{"count":39503,"next":"https://eartharxiv.org/api/articles/?format=json&limit=100&offset=7400","previous":"https://eartharxiv.org/api/articles/?format=json&limit=100&offset=7200","results":[{"pk":17644,"title":"Comparison of Pediatric Acute Appendicitis Before and During the COVID-19 Pandemic in New York City","subtitle":null,"abstract":"Background: \nAcute appendicitis (AA) is the most common abdominal surgical emergency in children and adolescents. In the year immediately following the declaration of the coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization (WHO), there was a precipitous decline in emergency department (ED) visits especially for surgical conditions and infectious diseases. Fear of exposure to severe acute respiratory coronavirus 2 infection resulted in delay in presentation and time to surgery, and a shift toward more conservative management.\nObjective:\n Our goal was to compare the incidence and severity of AA before and during the COVID-19 pandemic.\nMethods: \nPatients aged 2–18 years admitted with the diagnosis of AA to Flushing Hospital Medical Center or Jamaica Hospital Medical Center in Queens, New York, were selected for chart review. Data extracted from electronic health records included demographics, clinical findings, imaging studies, and operative and pathological findings. We calculated the Alvarado score (AS) for incidence and the American Association for the Surgery of Trauma (AAST) grade for severity. We compared patients admitted between March 1, 2018–February 29, 2020 (pre-pandemic) to patients admitted between March 1, 2020–February 28, 2021 (pandemic). We then compared pre-pandemic and pandemic groups to determine differences in pediatric AA incidence and severity.\nResults: \nOf 239 patients diagnosed with AA, 184 (77%) were in the pre-pandemic group and 55 (23%) in the pandemic group. Incidence (number per year) of AA declined by 40%. The pandemic group had significantly greater overall AS of ≥7, indicating increased likelihood to require surgery, (P = 0.04) and higher AAST grade demonstrating increased severity (P = 0.02).\nConclusion:\n There was a decline in the number of AA cases seen in our pediatric EDs and admitted during the first year of the pandemic. Clinicians need to be aware of increased severity of AA at time of presentation during public health emergencies such as a pandemic, possibly due to modified patient behavior.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"acute appendicitis, COVID-19, pediatrics, incidence, severity"}],"section":"Pediatrics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/48k1m9nc","frozenauthors":[{"first_name":"Priya","middle_name":"","last_name":"Mallikarjuna","name_suffix":"","institution":"Flushing Hospital Medical Center, Department of Pediatrics, Flushing, New York","department":"None"},{"first_name":"Saikat","middle_name":"","last_name":"Goswami","name_suffix":"","institution":"Flushing Hospital Medical Center, Department of Pediatrics, Flushing, New York","department":"None"},{"first_name":"Sandy","middle_name":"","last_name":"Ma","name_suffix":"","institution":"Flushing Hospital Medical Center, Department of Pediatrics, Flushing, New York","department":"None"},{"first_name":"Won","middle_name":"","last_name":"Baik-Han","name_suffix":"","institution":"Flushing Hospital Medical Center, Department of Pediatrics, Flushing, New York","department":"None"},{"first_name":"Kelly","middle_name":"L.","last_name":"Cervellione","name_suffix":"","institution":"Medisys Health Network, Department of Clinical Research, Jamaica, New York","department":"None"},{"first_name":"Gagan","middle_name":"","last_name":"Gulati","name_suffix":"","institution":"Flushing Hospital Medical Center, Department of Pediatrics, Flushing, New York","department":"None"},{"first_name":"Lily","middle_name":"Quon","last_name":"Lew","name_suffix":"","institution":"Flushing Hospital Medical Center, Department of Pediatrics, Flushing, New York","department":"None"}],"date_submitted":"2022-11-10T16:24:00+01:00","date_accepted":"2022-11-10T16:24:00+01:00","date_published":"2023-08-22T19:01:11+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17644/galley/9006/download/"}]},{"pk":17490,"title":"Exploring Muslim Women’s Reproductive Health Needs and Preferences in the Emergency Department","subtitle":null,"abstract":"Objective: \nWe explored individual Muslim women’s reproductive healthcare experiences, preferences, beliefs, and behaviors in the emergency department (ED) and in general.\nMethods:\n This was a qualitative study conducted at a community ED using semi-structured interviews with a piloted interview guide. We interviewed participants awaiting care in the ED with the following criteria: female gender; English or Arabic speaking; aged ≥18 years; and self-identified as Muslim. We conducted interviews in both English and Arabic until thematic saturation was reached. Transcripts were coded using an iteratively developed codebook, maintaining intercoder agreement greater than 80%. We used an inductive thematic analysis to identify themes, and results were interpreted in the context of interview language and patient’s age.\nResults:\n We interviewed 26 Muslim-identified female ED patients. We found that cultural representation and sensitivity among ED staff mitigated discrimination and promoted inclusion for Muslim ED patients. However, assumptions about Muslim identity also impacted the participants’ healthcare. Most participants endorsed a preference for a female clinician for their reproductive healthcare in general, but not necessarily for other areas of medicine. Clinician cultural concordance was not always preferred for participants in the ED due to fears about the loss of confidentiality. Marital status impacted beliefs about reproductive and sexual health in the context of Muslim identity. Overall, family planning was acceptable and encouraged in this patient population.\nConclusion: \nThe themes elucidated in this study may guide clinicians in developing culturally sensitive practices when providing reproductive healthcare to the Muslim population.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Muslim women, reproductive health, emergency department"}],"section":"Women's Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9p4745dq","frozenauthors":[{"first_name":"Anum","middle_name":"","last_name":"Naseem","name_suffix":"","institution":"Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan","department":"None"},{"first_name":"Morgan","middle_name":"","last_name":"Majed","name_suffix":"","institution":"Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan","department":"None"},{"first_name":"Samantha","middle_name":"","last_name":"Abdallah","name_suffix":"","institution":"Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan","department":"None"},{"first_name":"Mayssa","middle_name":"","last_name":"Saleh","name_suffix":"","institution":"Henry Ford Hospital Department of Emergency Medicine, Detroit, Michigan","department":"None"},{"first_name":"Meghan","middle_name":"","last_name":"Lirhoff","name_suffix":"","institution":"Henry Ford Hospital Department of Emergency Medicine, Detroit, Michigan","department":"None"},{"first_name":"Ahmed","middle_name":"","last_name":"Bazzi","name_suffix":"","institution":"Henry Ford Hospital Department of Emergency Medicine, Detroit, Michigan","department":"None"},{"first_name":"Martina","middle_name":"","last_name":"Caldwell","name_suffix":"","institution":"Henry Ford Hospital Department of Emergency Medicine, Detroit, Michigan","department":"None"}],"date_submitted":"2022-09-19T18:35:56+02:00","date_accepted":"2022-09-19T18:35:56+02:00","date_published":"2023-08-22T18:52:51+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17490/galley/8914/download/"}]},{"pk":17142,"title":"Gender and Inconsistent Evaluations: A Mixed-methods Analysis of Feedback for Emergency Medicine Residents","subtitle":null,"abstract":"Objectives: \nPrior research has demonstrated that men and women emergency medicine (EM) residents receive similar numerical evaluations at the beginning of residency, but that women receive significantly lower scores than men in their final year. To better understand the emergence of this gender gap in evaluations we examined discrepancies between numerical scores and the sentiment of attached textual comments.\nMethods:\n This multicenter, longitudinal, retrospective cohort study took place at four geographically diverse academic EM training programs across the United States from July 1, 2013–July 1, 2015 using a real-time, mobile-based, direct-observation evaluation tool. We used complementary quantitative and qualitative methods to analyze 11,845 combined numerical and textual evaluations made by 151 attending physicians (94 men and 57 women) during real-time, direct observations of 202 residents (135 men and 67 women).\nResults: \nNumerical scores were more strongly positively correlated with positive sentiment of the textual comment for men (r = 0.38, P &lt; 0.001) compared to women (r = −0.26, P &lt; 0.04); more strongly negatively correlated with mixed (r = −0.39, P &lt; 0.001) and negative (r = −0.46, P &lt; 0.001) sentiment for men compared to women (r = −0.13, P &lt; 0.28) for mixed sentiment (r = −0.22, P &lt; 0.08) for negative; and women were around 11% more likely to receive positive comments alongside lower scores, and negative or mixed comments alongside higher scores. Additionally, on average, men received slightly more positive comments in postgraduate year (PGY)-3 than in PGY-1 and fewer mixed and negative comments, while women received fewer positive and negative comments in PGY-3 than PGY-1 and almost the same number of mixed comments.\nConclusion:\n Women EM residents received more inconsistent evaluations than men EM residents at two levels: 1) inconsistency between numerical scores and sentiment of textual comments; and 2) inconsistency in the expected career trajectory of improvement over time. These findings reveal gender inequality in how attendings evaluate residents and suggest that attendings should be trained to provide all residents with feedback that is clear, consistent, and helpful, regardless of resident gender.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Medical Education"},{"word":"gender inequality"},{"word":"Emergency Medicine"},{"word":"Assessment"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3db1c2kg","frozenauthors":[{"first_name":"Alexandra","middle_name":"E.","last_name":"Brewer","name_suffix":"","institution":"University of Southern California: Los Angeles, Department of Sociology, Los Angeles, California","department":"None"},{"first_name":"Laura","middle_name":"","last_name":"Nelson","name_suffix":"","institution":"University of British Columbia, Department of Sociology, Vancouver, British Columbia, Canada","department":"None"},{"first_name":"Anna","middle_name":"S.","last_name":"Mueller","name_suffix":"","institution":"Indiana University, Department of Sociology, Bloomington, Indiana","department":"None"},{"first_name":"Rebecca","middle_name":"","last_name":"Ewert","name_suffix":"","institution":"Northwestern University, Chicago, Illinois","department":"None"},{"first_name":"Daniel","middle_name":"M.","last_name":"O'Connor","name_suffix":"","institution":"Massachusetts General Brigham Wentworth-Douglass Hospital, Dermatology and Skin Health, Dover, New Hampshire","department":"None"},{"first_name":"Arjun","middle_name":"","last_name":"Dayal","name_suffix":"","institution":"Rush Copley Medical Group, Aurora, Illinois","department":"None"},{"first_name":"Vineet","middle_name":"M.","last_name":"Arora","name_suffix":"","institution":"University of Chicago, Pritzker School of Medicine, Chicago, Illinois","department":"None"}],"date_submitted":"2022-07-26T00:43:21+02:00","date_accepted":"2022-07-26T00:43:21+02:00","date_published":"2023-08-22T18:43:57+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17142/galley/8660/download/"}]},{"pk":35199,"title":"A field report on Kongai language from Manipur, India","subtitle":null,"abstract":"This contribution introduces Kongai, a hitherto unreported Tibeto-Burman language spoken in Manipur, North-East India. This field report contains introductory sociolinguistic notes and preliminary information on Kongai phonological properties, such as syllable structure, rhymes, and prefixes. Additional linguistic data include the pronominal paradigm, comparative lexical materials, and a 100-items Swadesh wordlist.","language":"en","license":null,"keywords":[{"word":"Tibeto-Burman"},{"word":"kongai"},{"word":"ukhrul"}],"section":"Languages and Peoples of the Eastern Himalayan Region","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4db313cv","frozenauthors":[{"first_name":"Jessica","middle_name":"Katiuscia","last_name":"Ivani","name_suffix":"","institution":"University of Zurich","department":"None"}],"date_submitted":"2023-01-03T11:52:06+01:00","date_accepted":"2023-01-03T11:52:06+01:00","date_published":"2023-08-20T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/himalayanlinguistics/article/35199/galley/26198/download/"}]},{"pk":35196,"title":"Some preliminary notes on Challow, a Tibeto-Burman language from Manipur, India","subtitle":null,"abstract":"This contribution introduces Challow, a previously unreported and undescribed Tibeto-Burman language spoken in the Ukhrul district of Manipur, North-East India. It includes preliminary sociolinguistic, phonological, and lexical information, compared with data from other languages of the region. The study also offers a 100-items Swadesh wordlist of Challow lexical entries. At first glance, Challow reveals interesting properties, such as the presence of an original \np(ə̆)-\nprefix so far unattested in the languages of the area, and typologically rare phonological processes.","language":"en","license":null,"keywords":[{"word":"challow, Manipur, tibeto-burman"}],"section":"Languages and Peoples of the Eastern Himalayan Region","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5p52z5hq","frozenauthors":[{"first_name":"Jessica","middle_name":"Katiuscia","last_name":"Ivani","name_suffix":"","institution":"University of Zurich","department":"None"}],"date_submitted":"2022-12-20T15:37:36+01:00","date_accepted":"2022-12-20T15:37:36+01:00","date_published":"2023-08-20T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/himalayanlinguistics/article/35196/galley/26197/download/"}]},{"pk":45962,"title":"Gemella Endocarditis","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8d7767j0","frozenauthors":[{"first_name":"Samir","middle_name":"","last_name":"Bhalla","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Tina","middle_name":"","last_name":"Kapadia","name_suffix":"DO","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:24:21+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45962/galley/34694/download/"}]},{"pk":45961,"title":"Postoperative Pupil Dilation – Scopolamine Induced Anisocoria","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/92x7r6vm","frozenauthors":[{"first_name":"Aleksey","middle_name":"","last_name":"Korolyov","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Angela","middle_name":"","last_name":"Kleiber","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:22:21+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45961/galley/34693/download/"}]},{"pk":45960,"title":"Shared Medical Appointments: A Compendium to Implementation","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Commentary"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0gf9h9sp","frozenauthors":[{"first_name":"Courtney","middle_name":"","last_name":"DeCan","name_suffix":"MD, MPH","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Kaahukane","middle_name":"L.","last_name":"Yo","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Arielle","middle_name":"","last_name":"Sommer","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Gifty","middle_name":"","last_name":"Ntim","name_suffix":"MD, MPH","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Elizabeth","middle_name":"","last_name":"Ko","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:20:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45960/galley/34692/download/"}]},{"pk":45959,"title":"Recurrent Goiter and Hyperthyroidism after Total Thyroidectomy","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9nb498b5","frozenauthors":[{"first_name":"Dina","middle_name":"","last_name":"Kamel","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Jeong-hee","middle_name":"","last_name":"Ku","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:17:27+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45959/galley/34691/download/"}]},{"pk":45958,"title":"Treatment