","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Brian","middle_name":"","last_name":"Milman","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Samuel","middle_name":"","last_name":"Parnell","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine"}],"date_submitted":"2025-06-26T20:14:23+05:30","date_accepted":"2025-12-02T02:40:23.411000+05:30","date_published":"2026-01-01T00:15:00+05:30","render_galley":{"label":"Graf M, et al. Managing Conflict Case Admission of a Patient with Decompensated Schizophrenia, Hypertension, and Diabetes. JETem 2025. 10(5)CE30-42","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52341/galley/47797/download/"},"galleys":[{"label":"Graf M, et al. Managing Conflict Case Admission of a Patient with Decompensated Schizophrenia, Hypertension, and Diabetes. JETem 2025. 10(5)CE30-42","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52341/galley/47797/download/"}]},{"pk":52336,"title":"Difficult Conversation Case: Missed Testicular Cancer","subtitle":null,"abstract":"Audience: We administered this case to senior emergency medicine (EM) residents, but it is appropriate for senior medical students and EM residents at all levels of training.
\nIntroduction: The practice of emergency medicine regularly requires navigating challenging conversations and delivering difficult news. The way physicians interact with patients in these cases can significantly influence outcomes, including the patient’s understanding of their diagnosis and treatment plan, satisfaction with care, and willingness to follow medical advice. It is therefore imperative that emergency medicine residency training emphasizes communication skills, which will also be tested on the new American Board of Emergency Medicine (ABEM) Certifying Exam.
\nEducational Objectives: This difficult conversation case is intended to assess the examinee’s ability to disclose sensitive, unexpected information to a patient regarding a missed diagnosis of testicular cancer. By the end of this session, learners should be able to, 1) demonstrate effective communication, including establishing rapport, acknowledging a prior misdiagnosis, and disclosing a revised diagnosis of cancer, 2) elicit and react to the patient’s emotional and informational needs in an empathetic and professional manner, and 3) convey a patient-centered plan of care, including appropriate next steps and coordination with specialist services.
\nEducational Methods: We created a 10-minute case in the style of an Objective Structured Clinical Exam (OSCE) requiring resident examinees to break bad news. The case was revised after pilot testing on two additional faculty members. Materials included a task sheet for examinees based on example Certifying Exam materials provided by ABEM, a script for examiners with specific attention to eliciting elements of the SPIKES and NURSE frameworks, and a scoring sheet. The faculty who created the case then served as examiners during a Mock Certifying Exam Day for PGY-3 Emergency Medicine residents; alternatively, this case can be run with a standardized patient. For the remainder of this case, we will refer to the person playing the role of patient as “examiner.”
\nResearch Methods: Residents were evaluated using a 15-point rubric, with a score of 11/15 (73%) required to pass. The rubric, which was developed based on the objectives for Difficult Conversations Cases published on the ABEM website, included the following categories: establish rapport, determine baseline knowledge, disclose information, respond and react appropriately, and provide closure. Consistent with our program’s usual OSCE workflow, each resident was evaluated by a single faculty examiner. After completing the case, each resident completed an anonymous two-item evaluation: The first item, “This case increased my understanding of the certifying exam format,” was scored on a 5-point Likert scale from “strongly disagree” to “strongly agree.” The second item, “How would you rate the overall quality of this case?” was scored on a 5-point Likert scale from “poor” to “excellent.” The survey and protocol were reviewed by our institutional IRB on 12/3/2024, and this project was determined not to meet the definition of human subjects research.
\nResults: Seventeen PGY-3 emergency medicine residents completed the case, with a mean score of 13.35/15. Seventeen residents (100%) completed the post-case evaluation. When asked if this case increased understanding of the certifying exam format, 17 (100%) agreed or strongly agreed. When asked about the overall quality of the case, 17 (100%) said either very good or excellent. The case received a score of 4.82/5 for overall quality.
\nDiscussion: This case was effective, as evidenced by the results that all residents agreed or strongly agreed that the case increased their understanding of the certifying exam content, and all residents considered the case quality to be very good or excellent. Residents overall performed well on the case but may benefit from additional instruction on disclosure of sensitive, unwanted, or unexpected information. Specifically, residents should be taught to use the SPIKES (Setting, Perception, Invitation, Knowledge, Emotions/Empathy, Strategy/Summary) or GRIEV_ING (Gather, Resources, Identify, Educate, Verify, Give Space, Inquire, Nuts and Bolts, Give) frameworks for breaking bad news and NURSE (Naming, Understanding, Respecting, Supporting, Exploring) statements for responding to emotions. This case and its grading rubric could easily be adapted to other difficult conversation scenarios to prepare emergency medicine residents or graduates for their certifying exam. However, because each resident was evaluated by a single examiner within one residency program, inter-rater reliability could not be assessed, and generalizability may be limited.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Medical Education"},{"word":"difficult conversations"},{"word":"Breaking Bad News"},{"word":"Communication"},{"word":"certifying exam preparation"}],"section":"Certifying Exam Practice","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0xp2r7sk","frozenauthors":[{"first_name":"Joshua","middle_name":"","last_name":"Ginsburg","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Sarah","middle_name":"","last_name":"Zamamiri","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Marshall","middle_name":"","last_name":"Howell","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Samuel","middle_name":"","last_name":"Parnell","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine,"},{"first_name":"Brian","middle_name":"","last_name":"Milman","name_suffix":"","institution":"University of Texas Southwestern Medical Center","department":"Department of Emergency Medicine"}],"date_submitted":"2025-06-19T23:22:49+05:30","date_accepted":"2025-11-22T05:37:23.465000+05:30","date_published":"2025-12-31T23:44:00+05:30","render_galley":{"label":"Ginsburg J, et al. Difficult Conversation Case Missed Testicular Cancer. JETem 2025. 10(5)CE1-13","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52336/galley/47794/download/"},"galleys":[{"label":"Ginsburg J, et al. Difficult Conversation Case Missed Testicular Cancer. JETem 2025. 10(5)CE1-13","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52336/galley/47794/download/"},{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52336/galley/47795/download/"}]},{"pk":47389,"title":"Evaluation of Dizziness in the Emergency Department: Prevalence and Diagnostic Utility of Clinical Scales for Functional Vertigo","subtitle":null,"abstract":"Introduction: Functional vertigo is commonly missed in the emergency department (ED) and often misdiagnosed as other peripheral vestibular disorders. It is strongly associated with anxiety and depression, yet standardized diagnostic criteria are lacking in the ED setting, leading to unnecessary tests and misdiagnosis. We aimed to assess the diagnostic accuracy of the Vertigo Symptom Scale - Short Form - Autonomic (VSS-SF-A) and the Hospital Anxiety and Depression Scale – Anxiety (HADS-A) and – Depression (HADS-D) for distinguishing functional vertigo from other peripheral vertigos in the ED and to determine its prevalence.
\nMethods: This was a prospective, cross-sectional, observational studey of adult patients of a tertiary-care ED with dizziness.. We included patients who received an initial peripheral vertigo diagnosis from attending emergency physicians. Blinded otolaryngologists (ENT) verified all final diagnoses through standardized evaluation methods performed on the same day as the ED visit. We excluded patients with central, metabolic, cardiovascular conditions. Study participants received thorough vestibular evaluations while a separate physician, also blinded to diagnostic outcomes, administered the VSS and HADS tests, which typically require 15-20 minutes to complete. The final ENT evaluation served as the criterion reference for the diagnosis of functional vertigo. We evaluated the diagnostic accuracy of the scales through receiver operating characteristic (ROC) analysis.
\nResults: During the study period, 694 patients presented to the ED with dizziness-related complaints, of whom 69 (9.9%) met the inclusion criteria and were enrolled in the study. Of 69 patients initially diagnosed with peripheral vertigo in the ED, ENT specialists confirmed functional vertigo in 25 (36.2%) and peripheral vertigo in 44 (63.8%). Functional vertigo patients were significantly younger (43.4 ± 16.9 vs 60.1 ± 14.9 years of age, P < .001). In patients with functional vertigo, the mean VSS-SF-A, HADS-A, and HADS-D scores were 9.04, 9.28, and 7.52, respectively, compared to 3.80, 4.18, and 2.91 in peripheral vertigo cases. Conversely, the VSS-SF subscale—Vestibular-Balance (VSS-SF-V)—scores were higher in peripheral vertigo patients (13.05 vs 6.56), all P < .001. The ROC analysis showed that VSS-SF-A (cutoff ≥ 8, area under the curve [AUC] 0.85, 95% CI, 0.76-0.94) had the highest accuracy for diagnosing functional vertigo, with a sensitivity of 72% and specificity of 84.1%, followed by the HADS-A (cutoff ≥ 8, AUC = 0.81, 95% CI, 0.70-0.91), which had a sensitivity of 68% and specificity of 88.6%, while HADS-D (cutoff ≥ 4, AUC = 0.80 95% CI, 0.60-0.90) showed 76% sensitivity and 75% specificity.
\nConclusion: Functional vertigo is an underdiagnosed condition that produces dizziness in patients. The Vertigo Symptom Scale and Hospital Anxiety and Depression Scale show promise for enhancing early diagnosis while reducing unnecessary imaging and improving patient care. Future research is needed to confirm these findings through larger multicenter cohorts.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Functional vertigo"},{"word":"dizziness"},{"word":"Emergency Medicine"},{"word":"Vertigo Symptom Scale"},{"word":"Hospital Anxiety and Depression Scale"},{"word":"Peripheral vertigo"},{"word":"HADS"},{"word":"VSS"}],"section":"Neurology","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7rp5m67h","frozenauthors":[{"first_name":"Melis","middle_name":"","last_name":"Dorter","name_suffix":"","institution":"Primary Health Care Corporation, Doha, Qatar","department":""},{"first_name":"Yusuf","middle_name":"","last_name":"Koksal","name_suffix":"","institution":"Primary Health Care Corporation, Doha, Qatar","department":""},{"first_name":"Can","middle_name":"","last_name":"Aktas","name_suffix":"","institution":"Koç University Hospital, Department of Emergency Medicine, Istanbul, Türkiye","department":""}],"date_submitted":"2025-05-10T12:04:58.415000+05:30","date_accepted":"2025-09-15T21:43:08.931000+05:30","date_published":"2025-12-31T22:07:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47389/galley/47905/download/"}]},{"pk":48368,"title":"Disrupting Monoliths: Yogi Haider's Localization of Yoga in Pakistan","subtitle":null,"abstract":"Yogi Haider, a contemporary yoga teacher from Phalia, Punjab, now based in Islamabad, offers a compelling example of what teaching yoga in Pakistan entails. Despite the shared cultural heritage between India and Pakistan, post-Partition tensions have made yoga a controversial practice in Pakistan. This study explores how Yogi Haider’s individual narrative challenges stereotypical portrayals of Pakistan and reveals yoga’s often overlooked presence in the country. It provides an alternative perspective that situates yoga within Pakistan’s cultural, religious, and political landscape, countering its exclusive association with Hindu and Indian identity. This paper argues that Yogi Haider strategically uses social media to display how he localizes his teachings by incorporating poetry, spatial markers, and historical elements. In doing so, he challenges both Pakistan’s global image and India’s sole claim to yoga. His work highlights how yoga in Pakistan is under-represented in academic and media discourse due to prevailing biases. To analyze how Yogi Haider frames his teachings for a Pakistani audience, this study employs digital ethnography and discourse analysis of his public content on Facebook and YouTube posted in both Urdu and English. Digital ethnography enables immersion in his online community to observe how he constructs his persona and represents himself. Discourse analysis offers insight into his language and intertextual references revealing how he positions yoga within the Pakistani context and disrupts dominant narratives linking it exclusively to India and Hinduism.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"digital ethnography"},{"word":"Transnational Yoga"},{"word":"Yoga and Islam"},{"word":"Yoga in Pakistan"}],"section":"Articles and Personal Narratives","is_remote":true,"remote_url":"https://escholarship.org/uc/item/99k5m865","frozenauthors":[{"first_name":"Diane","middle_name":"","last_name":"Charmey","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-05-31T21:13:38+05:30","date_accepted":"2025-10-25T06:44:25+05:30","date_published":"2025-12-31T21:53:00+05:30","render_galley":{"label":"Galley_Charmey","type":"pdf","path":"https://journalpub.escholarship.org/raceandyoga/article/48368/galley/47774/download/"},"galleys":[{"label":"Galley_Charmey","type":"pdf","path":"https://journalpub.escholarship.org/raceandyoga/article/48368/galley/47774/download/"}]},{"pk":48701,"title":"Adherence to Accelerated Diagnostic Protocol for Chest Pain in Five Emergency Departments in Canada","subtitle":null,"abstract":"Introduction: In this study we sought to to assess the extent to which emergency physicians adhered to an institutional protocol for rapid chest pain assessment that incorporates a high sensitivity troponin I (hs-TnI) assay. We also sought to characterize clinical outcomes stratified by protocol adherence.
\nMethods: We conducted a retrospective cohort study that included all adult patients presenting to five major metropolitan hospital emergency departments (ED) with suspected cardiac chest pain who had at least one troponin measured. The study period was November 9, 2020–June 20, 2022. The primary outcome was protocol adherence for indeterminate-risk and high-risk patients, as defined by the protocol in use at the time of each patient’s presentation to hospital. Adjusted odds ratios (aOR) are reported with associated 95% confidence intervals.