of Refractory Norovirus Enteritis in a Pediatric Hematopoietic Stem Cell Transplant Recipient","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/92z0p77x","frozenauthors":[{"first_name":"Ekra","middle_name":"","last_name":"Rai","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Noah","middle_name":"","last_name":"Federman","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:15:11+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45958/galley/34690/download/"}]},{"pk":45957,"title":"Cannabinoid Hyperemesis Syndrome vs. Cyclical Vomiting Syndrome","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4k84h6r2","frozenauthors":[{"first_name":"Jason","middle_name":"","last_name":"Bahk","name_suffix":"MD, FACP","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Bryan","middle_name":"","last_name":"Lopez","name_suffix":"MD, FACP","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:10:46+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45957/galley/34689/download/"}]},{"pk":45956,"title":"Severely Depressed Testosterone in a 20-Year-Old Male","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6v79q7j8","frozenauthors":[{"first_name":"Robert","middle_name":"","last_name":"Li","name_suffix":"MD, PhD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:09:20+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45956/galley/34688/download/"}]},{"pk":45955,"title":"An Adult with Severe Phenotype of Roifman Syndrome","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2hm0t9p0","frozenauthors":[{"first_name":"Tara","middle_name":"","last_name":"Shahrvini","name_suffix":"BS, BA","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Amit","middle_name":"","last_name":"Levi","name_suffix":"BS, BA","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:08:04+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45955/galley/34687/download/"}]},{"pk":45954,"title":"Alcohol Use Disorder in the Preoperative Setting","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/62q096vp","frozenauthors":[{"first_name":"Khushboo","middle_name":"K.","last_name":"Akkad","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:06:14+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45954/galley/34686/download/"}]},{"pk":45953,"title":"Anabolic Steroid Induced Myocardial Infarction","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9rp814m2","frozenauthors":[{"first_name":"Nikita","middle_name":"","last_name":"Mogar","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Shalini","middle_name":"","last_name":"Bhat","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:04:26+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45953/galley/34685/download/"}]},{"pk":45952,"title":"Live-Attenuated Vaccination for Rheumatic Patient","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5v17g1vp","frozenauthors":[{"first_name":"Howard","middle_name":"H.","last_name":"Yang","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:02:53+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45952/galley/34684/download/"}]},{"pk":45951,"title":"An Unusual Case of Purulent Pericarditis","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5q59n9cn","frozenauthors":[{"first_name":"Jonathan","middle_name":"","last_name":"Gordin","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T19:01:10+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45951/galley/34683/download/"}]},{"pk":45950,"title":"Successful Management of Chronic Urticaria with Change in Omalizumab Formulation","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6fd9s2xb","frozenauthors":[{"first_name":"Andrew","middle_name":"","last_name":"Pham","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Lisa","middle_name":"","last_name":"Kohn","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Ami","middle_name":"","last_name":"Philipp","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T18:52:21+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45950/galley/34682/download/"}]},{"pk":45949,"title":"Propofol Sedation for GI Endoscopy in a Cannabis User","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0r80d3cn","frozenauthors":[{"first_name":"Bijan","middle_name":"","last_name":"Navidi","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T18:46:42+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45949/galley/34681/download/"}]},{"pk":45948,"title":"Ultrasound-Guided Lumbar Puncture","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/50c7w6b3","frozenauthors":[{"first_name":"Jasmine","middle_name":"","last_name":"Deng","name_suffix":"BA","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Julie","middle_name":"","last_name":"Magorien","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T18:44:52+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45948/galley/34680/download/"}]},{"pk":45947,"title":"Vaccinations in Rheumatology","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9mm7r8cr","frozenauthors":[{"first_name":"Yaqoot","middle_name":"","last_name":"Khan","name_suffix":"DO","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T18:43:44+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45947/galley/34679/download/"}]},{"pk":45946,"title":"A Young Man with Polycystic Kidneys’ Journey to End Stage Kidney Failure","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5zv431g7","frozenauthors":[{"first_name":"Niloofar","middle_name":"","last_name":"Nobakht","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Afshin","middle_name":"","last_name":"Pirzadeh","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Amir","middle_name":"","last_name":"Pirooz","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Mohammad","middle_name":"","last_name":"Kamgar","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T18:42:32+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45946/galley/34678/download/"}]},{"pk":45945,"title":"Challenges of Diagnosing and Treating Insulinoma in Patients with Co-Morbidities","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3z20v19v","frozenauthors":[{"first_name":"Jeong-hee","middle_name":"","last_name":"Ku","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Dina","middle_name":"","last_name":"Kamel","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T18:39:26+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45945/galley/34677/download/"}]},{"pk":45944,"title":"Suprascapular Neuropathy Caused by a Spinoglenoid Cyst","subtitle":null,"abstract":"","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Clinical Vignette"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0q51x2tv","frozenauthors":[{"first_name":"Ronald","middle_name":"","last_name":"Tsao","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"},{"first_name":"Lindsay","middle_name":"","last_name":"Wells","name_suffix":"MD","institution":"University of California, Los Angeles","department":"Medicine"}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-17T18:36:13+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucladom_proceedings/article/45944/galley/34676/download/"}]},{"pk":42184,"title":"Review of Applying Anthropology to General Education: Reshaping Colleges and Universities for the 21st Century. Jennifer R. Weis and Hillary J. Haldane, eds.","subtitle":null,"abstract":"","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7z4029vn","frozenauthors":[{"first_name":"Kathryn","middle_name":"A.","last_name":"King","name_suffix":"","institution":"University of Arkansas-Little Rock","department":"None"}],"date_submitted":"2023-05-30T23:59:08+02:00","date_accepted":"2023-05-30T23:59:08+02:00","date_published":"2023-08-15T20:29:53+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/teachinglearninganthro/article/42184/galley/31496/download/"}]},{"pk":17931,"title":"Improvement in Resident Scholarly Output with Implementation of a Scholarly Activity Guideline and Point System","subtitle":null,"abstract":"Introduction:\n Ensuring high-quality scholarly output by graduate medical trainees can be a challenge. Within many specialties, including emergency medicine (EM), it is unclear what constitutes appropriate resident scholarly activity. We hypothesized that the quantity and quality of scholarly activity would improve with a clearer guideline, including a point system for eligible scholarly activities.\nMethods: \nA resident Scholarly Activity Guideline was implemented for EM residents in a university setting. The guideline consists of a point system in which point values, ranging from 1–10, are assigned to various types of scholarly activities. Residents must earn at least 10 points and present their work to meet their scholarly graduation requirement. We tracked scholarly activities for graduates from the classes of 2014–2020, with the guideline being implemented for the class of 2016. In a blind analysis, we compared median total points per resident, mean counts of the Boyer model of scholarship components per resident, and mean counts of significant scholarly output per resident before vs after the guideline was implemented. Significant scholarly output was defined as an implemented protocol,a research project with data collection and analysis, a research abstract presentation, or an oral abstract presentation.\nResults: \nAmong 64 residents analyzed, 48 residents used the guideline. We found that median points per resident increased after the guideline was implemented (median, interquartile range: before 7 [7], after 11 [10, 13], P = 0.002). Post-guideline scholarly activities were found to represent more of Boyer’s components of scholarship [mean before 0.81 [SD 0.40], mean after 1.52 [SD 0.71], mean difference 0.71, 95% confidence interval [CI] 0.332 ± 1.09, P &lt; 0.001. There was no difference in the mean significant scholarly output per resident (mean before 1.38 [SD 1.02], mean after 1.02 [SD 1.00], mean difference 0.35, 95% CI 0.93 ± 0.23, P = 0.23).\nConclusion:\n Implementation of a Scholarly Activity Guideline point system significantly increased the quantity and, by one of two measures, increased the quality of scholarly output in our program. Our point-based guideline successfully incorporated traditional and modern forms of scholarship that can be tailored to resident interests.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"resident scholarship"},{"word":"scholarly activity"}],"section":"Education","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7dg1x28t","frozenauthors":[{"first_name":"Lauren","middle_name":"","last_name":"Evans","name_suffix":"","institution":"University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"},{"first_name":"Sarah","middle_name":"","last_name":"Greenberger","name_suffix":"","institution":"University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"},{"first_name":"Rachael","middle_name":"","last_name":"Freeze-Ramsey","name_suffix":"","institution":"University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"},{"first_name":"Amanda","middle_name":"","last_name":"Young","name_suffix":"","institution":"University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"},{"first_name":"Crystal","middle_name":"","last_name":"Sparks","name_suffix":"","institution":"University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"},{"first_name":"Rawle","middle_name":"","last_name":"Seupaul","name_suffix":"","institution":"University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"},{"first_name":"Travis","middle_name":"","last_name":"Eastin","name_suffix":"","institution":"University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"},{"first_name":"Carly","middle_name":"","last_name":"Eastin","name_suffix":"","institution":"University of Arkansas for Medical Sciences, College of Medicine, Department of Emergency Medicine, Little Rock, Arkansas","department":"None"}],"date_submitted":"2023-03-06T06:14:08+01:00","date_accepted":"2023-03-06T06:14:08+01:00","date_published":"2023-08-15T18:44:04+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17931/galley/9150/download/"}]},{"pk":54627,"title":"Transcending Boundaries: Blood Writing as a Catalyst for Transformation","subtitle":null,"abstract":"This paper delves into the practice of blood writing in Chinese Buddhism, a unique ascetic ritual dating back to the 6th century CE. Blood writing involves practitioners using their blood to transcribe sacred texts, both embodying sacred Buddhist scriptures and imbuing the practitioner with power. This work traces the origins of blood writing as a reflection of indigenous Chinese beliefs surrounding blood, the body, and morality while drawing attention to the influence of Indian Buddhist ideologies on this practice. Historical and ethnographic accounts of blood writing emphasize its transformative power, not only for individual practitioners but also for broader sociopolitical dynamics. Drawing on multiple embodiment theories, this work analyzes the performative nature of blood writing, highlighting its role in shaping cultural values and ideologies. Blood writing transcends conventional boundaries, embodying spiritual and cultural values, and ultimately serves as a potent force for socioreligious and political change.","language":"en","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"Blood Writing, Buddhism, Asceticism, Embodiment, Socioreligious and Political Transformation"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6q31q6r5","frozenauthors":[{"first_name":"Ethan","middle_name":"","last_name":"Lee","name_suffix":"","institution":"University of California, Los Angeles","department":""}],"date_submitted":"2024-08-16T02:34:50+02:00","date_accepted":"2024-08-16T02:34:50+02:00","date_published":"2023-08-15T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/alephucla/article/54627/galley/41171/download/"}]},{"pk":42160,"title":"Making Sense of a Pandemic through Trauma-Informed Pedagogy and the Value of Medical Anthropology","subtitle":null,"abstract":"It is difficult to describe the experience of living through the COVID-19 global pandemic while simultaneously teaching anthropology and sociology courses to undergraduates. My students and I experienced together not just the fear of sickness and death, but also social issues in the U.S. made more visible by the pandemic, such as racial tensions, challenges related to access to health care, and consequences of the social determinants of health. The “normal” that many are hoping we return to was heavily shaped by neoliberal policies that conceptualize health and illness as well as personhood in particular ways, such as through defining social problems as medical in nature and using medicine as a form of social control. The issue for us as educators, however, is that stress, depression, and anxiety are normal reactions to real conditions that we are all experiencing, albeit with strikingly different foundations and resources. In this paper I reflect on my own experiences in the classroom and discuss how I incorporated theoretical constructs of intersectional trauma, or trauma-informed pedagogy. I will showcase how I teach students these concepts through medical anthropology. I highlight how these concepts have helped students make sense of the impacts of the COVID-19 pandemic, and I argue that this framing is useful for understanding other crises for students and professors alike.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Medical anthropology"},{"word":"medical sociology"},{"word":"COVID-19 pandemic"},{"word":"explanatory models"},{"word":"Medicalization"},{"word":"structural violence"},{"word":"trauma-informed pedagogy"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2nq8m00p","frozenauthors":[{"first_name":"Shelly","middle_name":"","last_name":"Yankovskyy","name_suffix":"","institution":"Valdosta State University","department":"None"}],"date_submitted":"2021-10-15T23:20:47+02:00","date_accepted":"2021-10-15T23:20:47+02:00","date_published":"2023-08-15T02:14:10+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/teachinglearninganthro/article/42160/galley/31480/download/"}]},{"pk":1546,"title":"57-Year-Old Male Veteran with Recurrent Fevers","subtitle":null,"abstract":"<p class=\"MsoNormal\" style=\"line-height:200%;\">A 57-year-old male veteran presented to the emergency department for recurrent fevers for 10 days. The patient was febrile but had an overall benign physical exam. This interesting case explores the broad differential diagnosis and evaluation in a patient who presents with fever of unknown origin.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"liver abscess"},{"word":"E. histolytica"},{"word":"CPC"}],"section":"Clinicopathological Cases from the University of Maryland","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0c15k49q","frozenauthors":[{"first_name":"Eileen","middle_name":"","last_name":"Chu","name_suffix":"","institution":"University of Maryland Medical Center, Baltimore, Maryland","department":""},{"first_name":"Samantha","middle_name":"A.","last_name":"King","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland","department":""},{"first_name":"Laura","middle_name":"J","last_name":"Bontempo","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland","department":""},{"first_name":"T.","middle_name":"Andrew","last_name":"Windsor","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland","department":""}],"date_submitted":"2023-07-19T09:09:53.114000+02:00","date_accepted":"2023-07-21T00:31:05.052000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1546/galley/1125/download/"}]},{"pk":1549,"title":"A Case Report of Nitrous Oxide-induced Myelopathy: An Unusual Cause of Weakness in an Emergency Department","subtitle":null,"abstract":"<p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"><b style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">Introduction:</b> Weakness is a common symptom that within itself does not indicate a specific diagnosis. Recreational inhalant use such as nitrous oxide (NO) may not often be disclosed. Additionally, professional or occupational history, such as being a dentist or dental assistant, should be determined because of higher reported rates of NO misuse.<sup style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">1</sup> Nitrous oxide can cause vitamin B<sub style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">12</sub> deficiency and resulting neuropathy. Nitrous oxide toxicity can have a wide variation of presentations with or without laboratory abnormalities or remarkable imaging findings, which can further complicate a diagnosis of weakness secondary to NO use.<span class=\"Apple-converted-space\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">&nbsp;</span></p><p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"><b style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">Case Report:</b> A 33-year-old female presented to the emergency department with progressive bilateral leg numbness and objective weakness after repeated recreational NO use. After an extensive workup, she was found to have vitamin B<sub style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">12</sub> deficiency and an electromyography study consistent with myeloneuropathy, despite normal imaging. She was prescribed high-dose vitamin B<sub style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">12</sub> therapy and stopped using NO. One year after diagnosis, our patient maintained NO sobriety and had near-complete resolution of prior neurologic deficits.<span class=\"Apple-converted-space\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">&nbsp;</span></p><p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"><b style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">Conclusion: </b>The use of recreational inhalant and the patient’s occupation should be considered when a patient presents with weakness. Obtaining vitamin B<sub style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">12</sub> and methylmalonic acid levels should be considered for diagnosis. However, NO-induced neuropathy can be seen in patients with normal vitamin B<sub style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">12</sub> and methylmalonic levels and patients do not always have abnormal imaging findings. The healthcare team should consider the varied presentations and findings of substance-induced conditions such as NO toxicity.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Vitamin B12 neuropathy; nitrous oxide; weakness; case report"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/68r4344s","frozenauthors":[{"first_name":"Madeleine","middle_name":"S.","last_name":"Birch","name_suffix":"","institution":"Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California","department":""},{"first_name":"Emmelyn","middle_name":"J.","last_name":"Samones","name_suffix":"","institution":"Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California","department":""},{"first_name":"Tammy","middle_name":"","last_name":"Phan","name_suffix":"","institution":"Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California","department":""},{"first_name":"Mindi","middle_name":"","last_name":"Guptill","name_suffix":"","institution":"Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California","department":""}],"date_submitted":"2023-07-19T17:38:59.417000+02:00","date_accepted":"2023-07-19T17:43:33.935000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1549/galley/1136/download/"}]},{"pk":1581,"title":"Acute Epiglottitis Secondary to the Severe Acute Respiratory Syndrome Coronavirus 2: A Case Report","subtitle":null,"abstract":"<p><b>Introduction:</b> Acute epiglottis is a rapidly progressive, potentially life-threatening infection causing inflammation of the epiglottis and adjacent supraglottic structures.1-2 Since the introduction of the Haemophilus influenzae vaccine, the incidence of pediatric cases has decreased dramatically while adult instances have increased.1-4 Likewise, the etiology has changed considerably with the increasing prevalence of other causative bacterial and viral pathogens.1-4&nbsp;</p><p><b>Case Report</b>: We present a novel case of acute epiglottis secondary to infection with the severe acute respiratory syndrome coronavirus 2. This case report highlights the changing landscape of epiglottitis and the importance of airway assessment.</p><p><b>Conclusion:</b> Present-day epiglottitis differs greatly from our traditional understanding. Numerous etiologies beyond Haemophilus influenzae now afflict adults predominately. As a clinically significant, novel complication of coronavirus disease 2019, acute epiglottitis is a life-threatening airway emergency. Emergency physicians must maintain a high index of suspicion, especially given the evolving clinical landscape. Early airway assessment with nasopharyngolaryngoscopic is critical.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"airway emergencies; epiglottitis; coronavirus disease 2019; case report"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6hg8q434","frozenauthors":[{"first_name":"Melissa","middle_name":"","last_name":"Gunchenko","name_suffix":"","institution":"Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":""},{"first_name":"Mohammad","middle_name":"","last_name":"Abboud","name_suffix":"","institution":"Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":""},{"first_name":"Zachary","middle_name":"W.","last_name":"Risler","name_suffix":"","institution":"Nazareth Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":""},{"first_name":"Ryan","middle_name":"C.","last_name":"Gibbons","name_suffix":"","institution":"Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":""}],"date_submitted":"2023-08-02T00:41:20.220000+02:00","date_accepted":"2023-08-02T00:44:14.386000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1581/galley/1134/download/"}]},{"pk":1545,"title":"Acute Focal Bacterial Nephritis in a Patient with Solitary Kidney: Case Report","subtitle":null,"abstract":"<p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"></p><span style=\"color: rgb(0, 0, 0); margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 16px; line-height: normal; font-family: Arial;\"><p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 16px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"><span style=\"font-weight: bold; margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 16px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\">Introduction: </span>Acute focal bacterial nephritis is an underdiagnosed condition. It clinically resembles acute pyelonephritis. If unrecognized and undertreated, it may progress into complications (kidney abscess and scars). Contrast-enhanced computed tomography (CT) reveals specific images of the disease and is considered the gold standard to make the diagnosis.<span class=\"Apple-converted-space\" style=\"font-size: 16px; color: rgb(0, 0, 0);\">&nbsp;</span></p><p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 16px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"><span style=\"font-weight: bold; font-size: 16px; color: rgb(0, 0, 0);\">Case Report: </span>A 63-year-old male patient with solitary kidney presented with symptoms compatible with acute pyelonephritis. Kidney ultrasound was not conclusive. Because of persisting high-grade fever not resolving after 48 hours of antibiotics, a contrast-enhanced CT was then performed, and the diagnosis of acute focal bacterial nephritis was made. A repeat CT after three weeks of intravenous (IV) antibiotics showed marked improvement of the intrarenal lesions, and a fourth week of IV antibiotics was dispensed.</p><p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 16px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"><span class=\"s1\" style=\"letter-spacing: 0.1px; font-size: 16px; color: rgb(0, 0, 0);\"><span style=\"font-weight: bold; font-size: 16px; color: rgb(0, 0, 0);\">Conclusion: </span>Diagnosing acute focal bacterial nephritis is important (particularly in a patient with solitary kidney). This will dictate the therapy duration. Unlike acute pyelonephritis, acute focal bacterial nephritis requires at least three weeks duration of antibiotics to avoid progress into further complications.<span class=\"Apple-converted-space\" style=\"font-size: 16px; color: rgb(0, 0, 0);\">&nbsp;</span></p></span><p class=\"p1\" style=\"font-weight: bold; margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 16px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"></p></span><p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"></p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"acute focal bacterial nephritis; acute lobar nephronia; case report"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4hh063qq","frozenauthors":[{"first_name":"Adnane","middle_name":"","last_name":"Guella","name_suffix":"","institution":"University Hospital, Department of Internal Medicine, Sharjah, United Arab Emirates","department":""},{"first_name":"Rabab","middle_name":"Zaka","last_name":"Muhammad","name_suffix":"","institution":"University Hospital, Department of Internal Medicine, Sharjah, United Arab Emirates","department":""},{"first_name":"Mahdi","middle_name":"","last_name":"Aljallabi","name_suffix":"","institution":"University Hospital, Department of Emergency Medicine, Sharjah, United Arab Emirates","department":""},{"first_name":"Abeer","middle_name":"","last_name":"Mursi","name_suffix":"","institution":"University Hospital, Department of Emergency Medicine, Sharjah, United Arab Emirates","department":""},{"first_name":"Mohamed","middle_name":"","last_name":"Elmahi","name_suffix":"","institution":"University Hospital, Department of Internal Medicine, Sharjah, United Arab Emirates","department":""}],"date_submitted":"2023-07-19T08:30:34.243000+02:00","date_accepted":"2023-07-19T08:39:16.774000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1545/galley/1135/download/"}]},{"pk":1601,"title":"A Man with Severe, Left Lower Quadrant Abdominal Pain","subtitle":null,"abstract":"<p><b>Case presentation:</b>&nbsp; An 84-year-old man presented to the emergency department with sudden, left lower quadrant cramping pain. Because critical hypotension was noted, point-of-care ultrasonography (POCUS) was performed immediately. The study revealed a pulsatile flow extravasating from the left common iliac artery into the left psoas muscle with hypoechoic para-aortic fluid collection.&nbsp;</p><p><b>Discussion:</b> Common iliac artery rupture is rare and has nonspecific clinical presentations. A quick disposition can be made with a combination of clinical manifestations and POCUS results.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Common iliac artery rupture"},{"word":"diagnostic ultrasound"},{"word":"POCUS"}],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3nq5c6fm","frozenauthors":[{"first_name":"Ta-Jen","middle_name":"","last_name":"Wen","name_suffix":"","institution":"Tri-Service General Hospital, National Defense Medical Center, Department of Emergency Medicine, Taipei, Taiwan","department":""},{"first_name":"Yu-Te","middle_name":"","last_name":"Su","name_suffix":"","institution":"Tri-Service General Hospital, National Defense Medical Center, Department of Emergency Medicine, Taipei, Taiwan","department":""},{"first_name":"Hung-Yen","middle_name":"","last_name":"Ke","name_suffix":"","institution":"Tri-Service General Hospital, National Defense Medical Center, Division of Cardiovascular Surgery, Department of Surgery, Taipei, Taiwan","department":""},{"first_name":"Kuan-Cheng","middle_name":"","last_name":"Lai","name_suffix":"","institution":"Chiayi Branch, Taichung Veterans General Hospital, Department of Emergency Medicine, Chiayi, Taiwan","department":""}],"date_submitted":"2023-08-09T20:39:30.556000+02:00","date_accepted":"2023-08-09T20:44:08.066000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1601/galley/1145/download/"}]},{"pk":1580,"title":"A Previously Healthy Infant with Lemierre Syndrome in the Emergency Department: Case Report","subtitle":null,"abstract":"<p><b>Introduction:</b> Lemierre syndrome (LS) is a rare condition with a high mortality risk. It is well described in older children and young adults involving bacteremia, thrombophlebitis, and metastatic abscess commonly due to Fusobacterium infections. Young, pre-verbal children are also susceptible to LS; thus, careful attention must be given to their pattern of symptoms and history to identify this condition in the emergency department (ED).&nbsp;</p><p><b>Case Report:</b> A 12-month-old previously healthy boy with a recent diagnosis of acute otitis media and viral illness presented to the ED with a complaint of fever. Additional symptoms developed at the head and neck and were noted on subsequent ED visits. Advanced imaging revealed significant lymphadenopathy and deep space inflammation extending to the mediastinum. Subsequent imaging confirmed extensive sinus and deep vein thromboses, consistent with LS. Methicillin-resistant Staphylococcus aureus (MRSA) was the only organism identified. After surgical debridement, appropriate intravenous antibiotics, and heparin anticoagulation therapy, the patient experienced full recovery after prolonged hospitalization.</p><p><b>Conclusion:</b> A febrile infant with multiple acute care visits and development of lymphadenopathy, decreased oral intake, decreased cervical range of motion, and sepsis should raise suspicion for Lemierre syndrome. The medical evaluation of deep neck spaces and deep veins should be similar to that of older children and adults with LS, including advanced imaging of the head and neck. However, medical management should particularly target MRSA due to its emerging prevalence among infantile LS cases. Further research is necessary to determine the optimal management strategies of LS for this age group.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"infant; pediatric; Lemierre; thrombus; thrombophlebitis; MRSA; mediastinitis; case report"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4wb342sm","frozenauthors":[{"first_name":"Adeola","middle_name":"Adekunbi","last_name":"Kosoko","name_suffix":"","institution":"University of Texas Health Sciences Center at Houston, Department of Emergency Medicine, Houston, Texas","department":""},{"first_name":"Omoyeni","middle_name":"O.","last_name":"Clement","name_suffix":"","institution":"University of Texas Health Sciences Center at Houston, Department of Emergency Medicine, Houston, Texas","department":""}],"date_submitted":"2023-08-02T00:16:37.416000+02:00","date_accepted":"2023-08-02T00:19:17.831000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1580/galley/1132/download/"}]},{"pk":1622,"title":"CPC-EM Full Text Issue","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"CPC-EM Full-Text Issue","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6zt0p7db","frozenauthors":[{"first_name":"Cassandra","middle_name":"","last_name":"Saucedo","name_suffix":"","institution":"UC Irvine","department":""}],"date_submitted":"2023-08-14T20:58:12.967000+02:00","date_accepted":"2023-08-14T20:59:42.629000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1622/galley/1126/download/"}]},{"pk":1463,"title":"Delayed-onset Angioedema Following a Snakebite in a  Patient on ACE Inhibitors: A Case Report","subtitle":null,"abstract":"<p><b>Introduction: </b>Angiotensin converting enzyme inhibitors (ACEI) are a common class of medications prescribed to patients for hypertension. Anti-hypertensive use is not normally considered an important factor when treating patients with crotalid envenomations; however, in combination with the venom in this patient, it may have resulted in angioedema.