\nResults: A total of 14,027 patients were included in the study, among whom 8,962 (63.9%) were classified as low risk, 4,064 (29.0%) as indeterminate risk, and 1,001 (7.1%) who were in the high-risk/rule-in group. Overall, 35.9% of patients had care that adhered to the chest pain pathway protocol—22.1% of indeterminate-risk patients and 91.6% of high-risk/rule-in patients. Protocol adherence among indeterminate-risk patients was 6.6% when the initial troponin was in the range of 4-19 nanograms per liter (ng/L) and 75.4% for initial troponin levels 20-99 ng/L. Male sex was most strongly associated with protocol adherence; among those receiving adherent care, 65.8% were male compared to 34.2% female (aOR 1.67; 95% CI, 1.46-1.91). Patients in the non-adherent group with an initial troponin 4-19 ng/L experienced a significantly higher incidence of major adverse cardiac events (4.5% vs 1.7%, P < .001), compared to those in the low-risk group.
\nConclusion: Adherence to proposed assessment protocols for patients presenting to the ED with chest pain was low. This lack of adherence appears to disproportionally affect females and is associated with poor outcomes. Improving adherence to evidence-based guidelines in this setting is urgently needed.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"chest pain"},{"word":"Physician Adherence"},{"word":"Troponin"}],"section":"Cardiology","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1053v87p","frozenauthors":[{"first_name":"Jesse","middle_name":"","last_name":"Hill","name_suffix":"","institution":"University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Emergency Medicine, Edmonton, Alberta, Canada","department":""},{"first_name":"Esther","middle_name":"","last_name":"Yang","name_suffix":"","institution":"University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Emergency Medicine, Edmonton, Alberta, Canada; Alberta Health Services, The Alberta Strategy for Patient-Oriented Research Support Unit, Edmonton, Alberta, Canada","department":""},{"first_name":"Shandra","middle_name":"","last_name":"Doran","name_suffix":"","institution":"University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Emergency Medicine, Edmonton, Alberta, Canada","department":""},{"first_name":"Michelle","middle_name":"M.","last_name":"Graham","name_suffix":"","institution":"University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Medicine, Division of Cardiology, Mazankowski Heart Institute, Edmonton, Alberta, Canada","department":""},{"first_name":"Sean","middle_name":"","last_name":"van Diepen","name_suffix":"","institution":"University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Medicine, Division of Cardiology, Mazankowski Heart Institute, Edmonton, Alberta, Canada","department":""},{"first_name":"Joshua","middle_name":"E.","last_name":"Raizman","name_suffix":"","institution":"University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Laboratory Medicine and Pathology, Edmonton, Alberta, Canada; Alberta Precision Laboratories, Edmonton, Alberta, Canada","department":""},{"first_name":"Albert","middle_name":"KY","last_name":"Tsui","name_suffix":"","institution":"University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Laboratory Medicine and Pathology, Edmonton, Alberta, Canada; Alberta Precision Laboratories, Edmonton, Alberta, Canada","department":""},{"first_name":"Brian","middle_name":"H.","last_name":"Rowe","name_suffix":"","institution":"University of Alberta, College of Health Sciences, Faculty of Medicine and Dentistry, Department of Emergency Medicine, Edmonton, Alberta, Canada","department":""}],"date_submitted":"2025-06-19T20:21:35.094000+05:30","date_accepted":"2025-10-13T03:26:30.620000+05:30","date_published":"2025-12-31T21:52:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/48701/galley/47924/download/"}]},{"pk":47491,"title":"First-Generation Antihistamine Use in Geriatric Emergency Department Patients: Retrospective Review","subtitle":null,"abstract":"Introduction: First-generation antihistamines are frequently used in the emergency department (ED) but are discouraged in older adults due to increased adverse drug effects. Whether concerns about adverse drug effects apply to the ED is uncertain, as ED-specific data are limited, and risks with single-dose administration may differ from risks with chronic use. In this study we assessed frequency of use, adverse drug effects, and indications of first-generation antihistamines administered to older adults during ED visits.
\nMethods: This retrospective cohort study identified adults ≥ 65 years of age who received first?generation antihistamines from January 1–December 31, 2022 in the ED at a single, urban, academic medical center. Abstractors blinded to study hypotheses identified indications for use and adverse effects through chart review. Indications other than severe allergic reactions and continuation of home use were classified as potentially inappropriate. We evaluated sex, age ≥ 85, history of cognitive impairment, drug received, and number of doses for association with adverse drug effects by regression analysis.
\nResults: First-generation antihistamines were administered in 261 encounters (3% of geriatric ED encounters). Median patient age was 71 (range 65-107, interquartile range [IQR] 67-77) and 60.5% were female. Adverse drug effects occurred in 15% of encounters, with delirium (n = 20, 7.7%) and urinary retention (n = 11, 4.2%) being the most common. On multivariate analysis, patient age ≥ 85, history of cognitive impairment, and receipt of multiple doses were associated with elevated risk of adverse drug effects, with risk ratios of 5.5 (95% CI, 2.7-11.4), 3.1 (95% CI, 1.8-5.4), and 1.9 (95% CI, 1.1-3.6), respectively. Indications were classified as potentially inappropriate in 92% of encounters. Diphenhydramine was most used in patients with headache (n = 53, 30.1% of doses) and history of iodinated contrast media reaction (n = 46, 26.1% of doses), while hydroxyzine was most used for anxiety (n = 51, 60% of doses). The kappa value between abstractors was 0.84, indicating excellent agreement.
\nConclusion: Emergency department use of first-generation antihistamines in older adults, especially those ≥ 85 years of age and with prior cognitive impairment, was associated with infrequent but clinically significant harm. Most use was potentially inappropriate. Prophylactic use of diphenhydramine for patients with a prior reaction to iodinated contrast media emerged as a common indication.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Geriatrics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7230n5z1","frozenauthors":[{"first_name":"Emily","middle_name":"","last_name":"Killen","name_suffix":"","institution":"Saint Louis University School of Medicine, St. Louis, Missouri","department":""},{"first_name":"Michael","middle_name":"","last_name":"Cusumano","name_suffix":"","institution":"Saint Louis University School of Medicine, St. Louis, Missouri","department":""},{"first_name":"Zidong","middle_name":"","last_name":"Zhang","name_suffix":"","institution":"Saint Louis University School of Medicine, Advanced Health Data Institute, St. Louis, Missouri","department":""},{"first_name":"Richard","middle_name":"","last_name":"Newman","name_suffix":"","institution":"Saint Louis University School of Medicine, Division of Emergency Medicine, St. Louis, Missouri","department":""},{"first_name":"Jamie","middle_name":"","last_name":"Voigtmann","name_suffix":"","institution":"Saint Louis University Hospital, Department of Pharmacy, St. Louis, Missouri","department":""},{"first_name":"Angela","middle_name":"M.","last_name":"Sanford","name_suffix":"","institution":"Saint Louis University School of Medicine, Division of Geriatric Medicine, St. Louis, Missouri","department":""},{"first_name":"Cindy","middle_name":"C.","last_name":"Bitter","name_suffix":"","institution":"Saint Louis University School of Medicine, Division of Emergency Medicine, St. Louis, Missouri","department":""}],"date_submitted":"2025-05-21T06:51:17.382000+05:30","date_accepted":"2025-10-13T03:23:56.199000+05:30","date_published":"2025-12-31T21:43:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47491/galley/47926/download/"}]},{"pk":61874,"title":"Introduction to Territories issue on Gastrodiplomacy","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Gastrodiplomacy"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1mx4126v","frozenauthors":[{"first_name":"Paul","middle_name":"","last_name":"Rockower","name_suffix":"","institution":"Levantine Public Diplomacy","department":""}],"date_submitted":"2025-12-30T23:42:06.955000+05:30","date_accepted":"2025-12-30T23:43:17.711000+05:30","date_published":"2025-12-31T09:38:00+05:30","render_galley":{"label":"Other","type":"other","path":"https://journalpub.escholarship.org/territories/article/61874/galley/47788/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/territories/article/61874/galley/47787/download/"},{"label":"Other","type":"other","path":"https://journalpub.escholarship.org/territories/article/61874/galley/47788/download/"}]},{"pk":61920,"title":"Review: Levine, Jill Unfaithful. A Translator's Memoir (2025)","subtitle":null,"abstract":"","language":null,"license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Book Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/80c2f4q1","frozenauthors":[{"first_name":"Madison","middle_name":"","last_name":"Felman-Panagotacos","name_suffix":"","institution":"Otterbein Univeristy","department":"Department of History, Political Science, Languages & Cultures"}],"date_submitted":"2025-12-31T01:26:18.716000+05:30","date_accepted":"2025-12-31T01:27:02.180000+05:30","date_published":"2025-12-31T09:28:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/territories/article/61920/galley/47786/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/territories/article/61920/galley/47786/download/"}]},{"pk":39905,"title":"Thinking gastrodiplomacy through a gastrological reading of conflict","subtitle":null,"abstract":"The combination of the fields of study of gastronomy and diplomacy is generating a number of highly valuable academic works that cover multiple dimensions of knowledge and social spheres. However, the potential of gastrodiplomacy to explore conflict (or the possibility of it) has not been fully explored. This article aims to fill this gap by complementing the concept of gastrodiplomacy with that of gastrology. In this way, it aims to consider the relationship between gastronomy, diplomacy and conflict, understanding the latter as the conflict zones that emerge between communities, identities, worldviews or even different ways of understanding the value and uses of gastronomy. Based on this analysis, and assuming that gastronomy is part of every culture and, therefore, is open to a multiplicity of meanings giving rise to ambivalences, paradoxes and tensions, it will be argued that gastronomy (and gastrodiplomacy) as a tool, practice and discourse of mediation (and expansion) of estrangement tends to oscillate between the ordinary, the sublime and the grotesque. To this end, the article will refer to violent conflicts between minority and majority national groups. The aim is not to analyse each case in depth, but rather to explore the interrelationship between diplomacy and gastronomy and these conflicts. In doing so, the article will contribute to a better understanding of the potential of gastronomy and diplomacy to think about and work on difference, estrangement and conflict.
","language":null,"license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Gastrodiplomacy"},{"word":"gastrology"},{"word":"Diplomacy"},{"word":"Conflict"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6cs404vr","frozenauthors":[{"first_name":"Dennis","middle_name":"","last_name":"Sorondo Salazar","name_suffix":"","institution":"University of the Basque Country","department":"None"}],"date_submitted":"2024-11-03T22:47:17+05:30","date_accepted":"2025-10-13T05:39:00.240000+05:30","date_published":"2025-12-31T09:15:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/territories/article/39905/galley/47785/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/territories/article/39905/galley/47785/download/"}]},{"pk":48539,"title":"Korean War POWs’ Individual Gastrodiplomacy: Comparing Morris R. Wills and Clarence Adams’ Odyssey ","subtitle":null,"abstract":"How does food operate as a medium for informal diplomacy between individuals and nations? In what ways do citizen culinary diplomacy and individual gastrodiplomacy diverge from official or state-sponsored culinary exchanges? This article examines these questions through the experiences of two American POWs from the Korean War, Morris R. Wills and Clarence Adams, focusing on food as a site of private, people-to-people interaction. As POWs in Korea and later as foreign guests in China, Adams and Wills navigated identities suspended between official representation and personal agency, granting them unique access to Chinese diplomats and political elites. How did their trajectories evolve after returning to the United States during the Cultural Revolution? Wills attained a prestigious position at Harvard in the late 1960s, while Adams became the first African American millionaire through his ownership of a Chinese restaurant chain in the 1970s. While Wills prioritized survival—securing basic livelihood—Adams leveraged culinary entrepreneurship as a means of self-empowerment. Adams’ story, in particular, illuminates the role of semi-official food diplomacy and citizen culinary diplomacy in fostering cross-cultural understanding during a critical phase of U.S.-China relations.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/99p1t8tt","frozenauthors":[{"first_name":"Yanli","middle_name":"","last_name":"He","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-06-12T17:37:19.024000+05:30","date_accepted":null,"date_published":"2025-12-31T09:05:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/territories/article/48539/galley/47784/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/territories/article/48539/galley/47784/download/"}]},{"pk":39901,"title":"Food as a vehicle for successful inter-cultural communication among college students: Collaborative Online International Learning (COIL) in food and nutrition courses","subtitle":null,"abstract":"This case study examines how food may play a role in enhancing inter-cultural communication and collaboration through a food-related COIL project among students who are enrolled in food and nutrition courses in two different countries. Students taking a semester-long nutrition course at a university in California and students in a culinary art course in Ecuador worked in groups to complete a Food Product Analysis and Development project. The project focused on Ecuadorian food products, and most of the COIL activities involved examination of food. A qualitative evaluation revealed that food played an important role in enhancing inter-cultural communication and collaboration in different ways. First, food was an effective ice breaker and a tool for team building. Second, food also played a role in learning about culture and identifying similarities between the two cultures in a unique way. The project gave Ecuadorian students the opportunity to showcase their own culture, which provided them with a sense of pride. Among American students, learning about the history and consumption of food that was foreign to them sparked their curiosity about Ecuador. Finally, experiential learning through food, such as cooking and tasting food, appeared to help students keep motivated about the project and make the group project more enjoyable. Our findings suggest that food may be used as a vehicle for inter-cultural communication and global competency in higher education. Further research is needed to effectively evaluate learning outcomes of food-related COIL projects. The importance of developing interdisciplinary, community-based food-related COIL projects is also discussed.