</p><p><br></p><p><b>Case Report:</b> A 65-year-old male on ACEI presented to his community emergency department following a snake envenomation to his thumb. Six vials of Crotalidae polyvalent immune fab were administered, and he was transferred to a referral center. Approximately 18 hours after the envenomation, the patient complained of tongue swelling and difficulty speaking. There was evidence of angioedema, with the right side of the tongue significantly enlarged compared to the left. He was intubated for airway protection and remained on a ventilator for three days.&nbsp;</p><p><br></p><p><b>Conclusion: </b>Angiotensin converting enzyme inhibitors may potentiate the effects of exogenous bradykinin as some snake venom has naturally occurring bradykinin, which may further amplify its effects. Extra vigilance may be warranted for the development of angioedema in patients receiving ACEI.</p>","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"case report; angioedema; Crotalidae polyvalent immune fab; snakebite"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2cr9f8xm","frozenauthors":[{"first_name":"Christopher","middle_name":"Scott","last_name":"Sampson","name_suffix":"","institution":"University of Missouri School of Medicine, Department of Emergency Medicine, Columbia, Missouri","department":""},{"first_name":"Evan","middle_name":"","last_name":"Schwarz","name_suffix":"","institution":"Washington University School of Medicine in Saint Louis, Department of Emergency Medicine, Saint Louis, Missouri","department":""}],"date_submitted":"2023-06-27T03:45:43.682000+02:00","date_accepted":"2023-06-27T03:50:06.346000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1463/galley/1140/download/"}]},{"pk":1245,"title":"Emergency Department Point-of-care Ultrasound Identification of Suspected Lemierre’s Syndrome: A Case Report","subtitle":null,"abstract":"<p><b>Introduction: </b>Lemierre’s syndrome is septic thrombophlebitis of the internal jugular vein, most commonly associated with head and neck infections. While central catheters are associated with venous thromboembolism and catheter-associated bacterial infections, cases of Lemierre’s syndrome caused by central catheters are extraordinarily rare.</p><p><b>Case Report: </b>We detail a case of Lemierre’s syndrome resulting from a peripherally inserted central catheter in a pregnant female patient. Diagnosis of this rare and potentially life-threatening disease process was expedited using point-of-care ultrasound.&nbsp;&nbsp;</p><p><b>Conclusion: </b>Diagnosis of rare but potentially life- or limb-threatening pathologies is paramount to the successful practice of emergency medicine. Identifying these rare disease processes requires a high index of suspicion and a work-up strategy that includes consideration of medical history in combination with lab and imaging findings to determine appropriate interventions.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Case report; septic thrombophlebitis; Lemierre’s syndrome; point-of-care ultrasound"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1vm9v60z","frozenauthors":[{"first_name":"Paul","middle_name":"","last_name":"Craven","name_suffix":"","institution":"West Virginia University, Department of Emergency Medicine, Morgantown, West Virginia","department":""},{"first_name":"Bradley","middle_name":"","last_name":"End","name_suffix":"","institution":"West Virginia University, Department of Emergency Medicine, Morgantown, West Virginia","department":""},{"first_name":"Peter","middle_name":"","last_name":"Griffin","name_suffix":"","institution":"West Virginia University, Department of Emergency Medicine, Morgantown, West Virginia","department":""}],"date_submitted":"2023-03-27T07:22:11.474000+02:00","date_accepted":"2023-06-05T22:39:09.147000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1245/galley/1138/download/"}]},{"pk":1587,"title":"Erector Spinae Plane Block Performed in the Emergency Department for Abdominal Pain: A Case Series","subtitle":null,"abstract":"<p><b>Introduction:</b> Ultrasound-guided nerve blocks are fast becoming a core part of opioid- sparing, multimodal, acute pain management in the emergency department (ED) setting. The ultrasound-guided erector spinae plane block (ESPB) has been shown to be effective in treating a variety of musculoskeletal and neuropathic painful conditions in the ED.&nbsp;</p><p><b>Case Series:</b> Here we report the effective use of the ESPB for pain control in four patients who presented with acute abdominal pain related to biliary obstruction in a resource-limited setting.&nbsp;</p><p><b>Conclusion:</b> The ESPB may be helpful in treating abdominal pain related to biliary obstruction, which is a novel indication for this well-established technique. This application is particularly relevant in resource-limited settings with significant delay in definitive surgical management. Further research is needed prior to widespread adoption.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Erector spinae block; regional anesthesia; multimodal pain control; ultrasound-guided nerve blocks; case series"}],"section":"Case Series","is_remote":true,"remote_url":"https://escholarship.org/uc/item/46j6728n","frozenauthors":[{"first_name":"Daniel","middle_name":"","last_name":"Parsons-Moss","name_suffix":"","institution":"Hennepin County Medical Center, Department of Emergency Medicine, Minneapolis, Minnesota","department":""},{"first_name":"David","middle_name":"","last_name":"Martin","name_suffix":"","institution":"Alameda Health System - Highland Hospital, Department of Emergency Medicine, Alameda, California","department":""},{"first_name":"Maribel","middle_name":"","last_name":"Condori","name_suffix":"","institution":"Hospital Nacional Dos de Mayo, Department of Emergency Medicine, Cercado de Lima, Peru","department":""},{"first_name":"Andrea","middle_name":"","last_name":"Dreyfuss","name_suffix":"","institution":"Hennepin County Medical Center, Department of Emergency Medicine, Minneapolis, Minnesota","department":""}],"date_submitted":"2023-08-02T21:18:01.961000+02:00","date_accepted":"2023-08-02T21:29:54.135000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1587/galley/1128/download/"}]},{"pk":1548,"title":"Extreme Paralysis Following Rocuronium Administration in a Myasthenia Gravis Patient: A Case Report","subtitle":null,"abstract":"<p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"><b>Introduction: </b>The use of paralytics during rapid sequence intubation (RSI) in patients with myasthenia gravis (MG) remains a controversial topic in emergency medicine. Due to fewer functional acetylcholine receptors, these patients can be both sensitive and resistant to different types of neuromuscular blocking agents (NMBA). Their atypical sensitivity to non-depolarizing NMBAs such as rocuronium can increase both the duration and depth of paralysis after its use at typical RSI doses. However, the extent of rocuronium’s prolonged duration of effect in patients with MG has yet to be quantified in an emergency department setting.</p><p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"><b>Case Report: </b>We describe a case wherein a full RSI dose of 1.2 milligrams per kilogram of rocuronium led to a prolonged 232-minute duration of paralysis in a patient with MG. This sustained paralysis was suspected but only confirmed after the patient received the reversal agent sugammadex. Once administered, an acute change in neurologic function was seen, and the patient was emergently taken to the operating room for neurosurgical intervention.</p><p class=\"p1\" style=\"margin-bottom: 7.2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; font-size: 10.5px; line-height: normal; font-family: Arial; color: rgb(0, 0, 0);\"><b>Conclusion: </b>When intubating patients with MG, many emergency physicians are aware that using paralytics during RSI provides several challenges. If not properly dose-reduced, rocuronium may exert its paralytic effects for up to four hours in patients with MG. This unique case highlights the importance of personalizing care for this patient population before, during, and after RSI.</p>","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"case report; rapid sequence intubation; myasthenia gravis; rocuronium"},{"word":"paralytic"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0c3997m1","frozenauthors":[{"first_name":"Kelsey","middle_name":"","last_name":"Billups","name_suffix":"","institution":"Medical University of South Carolina, Department of Pharmacy, Charleston, South Carolina","department":""},{"first_name":"Charlotte","middle_name":"","last_name":"Collins","name_suffix":"","institution":"Medical University of South Carolina, Department of Emergency Medicine, Charleston, South Carolina","department":""},{"first_name":"Aimee","middle_name":"","last_name":"Weber","name_suffix":"","institution":"Medical University of South Carolina, Department of Neurosurgery, Charleston, South Carolina","department":""}],"date_submitted":"2023-07-19T17:16:22.869000+02:00","date_accepted":"2023-07-19T17:28:32.368000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1548/galley/1129/download/"}]},{"pk":1247,"title":"Female with Atraumatic Abdominal Bruising","subtitle":null,"abstract":"<p><b>Case presentation: </b>We describe the case of a 38-year-old female patient with a history of lupus presenting with atraumatic abdominal pain and ecchymosis. The ultimate diagnosis of abdominal lupus erythematous panniculitis was determined based on physical exam and imaging findings.</p><p><b>Discussion: </b>Lupus erythematous panniculitis is a rare diagnosis, but consideration is important as early recognition and treatment is important to reduce pain and lessen the possibility of irreversible disfigurement and unnecessary costs to affected patients.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Lupus erythematous panniculitis; dermatology"}],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9sd0z9cb","frozenauthors":[{"first_name":"Zachary","middle_name":"S.","last_name":"Pacheco","name_suffix":"","institution":"University of Alabama Birmingham Heersink School of Medicine, Department of Emergency Medicine, Birmingham, Alabama","department":"","country":"United States"},{"first_name":"Grace","middle_name":"","last_name":"Johnson","name_suffix":"","institution":"University of Alabama Birmingham Heersink School of Medicine, Department of Emergency Medicine, Birmingham, Alabama","department":"","country":"United States"},{"first_name":"Erin","middle_name":"F.","last_name":"Shufflebarger","name_suffix":"","institution":"University of Alabama Birmingham Heersink School of Medicine, Department of Emergency Medicine, Birmingham, Alabama","department":"","country":"United States"}],"date_submitted":"2023-03-27T08:11:46.298000+02:00","date_accepted":"2023-06-05T22:28:28.960000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1247/galley/1146/download/"}]},{"pk":1490,"title":"Implanted Progestin Causing Pain and Psychiatric Disturbances in Porphyria Attack: A Case Report","subtitle":null,"abstract":"<p><b>Introduction: </b>Acute hepatic porphyrias (AHP) are a rare group of inherited disorders caused by abnormal functioning of the heme synthesis pathway. Patients often present with diffuse abdominal pain, neurologic dysfunction, and hyponatremia.&nbsp;</p><p><b>Case Report:</b> We present a case of a 25-year-old female who presented with AHP after implantation&nbsp;</p><p>of progestin birth control. The patient was confused, markedly tachycardic and hypertensive, and complained of severe abdominal pain. Spot urine ordered during the emergency department workup was later found positive for porphyrins and porphobilinogen (PBG).</p><p><b>Conclusion:</b> Acute hepatic porphyrias typically present with nonspecific symptoms in young women and are often overlooked in the acute care setting. Spot urine testing for PBG and urine porphyrins should be initiated early in patients with clinical suspicion of AHP.&nbsp;</p>","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"case report; porphyria; hemin; urine porphyrins"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/69m3b7g5","frozenauthors":[{"first_name":"Ryan","middle_name":"K.","last_name":"Misek","name_suffix":"","institution":"Midwestern University, Chicago College of Osteopathic Medicine, Department of Emergency Medicine, Downers Grove, Illinois","department":""},{"first_name":"Massimo","middle_name":"F.","last_name":"Riitano","name_suffix":"","institution":"Midwestern University, Chicago College of Osteopathic Medicine, Downers Grove, Illinois","department":""}],"date_submitted":"2023-07-03T20:17:01.968000+02:00","date_accepted":"2023-07-03T20:25:13.573000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1490/galley/1131/download/"}]},{"pk":1489,"title":"Internal Carotid Artery Occlusion as a Rare Presentation of Infectious Endocarditis: A Case Report","subtitle":null,"abstract":"<p><b>Introduction:</b> Internal carotid artery occlusion as a result of a septic embolism is a rare, commonly fatal, complication of mitral valve infectious endocarditis. Prompt recognition of this condition by the emergency physician may improve the chance of functional neurological survival.&nbsp;</p><p><b>Case Report:</b> A 50-year-old male presented minimally responsive with a right gaze deviation,&nbsp;</p><p>left hemiparesis, and a score of 26 on the National Institutes of Health Stroke Scale. A bedside echocardiogram showed a large mitral valve vegetation, and computed tomography angiography demonstrated an internal carotid artery occlusion.&nbsp;</p><p><b>Conclusion: </b>The emergency physician should consider this potentially life-threatening condition and know the fundamental management recommendations once identified.</p>","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"septic embolism; infectious endocarditis; stroke; case report"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4cq8x3hp","frozenauthors":[{"first_name":"Thijs","middle_name":"","last_name":"Wolf","name_suffix":"","institution":"University of Rochester Medical Center, Strong Memorial Hospital, Division of Emergency Medicine, Rochester, New York","department":""},{"first_name":"Kayla","middle_name":"","last_name":"Dewey","name_suffix":"","institution":"University of Rochester Medical Center, Strong Memorial Hospital, Division of Emergency Medicine, Rochester, New York","department":""},{"first_name":"David","middle_name":"","last_name":"Adler","name_suffix":"","institution":"University of Rochester Medical Center, Strong Memorial Hospital, Division of Emergency Medicine, Rochester, New York","department":""}],"date_submitted":"2023-07-03T20:04:35.290000+02:00","date_accepted":"2023-07-03T20:07:16.298000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1489/galley/1130/download/"}]},{"pk":1588,"title":"Intracranial Hemorrhage and Facial Fractures After Nose Blowing and Sternutation: A Case Report","subtitle":null,"abstract":"<p><b>Introduction: </b>Blowing the nose and sneezing are ubiquitous physiologic processes. While exceedingly rare, traumatic injuries have been described. We detail a case of spontaneous intracranial hemorrhage and orbital fractures sustained as a result of these two phenomena in an otherwise healthy adult without known risk factors for bleeding or intracranial hemorrhage.&nbsp;</p><p><b>Case Report:</b> A 79-year-old female presented to the emergency department after blowing her nose with an episode of sneezing following mild epistaxis. She denied any history of trauma, anticoagulation use, bleeding disorders, or pain associated with her symptoms. On examination, she had notable right periorbital swelling. Computed tomography revealed multiple areas of intracranial hemorrhage along with right-sided orbital and zygomatic fractures. After consulting trauma surgery and neurosurgery, we elected to pursue conservative management with repeat imaging. The patient had an uneventful course and was discharged with outpatient follow-up two days later.</p><p><b>Conclusion:</b> To our knowledge, this is the first case described of this constellation of injuries after a relatively benign process. Despite not having increased risk factors for intracranial hemorrhage (anticoagulation use, history of trauma, history of coagulopathy), this patient had severe injuries that presented with few external symptoms. This case serves as a reminder that while physiologic processes are almost always benign, serious traumatic injuries can result. Clinicians should have a low threshold for advanced imaging when there is a high clinical suspicion of facial fractures or more ominous processes.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"case report; intracranial hemorrhage; sneezing; blowing nose; orbital fracture"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7zd6x75d","frozenauthors":[{"first_name":"Cameron","middle_name":"G.","last_name":"Hanson","name_suffix":"","institution":"Henry Ford Health-Macomb, Department of Emergency Medicine, Clinton Township, Michigan","department":""},{"first_name":"Christopher","middle_name":"","last_name":"Stewart","name_suffix":"","institution":"Henry Ford Health-Macomb, Department of Emergency Medicine, Clinton Township, Michigan","department":""},{"first_name":"Keith","middle_name":"","last_name":"Cronovich","name_suffix":"","institution":"Henry Ford Health-Macomb, Department of Emergency Medicine, Clinton Township, Michigan","department":""}],"date_submitted":"2023-08-04T20:27:36.672000+02:00","date_accepted":"2023-08-04T20:35:26.942000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1588/galley/1142/download/"}]},{"pk":1248,"title":"Leser-Trélat Sign as a Marker for Underlying Pancreatic Cancer","subtitle":null,"abstract":"<p><b>Case Presentation: </b>Early diagnosis and rapid treatment of cancer is essential for good clinical outcomes for patients. In this case, an 85-year-old man presented with failure to thrive and was noted to have rapid-onset, multiple seborrheic keratoses (Leser-Trélat sign) on his chest and back. He was ultimately diagnosed with pancreatic cancer using computed tomography.&nbsp;&nbsp;</p><p><b>Discussion: </b>Leser-Trélat sign is a rare cutaneous marker for underlying malignancy. Identification of this sign can help guide diagnostic imaging and lab work to identify an occult internal malignancy, resulting in more rapid diagnosis, earlier treatment, and potentially better clinical outcomes.</p><p></p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\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":"Leser-Trélat"},{"word":" cancer; malignancy; seborrheic keratosis"}],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/65n67683","frozenauthors":[{"first_name":"Kalpit","middle_name":"","last_name":"Modi","name_suffix":"","institution":"Einstein Healthcare Network, Einstein Medical Center Montgomery Emergency Department, East Norriton, Pennsylvania","department":""},{"first_name":"Richard","middle_name":"","last_name":"Chen","name_suffix":"","institution":"Einstein Healthcare Network, Einstein Medical Center Montgomery Emergency Department, East Norriton, Pennsylvania","department":""},{"first_name":"Layla","middle_name":"","last_name":"Abubshait","name_suffix":"","institution":"Einstein Healthcare Network, Einstein Medical Center Montgomery Emergency Department, East Norriton, Pennsylvania","department":""}],"date_submitted":"2023-03-27T08:20:51.678000+02:00","date_accepted":"2023-06-23T22:54:30.814000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1248/galley/1147/download/"}]},{"pk":1603,"title":"Low-dose Fosphenytoin for Aborting Acute Trigeminal Neuralgia Pain: A Case Report","subtitle":null,"abstract":"<p><b>Introduction:</b> While the typical treatment for trigeminal neuralgia is carbamazepine, the dose must be gradually titrated over time to achieve pain control, which makes the drug a less than ideal candidate for treatment for acute exacerbation of pain due to trigeminal neuralgia in the emergency department (ED) setting. The literature for other effective treatments for acute exacerbations of trigeminal neuralgia is currently lacking. We discuss a case where intravenous (IV) fosphenytoin was used for treatment of acute pain due to trigeminal neuralgia in the ED.&nbsp;</p><p><b>Case Report:</b> This is a case of a 35-year-old male diagnosed with trigeminal neuralgia who presented with acute facial pain. His history and physical exam were consistent with an acute exacerbation of his trigeminal neuralgia. The patient was refractory to multiple doses of standard pain medication in the ED, and the decision was made to attempt IV fosphenytoin to relieve his pain. He was given 250 milligrams of fosphenytoin that was infused via IV over 10 minutes. By the end of the infusion, the patient had reported complete resolution of his pain.</p><p><b>Conclusion:</b> Fosphenytoin is a viable treatment option for pain relief in patients with acute exacerbation of trigeminal neuralgia. It may be a more favorable drug to use in the ED for acute pain given that carbamazepine must be titrated to effect. It is also possible that lower doses of fosphenytoin may provide equally beneficial analgesic effect than what is described in the literature, as pain relief was achieved in our case with approximately 3 milligrams/kilogram of fosphenytoin.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"fosphenytoin; trigeminal neuralgia; emergency department management; case report"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2n63j92w","frozenauthors":[{"first_name":"Jamie","middle_name":"","last_name":"Baydoun","name_suffix":"","institution":"University of Nevada Las Vegas School of Medicine, Department of Emergency Medicine, Las Vegas, Nevada; University Medical Center of Southern Nevada, Department of Psychiatry and Behavioral Health, Las Vegas, Nevada; Sound Emergency Physicians, Department of Emergency Medicine, Las Vegas, Nevada","department":""},{"first_name":"Alexander","middle_name":"","last_name":"Lin","name_suffix":"","institution":"University of Nevada Las Vegas School of Medicine, Department of Emergency Medicine, Las Vegas, Nevada; University Medical Center of Southern Nevada, Department of Psychiatry and Behavioral Health, Las Vegas, Nevada","department":""},{"first_name":"Jared","middle_name":"","last_name":"Miya","name_suffix":"","institution":"University of Nevada Las Vegas School of Medicine, Department of Emergency Medicine, Las Vegas, Nevada; University Medical Center of Southern Nevada, Department of Psychiatry and Behavioral Health, Las Vegas, Nevada","department":""}],"date_submitted":"2023-08-10T06:48:59.359000+02:00","date_accepted":"2023-08-10T07:52:10.767000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1603/galley/1141/download/"}]},{"pk":1584,"title":"Point-of-care Ultrasound Identification of Tension Hydrothorax in the Emergency Department: A Case Series","subtitle":null,"abstract":"<p><b>Introduction:</b> Tension hydrothorax is an uncommon emergent condition in which hemodynamic instability and respiratory compromise may occur. Emergency physicians may diagnose tension hydrothorax by point-of-care ultrasound.&nbsp;</p><p><b>Case Series:</b> We discuss the key sonographic features assisting in identification. Four patients with history of malignancy who were found to have tension hydrothorax exhibited the following common ultrasound findings: massive, left-sided pleural effusion; complete, compressive atelectasis; and shift of cardiac structures into the right hemithorax, resulting in right-sided probe placement to obtain cardiac views.&nbsp;</p><p><b>Conclusion:</b> This is the first instance to our knowledge of point-of-care ultrasound findings in tension hydrothorax to be described in the literature.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"tension hydrothorax; point-of-care ultrasound"}],"section":"Case Series","is_remote":true,"remote_url":"https://escholarship.org/uc/item/91m4t3qh","frozenauthors":[{"first_name":"Allison","middle_name":"","last_name":"Clark","name_suffix":"","institution":"Aventura Hospital and Medical Center, Emergency Medicine Residency Program, Aventura, Florida","department":""},{"first_name":"Peyton","middle_name":"","last_name":"Lampley","name_suffix":"","institution":"Aventura Hospital and Medical Center, Emergency Medicine Residency Program, Aventura, Florida","department":""},{"first_name":"Vu","middle_name":"Huy","last_name":"Tran","name_suffix":"","institution":"Aventura Hospital and Medical Center, Emergency Medicine Residency Program, Aventura, Florida","department":""}],"date_submitted":"2023-08-02T20:21:26.100000+02:00","date_accepted":"2023-08-02T20:42:25.096000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1584/galley/1127/download/"}]},{"pk":1461,"title":"Posterior Reversible Encephalopathy Syndrome in a Patient with Septic Shock: A Case Report","subtitle":null,"abstract":"<p><b>Introduction:</b> Posterior reversible encephalopathy syndrome (PRES) is a reversible condition with nonspecific neurologic and characteristic radiologic findings. Clinical presentation may include headache, nausea, vomiting, altered mental status, seizures, and vision changes. Diagnosis is confirmed through T2-weighted brain magnetic resonance imaging (MRI) showing bilateral hyperintensities in the white matter of posterior circulatory regions.&nbsp;</p><p><b>Case Report:</b> We report a case of PRES in a patient suffering from complicated diverticulitis. Following medical management in the emergency department, the patient deteriorated, becoming hypotensive and altered. Bowel resection under general anesthesia was performed. Postoperative brain MRI demonstrated bilateral and symmetric T2 signal hyperintensities suggestive of PRES. Following supportive treatment, the patient was discharged from the surgical intensive care unit on postoperative day 21 with no residual deficits.</p><p><b>Conclusion:</b> It is important to recognize the nonspecific neurologic symptoms associated with PRES. Emergency physicians should suspect acute PRES when managing patients with prolonged or unexplained encephalopathy, while recognizing that hypertension need not be present.</p>","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"posterior reversible encephalopathy syndrome; PRES; septic shock; case report"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1wk813q6","frozenauthors":[{"first_name":"Eric","middle_name":"","last_name":"Boccio","name_suffix":"","institution":"UMass Chan Medical School – Baystate, Department of Emergency Medicine, Department of Healthcare Delivery & Population Sciences, Springfield, Massachusetts","department":""},{"first_name":"Fiore","middle_name":"","last_name":"Mastroianni","name_suffix":"","institution":"New York University Long Island School of Medicine, Department of Medicine, Mineola, New York","department":""},{"first_name":"Todd","middle_name":"","last_name":"Slesinger","name_suffix":"","institution":"Herbert Wertheim College of Medicine, Florida International University, Department of Emergency Medicine, Miami, Florida","department":""}],"date_submitted":"2023-06-26T05:07:35.032000+02:00","date_accepted":"2023-06-26T05:10:23.307000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1461/galley/1133/download/"}]},{"pk":1602,"title":"Retropharyngeal Hematoma Causing Airway Compromise After Tissue Plasminogen Activator Administration:  A Case Report","subtitle":null,"abstract":"<p><b>Introduction:</b> Tissue plasminogen activator (tPA), commonly used for treatment of acute ischemic stroke, is associated with life-threatening bleeding intracranially as well as surrounding the airway.&nbsp;</p><p><b>Case Report: </b>A 78-year-old year old male who presented with stroke symptoms and after tPA administration developed a retropharyngeal hematoma requiring intubation and surgical intervention.&nbsp;</p><p><b>Conclusion:</b> Numerous threats to the patient’s airway can develop after tPA administration. While angioedema is the most common cause, it is important to be prepared for other causes related to hemorrhage.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"retropharyngeal hematoma"},{"word":"tissue plasminogen activator"},{"word":"stroke"},{"word":"airway"},{"word":"hemorrhage"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/47c010vm","frozenauthors":[{"first_name":"Christian","middle_name":"","last_name":"Provenza","name_suffix":"","institution":"University of Tennessee Health Science Center - Department of Emergency Medicine, Memphis, Tennessee","department":""},{"first_name":"Arun","middle_name":"Christian","last_name":"Habermann","name_suffix":"","institution":"University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee","department":""},{"first_name":"Theron","middle_name":"","last_name":"Williams","name_suffix":"","institution":"University of Tennessee Health Science Center - Department of Emergency Medicine, Memphis, Tennessee","department":""},{"first_name":"Jeffrey","middle_name":"","last_name":"Metter","name_suffix":"","institution":"University of Tennessee Health Science Center – Department of Neurology, Memphis, Tennessee","department":""},{"first_name":"James","middle_name":"Richard","last_name":"Walker","name_suffix":"III","institution":"University of Tennessee Health Science Center – Department of Neurology, Memphis, Tennessee","department":""}],"date_submitted":"2023-08-10T06:13:39.057000+02:00","date_accepted":"2023-08-10T06:31:19.609000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1602/galley/1137/download/"}]},{"pk":1319,"title":"Shone Complex: A Case Report of Congenital Heart Disease Detected Using Point-of-care Ultrasound","subtitle":null,"abstract":"<p><b>Introduction:</b> Undiagnosed congenital heart disease and management of pediatric cardiogenic shock presents a diagnostic challenge for the emergency clinician. These diagnoses are rare and require a high index of suspicion given the overlap with more common pediatric pathology. Point-of-care ultrasound can assist in differentiating these presentations. We present a case of neonatal cardiogenic shock secondary to a previously undiagnosed congenital heart disease, specifically Shone complex, detected using point-of-care ultrasound.&nbsp;</p><p><b>Case Report:</b> A six-week-old female presented with severe respiratory distress and was found to be in cardiogenic shock secondary to a previously undiagnosed congenital heart defect.</p><p><b>Conclusion:</b> Initial diagnosis of congenital heart disease is uncommon in the emergency department, but it should be recognized by clinicians given the high associated morbidity and mortality. Point-of-care ultrasound is a powerful tool to assist in evaluating for cardiac abnormalities as an etiology for undifferentiated shock in the pediatric population.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"case report; Shone complex; point-of-care ultrasound; cardiogenic shock; congenital heart disease"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8tp5w20j","frozenauthors":[{"first_name":"Jordan","middle_name":"C.","last_name":"Seaback","name_suffix":"","institution":"Atrium Health Wake Forest Baptist, Department of Emergency Medicine, Winston Salem, North Carolina","department":""},{"first_name":"David","middle_name":"A.","last_name":"Masneri","name_suffix":"","institution":"Atrium Health Wake Forest Baptist, Department of Emergency Medicine, Winston Salem, North Carolina","department":""},{"first_name":"Jacob","middle_name":"H.","last_name":"Schoeneck","name_suffix":"","institution":"Atrium Health Wake Forest Baptist, Department of Emergency Medicine, Winston Salem, North Carolina","department":""}],"date_submitted":"2023-04-13T18:30:24.230000+02:00","date_accepted":"2023-06-30T22:41:58.946000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1319/galley/1143/download/"}]},{"pk":1590,"title":"Spontaneous Coronary Sinus Thrombosis Detected by Point-of-care Transthoracic Echo: A Case Report","subtitle":null,"abstract":"<p><b>Introduction:</b> Coronary sinus thrombosis (CST) is a rare condition, primarily occurring after instrumentation of the heart, with no prior reported cases diagnosed via point-of-care ultrasound or of spontaneous occurrence without predisposing medical or surgical history. Patients typically present with critical illness, and CST has a reported mortality of 80%.&nbsp;</p><p><b>Case Report:</b> We present a case of a healthy 38-year-old male with chest pain one hour after cocaine use, with an electrocardiogram pattern consistent with Wellens syndrome, whose point-of-care cardiac ultrasound revealed CST.&nbsp;</p><p><b>Conclusion:</b> This uncommon ultrasonographic finding has never been reported in the emergency medicine literature to our knowledge. It can be recognized by the clinician sonographer during standard point-of-care transthoracic echocardiogram.