","language":null,"license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"COIL"},{"word":"Higher education"},{"word":"Food"},{"word":"Culture"},{"word":"experiential learning"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5mq2s8nk","frozenauthors":[{"first_name":"Keiko","middle_name":"","last_name":"Goto","name_suffix":"","institution":"Other","department":""},{"first_name":"Sebastian","middle_name":"","last_name":"Navas","name_suffix":"","institution":"Universidad San Francisco de Quito (USFQ).","department":"None"},{"first_name":"Sally","middle_name":"","last_name":"Mead","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2022-11-18T04:18:39+05:30","date_accepted":"2025-12-31T00:33:34.703000+05:30","date_published":"2025-12-31T08:37:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/territories/article/39901/galley/47783/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/territories/article/39901/galley/47783/download/"}]},{"pk":62212,"title":"[SoK] Systematizing Inference Placement For Deep Learning Across Edge And Cloud Platforms: A Multi-Objective Optimization Perspective","subtitle":null,"abstract":"Edge intelligent applications like VR/AR and language model based chatbots have become widespread with the rapid expansion of IoT and mobile devices. However, constrained edge devices often cannot serve the increasingly large and complex deep learning (DL) models. To mitigate these challenges, researchers have proposed optimizing and offloading partitions of DL models among user devices, edge servers, and the cloud. In this setting, users can take advantage of different services to support their intelligent applications. For example, edge resources offer low response latency. In contrast, cloud platforms provide low monetary cost computation resources for computation-intensive workloads. However, communication between DL model partitions can introduce transmission bottlenecks and pose risks of data leakage. Recent research aims to balance accuracy, computation delay, transmission delay, and privacy concerns. They address these issues with model compression, model distillation, transmission compression, and model architecture adaptations, including internal classifiers. This survey contextualizes the state-of-the-art model offloading methods and model adaptation techniques by studying their implication to a multi-objective optimization comprising inference latency, data privacy, and resource monetary cost.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/23j1s4bg","frozenauthors":[{"first_name":"Zongshun","middle_name":"","last_name":"Zhang","name_suffix":"","institution":"Boston University","department":"Department of Computer Science","country":"United States"},{"first_name":"Ibrahim","middle_name":"","last_name":"Matta","name_suffix":"","institution":"Boston University","department":"Department of Computer Science","country":"United States"}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-31T00:15:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jsys/article/62212/galley/48046/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jsys/article/62212/galley/48046/download/"}]},{"pk":61917,"title":"Review of Austin Frerick, Barons: Money, Power, and the Corruption of America’s Food Industry (Island Press, 2024)","subtitle":null,"abstract":"","language":null,"license":{"name":"Creative Commons Attribution-NonCommercial-ShareAlike 4.0","short_name":"CC BY-NC-SA","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
This paper argues that decarbonization will fail to deliver climate justice unless the transition to clean energy confronts the racialized political economy that has historically structured extractive activity and shaped international economic law. Grounding its analysis in racial capitalism, the paper contends that the growing demand for critical minerals risks reproducing patterns of exploitation, expropriation, and expulsion. Using lithium extraction in Chile as a case study, it shows how colonial legacies, dictator-era neoliberal reforms, and present-day regulatory architectures governing foreign investment and natural resource extraction have prioritized investors over human rights and the environment. Recent decisions of the International Court of Justice and the Inter-American Court of Human Rights on climate change provide a normative counterweight to international investment law and potentially a pathway for inclusive and transformative reforms. By foregrounding racial equity, the clean energy transition can avoid replicating the distributive injustices of the fossil fuel era.
","language":null,"license":{"name":"Creative Commons Attribution-NonCommercial-ShareAlike 4.0","short_name":"CC BY-NC-SA","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
The way people treat each other and the way they treat their environment are inextricably intertwined. Thus, it is unsurprising that five centuries of colonialism, genocide, slavery, apartheid, and racial discrimination have produced climate change, mass extinction, desertification, deforestation, and polluted air, water, and lands. The West has used international law to institutionalize unaccountability for its racism and environmental harms. This article argues that international law’s inability to stem accelerating ecological decline is attributable to and inseparable from the discipline’s racism, and vice versa. This article explores five legal techniques—comparison, objectification, exploitation, taming, and extermination—that produce racist and environmentally harmful outcomes while cloaked in the legitimacy of the law. The racializing of nature and the naturalizing of race through international law depend on the erasure of subaltern worldviews. But another international law is possible where diverse sustainable legal traditions heretofore silenced make international law on their own terms.
","language":null,"license":{"name":"Creative Commons Attribution-NonCommercial-ShareAlike 4.0","short_name":"CC BY-NC-SA","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
This article examines how the enduring legacies of racial capitalism and discriminatory land policies shape climate vulnerability and adaptation in US cities, using Miami as a primary example. It highlights how flooding and heat waves disproportionately impact marginalized, historically disinvested neighborhoods, which are further threatened by displacement resulting from “climate gentrification.” Miami illustrates these dynamics, as affluent residents relocate from vulnerable coastal zones to higher-elevation, previously segregated neighborhoods, driving investment and property value increases that endanger longtime residents with displacement. The article explores how factors such as land use policy, zoning, and public investments embed racialized landscapes and drive displacement risk in these communities. The article calls for “just adaptation economies” that embed antidisplacement measures in resilience investments, support community ownership and stewardship of land instead of speculative development in historically marginalized neighborhoods, and prioritize policies that counteract persistent social and spatial inequities. The article explores a few examples of where adaptation economies are emerging through designated justice-oriented green urban development zones.
","language":null,"license":{"name":"Creative Commons Attribution-NonCommercial-ShareAlike 4.0","short_name":"CC BY-NC-SA","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0m34p885","frozenauthors":[{"first_name":"Craig","middle_name":"","last_name":"Howes","name_suffix":"","institution":"U of Hawaii Manoa","department":""}],"date_submitted":"2025-12-21T09:25:25.916000+05:30","date_accepted":"2025-12-21T09:26:04.427000+05:30","date_published":"2025-12-29T23:15:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61756/galley/47640/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61756/galley/47640/download/"}]},{"pk":61877,"title":"Climate Injustice, Racial Capitalism, and the Contradictions of Property","subtitle":null,"abstract":"This article examines the legal constitution of racialized climate injustice, assessing the racialized dynamics of property in the context of climate change. It explores these examples: first, the failure of the international climate regime to contest unjust appropriation of the atmosphere by industrialized countries regarding historical emissions; second, the limitations of the “no-harm” rule, which is effectively the internationalization of the domestic principles of the tort of nuisance, in providing compensation for the racialized harm caused by climate change; and third, how international investment law is allowing fossil fuel companies to seek compensation if governmental actions in response to climate concern impact their investment or hoped-for returns.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-ShareAlike 4.0","short_name":"CC BY-NC-SA","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Climate change is a direct consequence of capitalism’s drive to maximize profits through the unbridled extraction of wealth from humans and nature, aided and abetted at every turn by law. In its voracious demand for cheap labor, cheap raw materials, and cheap waste disposal, capitalism has created a treadmill of fossil fuel–dependent production and consumption that has triggered a planetary emergency. It has also produced extreme economic inequality—a racialized division of wealth grounded in colonialism that enables the ultrarich to capture the spoils of the capitalist global economy while billions of people continue to live in extreme poverty. The articles published in this special issue examine the climate emergency and other ecological crises through the framework of racial capitalism. The theory of racial capitalism offers valuable insights into capitalism’s inherently eco-destructive logic and its reliance on racial stratification for the extraction of profit.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-ShareAlike 4.0","short_name":"CC BY-NC-SA","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Springtails (Collembola) are among the most abundant subterranean invertebrates, yet knowledge of their diversity in Italian caves remains incomplete. This study serves to update the Italian cave springtail checklist, which has been previously documented as containing 106 species. The updated checklist, which incorporates data from literature up to the year 2025, as well as the results of new field surveys conducted in northern Italy and DNA barcoding analyses, now lists 134 species. Among the recorded taxa, 38 are obligate cave-dwellers and 28 are endemic, with Onychiuridae being the most represented family. The following three new species are described: Onychiuroides alpinus n. sp., Deuteraphorura venetiana n. sp., and Protaphorura baldanii n. sp. These species are from Veneto and Lombardy. The analysis of data from ice caves has led to the conclusion that these environments serve as refugia for cold-adapted species. Furthermore, the data suggest the presence of a previously unrecognized shared Alpine–Pyrenean lineage. These findings underscore the rich and understudied subterranean biodiversity in Italy and highlight the importance of continued taxonomic and ecological research to inform conservation strategies for vulnerable cave ecosystems.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Collembola"},{"word":"Cave Biodiversity"},{"word":"troglobiont"},{"word":"DNA barcoding"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/196133z6","frozenauthors":[{"first_name":"Barbara","middle_name":"","last_name":"Valle","name_suffix":"","institution":"University of Siena","department":"Department of Life Sciences,","country":"Italy"}],"date_submitted":"2025-11-17T00:40:34.167000+05:30","date_accepted":"2025-12-24T16:32:51.478000+05:30","date_published":"2025-12-29T14:51:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/biogeographia/article/53969/galley/47763/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/biogeographia/article/53969/galley/47763/download/"}]},{"pk":61338,"title":"Review of Cannon, Footsteps of the Traveller","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution 4.0 International (CC BY 4.0)","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/76p765qd","frozenauthors":[{"first_name":"Thomas","middle_name":"","last_name":"McIlwraith","name_suffix":"","institution":"University of Guelph","department":"Sociology and Anthropology"}],"date_submitted":"2025-12-05T19:56:21.908000+05:30","date_accepted":"2025-12-05T20:32:31.374000+05:30","date_published":"2025-12-27T03:30:00+05:30","render_galley":{"label":"Review of Cannon Footsteps of the Travel by McIlwraith","type":"pdf","path":"https://journalpub.escholarship.org/jac/article/61338/galley/47752/download/"},"galleys":[{"label":"Review of Cannon Footsteps of the Travel by McIlwraith","type":"pdf","path":"https://journalpub.escholarship.org/jac/article/61338/galley/47752/download/"}]},{"pk":48925,"title":"Comparison of Acute Stroke Outcomes Between Code Trauma vs Code Stroke Activations","subtitle":null,"abstract":"Introduction: Patients with acute stroke may occasionally present as trauma activations, particularly after being found down or sustaining falls. This atypical presentation can delay diagnosis and treatment. Our objective in this study was to compare time to brain imaging, use of reperfusion therapies, and clinical outcomes, including discharge disposition and mortality, between patients with acute stroke presenting as code trauma activations and those presenting as code stroke activations.
\nMethods: We conducted a retrospective review of all trauma activations at our Level I trauma center from January 2018-December 2024. Patients diagnosed with acute stroke on initial trauma imaging after trauma evaluation formed the code trauma activation (CTA) group. These patients were compared to all patients diagnosed with acute stroke after a code stroke activation (CSA) in 2024. The primary outcome was door-to-imaging time; secondary outcomes included door-to-intervention time, discharge disposition, and mortality.
\nResults: There were 208 CSA patients and 198 CTA patients. The CTA patients were older (75.3 vs 70.3 years of age, P < .001) and had a higher percentage of hemorrhagic stroke (43.9% vs 14.4%, P < .001). The CTA patients had a higher National Institutes of Health Stroke Scale score (14.44 vs 9.67, P < .001). Despite minimal injuries (mean Injury Severity Score 3.3), CTA patients experienced longer times to initial brain imaging (47.4 vs 24.8 minutes, P < .001). Mean door-to-thrombolysis (50.3 vs 43.7 minutes, P = .19) and door-to-puncture time (98 vs 82 minutes, P =.18) did not differ significantly. The CTA patients had lower rates of discharge home (23.2% vs 42.8%, P < .001) and higher mortality (24.2% vs 12%, P < .001). On multivariate analysis, trauma activation itself was not independently associated with mortality (OR 1.57, CI, 0.53-4.27, P =.42). Age, stroke severity scores, hemorrhagic stroke, and early imaging were independently associated with mortality after acute stroke.
\nConclusion: Acute stroke patients presenting as trauma activations face significant delays in imaging and lower rates of thrombolytic treatment, despite low injury burden. While trauma activation designation was not independently associated with mortality, delays in imaging and higher hemorrhage prevalence were strongly linked to worse outcomes. These findings highlight modifiable workflow opportunities, particularly streamlined imaging and early stroke recognition in low-impact trauma presentations, to improve delivery of care.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"stroke"},{"word":"Trauma"}],"section":"Neurology","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7jd8j373","frozenauthors":[{"first_name":"Jacob","middle_name":"","last_name":"Brown","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California","department":""},{"first_name":"Mallory","middle_name":"","last_name":"Jebbia","name_suffix":"","institution":"Desert Regional Medical Center, Department of Surgery, Palm Springs, California","department":""},{"first_name":"Esther","middle_name":"","last_name":"Lee","name_suffix":"","institution":"Desert Regional Medical Center, Department of Surgery, Palm Springs, California","department":""},{"first_name":"Albert","middle_name":"","last_name":"Kazi","name_suffix":"","institution":"Desert Regional Medical Center, Department of Surgery, Palm Springs, California","department":""},{"first_name":"Aaron","middle_name":"","last_name":"Strumwasser","name_suffix":"","institution":"Desert Regional Medical Center, Department of Surgery, Palm Springs, California","department":""},{"first_name":"Bryan","middle_name":"","last_name":"Love","name_suffix":"","institution":"Desert Regional Medical Center, Department of Surgery, Palm Springs, California","department":""},{"first_name":"John","middle_name":"","last_name":"Woods","name_suffix":"","institution":"Desert Regional Medical Center, Department of Surgery, Palm Springs, California","department":""},{"first_name":"Babak","middle_name":"","last_name":"Khazaeni","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California","department":""}],"date_submitted":"2025-07-09T11:47:37.888000+05:30","date_accepted":"2025-09-23T23:04:05.050000+05:30","date_published":"2025-12-26T23:43:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/48925/galley/47904/download/"}]},{"pk":47285,"title":"Resuscitation Leadership Education: A Needs Assessment of Emergency Medicine Residencies","subtitle":null,"abstract":"Introduction: Effective resuscitation leadership is a critical competency for emergency physicians, with evidence correlating strong leadership with improved team performance and patient outcomes during resuscitations. Despite its importance, the extent and nature of structured resuscitation leadership education in emergency medicine (EM) residency training remains unclear.
\nMethods: We conducted a voluntary, anonymous, needs assessment survey of United States (US) EM residency programs between August–October 2021. The survey assessed for the presence, content, and methods of formal resuscitation leadership curricula within these programs. We used descriptive statistics to analyze responses.
\nResults: Of the 261 US EM residency programs invited to participate, 80 responded (30.7%). Nineteen programs (23.8%) reported offering resuscitation leadership training through formal curricula, with considerable variation in both educational methods and content. Additionally, 68.4% of responding programs offered external generalized leadership development opportunities through partnerships with hospitals, universities, community organizations, and research entities.
\nConclusion: A minority of surveyed US EM residency programs incorporate formal resuscitation leadership training into their curricula with significant variance in curricular content and educational methods. Given the critical role of resuscitation leadership in EM, our findings highlight the need for further research to evaluate the effectiveness of existing curricula and educational approaches.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"leadership"},{"word":"resuscitation"},{"word":"Graduate Medical Education"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/24m0p18h","frozenauthors":[{"first_name":"Michael","middle_name":"","last_name":"Sobin","name_suffix":"","institution":"Corewell Health William Beaumont University Hospital, Department of Emergency Medicine, Royal Oak, Michigan","department":""},{"first_name":"Brett","middle_name":"","last_name":"Todd","name_suffix":"","institution":"Corewell Health William Beaumont University Hospital, Department of Emergency Medicine, Royal Oak, Michigan","department":""},{"first_name":"Nai-Wei","middle_name":"","last_name":"Chen","name_suffix":"","institution":"University of Missouri School of Medicine, Department of Biomedical Informatics, Biostatistics and Medical Epidemiology, Columbia, Missouri","department":""},{"first_name":"Danielle","middle_name":"","last_name":"Turner-Lawrence","name_suffix":"","institution":"Corewell Health William Beaumont University Hospital, Department of Emergency Medicine, Royal Oak, Michigan","department":""}],"date_submitted":"2025-05-08T02:04:04.437000+05:30","date_accepted":"2025-10-03T22:01:44.531000+05:30","date_published":"2025-12-26T23:11:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47285/galley/47902/download/"}]},{"pk":49092,"title":"A Mathematical Model of Civilizational Dynamics: Quantifying Toynbee’s Challenge–Response Theory with Newtonian Mechanics","subtitle":null,"abstract":"This study presents a civilizational dynamics model that applies Newtonian mechanics to Toynbee's challenge-response theory. By defining quantifiable indicators of societal response (α) and challenge (β), the model constructs a civilizational sustainability index S(t)=lnα(t)−lnβ(t). The first, second, and third differences of S(t) are interpreted as civilizational velocity, acceleration, and jerk, respectively, offering dynamic insights into the non-linear changes of civilizational states. Simulations applied to Roman civilization (BC 100 – AD 100) identify critical transitions within this historical period, providing empirical support for Toynbee’s hypothesis that civilizations collapse when challenges are either too weak or overwhelming. The model offers a novel quantitative method to analyze civilizational resilience and decay by capturing structural transformations through mathematical dynamics. While acknowledging the limitations of quantitative modeling in the humanities, this interdisciplinary approach demonstrates significant potential for extension to fields such as economics, politics, and systemic risk analysis.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Toynbee’s theory"},{"word":" civilizational dynamics"},{"word":" Newtonian mechanics"},{"word":" challenge-response"},{"word":" simulation modeling"},{"word":" historical cycles"},{"word":" S-curve"},{"word":" systemic collapse"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/58z1j452","frozenauthors":[{"first_name":"Jung","middle_name":"Won","last_name":"Lee","name_suffix":"","institution":"Lee Institute for Mathematical Science (Informal Research Center)","department":""}],"date_submitted":"2025-07-23T02:28:59.467000+05:30","date_accepted":"2025-11-17T18:08:23.752000+05:30","date_published":"2025-12-25T17:33:00+05:30","render_galley":{"label":"Final version","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/49092/galley/48733/download/"},"galleys":[{"label":"Final version","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/49092/galley/48733/download/"}]},{"pk":53812,"title":"On the Life Cycle of Empires","subtitle":null,"abstract":"We provide empirical evidence that the distribution of empires' lifetime is exponential with a typical time-scale of 300 years. After introducing and computing a proxy measure for the dimension of a large polity we interpret the data by means of a simple dynamical model for the empires' evolution. The resulting theory suggests that the behavior of a long-lived empire is qualitatively different from a short-lived one. They all experience an initial expansion phase but while the former goes through a contraction period over the last $20\\%$ of its life, the latter stays essentially unchanged after reaching its maximum size. In both cases, a sudden collapse occurs when the empire's size is still close to its own historical average.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Empires"},{"word":"Life cycle"},{"word":"Collapse"},{"word":"World History"},{"word":"civilizations"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8p0176zr","frozenauthors":[{"first_name":"Stefano","middle_name":"","last_name":"Ciliberti","name_suffix":"","institution":"Paris Sciences Lettres","department":"EPHE"}],"date_submitted":"2025-10-31T22:23:34.124000+05:30","date_accepted":"2025-11-20T18:31:33.241000+05:30","date_published":"2025-12-25T17:24:00+05:30","render_galley":{"label":"PDF_final","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/53812/galley/48732/download/"},"galleys":[{"label":"Manuscript_final","type":"other","path":"https://journalpub.escholarship.org/cliodynamics/article/53812/galley/48731/download/"},{"label":"PDF_final","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/53812/galley/48732/download/"}]},{"pk":48378,"title":"Grain Yields and the Causes of the Russian Revolution","subtitle":null,"abstract":"In the study of the causes of the Russian Revolution, the problem of the standard of living of the population plays an important role. This problem, in turn, is linked to the question of agricultural productivity. In modern historiography, both domestic and foreign, the thesis of the growing productivity of Russian agriculture in the post-reform period is considered proven - and in particular the increase in grain yields. This thesis is based on the well-known works of V.G. Mikhailovsky, V.M. Obukhov and A.S. Nifontov, in which time series of grain yields in European Russia were constructed on the basis of official statistics. Meanwhile, the opinion of the experts of the 1901 Commission is well known, who believed that the increase in yields recorded in official statistics was explained by the improvement in the system of collecting harvest data. Reforms to improve the survey system were carried out in 1870, 1883 and 1893. The author examines the dynamics of 4-year averages and shows that when 4-year periods containing the years indicated are excluded from consideration, the yield in the remaining time intervals does not increase. In other words, the increase in yield in the time series shown was explained by more detailed accounting.
\nThe period 1893-1914 is considered separately, when it is assumed that the yield data were quite accurate and no new reforms were made in the field of their collection. Previously it was assumed that the yield, calculated by the regression coefficient of the linear model, increased by 12% during this period. The author conducts a more detailed analysis and shows that the regression coefficient used previously is statistically insignificant. Thus, the claim of an increase in returns over this period cannot be statistically substantiated. Perhaps the return was a random variable independent of time.
\nThe paper also examines the dynamics of gross cereal yields per capita and shows that average per capita yields did not increase between 1893 and 1914.
\nThus, the prevailing opinion about the growth of agricultural productivity in Russia in the post-reform period needs to be revised
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3rt8w616","frozenauthors":[{"first_name":"Sergey","middle_name":"","last_name":"Nefedov","name_suffix":"","institution":"Sergey Nefedov","department":""}],"date_submitted":"2025-06-02T10:37:33.807000+05:30","date_accepted":"2025-06-02T10:38:23.446000+05:30","date_published":"2025-12-25T16:00:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/48378/galley/36431/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/48378/galley/36431/download/"}]},{"pk":53009,"title":"Growth of human capital in the regions of the Russian Empire in 1897-1913: the role of local self-government bodies (zemstva) financing ","subtitle":null,"abstract":"The previous research with incomplete data revealed that zemstva expenditure on education per capita were higher in regions with low level of education, but these spending did not make much of a difference – human capital in these regions remained relatively low (Popov, Konchakov, Didenko, 2024). The results reported in this paper provide additional and more rigorous proof that zemstva activities and the increase in their spending for education in 1897-1913 contributed to the spread of primary education and to the decline in the inequality of the distribution of human capital not only between the regions< but also within the regions (ratio of secondary to primary education enrollment).
\nBut we also show that there were more powerful forces at play – education for tuition fees, central government and city/town administration financing – that were pushing the development in an opposite direction, increasing the secondary education enrollment in most regions faster than the primary education enrollment. The result was the widening gap between low and high educated individuals that could have contributed to the formation of the intelligentsia phenomenon – educated intellectuals that were not able to find the proper place in the national economy to apply their knowledge. Intelligentsia opposition to the tsarist regime, however, did not take violent forms – regions with fast growing educational disparities registered lower, not higher increases in peasants’ unrest, industrial strikes and crimes against persons.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"school enrollment"},{"word":"inequality"},{"word":"land distribution"},{"word":"growth"},{"word":"educational attainment"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/20p8h7j2","frozenauthors":[{"first_name":"Vladimir","middle_name":"","last_name":"Popov","name_suffix":"","institution":"Russian Academy of Siences","department":"CEMI RAN"},{"first_name":"Roman","middle_name":"","last_name":"Konchakov","name_suffix":"","institution":"RANEPA","department":""},{"first_name":"Dmitry","middle_name":"","last_name":"Didenko","name_suffix":"","institution":"RANEPA","department":""}],"date_submitted":"2025-10-02T22:04:47.776000+05:30","date_accepted":"2025-11-18T17:39:57.663000+05:30","date_published":"2025-12-25T15:11:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/53009/galley/48762/download/"}]},{"pk":50853,"title":"Quantifying History Across Eras: Benchmarking the Battle of Granicus from Troy to WWII through DEA Analysis","subtitle":null,"abstract":"The paper aims to suggest Data Envelopment Analysis (DEA), as a preliminary tool of military efficiency. This approach examines battles as a decision-making unit (DMU) characterized by multiple inputs and outputs. Data: Data are measurable indicators such as battles won, territorial expansion, casualties, and historical impact. By assigning quantitative values, the study facilitates cross-temporal comparisons of military effectiveness. Analysis: The strategic performance of Alexander the Great at the Battle of Granicus River (334 BCE) serves as a primary case study of DEA employment. The scope of analysis extends to a range of historically significant conflicts, from the Trojan War to World War II to compare with and be used as benchmarks. Results: The study demonstrates the practical utility of quantifying historical events into a single comparable metric, facilitating clearer comparisons across diverse battles ranked from highest to lowest values.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Quantifying history"},{"word":"Data Envelopment Analysis (DEA)"},{"word":"Battle of Granicus River"},{"word":"Battlefield Benchmarking"},{"word":"Military History Modeling"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/07k5m5q4","frozenauthors":[{"first_name":"Christina","middle_name":"","last_name":"Laspa","name_suffix":"","institution":"","department":""},{"first_name":"Alexander","middle_name":"","last_name":"Laspas","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-09-06T03:02:30.543000+05:30","date_accepted":"2025-11-18T17:39:13.950000+05:30","date_published":"2025-12-25T15:02:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/50853/galley/48751/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/cliodynamics/article/50853/galley/48751/download/"}]},{"pk":47475,"title":"Emergency Department Presentations of West Nile Virus","subtitle":null,"abstract":"Introduction: Maricopa County, Arizona, experienced its largest West Nile virus outbreak in 2021, with 1,487 cases and 101 deaths, in the midst of the COVID-19 pandemic. We sought to describe initial presentations of emergency department (ED) patients ultimately diagnosed with West Nile virus and determine how often patients presented to the ED before their diagnosis. To assist with disease recognition during future outbreaks, we examined in detail cases where emergency physicians initially did not suspect West Nile virus.
\nMethods: We reviewed records from May–December 2021 for patients with a positive West Nile virus result and at least one ED visit within 15 days. Data included age, sex, race, Emergency Severity Index (ESI) score, number of ED visits, chief complaint, vital signs, blood or cerebrospinal fluid (CSF) testing, diagnosis, and disposition. We excluded cases with only immoglobulin G-positive results or outpatient tests, leaving 147 cases.
\nResults: Among 147 ED West Nile virus cases, the median patient age was 67 years, with patients being predominantly male (66.7%) and White (97.3%). The most common presenting chief complaints included fever (23.8%), headache (17.7%), and generalized weakness (11.6%). Emergency physicians initiated testing for the virus in 63 cases (42.9%). Patients dispositioned (n = 84, either discharged or admitted) from the ED without initiation of testing tended to be older (median 73 vs 62 years, P < .001), with higher triage respiratory rate (mean 19.4 vs 18.3 breaths per minute, P = .05) and lower triage oxygen saturation (median 96% vs 97%; P =.02). Emergency physicians predominantly performed CSF testing (n = 42 patients) over serum testing (n = 21 patients). Patients tested via CSF had lower ESI scores than those tested via serum (ESI score of 1-2 45.3% vs 14.3%, P = .03).