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Case report; POCUS; TTE; coronary sinus thrombosis; ECG"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1tb9m636","frozenauthors":[{"first_name":"Lily","middle_name":"Leitner","last_name":"Berrin","name_suffix":"","institution":"Highland Hospital, Alameda Health System, Department of Emergency Medicine, Oakland, California","department":""},{"first_name":"Kaitlen","middle_name":"","last_name":"Howell","name_suffix":"","institution":"Highland Hospital, Alameda Health System, Department of Emergency Medicine, Oakland, California","department":""},{"first_name":"Amanda","middle_name":"","last_name":"Foote","name_suffix":"","institution":"University of California San Francisco, Department of Emergency Medicine, San Francisco, California","department":""},{"first_name":"Jordan","middle_name":"","last_name":"Mullings","name_suffix":"","institution":"Highland Hospital, Alameda Health System, Department of Emergency Medicine, Oakland, California","department":""},{"first_name":"Akash","middle_name":"","last_name":"Desai","name_suffix":"","institution":"Highland Hospital, Alameda Health System, Department of Emergency Medicine, Oakland, California","department":""},{"first_name":"Martha","middle_name":"","last_name":"Montgomery","name_suffix":"","institution":"Highland Hospital, Alameda Health System, Department of Emergency Medicine, Oakland, California","department":""},{"first_name":"Sophie","middle_name":"","last_name":"Barbant","name_suffix":"","institution":"Highland Hospital, Alameda Health System, Department of Cardiology, Oakland, California","department":""},{"first_name":"Arun","middle_name":"","last_name":"Nagdev","name_suffix":"","institution":"Highland Hospital, Alameda Health System, Department of Emergency Medicine, Oakland, California","department":""}],"date_submitted":"2023-08-04T21:21:55.923000+02:00","date_accepted":"2023-08-04T21:26:58.555000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1590/galley/1144/download/"}]},{"pk":1586,"title":"The Diagnostic Dilemma in Delayed Subarachnoid Hemorrhage: A Case Report","subtitle":null,"abstract":"<p><b>Introduction:</b> Radiologically negative subarachnoid hemorrhage (SAH) has a low incidence and is associated with good clinical outcomes.&nbsp;</p><p><b>Case Report:</b> We present the case of a 44-year-old male with new-onset headaches, which began one week prior while bike riding. At an outside hospital, he had normal computed tomography head and angiogram. He declined a lumbar puncture. Over the following week, the headache was persistent. He lacked meningeal signs. Repeat studies were normal. Lumbar puncture was positive for xanthochromia.&nbsp;</p><p><b>Conclusion: </b>Radiologically negative SAH should be included in the differential diagnosis of patients presenting with unremitting headache in the setting of recent exercise, despite negative imaging, and meningeal signs.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"subarachnoid hemorrhage; lumbar puncture; radiologically negative"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8s09x4mj","frozenauthors":[{"first_name":"Danielle","middle_name":"A.","last_name":"Bazer","name_suffix":"","institution":"Stony Brook University Hospital, Department of Neurology, Stony Brook, New York; Johns Hopkins Medicine, Department of Neurology, Baltimore, Maryland","department":""},{"first_name":"Nicholas","middle_name":"","last_name":"Koroneos","name_suffix":"","institution":"Stony Brook University Hospital, Department of Neurology, Stony Brook, New York","department":""},{"first_name":"Matthew","middle_name":"","last_name":"Orwitz","name_suffix":"","institution":"Stony Brook University Hospital, Department of Neurology, Stony Brook, New York","department":""},{"first_name":"Jordan","middle_name":"","last_name":"Amar","name_suffix":"","institution":"Washington University in St. Louis, Department of Neurology, St. Louis, Missouri","department":""},{"first_name":"Ryan","middle_name":"","last_name":"Corn","name_suffix":"","institution":"Stony Brook University Hospital, Department of Neurology, Stony Brook, New York","department":""},{"first_name":"Elizabeth","middle_name":"","last_name":"Wirkowski","name_suffix":"","institution":"Stony Brook University Hospital, Department of Neurology, Stony Brook, New York","department":""}],"date_submitted":"2023-08-02T20:53:16.376000+02:00","date_accepted":"2023-08-02T21:01:43.834000+02:00","date_published":"2023-08-14T18:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1586/galley/1139/download/"}]},{"pk":17687,"title":"Sexual Assault Nurse Examiners Lead to Improved Uptake of Services: A Cross-Sectional Study","subtitle":null,"abstract":"Introduction:\n Sexual Assault Nurse Examiners (SANE), who are trained to provide comprehensive and compassionate specialty care to sexual assault survivors, are increasingly used in the emergency department (ED), but there is little published literature to support their benefit. In this study we aimed to compare services offered and received by sexual assault survivors in the ED when care was provided by a SANE vs those with traditional care teams, hypothesizing that SANE utilization will be associated with improved uptake of recommended services.\nMethods:\n This was a retrospective review examining all patient encounters in which a sexual assault was disclosed in a large, urban, adult ED between June 1, 2019–June 30, 2022. We extracted timeline information from the ED encounter, demographic information, resources offered to and accepted by the patient, clinical care data, and continuity of care data from the medical record. We used unadjusted and adjusted analyses to compare patient demographics and services offered and accepted between SANE and non-SANE encounters.\nResults:\n We included a total of 182 encounters in the analysis, of which 130 (71.4%) involved SANEs. Demographics were similar between groups, except there was a larger proportion of cisgender men in the non-SANE group (14.0% vs 5.5%), and the timing of visits differed, with non-SANE visits more common during the overnight shift. All recommended testing, prophylaxis, and resources were offered more frequently during SANE visits, and all but one were more frequently accepted by patients during SANE visits, although not all comparisons reached statistical significance.\nConclusion:\n Patients who received care from a SANE were more often offered recommended services and resources and more frequently accepted them. Making SANE care available at all times to these vulnerable patients would both improve patient outcomes and allow hospitals to meet required quality metrics. States should consider expanding legislation to encourage and fund SANE coverage for all hospitals to support access to vital resources in the ED for survivors of sexual assault.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Sexual Assault, SANE, Health Equity, Quality Metrics, Emergency Department"}],"section":"Women's Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7gm2m54c","frozenauthors":[{"first_name":"Meredith","middle_name":"","last_name":"Hollender","name_suffix":"","institution":"University of Chicago, Pritzker School of Medicine, Chicago, Illinois","department":"None"},{"first_name":"Ellen","middle_name":"","last_name":"Almirol","name_suffix":"","institution":"Chicago Center for HIV Elimination, Chicago, Illinois","department":"None"},{"first_name":"Makenna","middle_name":"","last_name":"Meyer","name_suffix":"","institution":"Chicago Center for HIV Elimination, Chicago, Illinois","department":"None"},{"first_name":"Heather","middle_name":"","last_name":"Bearden","name_suffix":"","institution":"University of Chicago, Section of Emergency Medicine, Chicago, Illinois","department":"None"},{"first_name":"Kimberly","middle_name":"","last_name":"Stanford","name_suffix":"","institution":"Chicago Center for HIV Elimination, Chicago, Illinois; University of Chicago, Section of Emergency Medicine, Chicago, Illinois","department":"None"}],"date_submitted":"2022-11-30T05:29:24+01:00","date_accepted":"2022-11-30T05:29:24+01:00","date_published":"2023-08-11T17:53:04+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17687/galley/9031/download/"}]},{"pk":17535,"title":"Emergency Department Use Among Recently Homeless Adults in a Nationally Representative Sample","subtitle":null,"abstract":"Introduction:\n In this study we examined the association of homelessness and emergency department (ED) use, considering social, medical, and mental health factors associated with both homelessness and ED use. We hypothesized that social disadvantage alone could account for most of the association between ED use and homelessness.\nMethods: \nWe used nationally representative data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). Emergency department use within the prior year was categorized into no use (27,674; 76.61%); moderate use (1–4 visits: 7,972; 22.1%); and high use (5 or more visits: 475; 1.32%). We used bivariate analyses followed by multivariable-adjusted logistic regression analyses to identify demographic, social, medical, and mental health characteristics associated with ED use.\nResults: \nAmong 36,121 respondents, unadjusted logistic regression showed prior-year homelessness was strongly associated with moderate and high prior-year ED use (odds ratio[OR] 2.31 and 7.34, respectively, P &lt; 0.001). After adjusting for sociodemographic factors, the associations of homelessness with moderate/high ED use diminished (adjusted OR [AOR] 1.27 and 1.62, respectively, both P &lt; 0.05). Adjusting for medical/mental health variables, alone, similarly diminished the association between homelessness and moderate/high ED use (AOR 1.26, P &lt; .05 and 2.07, P &lt; 0.001, respectively). In a final stepwise model including social and healthvariables, homelessness was no longer significantly associated with moderate or high ED usein the prior year.\nConclusion:\n After adjustment for social disadvantage and health problems, we found no statistically significant association between homelessness and ED use. The implications of our findings suggest that ED service delivery must address both health issues and social factors.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Social Emergency Medicine, Homelessness, Utilization, Health Equity"}],"section":"Health Equity","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9r3498q6","frozenauthors":[{"first_name":"Caitlin","middle_name":"R.","last_name":"Ryus","name_suffix":"","institution":"Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut","department":"None"},{"first_name":"Elina","middle_name":"","last_name":"Stefanovics","name_suffix":"","institution":"U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut","department":"None"},{"first_name":"Jack","middle_name":"","last_name":"Tsai","name_suffix":"","institution":"Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; VA National Center on Homelessness among Veterans, Washington, DC; School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas","department":"None"},{"first_name":"Taeho","middle_name":"Greg","last_name":"Rhee","name_suffix":"","institution":"U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut","department":"None"},{"first_name":"Robert","middle_name":"A.","last_name":"Rosenheck","name_suffix":"","institution":"U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut","department":"None"}],"date_submitted":"2022-09-29T20:46:11+02:00","date_accepted":"2022-09-29T20:46:11+02:00","date_published":"2023-08-11T17:44:07+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17535/galley/8941/download/"}]},{"pk":31459,"title":"International Organizations as Constitution-Shapers: Lawful but Sometimes Illegitimate, and Often Futile","subtitle":null,"abstract":"<p>This article analyses widespread constitution-shaping activities by a range of international organizations at different places on the globe. The principles governing the processes and substance of constitution-making—as propagated by the international organisations—have remained similar since 1989: rule of law (or its elements and emanations), human rights, and democracy (or variants and family members such as inclusion, openness, participation, and the like), the so-called constitutionalist trinity. The modalities of constitution-shaping are pre-accession-incentives, conditionalities, indicators, and benchmarking.</p>\n<p>The article raises a dual question: First, do we see, in the current era of anti-globalisation, populism, and charges of ostensible obsoleteness of liberalism, a change in the law and practice of the organizations? Have the international organizations in fact given up on the constitutionalist trinity and have they stopped offering assistance? My answer is that this does not (yet) seem to be the case. In other words, despite critique and pushbacks, the language and practice have not changed until the present day.</p>\n<p>Second and normatively speaking, is the international organizations’ continued insistence on the constitutionalist trinity a good thing? Should not the traditional constitutional principles be substituted by new ones? Or, alternatively, should not the international organizations abstain from getting involved in the first place? The article examines the effectiveness, the lawfulness, and the legitimacy of international involvement. It concludes that the constitution-shaping activity by international organizations needs to pay much more attention to the implementation of constitutional law and its translation into more specific laws, regulations, and practices in the administration on the ground to be effective. It needs be wary of crossing the threshold to unlawful intervention to remain lawful. And it must absorb post-colonial concerns and needs to pursue a much deeper social agenda with a global ambition, to regain legitimacy. Thus revamped, international organisations’ constitution-shaping role could be re-invigorated. It would thus form one building block of transnational or global constitutionalism and contribute to transnational ordering.</p>","language":null,"license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/45n6k5vk","frozenauthors":[{"first_name":"Anne","middle_name":"","last_name":"Peters","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-11T02:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jitcl/article/31459/galley/22528/download/"}]},{"pk":31460,"title":"Masthead, Mission Statement, and Table of Contents","subtitle":null,"abstract":"None","language":null,"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/40g1g1m0","frozenauthors":[],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-11T02:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jitcl/article/31460/galley/22529/download/"}]},{"pk":31461,"title":"Rethinking Enmeshment and the Rule of Law in Authoritarian Contexts","subtitle":null,"abstract":"<p>Scholars frequently cite Turkey under Recep Tayyip Erdoğan’s rule among the leading examples of populism and authoritarianism in contemporary politics. Long an authoritarian regime, Turkey has in indeed evolved into a full-blown autocratic regime engaged in serious human rights violations and systemic rule of law violations. What makes this case particularly striking, however, is that this backsliding has occurred under the watch of European institutions. Claiming that the Turkish case speaks to broader issues concerning the ways in which transnational human rights and rule of law organizations interact with authoritarian regimes, this article puts forth theoretical insights for the rule of law scholarship. Going beyond conventional analyses which characterize interactions between international institutions and nation states as one-way relationships where norms flow (or not) from the top-down, it looks into the “enmeshment” of domestic and international law in authoritarian settings described in the introductory article of this special issue. Doing so, however, the article does not solely ask whether and how human rights norms are applied in authoritarian contexts, but also looks into how international organizations tasked with upholding the rule of law can not only permit illiberal states to violate those norms, but also themselves undermine these principles. </p>\n<p>Conceptually, the article illustrates that the rule of law-rule by law spectrum fails to account for authoritarian contexts, where states go beyond rule by law to engage in legal repression and resort to lawlessness towards certain (racialized) segments of the population. Thus, it argues, if the rule of law is at one end of the analytical spectrum on the arbitrary exercise of power, what lies at the other end is lawless rule, not rule by law, and the dual state lies somewhere in between. Empirically, the article analyzes Turkey’s decades-long relationship with the European Union and in particular the European Court of Human Rights (ECtHR). It zooms in on the latter’s case law concerning Erdoğan’s resort to the law to consolidate his power (rule by law) and utter disregard of legal rules, including domestic ones, in repressing democratic dissent and engaging in state violence (lawlessness). Methodologically, to display and contest conventional scholarship’s depiction of the ECtHR as a supranational court exercising strict scrutiny of authoritarian regimes, the article goes beyond judgments, which constitute a mere 9 percent of jurisprudence, and takes a close look at inadmissibility decisions and strike-out rulings concerning Turkey’s resort to rule by law and lawlessness. </p>","language":null,"license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6d84c9f5","frozenauthors":[{"first_name":"Dilek","middle_name":"","last_name":"Kurban","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-11T02:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jitcl/article/31461/galley/22530/download/"}]},{"pk":31462,"title":"The Evolving Rule of Law with Chinese Characteristics and Its Impacts on the International Legal Order","subtitle":null,"abstract":"<p>The rule of law, an abstract concept heavily debated among legal scholars and social scientists, has in the past few decades acquired a nearly universal appeal, as democracies, autocracies, and oligarchies all claim to uphold it. The Chinese government, for instance, announced in 2012 a comprehensive plan to advance law-based governance in China and has since undertaken major legal reforms. Repeatedly, Xi and the leaders of the Chinese Communist Party (“CCP”) have pledged to build a “rule of law country.” But when the ruling elites of a one-party authoritarian state allege commitment to the rule of law, what do they really mean? How is it different from the Western concepts of the rule of law, especially the “thick” version of it, that has been closely tied to liberal democratic values? What are the key features of the “rule of law with Chinese characteristics”? And how will it impact the international legal order? Applying a transnational legal ordering framework, this Article attempts some answers. It proceeds in two sections. Section One traces the development of the Chinese legal system and the evolving rule of law debates in China. Unlike prior research on this topic, which has generally treated the sovereign state as the unit of analysis, this section highlights the power dynamics within the Chinese ruling elites and the influence of the international legal community as well as the global rule of law discourse. Section Two reverses the inquiry and explores how China might impact the international legal order. It contends that varying coalitions of Chinese actors populate the interfaces between China and international law across different issue areas and that China’s impacts on the international legal order vary as well. Both sections will also discuss how the ideological remnants have produced three common, entrenched perceptions of law and legal institutions: legal instrumentalism, economic determinism, and linearity of institutional changes, and how these perceptions have modified China’s interactions with international law. </p>","language":null,"license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9jm592xt","frozenauthors":[{"first_name":"Ji","middle_name":"","last_name":"Li","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-11T02:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jitcl/article/31462/galley/22531/download/"}]},{"pk":31463,"title":"The Rule of Law in Transnational Context: Introduction to the Symposium","subtitle":null,"abstract":"None","language":null,"license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3x6644jw","frozenauthors":[{"first_name":"Gregory","middle_name":"","last_name":"Shaffer","name_suffix":"","institution":"","department":""},{"first_name":"Wayne","middle_name":"","last_name":"Sandholtz","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-11T02:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jitcl/article/31463/galley/22532/download/"}]},{"pk":31464,"title":"Transnational Legal Order Through Rule of Law? Appraising the United Nations Security Council, 1990-2022","subtitle":null,"abstract":"<p>Utilizing the theoretical framework of transnational legal orders (TLOs), this article treats two master questions in global governance: what are the limits to the power of the UN Security Council? Can norms of rule-of-law constrain UNSC powers? First, we outline a research design with emphasis on its documentary and unique internal empirical sources. Second, we sketch an interpretive narrative of UNSC engagement from the early 1990s to the present with ROL in three areas of UNSC action: peacekeeping, sanctions, and force. Third, we offer a new conceptual approach by proposing that ROL in the UNSC manifests itself in three dimensions: discourse; procedure (or rules); and structures. These dimensions come into play both internally, within the UNSC itself, and externally, to ROL institution-building in and between states, as well as in post-conflict zones, with a rather gray area between (e.g., when the UN peacekeeping missions are themselves subject to ROL oversight for the behavior of their personnel). Fourth, we examine the emergence of micro-TLOs under construction within the UNSC itself. We conclude with reflections on the potential for empowering elected members of the UNSC and weaker states in the UN to press ROL norms on the UNSC as a springboard for ROL global governance via the UNSC. </p>","language":null,"license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5nf2c8x4","frozenauthors":[{"first_name":"Jeremy","middle_name":"","last_name":"Farrall","name_suffix":"","institution":"","department":""},{"first_name":"Terence","middle_name":"","last_name":"Halliday","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-11T02:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jitcl/article/31464/galley/22533/download/"}]},{"pk":31465,"title":"Why Sovereigns Are Entitled to (Horizontal) Benefits of the International Rule of Law","subtitle":null,"abstract":"<p><em> </em>A dozen years ago, Jeremy Waldron published an influential article arguing that sovereign states are not entitled to the benefits of the international rule of law. His conclusion follows from his assertions that the purpose of the rule of law is to protect individual liberty, and the purpose of international law is to protect individuals. This article critically responds to his position. International law is based on the notion that states are autonomous and equal members of the international society ordered through legal relations. The legal relations of the international community of states, I argue, constitute the horizontal dimension of the rule of law, which Waldron overlooked. Focusing on horizontal rule of law functions, I provide descriptive, theoretical, and normative reasons why states are, and should be, entitled to the benefits of the rule of law. </p>","language":null,"license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/17x6q2wg","frozenauthors":[{"first_name":"Brian","middle_name":"Z.","last_name":"Tamanaha","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2023-08-11T02:00:00+02:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jitcl/article/31465/galley/22534/download/"}]},{"pk":235,"title":"Number Agreement Attraction in Czech and English Comprehension: A Direct Experimental Comparison","subtitle":null,"abstract":"Number agreement attraction in comprehension is a phenomenon that has been documented in various typologically diverse languages. This evidence has led to claims about the cross-linguistic uniformity of agreement attraction effects and its independence from the grammatical features of a particular language. However, recent research has shown that in Czech, number agreement attraction effects are either absent or negligible in size. This directly contradicts the cross-linguistic uniformity hypothesis. The current paper aims to further corroborate this finding and presents a direct experimental comparison of Czech and English. Two comparable self-paced reading experiments were conducted using stimuli that were translation equivalents in Czech and English. Our analyses demonstrate a preference for the null model in Czech (no agreement attraction), unlike in English, where an interaction between verb number and attractor number was preferred. Moreover, when we compare the data from the two experiments directly, we find that the interaction between language and attraction was also preferred. In sum, we provide evidence against the cross-linguistic uniformity hypothesis for agreement attraction effects and suggest that processing patterns may differ between languages even for almost identical structures, such as agreement relations.","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":"Regular Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4md8g417","frozenauthors":[{"first_name":"Jan","middle_name":"","last_name":"Chromý","name_suffix":"","institution":"Faculty of Arts, Charles University","department":"Institute of Czech Language and Theory of Communication"},{"first_name":"James","middle_name":"Liam","last_name":"Brand","name_suffix":"","institution":"Faculty of Arts, Charles University","department":"Institute of Czech Language and Theory of Communication"},{"first_name":"Anna","middle_name":"","last_name":"Laurinavichyute","name_suffix":"","institution":"University of Potsdam","department":""},{"first_name":"Radim","middle_name":"","last_name":"Lacina","name_suffix":"","institution":"Universität Osnabrück","department":""}],"date_submitted":"2023-01-17T13:51:23.975000+01:00","date_accepted":"2023-06-22T13:56:43.907000+02:00","date_published":"2023-08-10T19:15:00+02:00","render_galley":{"label":"XML","type":"xml","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/235/galley/1099/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/235/galley/1098/download/"},{"label":"XML","type":"xml","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/235/galley/1099/download/"}]},{"pk":175,"title":"How abstract are logical representations? The role of verb semantics in representing quantifier scope","subtitle":null,"abstract":"<p class=\"p1\" style=\"margin-bottom: 12px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; line-height: normal;\">Language comprehension involves the derivation of the meaning of sentences by combining the meanings of their parts. In some cases, this can lead to ambiguity. A sentence like <i>Every hiker climbed a hill</i> allows two logical representations: One that specifies that every hiker climbed a different hill and one that specifies that every hiker climbed the same hill. The interpretations of such sentences can be primed: Exposure to a particular reading increases the likelihood that the same reading will be assigned to a subsequent similar sentence. Feiman and Snedeker (2016) observed that such priming is not modulated by overlap of the verb between prime and target. This indicates that mental logical representations specify the compositional structure of the sentence meaning without conceptual meaning content. We conducted a close replication of Feiman and Snedeker’s experiment in Dutch and found no verb-independent priming. Moreover, a comparison with a previous, within-verb priming experiment showed an interaction, suggesting stronger verb-specific than abstract priming. A power analysis revealed that both Feiman and Snedeker’s experiment and our Experiment 1 were underpowered. Therefore, we replicated our Experiment 1, using the sample size guidelines provided by our power analysis. This experiment again showed that priming was stronger if a prime-target pair contained the same verb. Together, our experiments show that logical representation priming is enhanced if the prime and target sentence contain the same verb. This suggests that logical representations specify compositional structure and meaning features in an integrated manner.<br></p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Regular Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5bn3t780","frozenauthors":[{"first_name":"Mieke","middle_name":"Sarah","last_name":"Slim","name_suffix":"","institution":"Ghent University","department":"Department of Experimental Psychology","country":"Belgium"},{"first_name":"Peter","middle_name":"","last_name":"Lauwers","name_suffix":"","institution":"Ghent University","department":"Department of Linguistics","country":"Belgium"},{"first_name":"Robert","middle_name":"","last_name":"Hartsuiker","name_suffix":"","institution":"Ghent University","department":"Department of Experimental Psychology","country":"Belgium"}],"date_submitted":"2022-07-05T17:42:57.929000+02:00","date_accepted":"2023-05-26T10:52:01.497000+02:00","date_published":"2023-08-10T19:10:00+02:00","render_galley":{"label":"XML","type":"xml","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/175/galley/1040/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/175/galley/1039/download/"},{"label":"XML","type":"xml","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/175/galley/1040/download/"}]},{"pk":41762,"title":"Revision of northeast Pacific Paleogene cypraeoidean gastropods (Mollusca), including recognition of three new species: Implications for paleobiogeographic distribution and faunal turnover","subtitle":null,"abstract":"The Paleogene cypraeoidean fauna of the northeast Pacific region (NEP), extending from Vancouver Island, British Columbia, Canada southward to Baja California Sur, México, consists of 12 genera, 20 named species (three of which are new), six open-nomenclature species, one Cypraeidae, indeterminate to genus and species, one cf. species, and four nomina dubia. All taxa are figured here. Species reassigned at the genus level are \nProtocypraea\n? \nsimiensis \n(Nelson, 1925) and \nLuponovula maniobraensis\n (Squires and Advocate, 1986). Improved documentation of known NEP species include \nPropustularia kemperae\n (Nelson, 1925), \nGrovesia castacensis\n (Stewart, 1926) [1927]), \nG. mathewsonii\n (Gabb, 1864), and \nEratotrivia crescentensis\n (Weaver and Palmer, 1922). The three new species, \nSubepona leahae\n, \nBernaya kaylinae\n, and \nEocypraea judithsmithae\n are from the upper lower Eocene Llajas Formation of Simi Valley, Ventura County and Devil Canyon, Los Angeles County, California. Six open-nomenclature species need better preserved material; they are: \nBernaya \nsp., two \nProtocypraea\n? sp., \nGisortia \nsp., \nEocypraea \nsp., and \nCypraedia \nsp., as does an indeterminate cypraeid from the Lodo Formation of central California. Nomina dubia are “\nBernaya\n” \nfresnoensis \n(Anderson, 1905), “\nEocypraea\n” \nbayerquei \n(Gabb, 1864), “\nSphaerocypraea\n” \nmartini \n(Dickerson, 1914), and “\nSulcocypraea\n” \noakvillensis \n(Van Winkle, 1918). \nEratotrivia \nmackini (Durham, 1944) is herein reassigned to the synonymy of \nGrovesia mathewsonii \n(Gabb, 1869). The NEP Paleocene cypraeoidean fauna consists of four genera, a cypraeid of unknown generic affinity, and two nomina dubia. The early Eocene “Capay Stage” cypraeoidean fauna is comprised of eight genera and two nomina dubia. That was during the peak of NEP cypraeoidean biodiversity, which coincided with the “Early Eocene Climate Optimum” (EECO), the warmest time of the Paleogene. At the end of “Capay” time, biodiversity abruptly decreased, and this trend continued to the end of “Domengine Stage” time, when a faunal turnover took place. The cypraeoidean faunas in the subsequent “Tejon Stage” and Galvinian Stage continued to be diminished because of the ongoing cooling of the ocean waters. Continued global cooling eventually caused the disappearance of the thermophilic Paleogene NEP cypraeoideans before the beginning of the Oligocene. Most of the NEP cypraeoidean fauna is very similar morphologically to species found in the Tethys region of Europe, especially France, Italy, and Ukraine. These similar species are indicative that the introduction of most of the NEP cyraeoidean genera into the NEP region was via a westward-directed, warm-water current originating in the ancient Tethys Sea region of western Europe. The point of origin of the Paleocene \nPropustularia \nis unknown, and the late Eocene \nNuceolaria \nmost likely arrived in the NEP region via a Pacific Ocean route.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-ShareAlike 4.0","short_name":"CC BY-NC-SA 4.0","text":"<p><!-- x-tinymce/html --></p>\n<p>Readers are free to:</p>\n<ul>\n<li><strong>Share</strong> — copy and redistribute the material in any medium or format</li>\n<li><strong>Adapt</strong> — remix, transform, and build upon the material<br><br>The licensor cannot revoke these freedoms as long as you follow the license terms.</li>\n</ul>\n<p>Under the following terms:</p>\n<ul>\n<li><strong>Attribution</strong> — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.