\nConclusion: Emergency physicians did not initiate testing in 57.1% of initial ED encounters of patients ultimately found to have West Nile virus. During West Nile virus outbreaks, emergency physicians should stay vigilant for less acute presentations, such as generalized weakness in elderly patients, along with typical presentations including fever and headache, to avoid delayed diagnosis.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"emergency department"},{"word":"West Nile virus"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/392348zt","frozenauthors":[{"first_name":"Kylie","middle_name":"","last_name":"Jenkins","name_suffix":"","institution":"Creighton University School of Medicine, Department of Emergency Medicine, Phoenix, Arizona; Mayo Clinic Arizona, Department of Emergency Medicine, Phoenix, Arizona","department":""},{"first_name":"Wayne","middle_name":"","last_name":"Martini","name_suffix":"","institution":"Mayo Clinic Arizona, Department of Emergency Medicine, Phoenix, Arizona","department":""},{"first_name":"Alyssa","middle_name":"K.","last_name":"McGary","name_suffix":"","institution":"Mayo Clinic, Department of Quantitative Health Sciences, Scottsdale, Arizona","department":""},{"first_name":"Heidi","middle_name":"E.","last_name":"Kosiorek","name_suffix":"","institution":"Mayo Clinic, Department of Quantitative Health Sciences, Scottsdale, Arizona","department":""},{"first_name":"Nicole","middle_name":"R.","last_name":"Hodgson","name_suffix":"","institution":"Mayo Clinic Arizona, Department of Emergency Medicine, Phoenix, Arizona","department":""}],"date_submitted":"2025-05-19T22:54:00.859000+05:30","date_accepted":"2025-10-09T04:27:42.289000+05:30","date_published":"2025-12-24T21:49:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47475/galley/47925/download/"}]},{"pk":47456,"title":"Case Study and Qualitative Analysis of Emergency Department Community Advisory Council on Intimate Partner Violence","subtitle":null,"abstract":"Introduction: As part of a quality improvement initiative, our emergency department (ED) implemented a community advisory council consisting of leaders from five community-based organizations (CBO) that provide services for survivors of intimate partner violence. We used qualitative interviews with participants from the organizations to evaluate the council by identifying factors that promoted and hindered their engagement in this partnership between the community and the ED as well as best practices for future collaborations
\nMethods: We conducted five, 30-minute semi-structured interviews, one for each CBO representative on the council. Interview questions were based on validated toolkits for evaluating community-based participatory research. We conducted thematic analysis using a barriers and facilitators framework.
\nResults: Our focus on building relationships within the community advisory council facilitated collaboration between the ED and the CBOs. We identified structural barriers to and facilitators of the relationship-building process, as well as four behaviors that promoted relationship-building within the council. These behaviors included a joint problem-solving orientation, a culture of curiosity, shared empathy between emergency clinicians and CBO members, and a deeper understanding of barriers to caring for survivors of intimate partner violence in the ED. Themes regarding the impact of the council included the results of tangible projects as well as cultural shifts in the ED as perceived by leaders of the CBOs.
\nConclusion: We share a case study of a collaboration between the ED and community-based organizations that illustrates barriers to and facilitators of engagement by leaders of these organizations in community-healthcare partnerships. The ED is a short but meaningful stop in recovery for many survivors, and a warm handoff to a CBO can be an essential next step in their care. When rooted in mutually respectful, trusting relationships, ED-CBO partnerships have the potential to enable survivor-centered, quality improvement efforts that work to improve the continuum of care between the ED and the community.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"intimate partner violence"},{"word":"community partnerships"},{"word":"Quality Improvement"}],"section":"Behavioral Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9xn885dr","frozenauthors":[{"first_name":"Eva","middle_name":"","last_name":"Kitlen","name_suffix":"","institution":"University of California, San Francisco School of Medicine, San Francisco, California","department":""},{"first_name":"Alice","middle_name":"","last_name":"Lu","name_suffix":"","institution":"University of California, San Francisco School of Medicine, San Francisco, California; Mass General Brigham, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"Katrin","middle_name":"","last_name":"Jaradeh","name_suffix":"","institution":"University of California, San Francisco, San Francisco General Hospital, Department of Emergency Medicine, San Francisco, California","department":""},{"first_name":"Stephanie","middle_name":"","last_name":"Lawless","name_suffix":"","institution":"University of California, San Francisco, San Francisco General Hospital, Department of Emergency Medicine, San Francisco, California","department":""},{"first_name":"Elizabeth","middle_name":"","last_name":"Raby","name_suffix":"","institution":"University of California, San Francisco School of Medicine, San Francisco, California","department":""},{"first_name":"Theresa","middle_name":"H","last_name":"Cheng","name_suffix":"","institution":"University of California, San Francisco, San Francisco General Hospital, Department of Emergency Medicine, San Francisco, California","department":""},{"first_name":"Leigh","middle_name":"","last_name":"Kimberg","name_suffix":"","institution":"University of California, San Francisco, San Francisco General Hospital, Division of General Internal Medicine, San Francisco, California","department":""},{"first_name":"Christopher","middle_name":"","last_name":"Peabody","name_suffix":"","institution":"University of California, San Francisco School of Medicine, San Francisco, California; University of California, San Francisco, San Francisco General Hospital, Department of Emergency Medicine, San Francisco, California","department":""}],"date_submitted":"2025-05-16T10:17:04.533000+05:30","date_accepted":"2025-09-22T21:08:09.798000+05:30","date_published":"2025-12-23T23:22:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47456/galley/47912/download/"}]},{"pk":4378,"title":"Pioneers of Egyptian Language Studies (1822 – 1880)","subtitle":null,"abstract":"During the six decades between 1822 and 1880, Egyptology initially witnessed intense debate over Jean-François Champollion’s decipherment of the hieroglyphic script and an emerging consensus over its validity. This was followed by an era of growing lexicographic understanding and outstanding achievements in philology and translation. The time was not yet ripe, however, for a truly linguistic analysis of the Egyptian language. For this, the Egyptological community had to wait until the 1880s—for the discoveries of a circle of scholars headed by Adolf Erman, known as the “Berlin School.”
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Language, Text and Writing","is_remote":true,"remote_url":"https://escholarship.org/uc/item/22t5c422","frozenauthors":[{"first_name":"Sami","middle_name":"","last_name":"Uljas","name_suffix":"","institution":"Uppsala University","department":"Department of Archaeology, Ancient History and Conservation; Egyptology","country":"Sweden"}],"date_submitted":"2009-01-29T23:17:29+05:30","date_accepted":"2025-12-23T21:35:25.929000+05:30","date_published":"2025-12-23T21:22:00+05:30","render_galley":null,"galleys":[{"label":"4378_Uljas_Pioneers","type":"pdf","path":"https://journalpub.escholarship.org/nelc_uee/article/4378/galley/47720/download/"}]},{"pk":47302,"title":"Factors Associated with Patients Leaving Without Being Seen in a Canadian Emergency Department","subtitle":null,"abstract":"Introduction: Patients leaving without being seen is a critical quality metric for emergency department (ED) performance and is associated with negative patient outcomes and operational inefficiencies. In this study we aimed to systematically assess patient- and system-level factors influencing leaving-without-being-seen behavior.
\nMethods: We conducted a retrospective cohort study at The Ottawa Hospital, a tertiary-care ED with 85,000 annual ED visits in Ottawa, Canada. We analyzed all patient encounters for two years from May 2022–April 2024. Variables included demographics characteristics (age, sex), visit specifics (arrival day and time, Canadian Triage and Acuity Scale [CTAS] scores, presenting complaints), and operational metrics (ED occupancy metrics). Multivariate logistic regression analyses evaluated the influence of these factors on rates of leaving without being seen.
\nResults: Of 170,536 ED visits, 15,473 (9.1%) patients left without being seen, and 2,716 (1.6%) left before triage. Each additional 10 years of age reduced the adjusted odds of leaving without being seen by 20.2% (older patients left less frequently). Male patients had 9.4% higher adjusted odds of leaving without being seen compared to females. For every five patients waiting to be seen, the adjusted odds of leaving increased by 16.9% for a newly arriving patient. For every five patients already seen but awaiting disposition, the adjusted odds of leaving increased by 9.6% for a newly arriving patient. Compared to CTAS 2 patients (high acuity), CTAS 3 patients had 67.1% higher adjusted odds of leaving, CTAS 4 patients had 134% higher adjusted odds, and CTAS 5 patients (lowest acuity) had 176% higher adjusted odds of leaving.
\nConclusion: Younger age, male sex, lower acuity, and ED crowding independently and significantly increase rates of leaving without being seen. Importantly, both crowding and volume of patients waiting impact left-without-being-seen behaviour. Optimizing patient flow through strategic movement within the ED may enhance the perception of progress, encouraging patients to remain for care.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"ED operations"},{"word":"Patient flow"},{"word":"Left without being seen"}],"section":"Emergency Department Operations","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1gt267d7","frozenauthors":[{"first_name":"Scott","middle_name":"","last_name":"Odorizzi","name_suffix":"","institution":"University of Ottawa, Department of Emergency Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada","department":""},{"first_name":"Sandra","middle_name":"","last_name":"Blais-Amyot","name_suffix":"","institution":"The Ottawa Hospital, Ottawa, Ontario, Canada","department":""},{"first_name":"Peter","middle_name":"","last_name":"Greenstreet","name_suffix":"","institution":"The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada","department":""},{"first_name":"Omar","middle_name":"","last_name":"Anjum","name_suffix":"","institution":"University of Ottawa, Department of Emergency Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada","department":""},{"first_name":"Jeffrey","middle_name":"J.","last_name":"Perry","name_suffix":"","institution":"University of Ottawa, Department of Emergency Medicine, Ottawa, Ontario, Canada; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada","department":""}],"date_submitted":"2025-04-25T08:03:20.935000+05:30","date_accepted":"2025-09-25T04:48:14.578000+05:30","date_published":"2025-12-23T20:13:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47302/galley/47910/download/"}]},{"pk":48698,"title":"Association of Shock Index and Variants with Mortality in Acute Pulmonary Embolism","subtitle":null,"abstract":"Introduction: Pulmonary embolism (PE) is common with potential for morbidity and mortality. Several PE risk-stratification tools exist; however, more granular and patient-specific indicators of potential decompensation or short-term mortality that can be easily obtained are needed for the bedside clinician to further sub-stratify risk and inform management decisions. We sought to determine the association of early emergency department (ED) measurement of the shock index (SI) and SI variants (modified SI, SI to peripheral oxygen saturation ratio, age-adjusted SI, respiratory-adjusted SI, and double product) and mortality among patients with acute PE.
\nMethods: This was an observational case-control study of adult patients who presented to the ED at a single health system (January 2021–April 2023) and had PE response team (PERT) activation for newly diagnosed acute PE. We evaluated the association of 30-day in-hospital mortality with the SI (heart rate/systolic blood pressure) and variants of the SI—modified SI = heart rate/mean arterial pressure; SI to peripheral oxygen saturation ratio = SI/peripheral oxygen saturation; age-adjusted SI = age x SI; respiratory-adjusted SI = SI x (respiratory rate/10); double product = systolic blood pressure x heart rate—in addition to the Simplified Pulmonary Embolism Severity Index (sPESI) and European Society of Cardiology (ESC) risk schema. We used the area under the receiver operating characteristic curve (AUC) to assess discriminatory efficiency of the SI and each variant with the primary outcome. Multivariable logistic regression measured the association between SI and variants with 30-day mortality.
\nResults: Of 121 patients included in the study, 12 (9.9%) died. The SI and variants were all significantly different between survivors and non-survivors (P < .05), while the sPESI was not different (P = .30). The age-adjusted SI had the highest discriminatory efficiency for mortality (AUC 0.82; 95% CI, 0.71-0.93), followed by the SI (AUC 0.78; 0.67-0.89), the SI/peripheral oxygen saturation (AUC 0.77; 0.65-0.90), double product (AUC 0.76; 0.61-0.91), modified SI (AUC 0.75; 0.61-0.90), ESC risk schema (AUC 0.71; 0.52-0.90), and the respiratory-adjusted SI (AUC 0.70; 0.54-0.87).
\nConclusion: Among patients presenting to the ED who had a PERT activation for acute PE, the age-adjusted SI had the highest discriminatory efficiency for mortality, followed by the SI and its other variants. Further investigation regarding use of the age-adjusted SI for prognostication of acute PE and implications on PE management is warranted.
","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"pulmonary embolism"},{"word":"Shock index"},{"word":"spesi"},{"word":"pulmonary embolism response team"}],"section":"Critical Care","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5cj2c69s","frozenauthors":[{"first_name":"Cameron","middle_name":"P.","last_name":"Upchurch","name_suffix":"","institution":"University of Vermont Larner College of Medicine, Department of Emergency Medicine, Burlington, Vermont; University of Vermont Larner College of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Burlington, Vermont","department":""},{"first_name":"Kristen","middle_name":"","last_name":"Sanfilippo","name_suffix":"","institution":"Washington University in St. Louis School of Medicine, Department of Medicine, Division of Hematology, St. Louis, Missouri","department":""},{"first_name":"Daphne","middle_name":"","last_name":"Lew","name_suffix":"","institution":"Washington University in St. Louis School of Medicine, Institute for Informatics, Data Science, and Biostatistics, Center for Biostatistics and Data Science, St. Louis, Missouri","department":""},{"first_name":"Maanasi","middle_name":"","last_name":"Samant","name_suffix":"","institution":"Northwestern University Feinberg School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Chicago, Illinois","department":""},{"first_name":"Rachel","middle_name":"","last_name":"McDonald","name_suffix":"","institution":"Washington University in St. Louis School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, St. Louis, Missouri","department":""}],"date_submitted":"2025-06-19T15:37:37.254000+05:30","date_accepted":"2025-09-28T16:06:45.106000+05:30","date_published":"2025-12-23T18:34:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/48698/galley/47914/download/"}]},{"pk":52395,"title":"Seven Steps for Emergency Physicians to Dismantle Access Barriers and Build Equitable Care Systems","subtitle":null,"abstract":"n/a
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Emergency Medicine"},{"word":"addiction"},{"word":"Reproductive Healthcare"},{"word":"practice reform"},{"word":"practice change"},{"word":"buprenorphine"},{"word":"mifepristone"},{"word":"physician leadership"}],"section":"Health Equity","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0m70f789","frozenauthors":[{"first_name":"Alicia","middle_name":"","last_name":"Gonzalez","name_suffix":"","institution":"Public Health Institute, The Bridge Center, Oakland, California; Pioneers Memorial Hospital, Brawley, California","department":""},{"first_name":"Elizabeth","middle_name":"","last_name":"Keating","name_suffix":"","institution":"Public Health Institute, The Bridge Center, Oakland, California","department":""},{"first_name":"Aimee","middle_name":"","last_name":"Moulin","name_suffix":"","institution":"University of California Davis Health, Department of Emergency Medicine, Davis, California; University of California Davis Health, Department of Psychiatry, Davis, California; Public Health Institute, The Bridge Center, Oakland, California","department":""}],"date_submitted":"2025-09-12T03:29:26.016000+05:30","date_accepted":"2025-09-15T04:39:50.518000+05:30","date_published":"2025-12-23T17:33:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/52395/galley/47898/download/"}]},{"pk":48357,"title":"Women with Suicidal Ideation, Substance Use Disorder, or Intimate Partner Violence in the Emergency Department: Retrospective Analysis of Contraceptive Documentation","subtitle":null,"abstract":"Introduction: Prior research demonstrates that emergency department (ED) patients with suicidal ideation (SI), substance use (SUD), and/or intimate partner violence (IPV) have disproportionate adverse outcomes for both women and infants. The 2013 Hague Protocol suggested that children with caregivers with the above characteristics are also more likely to suffer from child maltreatment. Of all pregnancies in this group, as many as 90% are unintended. We hypothesized that women with SI/SUD/IPV have gaps in care access, high levels of unscheduled care use, and reduced ED contraceptive inquiry, which if addressed could potentially improve outcomes.
\nMethods: We conducted a chart review of 62,284 ED visits from 2018–2021 from a suburban four-hospital system in the Southern United States. We compared women of reproductive age (15-44) with SI/SUD/IPV (4,776) against controls (57,508). The exposures were defined as women with SI, SUD, and/or IPV. We analyzed results using the chi-square test (χ²) with Bonferroni adjustment to test for independence and logistic regression.
\nResults: Women suffering from SI/SUD/IPV who present to the ED have contraceptive status less frequently documented compared to controls without these factors (39.5 vs 51.7%, RR 0.77, CI, 0.74-0.79, P < .001). They also have reduced access to care, with higher rates of uninsurance (32.7 vs 26.1%, P < .001), more care in the acute care environment, longer ED length of stay (LOS) (mean was 10.38 vs 3.87 hours, P < .001), higher hospitalization rates (61.0 vs 8.7%, P < .001), and higher 30-day ED revisits (11.8 vs 8.8%, P < .001), even after adjusting for the Social Vulnerability Index, acuity, age, and obesity (adjusted odds ratio 1.52 95% CI 1.36-1.70 P < .001).
\nConclusion: Despite significant morbidity coupled with reduced access to ambulatory care and disproportionately increased ED use, little ED contraceptive documentation exists. This practice contributes to inequity, given the increased number of unintended pregnancies and greater need of contraceptives in women with suicidal ideation/substance use disorder/intimate partner violence.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"adverse childhood experiences"},{"word":"Substance Use Disorder"},{"word":"Suicide"},{"word":"intimate partner violence"},{"word":"Behavioral Emergencies"},{"word":"contraception"}],"section":"Women's Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8f27376k","frozenauthors":[{"first_name":"Alison","middle_name":"","last_name":"Ruch","name_suffix":"","institution":"Northeast Georgia Medical Center, Department of Emergency Medicine, Gainesville, Georgia","department":""},{"first_name":"Adam","middle_name":"","last_name":"Henderson","name_suffix":"","institution":"Medical College of Georgia at Augusta University, Department of Emergency Medicine, Augusta, Georgia","department":""},{"first_name":"Ania","middle_name":"Izabela","last_name":"Rynarzewska","name_suffix":"","institution":"Georgia College and State University, Department of Management, Marketing & Logistics Department, Milledgeville, Georgia","department":""},{"first_name":"Hardeep","middle_name":"","last_name":"Singh","name_suffix":"","institution":"Northeast Georgia Medical Center, Department of GME Research & Quality Improvement, Gainesville, Georgia","department":""},{"first_name":"louise","middle_name":"","last_name":"jones","name_suffix":"","institution":"Northeast Georgia Medical Center, Department of GME Research & Quality Improvement, Gainesville, Georgia","department":""}],"date_submitted":"2025-05-30T13:36:22.091000+05:30","date_accepted":"2025-09-25T04:40:57.296000+05:30","date_published":"2025-12-23T14:58:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/48357/galley/47907/download/"}]},{"pk":61859,"title":"JRWS, vol. 3, iss. 2 (2025)","subtitle":null,"abstract":"","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Full Issue","is_remote":true,"remote_url":"https://escholarship.org/uc/item/21z721js","frozenauthors":[],"date_submitted":"2025-12-23T10:26:31.424000+05:30","date_accepted":"2025-12-23T10:27:34.111000+05:30","date_published":"2025-12-23T10:32:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/61859/galley/47717/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/61859/galley/47717/download/"}]},{"pk":61696,"title":"Introduction","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9zn3355z","frozenauthors":[{"first_name":"Mita","middle_name":"","last_name":"Banerjee","name_suffix":"","institution":"Johannes Gutenberg-Universitaet Mainz","department":"","country":"Germany"}],"date_submitted":"2025-12-18T06:39:28.489000+05:30","date_accepted":"2025-12-18T06:40:13.700000+05:30","date_published":"2025-12-23T07:01:00+05:30","render_galley":{"label":"Other","type":"other","path":"https://journalpub.escholarship.org/jtas/article/61696/galley/47715/download/"},"galleys":[{"label":"Other","type":"other","path":"https://journalpub.escholarship.org/jtas/article/61696/galley/47715/download/"}]},{"pk":43559,"title":"“A Planet-Wide Race War”: The Global Circulation of White Supremacist Violence in the Late Twentieth Century","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"White Supremacy"},{"word":"Political violence"},{"word":"terrorism"},{"word":"Neo-Nazism"},{"word":"Europe"},{"word":"Britain"},{"word":"Rhodesia"},{"word":"Yugoslavia"},{"word":"Northern Ireland"},{"word":"Central America"},{"word":"transnational right"},{"word":"global terrorism"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4ch6s67r","frozenauthors":[{"first_name":"Kyle","middle_name":"","last_name":"Burke","name_suffix":"","institution":"University of South Florida","department":"History"}],"date_submitted":"2025-02-22T01:57:29.790000+05:30","date_accepted":"2025-12-22T10:51:37.912000+05:30","date_published":"2025-12-23T06:29:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/43559/galley/47650/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/43559/galley/47650/download/"}]},{"pk":46804,"title":"Mapping the Influence of Conservative Catholic Political Thought on the American Right","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. 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You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Ku Klux Klan"},{"word":"Nativism"},{"word":"racism"},{"word":"1920s"},{"word":"United States federal politics"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/853199mj","frozenauthors":[{"first_name":"Felix","middle_name":"","last_name":"Harcourt","name_suffix":"","institution":"Austin College","department":"History"}],"date_submitted":"2025-02-19T22:39:18.476000+05:30","date_accepted":"2025-12-22T10:49:49.896000+05:30","date_published":"2025-12-23T06:22:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/43546/galley/47649/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/43546/galley/47649/download/"}]},{"pk":61763,"title":"Introduction—When the Radical Becomes Ordinary: A State of the Field of the Far Right in US History","subtitle":null,"abstract":"","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9sg020kg","frozenauthors":[{"first_name":"Olivier","middle_name":"","last_name":"Burtin","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-12-22T10:38:16.234000+05:30","date_accepted":"2025-12-22T10:39:33.686000+05:30","date_published":"2025-12-23T06:20:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/61763/galley/47646/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/61763/galley/47646/download/"}]},{"pk":46988,"title":"“Democracy Must Be Made Safe for the World”: Ralph Adams Cram and the Tradition of American Monarchism","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Ralph Adams Cram"},{"word":"Curtis Yarvin"},{"word":"Dark Enlightenment"},{"word":"far-right"},{"word":"monarchism"},{"word":"Neoreaction"},{"word":"Political Thought"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2rx1b05z","frozenauthors":[{"first_name":"Christian","middle_name":"T.","last_name":"Ruth","name_suffix":"","institution":"University of Florida","department":"Civics and Classical Education"}],"date_submitted":"2025-03-11T03:22:12.961000+05:30","date_accepted":"2025-12-22T10:47:19.444000+05:30","date_published":"2025-12-23T06:18:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/46988/galley/47648/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/46988/galley/47648/download/"}]},{"pk":61766,"title":"3.2 front matter","subtitle":null,"abstract":"","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Front Matter","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2q15k8jh","frozenauthors":[],"date_submitted":"2025-12-22T11:33:45+05:30","date_accepted":"2025-12-22T11:35:51.972000+05:30","date_published":"2025-12-23T06:14:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/61766/galley/47654/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/61766/galley/47654/download/"}]},{"pk":61764,"title":"God's Soldiers: Clerico-Fascism and the Deep History of Christian Nationalism","subtitle":null,"abstract":"","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Essay","is_remote":true,"remote_url":"https://escholarship.org/uc/item/56z0s6qc","frozenauthors":[{"first_name":"Alex","middle_name":"","last_name":"McPhee-Browne","name_suffix":"","institution":"Cambridge University","department":""}],"date_submitted":"2025-12-22T10:59:17.724000+05:30","date_accepted":"2025-12-22T11:00:39.056000+05:30","date_published":"2025-12-23T05:43:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/61764/galley/47652/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/61764/galley/47652/download/"}]},{"pk":45136,"title":"\"Chased from the Mainstream\": Tito Perdue and Far-Right Fiction Read via Bourdieu's Field Theory","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Tito Perdue"},{"word":"Greg Johnson"},{"word":"Literary Field"},{"word":"Pierre Bourdieu"},{"word":"Metapolitics"},{"word":"far-right fiction"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8w7855vc","frozenauthors":[{"first_name":"Sof","middle_name":"","last_name":"Sabbioni","name_suffix":"","institution":"University of Basel","department":"Department of Languages and Literatures"}],"date_submitted":"2025-02-28T17:41:44.643000+05:30","date_accepted":"2025-12-22T10:55:04.275000+05:30","date_published":"2025-12-23T05:41:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/45136/galley/47651/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/45136/galley/47651/download/"}]},{"pk":61741,"title":"Alfred at Eighty--Really?","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9z37g8ds","frozenauthors":[{"first_name":"Susanne","middle_name":"","last_name":"Becker von Dadelsen","name_suffix":"","institution":"ZDF public broadcaster","department":"Culture"}],"date_submitted":"2025-12-20T03:38:11.846000+05:30","date_accepted":"2025-12-20T17:17:31.035000+05:30","date_published":"2025-12-23T02:14:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61741/galley/47644/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61741/galley/47644/download/"}]},{"pk":61667,"title":"Reflective Essay for Alfred Hornung's Eightieth Birthday","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6795q6sc","frozenauthors":[{"first_name":"Aiko","middle_name":"","last_name":"Takeuchi-Demirci","name_suffix":"","institution":"Stanford University","department":"International Relations"}],"date_submitted":"2025-12-16T04:41:11.760000+05:30","date_accepted":"2025-12-16T04:42:02.247000+05:30","date_published":"2025-12-23T00:42:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61667/galley/47577/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61667/galley/47577/download/"}]},{"pk":61765,"title":"3.2 letter from the editor","subtitle":null,"abstract":"","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Letter from the Editor","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6bb1x8mm","frozenauthors":[{"first_name":"Lawrence","middle_name":"","last_name":"Rosenthal","name_suffix":"","institution":"University of California, Berkeley","department":""}],"date_submitted":"2025-12-22T11:04:47.906000+05:30","date_accepted":"2025-12-22T11:31:10.019000+05:30","date_published":"2025-12-23T00:17:10.059000+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/61765/galley/47653/download/"},{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jrws/article/61765/galley/47711/download/"}]},{"pk":61854,"title":"American Eagles and Tibetan Vultures","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/364789zk","frozenauthors":[{"first_name":"Nadja","middle_name":"","last_name":"Gernalzick","name_suffix":"","institution":"Johannes Gutenberg-Universitaet Mainz","department":"Obama Institute for Transnational American Studies"}],"date_submitted":"2025-12-22T23:17:53.075000+05:30","date_accepted":"2025-12-22T23:18:34.926000+05:30","date_published":"2025-12-22T22:29:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61854/galley/47708/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61854/galley/47708/download/"}]},{"pk":54369,"title":"The new Checklist of the Italian Fauna: Cladocera (Branchiopoda: Ctenopoda, Anomopoda, Onychopoda, and Haplopoda)","subtitle":null,"abstract":"The new Checklist of the Italian Fauna provides an updated inventory of Cladocera species in Italy, encompassing the orders Ctenopoda, Anomopoda, Onychopoda, and Haplopoda. The checklist contains 121 species belonging to 13 families, with Chydoridae and Daphniidae being the most abundant. Seven freshwater species have been added since the previous checklist, while the number of marine species remains unchanged at six. Following recent taxonomic revisions, changes in the nomenclature have been introduced, primarily within the subfamily Aloninae. None of the species is endemic to Italy, but six are considered alien. The presence of species in each macroregion and administrative region is reported, with the number of species per region ranging from 10 in Molise to 77 in Lombardy administrative regions. A total of 165 new regional citations are recorded, with southern regions showing increases exceeding 40% of their total records respect to the previously reported ones in the CKmap database published in 2005. Although the total number of Italian cladoceran species is well known, their taxonomy is still evolving, particularly within Aloninae and Daphniinae. Molecular studies are expected to reveal cryptic species and refine biogeographic patterns.
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","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5r6163r3","frozenauthors":[{"first_name":"Shirley","middle_name":"","last_name":"Geok-Lin Lim","name_suffix":"","institution":"UC Santa Barbara","department":"","country":"United States"}],"date_submitted":"2025-12-21T07:54:12.489000+05:30","date_accepted":"2025-12-21T07:55:24.908000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61751/galley/47636/download/"}]},{"pk":61757,"title":"For Alfred on his Eightieth Birthday","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/22c7n3qz","frozenauthors":[{"first_name":"Jochen","middle_name":"","last_name":"Achilles","name_suffix":"","institution":"University of Würzburg","department":"American Studies"}],"date_submitted":"2025-12-21T12:09:40.926000+05:30","date_accepted":"2025-12-21T12:10:40.459000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61757/galley/47645/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61757/galley/47645/download/"}]},{"pk":61708,"title":"Homage to Alfred","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3g9351ws","frozenauthors":[{"first_name":"Dorothea","middle_name":"","last_name":"Gail","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-12-18T19:52:16.081000+05:30","date_accepted":"2025-12-19T02:34:16.553000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61708/galley/47604/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61708/galley/47604/download/"}]},{"pk":61674,"title":"\"interdisciplinary in the best sense of American studies”","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9th8d70z","frozenauthors":[{"first_name":"Sabine","middle_name":"N.","last_name":"Meyer","name_suffix":"","institution":"University of Bonn","department":"Department of English, American and Celtic Studies"}],"date_submitted":"2025-12-16T15:02:01.983000+05:30","date_accepted":"2025-12-17T22:37:22.867000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61674/galley/47657/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61674/galley/47657/download/"}]},{"pk":61731,"title":"Larger than Life: Alfred Hornung","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"autobiography; life writing; Hornung"}],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9f05p88s","frozenauthors":[{"first_name":"Julie","middle_name":"","last_name":"Rak","name_suffix":"","institution":"University of Alberta","department":"English and Film Studies"}],"date_submitted":"2025-12-19T23:29:34.387000+05:30","date_accepted":"2025-12-20T16:42:09.880000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61731/galley/47625/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61731/galley/47625/download/"}]},{"pk":61770,"title":"Not Determined by Deadlines: A Tribute to Alfred Hornung","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/31w989wb","frozenauthors":[{"first_name":"Jennifer","middle_name":"A.","last_name":"Reimer","name_suffix":"","institution":"Oregon State University–Cascades","department":"","country":"United States"}],"date_submitted":"2025-12-22T20:58:10.814000+05:30","date_accepted":"2025-12-22T20:58:59.452000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61770/galley/47705/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61770/galley/47705/download/"}]},{"pk":61753,"title":"On Arriving Late to the Table that Alfred Hornung Set","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2cq5c96k","frozenauthors":[{"first_name":"Brian","middle_name":"Russell","last_name":"Roberts","name_suffix":"","institution":"Brigham Young University","department":"","country":"United States"}],"date_submitted":"2025-12-21T08:17:42.697000+05:30","date_accepted":"2025-12-21T08:18:34.441000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61753/galley/47638/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61753/galley/47638/download/"}]},{"pk":61733,"title":"Splashes, Happenings, and Journeys: Learning with Alfred Hornung","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3ps5m0jg","frozenauthors":[{"first_name":"Mary Rose","middle_name":"","last_name":"Montemayor","name_suffix":"","institution":"Johannes Gutenberg University Mainz","department":""}],"date_submitted":"2025-12-20T00:07:17.370000+05:30","date_accepted":"2025-12-20T16:52:05.461000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61733/galley/47626/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61733/galley/47626/download/"}]},{"pk":61722,"title":"Support for Early Career Researchers Revisited","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/69j0c15f","frozenauthors":[{"first_name":"Barbara","middle_name":"","last_name":"Schwerdtfeger","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-12-19T15:11:50.035000+05:30","date_accepted":"2025-12-19T15:40:06.350000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61722/galley/47643/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61722/galley/47643/download/"}]},{"pk":61852,"title":"The Model Mentor","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5d2121h1","frozenauthors":[{"first_name":"Pia","middle_name":"","last_name":"Wiegmink","name_suffix":"","institution":"University of Bonn","department":"","country":"Germany"}],"date_submitted":"2025-12-22T22:53:28.029000+05:30","date_accepted":"2025-12-22T22:55:32.851000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61852/galley/47707/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61852/galley/47707/download/"}]},{"pk":61739,"title":"The Signature of Alfred Hornung","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4km4h6wv","frozenauthors":[{"first_name":"Manfred","middle_name":"","last_name":"Siebald","name_suffix":"","institution":"Johannes Gutenberg University, Mainz","department":"Obama Institue for Transnational American Studies"}],"date_submitted":"2025-12-20T02:55:32.073000+05:30","date_accepted":"2025-12-20T17:17:04.608000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61739/galley/47641/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61739/galley/47641/download/"}]},{"pk":61752,"title":"Wagons, Ho! US Route 80","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5s32q121","frozenauthors":[{"first_name":"Nina","middle_name":"","last_name":"Morgan","name_suffix":"","institution":"Kennesaw State University","department":"","country":"United States"}],"date_submitted":"2025-12-21T08:05:21.256000+05:30","date_accepted":"2025-12-21T08:06:10.502000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61752/galley/47637/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61752/galley/47637/download/"}]},{"pk":61701,"title":"Working Together with Alfred Hornung over the Years","subtitle":null,"abstract":".
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"Alfred Hornung"},{"word":"MESEA"},{"word":"Atlantic Studies: Global Currents"}],"section":"Special Section in Honor of Alfred Hornung","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3kr9x6pb","frozenauthors":[{"first_name":"Rocío","middle_name":"G.","last_name":"Davis","name_suffix":"","institution":"University of Navarra","department":"","country":"Spain"},{"first_name":"Dorothea","middle_name":"","last_name":"Fischer-Hornung","name_suffix":"","institution":"University of Heidelberg","department":"English"}],"date_submitted":"2025-12-18T12:57:12.822000+05:30","date_accepted":"2025-12-18T18:45:03.378000+05:30","date_published":"2025-12-22T04:31:00+05:30","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61701/galley/47605/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/61701/galley/47605/download/"}]},{"pk":63077,"title":"Make Room for the Mushroom: Legal Vehicles for Conservation of the Kingdom Fungi","subtitle":null,"abstract":"","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Student Comments","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4mp4x79w","frozenauthors":[{"first_name":"Julia","middle_name":"","last_name":"Larkin","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-21T03:39:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_jelp/article/63077/galley/48713/download/"}]},{"pk":63076,"title":"Land in Transition: Repurposing Water-Constrained Farmland for Sustainable Solar Development in the San Joaquin Valley","subtitle":null,"abstract":"","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Student Comments","is_remote":true,"remote_url":"https://escholarship.org/uc/item/11n0x4mn","frozenauthors":[{"first_name":"Maeve","middle_name":"","last_name":"Anderson","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-21T03:37:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_jelp/article/63076/galley/48712/download/"}]},{"pk":63075,"title":"A Silver Lining: Interpreting the Endangered Species Act to Envision Management of the Rio Grande Silvery Minnow in a Broader Cultural, Ecological, and Political Context","subtitle":null,"abstract":"The Rio Grande silvery minnow, listed as an endangered species in 1994, is the subject of significant debate, litigation, and water management decisions. This article documents the history of the minnow as it related to the Endangered Species Act. Even as outcomes for the species fail to improve, the minnow plays an important role in Middle Rio Grande water management. The water supplied for the minnow also provides benefits to the human community and larger ecological community. This article posits that the next era of minnow management, beginning with the upcoming 2028 Biological Opinion, should consider a wider set of values, to provide benefits for both the Rio Grande silvery minnow and the larger Middle Rio Grande community.
","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6481b6z1","frozenauthors":[{"first_name":"Katherine","middle_name":"H.","last_name":"Tara","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-21T03:35:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_jelp/article/63075/galley/48711/download/"}]},{"pk":63073,"title":"Front Matter","subtitle":null,"abstract":"","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Front Matter","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6ms3n7cd","frozenauthors":[],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-21T01:39:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_jelp/article/63073/galley/48710/download/"}]},{"pk":46577,"title":"An Organized Approach to Using Large Language Models for Medical Information","subtitle":null,"abstract":"Introduction: ChatGPT and other large language models (LLM) have increased in popularity. Despite the rapid rise in the implementation of such technologies, frameworks for implementing appropriate prompting techniques in medical applications are limited. In this paper we establish the nomenclature of “variable” and “clause” in the prompting of a LLM, while providing example interviews that outline the utility of such an approach in medical applications.
\nMethods: In this study assessing the LLM ChatGPT-4, we define terms used in prompting procedures including “input prompt,” “variable,” “demographic variable and clause,” “independent variable and clause,” “dependent variable and clause,” “generative clause,” and “output.” This methodology was implemented with three sample patient cases from both a patient and physician perspective.
\nResults: As demonstrated in our three cases, precise combinations of variables and clauses that consider the patient’s age, gender, weight, height, and education level can yield unique outputs. The software can do so quickly and in a personalized, patient-specific manner. Our findings demonstrate that LLMs can be used to generate comprehensive sets of educational material to augment current limitations, with the potential of improving healthcare outcomes as the use of LLM is further explored.
\nConclusion: The framework we describe represents a unique attempt to standardize a methodology for medical inputs into a large language model. Doing so expands the potential for outlining patient-specific information that can be implemented in a query by either a patient or a physician. Most notably, future projects should consider the specialty- and presentation-specific input changes that may yield the best outputs for the desired goals.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Technology in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5rc1448z","frozenauthors":[{"first_name":"Saman","middle_name":"","last_name":"Andalib","name_suffix":"","institution":"University of California, Irvine, School of Medicine, Irvine, California","department":""},{"first_name":"Aidin","middle_name":"","last_name":"Spina","name_suffix":"","institution":"University of California, Irvine, School of Medicine, Irvine, California","department":""},{"first_name":"Faris","middle_name":"F.","last_name":"Halaseh","name_suffix":"","institution":"University of California, Irvine, School of Medicine, Irvine, California","department":""},{"first_name":"Anagha","middle_name":"","last_name":"Thiagarajan","name_suffix":"","institution":"University of California, Irvine, School of Medicine, Irvine, California","department":""},{"first_name":"Rishi","middle_name":"","last_name":"Vermani","name_suffix":"","institution":"University of California, Irvine, School of Medicine, Irvine, California","department":""},{"first_name":"Jason","middle_name":"","last_name":"Liang","name_suffix":"","institution":"University of California, Irvine, School of Medicine, Irvine, California","department":""},{"first_name":"Warren","middle_name":"F.","last_name":"Wiechmann","name_suffix":"","institution":"University of California, Irvine, School of Medicine, Irvine, California","department":""}],"date_submitted":"2025-03-06T03:53:39.209000+05:30","date_accepted":"2025-09-25T04:57:10.856000+05:30","date_published":"2025-12-20T16:48:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/46577/galley/47923/download/"}]},{"pk":52943,"title":"The One Big Beautiful Bill: A Looming Crisis for Health Equity and Emergency Medicine","subtitle":null,"abstract":"","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Health Equity","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2nn0g7bs","frozenauthors":[{"first_name":"Melanie","middle_name":"","last_name":"Yates","name_suffix":"","institution":"George Washington University, School of Medicine and Health Sciences, Department of Emergency Medicine, Washington, DC","department":""},{"first_name":"Peter","middle_name":"","last_name":"Yun","name_suffix":"","institution":"University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, Texas","department":""}],"date_submitted":"2025-09-25T05:33:27.048000+05:30","date_accepted":"2025-09-25T05:34:58.588000+05:30","date_published":"2025-12-20T16:24:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/52943/galley/47899/download/"}]},{"pk":47360,"title":"Emergency Department Visit-Severity Algorithm for Immediate Care Clinic Visits","subtitle":null,"abstract":"Background: Immediate care clinics (ICC) account for a significant portion of acute, low-severity visits that preclude the use of resources from an emergency department (ED). Given the chronic issue of ED crowding and its detrimental effects on quality of care and health system efficiency, understanding and optimizing the use of ICCs for non-emergent visits could significantly alleviate pressures faced by EDs and improve patient satisfaction, as well as control the overall cost of care. This study describes the application of the Billings/Ballard severity algorithm to ICC visits over a seven-year period and compares the findings to previously published ED literature.
\nMethods: We obtained data from ICC visits within a large, academic health system. The analytical sample included 306,395 visits from 125,063 unique patients. We describe ICC patient characteristics and the Billings/Ballard severity classification. We used negative binomial regression analysis to evaluate the associations between patient characteristics and total visits to ICCs and primary care physician (PCP), and multivariate regression analysis to assess the relationship between ICC visit severity and patient characteristics, controlling for multiple visits per patient. The algorithm was also used to identify and classify the most common International Classification of Diseases, 9th and 10th modifications (ICD-9/10) diagnosis codes by severity.
\nResults: In total, 9.17% of ICC visits were classified as emergent, 81.25% as non-emergent, 0.79% as indeterminate, and 8.79% as unclassified, compared to literature-reported ED distributions of 37.90% emergent, 45.08% non-emergent, 11.32% indeterminate, and 5.70% unclassified. The ICC visits included a greater proportion of non-emergent presentations. The ICD-9/10 diagnosis distribution revealed a distinct ICC environment compared with that of the ED. The most frequent diagnoses among emergent ICC visits included chest pain, asthma exacerbation, and shortness of breath, while non-emergent visits were predominantly for upper respiratory tract infections. Within one year at the same healthcare system, 47% of patients had repeat ICC visits and 41% had primary care follow-up.
\nConclusion: These results demonstrate that immediate care clinics deliver predominantly non-emergent care as intended (81% vs 45% in the ED), potentially reducing ED crowding and validating current clinician- and patient-initiated referral practices. High rates of repeat ICC visits (47%) and follow-up with primary care physicians (41%) within the same healthcare system suggest these facilities foster care continuity while providing accessible, non-emergent care alternatives. However, user disparities persist as self-pay and uninsured patients show lower overall ICC use, while uninsured and publicly insured individuals present with emergent conditions more frequently than privately insured patients. These findings inform care-seeking education and health service delivery while highlighting the need to improve ICC accessibility across insurance types to optimize efficiency and patient outcomes.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Billings/Ballard Algorithm"},{"word":"Immediate Care"},{"word":"urgent care"},{"word":"Emergency Medicine"},{"word":"Primary Care"},{"word":"health systems"},{"word":"Health Care Utilization"}],"section":"Emergency Department Access","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2mk2p147","frozenauthors":[{"first_name":"Jacy","middle_name":"E.","last_name":"Neczypor","name_suffix":"","institution":"Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois","department":""},{"first_name":"Talar","middle_name":"W.","last_name":"Markossian","name_suffix":"","institution":"Loyola University Chicago, Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Maywood, Illinois","department":""},{"first_name":"Luther","middle_name":"","last_name":"Walls","name_suffix":"","institution":"University of Illinois, Department of Family and Community Medicine, College of Medicine, Chicago, Illinois","department":""},{"first_name":"Michael","middle_name":"","last_name":"Cirone","name_suffix":"","institution":"Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois","department":""},{"first_name":"Beatrice","middle_name":"D.","last_name":"Probst","name_suffix":"","institution":"Loyola University Medical Center, Department of Emergency Medicine, Maywood, Illinois","department":""}],"date_submitted":"2025-05-24T03:38:41.201000+05:30","date_accepted":"2025-09-12T00:11:36.989000+05:30","date_published":"2025-12-20T16:16:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47360/galley/47921/download/"}]},{"pk":46552,"title":"Respiratory Illness-related Emergency Visits Among Children, COVID-19 and Beyond: Observing a Return to Seasonal Patterns?","subtitle":null,"abstract":"Introduction: The COVID-19 pandemic disrupted care-seeking and respiratory disease epidemiology across healthcare settings, notably for emergency department (ED) care. The scope of this disruption and whether patterns of ED visits have returned to predictable seasonal patterns is of interest in planning ED staffing and resource availability for future illness surges, pandemic or not. We evaluated ED visits for acute respiratory illness among children in a large, integrated healthcare delivery system to describe illness and patient characteristics in the years before, during, and after the pandemic peak.
\nMethods: We conducted a cross-sectional study of ED visits among patients 0-17 years of age to the 21 EDs of Kaiser Permanente Northern California, from January 1, 2018–December 31, 2019, pre-pandemic; January 1, 2020–December 31, 2021, pandemic; and January 1, 2022–March 31, 2024, post-vaccine (vaccines for children > 5 years of age approved and available). We electronically extracted eligible ED visits with acute respiratory infection diagnoses and a range of sociodemographic, medical comorbidity, and utilization characteristics.
\nResults: We observed 151,983 pediatric ED visits with eligible respiratory infection diagnoses, 49,912 (32.8%) visits pre-pandemic, 27,109 (17.8%) visits during the pandemic, and 74,962 (49.3%) visits post-vaccine. Eligible visits dropped every month from 6,361 in February 2020, just prior to the pandemic onset, to their lowest volume (243) in June 2020. In the post-vaccine period, visits peaked at 10,638 in November 2022, the highest of any month during the study period. Sex, race/ethnicity, and tobacco exposure were comparable over time, but the proportion of visits by patients with under-immunized diagnosis trended upward over time. Upper respiratory infection (30% pre-pandemic, 32% pandemic, and 33% post-vaccine periods), asthma (15% pre-pandemic, 12% pandemic, and 12% post-vaccine periods), and cough (9.9% pre-pandemic, 12% pandemic, and 12% post-vaccine periods), were the top three diagnoses across all periods.
\nConclusion: In this cross-sectional study of acute respiratory illness-related ED visits in an integrated healthcare system, from 2022 onward seasonal variation in respiratory illness ED visits rebounded, with notable and unseasonal peaks in late 2022. COVID-19 appears to be a minor contributor to ED visits for pediatric respiratory illness. However, an increased overall and seasonal burden of ED visits has implications for surge planning and mitigation, with COVID-19 now being endemic and typical respiratory pathogens having resurfaced
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Pediatric EM"},{"word":"Infectious disease"}],"section":"Pediatrics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/19k3d2d5","frozenauthors":[{"first_name":"Mamata","middle_name":"V.","last_name":"Kene","name_suffix":"","institution":"The Permanente Medical Group, Oakland, California; Kaiser Foundation Hospital, Department of Emergency Medicine, Fremont, California","department":""},{"first_name":"Madeline","middle_name":"J.","last_name":"Somers","name_suffix":"","institution":"Kaiser Permanente Division of Research, Pleasanton, California","department":""},{"first_name":"Dustin","middle_name":"W.","last_name":"Ballard","name_suffix":"","institution":"The Permanente Medical Group, Oakland, California; Kaiser Permanente Division of Research, Pleasanton, California; Kaiser Foundation Hospital, Department of Emergency Medicine, San Rafael, California","department":""},{"first_name":"Dana","middle_name":"R.","last_name":"Sax","name_suffix":"","institution":"The Permanente Medical Group, Oakland, California; Kaiser Permanente Division of Research, Pleasanton, California; Kaiser Foundation Hospital, Department of Emergency Medicine, Oakland, California","department":""},{"first_name":"Mary","middle_name":"E.","last_name":"Reed","name_suffix":"","institution":"Kaiser Permanente Division of Research, Pleasanton, California","department":""},{"first_name":"Tara","middle_name":"L.","last_name":"Greenhow","name_suffix":"","institution":"The Permanente Medical Group, Oakland, California; Kaiser Foundation Hospital, Department of Pediatric Infectious Diseases, San Francisco, California","department":""}],"date_submitted":"2025-03-05T01:42:09.511000+05:30","date_accepted":"2025-09-12T00:16:14.083000+05:30","date_published":"2025-12-20T15:50:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/46552/galley/47913/download/"}]},{"pk":45709,"title":"Retrospective Comparison of Empiric Antivenom vs. Expectant Treatment for Eastern Coral Snakebites","subtitle":null,"abstract":"Introduction: The coral snake is the only native elapid in North America. Their venom contains potent neurotoxins. Historically, all confirmed/presumed bites were treated with antivenom whether or not symptoms were present. Production of antivenom ceased in 2003. The resultant national shortage prompted clinicians to investigate alternative treatment strategies such as a wait-and-see approach where antivenom is held until signs of systemic toxicity manifest. Now that production has resumed there is limited research available comparing these two treatment paradigms, empiric administration vs the wait-and-see approach. Our objective in this study was to compare outcomes of the two treatment paradigms to determine whether one is associated with better patient outcomes.
\nMethods: This was a retrospective analysis of coral snakebite cases reported to the Florida Poison Information Center Network from January 1, 1998–December 31, 2021. We collected demographic, clinical, and outcome variables. Patients were stratified into two groups, empiric antivenom administration vs the wait-and-see approach in patients who were asymptomatic in terms of systemic symptoms at the time of initial presentation to the emergency department. We used multivariable logistic regression models, controlling for whether the bite occurred during the North American Coral Snake Antivenin (NACSA) shortage period (yes/no), age, sex, and whether systemic effects developed (yes/no), to determine differences between study groups in the incidence of the main outcomes: intensive care unit (ICU) admission; intubation; and death, as well as ICU and hospital length of stay.
\nResults: We analyzed 301 cases: 171 (56.8%) empiric; and 130 (43.2%) wait-and-see. Patients in the empiric treatment group had approximately three times higher likelihood of ICU admission (empiric 121 [75.2%] and wait-and-see 71 [56.8%]), odds ratio [OR} 3.047, P = .05). There was no difference in the incidence of intubation (empiric 2 [1.2%] and wait-and-see 1 [<1%]), OR 2.486, P = .63) or in ICU length of stay (OR 0.485, P = .08). Of the patients treated with NACSA (191), adverse reactions to the antivenom occurred in 38 (19.9%) patients—35 patients in the empiric group and three in the wait-and-see group who later received antivenom. Of these 38 patients, eight (21.1%) experienced an anaphylactic reaction.
\nConclusion: Empiric North American Coral Snake Antivenin administration was associated with higher ICU admissions and with a considerably higher risk of adverse reactions, which may serve to impose caution when treating empirically.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Snake Envenomations"},{"word":"Emergency Medicine"},{"word":"Eastern Coral Snake"},{"word":"Snake Bites"},{"word":"Elapid Envenomations"},{"word":"Neuro-toxic Snake Envenomations"}],"section":"Toxicology","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3wm1442p","frozenauthors":[{"first_name":"Reeves","middle_name":"","last_name":"Simmons","name_suffix":"","institution":"University of Florida Health Jacksonville, Florida/USVI Poison Information Center-Jacksonville, Jacksonville, Florida","department":""},{"first_name":"Chiemela","middle_name":"","last_name":"Ubani","name_suffix":"","institution":"University of Florida Health Jacksonville, Florida/USVI Poison Information Center-Jacksonville, Jacksonville, Florida","department":""},{"first_name":"Gerard","middle_name":"","last_name":"Garvin","name_suffix":"","institution":"University of Florida College of Medicine-Jacksonville, Center for Data Solutions, Jacksonville, Florida","department":""},{"first_name":"Molly","middle_name":"","last_name":"Stott","name_suffix":"","institution":"University of Florida Health Jacksonville, Florida/USVI Poison Information Center-Jacksonville, Jacksonville, Florida","department":""},{"first_name":"Dawn","middle_name":"","last_name":"Sollee","name_suffix":"","institution":"University of Florida Health Jacksonville, Florida/USVI Poison Information Center-Jacksonville, Jacksonville, Florida; University of Florida College of Medicine-Jacksonville, Department of Emergency Medicine, Jacksonville, Florida","department":""},{"first_name":"Jay","middle_name":"","last_name":"Schauben","name_suffix":"","institution":"University of Florida Health Jacksonville, Florida/USVI Poison Information Center-Jacksonville, Jacksonville, Florida; University of Florida College of Medicine-Jacksonville, Department of Emergency Medicine, Jacksonville, Florida","department":""},{"first_name":"Alexandra","middle_name":"","last_name":"Derr","name_suffix":"","institution":"University of Florida College of Medicine-Jacksonville, Department of Emergency Medicine, Jacksonville, Florida","department":""},{"first_name":"Colleen","middle_name":"","last_name":"Cowdery","name_suffix":"","institution":"University of Florida College of Medicine-Jacksonville, Department of Emergency Medicine, Jacksonville, Florida","department":""},{"first_name":"Lindsay","middle_name":"","last_name":"Schaack Rothstein","name_suffix":"","institution":"University of Florida Health Jacksonville, Florida/USVI Poison Information Center-Jacksonville, Jacksonville, Florida","department":""},{"first_name":"Hayley","middle_name":"","last_name":"Gartner","name_suffix":"","institution":"University of Florida Health Jacksonville, Florida/USVI Poison Information Center-Jacksonville, Jacksonville, Florida","department":""},{"first_name":"Ashton","middle_name":"","last_name":"Federico","name_suffix":"","institution":"University of Florida College of Medicine-Jacksonville, Department of Emergency Medicine, Jacksonville, Florida","department":""},{"first_name":"Sophia","middle_name":"","last_name":"Sheikh","name_suffix":"","institution":"University of Florida Health Jacksonville, Florida/USVI Poison Information Center-Jacksonville, Jacksonville, Florida; University of Florida College of Medicine-Jacksonville, Department of Emergency Medicine, Jacksonville, Florida","department":""}],"date_submitted":"2025-03-19T20:58:08.319000+05:30","date_accepted":"2025-07-25T05:24:56.530000+05:30","date_published":"2025-12-20T15:00:00+05:30","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/45709/galley/47919/download/"}]}]}