</li>\n<li><strong>NonCommercial</strong> — You may not use the material for commercial purposes .</li>\n<li><strong>ShareAlike</strong> — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.<br><br>No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.</li>\n</ul>\n<p>Notices:</p>\n<p>You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.</p>\n<p>No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.</p>","url":"https://creativecommons.org/licenses/by-nc-sa/4.0"},"keywords":[{"word":"Paleocene, Eocene, cypraeids, eocypraeids, faunal changes"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1dd6d638","frozenauthors":[{"first_name":"Lindsey","middle_name":"","last_name":"Groves","name_suffix":"","institution":"Natural History Museum of Los Angeles County, Invertebrate Paleontology Department, 900 Exposition Boulevard, Los Angeles, California, 90007","department":"None"},{"first_name":"Richard","middle_name":"L.","last_name":"Squires","name_suffix":"","institution":"Research Associate, Natural History Museum of Los Angeles County, Invertebrate Paleontology Department, 900 Exposition Boulevard, Los Angeles, California, 90007; Professor Emeritus, Department of Geological Sciences, California State University, 18111 Nordhoff Street, Northridge, California, 91330-8266, USA","department":"None"}],"date_submitted":"2022-06-16T20:50:20+02:00","date_accepted":"2022-06-16T20:50:20+02:00","date_published":"2023-08-10T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/ucmp_paleobios/article/41762/galley/31228/download/"}]},{"pk":2463,"title":"Language as power: Translanguaging’s interaction with Chinese international students’ English academic writing processes outside the classroom","subtitle":null,"abstract":"International students in the US face challenges in navigating university-level academic writing, particularly if English is not their first language. To succeed in their coursework, they must demonstrate mastery of course content, academic English, and writing conventions, while also balancing their native writing habits. Facing these difficulties, international students employ different resources (i.e., repertoires) to facilitate their writing. Understanding challenges international students face as well as resources they employ allows instructors to better support this population.This study examines the academic writing experiences of Chinese university-level international students through the lens of translanguaging in order to identify these repertoires and explore how students use them. The research question is: how does translanguaging interact with Chinese international students’ academic writing outside the traditional classroom setting? Through in-depth interviews with seven multilingual Chinese international students, this study reveals that Chinese international students may feel disadvantaged in the American education system because they cannot fully showcase their mastery of course content in their second language, English. Translanguaging is a tool that can help alleviate this disadvantage, and participants in this study used it automatically. However, they kept this process in their mind, separate from the policed zone of written text due to internalized English-only policies.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives  4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\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-nd/4.0"},"keywords":[{"word":"translanguaging, multilingual education, university-level academic writing"}],"section":"Brief Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/92v3472c","frozenauthors":[{"first_name":"Mingyu","middle_name":"","last_name":"Zhu","name_suffix":"","institution":"UC Berkeley","department":"None"}],"date_submitted":"2023-05-16T02:32:06+02:00","date_accepted":"2023-05-16T02:32:06+02:00","date_published":"2023-08-09T19:06:18+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/l2/article/2463/galley/1513/download/"}]},{"pk":17818,"title":"Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department Patients","subtitle":null,"abstract":"Introduction:\n Diabetes screening traditionally occurs in primary care settings, but many who are at high risk face barriers to accessing care and therefore delays in diagnosis and treatment. These same high-risk patients do frequently visit emergency departments (ED) and, therefore, might benefit from screening at that time. Our objective in this study was to analyze one year of results from a multisite, ED-based diabetes screening program.\nMethods:\n We assessed the demographics of patients screened, identified differences in rates of newly diagnosed diabetes by clinical site, and the geographic distribution of high and low hemoglobin A1c (HbA1c) results.\nResults:\n We performed diabetes screening (HbA1c) among 4,211 ED patients 40–70 years old, with a body mass index ≥25, and no prior history of diabetes. Of these patients screened for diabetes, 9% had a HbA1c result consistent with undiagnosed diabetes, and nearly half of these patients had a HbA1c ≥9.0%. Rates of newly diagnosed diabetes were notably higher at EDs located in neighborhoods of lower socioeconomic status.\nConclusion:\n Emergency department-based diabetes screening may be a practical and scalable solution to screen high-risk patients and reduce health disparities experienced in specific neighborhoods and demographic groups.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Diabetes"},{"word":"screening"},{"word":"health disparities"},{"word":"emergency department"}],"section":"Public Health","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8fn9h7hd","frozenauthors":[{"first_name":"David","middle_name":"C.","last_name":"Lee","name_suffix":"","institution":"New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York; New York University, NYU Grossman School of Medicine, Department of Population Health, New York, New York; Bellevue Hospital Center, Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Harita","middle_name":"","last_name":"Reddy","name_suffix":"","institution":"New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Christian","middle_name":"A.","last_name":"Koziatek","name_suffix":"","institution":"New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York; New York University, NYU Grossman School of Medicine, Department of Population Health, New York, New York","department":"None"},{"first_name":"Noah","middle_name":"","last_name":"Klein","name_suffix":"","institution":"New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Anup","middle_name":"","last_name":"Chitnis","name_suffix":"","institution":"New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Kashif","middle_name":"","last_name":"Creary","name_suffix":"","institution":"New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Gerard","middle_name":"","last_name":"Francois","name_suffix":"","institution":"New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Olumide","middle_name":"","last_name":"Akindutire","name_suffix":"","institution":"New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Robert","middle_name":"","last_name":"Femia","name_suffix":"","institution":"New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York; Bellevue Hospital Center, Department of Emergency Medicine, New York, New York","department":"None"},{"first_name":"Reed","middle_name":"","last_name":"Caldwell","name_suffix":"","institution":"New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New York","department":"None"}],"date_submitted":"2023-01-21T22:19:16+01:00","date_accepted":"2023-01-21T22:19:16+01:00","date_published":"2023-08-08T21:10:33+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17818/galley/9099/download/"}]},{"pk":18076,"title":"From the Editors – Future Directions to Strengthen the Emergency Department Safety Net","subtitle":null,"abstract":"-","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\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/8x4928x8","frozenauthors":[{"first_name":"Rama","middle_name":"","last_name":"Salhi","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Wendy","middle_name":"L.","last_name":"Macias-Konstantopoulos","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Caitlin","middle_name":"R.","last_name":"Ryus","name_suffix":"","institution":"Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut","department":"None"}],"date_submitted":"2023-04-17T18:54:20+02:00","date_accepted":"2023-04-17T18:54:20+02:00","date_published":"2023-08-08T20:58:21+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/18076/galley/9215/download/"}]},{"pk":17532,"title":"Prehospital mSOFA Score for Quick Prediction of Life-Saving Interventions and Mortality in Trauma Patients: A Prospective, Multicenter, Ambulance-based, Cohort Study","subtitle":null,"abstract":"Background:\n Prehospital emergency medical services (EMS) are the main gateway for trauma patients. Recent advances in point-of-care testing and the development of early warning scores have allowed EMS to improve patient classification. We aimed to identify patients presenting with major trauma involving life-saving interventions (LSI) using the modified Sequential Organ Failure Assessment (mSOFA) score in the prehospital scenario, and to compare these results with those of other trauma scores.\nMethods: \nThis was a prospective, ambulance-based, multicenter, training-validation study in trauma patients who were treated in a prehospital setting and subsequently transported to a hospital. The study involved six Advanced Life Support units, 38 Basic Life Support units, and four hospitals. The primary outcome was LSI performed at the scene or en route and intensive care unit (ICU) admission and all-cause two-day in-hospital mortality. We collected epidemiological variables, creatinine, lactate, base excess, international normalized ratio, and vital signs. Discriminative power (area under the receiver operating characteristic curve [AUC]), calibration (observed vs predicted outcome agreement), and decision-curve analysis (DCA, clinical utility) were used to assess the reliability of the mSOFA in comparison to other scores.\nResults: \nBetween January 1, 2020–April 30, 2022, a total of 763 patients were selected. The mSOFA score’s AUC was 0.927 (95% confidence interval [CI] 0.898–0.957) for LSI, 0.845 (95% CI 0.808–0.882) for ICU admission, and 0.979 (95% CI 0.966–0.991) for two-day mortality.\nConclusion:\n The mSOFA score outperformed the other scores, allowing a quick identification of high-risk patients. The routine implementation in EMS of mSOFA could provide critical support in the decision-making process in time-dependent trauma injuries.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"life-saving interventions"},{"word":"prehospital"},{"word":"Trauma"},{"word":"mSOFA"},{"word":"ICU"},{"word":"Mortality"}],"section":"Emergency Medical Services","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5zz0w01x","frozenauthors":[{"first_name":"Francisco","middle_name":"","last_name":"Martin-Rodriguez","name_suffix":"","institution":"Universidad de Valladolid, Faculty of Medicine, Valladolid, Spain; Emergency Medical Services (SACYL), Advanced Life Support, Valladolid, Spain; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain","department":"None"},{"first_name":"Ancor","middle_name":"","last_name":"Sanz-Garcia","name_suffix":"","institution":"Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain; Universidad de Castilla la Mancha, Faculty of Health Sciences, Talavera de la Reina, Spain","department":"None"},{"first_name":"Ana","middle_name":"","last_name":"Benito Justel","name_suffix":"","institution":"Emergency Medical Services (SACYL), Advanced Life Support, Valladolid, Spain","department":"None"},{"first_name":"Almudena","middle_name":"","last_name":"Morales Sánchez","name_suffix":"","institution":"Emergency Medical Services (SACYL), Advanced Life Support, Valladolid, Spain","department":"None"},{"first_name":"Cristina","middle_name":"","last_name":"Mazas Perez Oleaga","name_suffix":"","institution":"Universidad Europea del Atlántico, Department of Emergency Medicine, Santader, Spain; Universidad Internacional Iberoamericana, Department of Emergency Medicine, Campeche, México","department":"None"},{"first_name":"Irene","middle_name":"","last_name":"Delgado Noya","name_suffix":"","institution":"Universidad Europea del Atlántico, Department of Emergency Medicine, Santader, Spain; Universidade Internacional do Cuanza, Department of Emergency Medicine, Cuito, Bié, Angola","department":"None"},{"first_name":"Irene","middle_name":"","last_name":"Sánchez Soberón","name_suffix":"","institution":"Emergency Medical Services (SACYL), Advanced Life Support, Valladolid, Spain","department":"None"},{"first_name":"Carlos","middle_name":"","last_name":"del Pozo Vegas","name_suffix":"","institution":"Universidad de Valladolid, Faculty of Medicine, Valladolid, Spain; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain; Hospital Clínico Universitario, Department of Emergency Medicine, Valladolid, Spain","department":"None"},{"first_name":"Juan","middle_name":"F.","last_name":"Delgado Benito","name_suffix":"","institution":"Emergency Medical Services (SACYL), Advanced Life Support, Valladolid, Spain; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain","department":"None"},{"first_name":"Raúl","middle_name":"","last_name":"López-Izquierdo","name_suffix":"","institution":"Universidad de Valladolid, Faculty of Medicine, Valladolid, Spain; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain; Hospital Universitario Rio Hortega, Department of Emergency Medicine, Valladolid, Spain","department":"None"}],"date_submitted":"2022-09-29T12:02:40+02:00","date_accepted":"2022-09-29T12:02:40+02:00","date_published":"2023-08-08T20:49:49+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17532/galley/8939/download/"}]},{"pk":17605,"title":"Influence of Body Mass Index on the Evaluation and Management of Pediatric Abdominal Pain in the Emergency Department","subtitle":null,"abstract":"Introduction: \nChildhood obesity is a serious concern in the United States, with over one third of the pediatric population classified as obese. Abdominal pain is one of the most common chief complaints among pediatric emergency department (ED) visits. We hypothesized that overweight and obese children being evaluated in the ED for abdominal pain would have higher resource utilization than their normal and underweight peers.\nMethods: \nThis was a retrospective review of pediatric patients &lt;18 years who presented with abdominal pain to the ED of a tertiary care center from January 1, 2014–September 3, 2020. Patients were excluded if they did not have both a height and weight recorded. We categorized patients as underweight (body mass index [BMI] &lt;5th percentile); normal weight (BMI 5th to &lt;85th percentile), overweight (BMI 85th to&lt;95th percentile); or obese (BMI ≥95th percentile). Descriptive statistics were used to examine the study population. We used chi-square tests to examine the differences in patient characteristics between normal/underweight patients and overweight/obese patients. The Kruskal-Wallis test was completed for examining differences in the medians. We used multivariable logistic regression to examine visit characteristics associated with overweight/obese patients, including ED interventions, testing, and length of stay (LOS).\nResults: \nOf the 184 subjects included in the analysis, nine (4.9%) were underweight, 108 (58.7%) werenormal weight, 21 (11.4%) were overweight, and 46 (25.0%) were obese. Patients with a BMI of ≥85th percentile were older (median 15 vs 13 years, P = 0.01). They were otherwise similar in demographics. There was no significant difference between normal/underweight and overweight/obese subjects in disposition (37% vs 43% discharge, P = 0.38), 72-hour return (7% vs 6%, P = 0.82), ED LOS (median 4.42 vs 3.95 hours, P = 0.195), or inpatient LOS (median 42.0 vs 34.2 hours, P = 0.06). There were no statistically significant differences in total number of ED tests or interventions received by overweight/obese patients compared to normal/underweight patients, and each subject received a median of six tests (interquartile range [IQR] 4–7) and two interventions (IQR 1–3).\nConclusion: \nAmong pediatric patients presenting to the ED with abdominal pain, we found that patient characteristics and ED resource utilization (including testing, intervention, disposition, and LOS) did not differ significantly across BMI categories.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Pediatric, Abdominal Pain, Body Mass Index, BMI, Emergency, PEM"}],"section":"Pediatrics","is_remote":true,"remote_url":"https://escholarship.org/uc/item/93r144fj","frozenauthors":[{"first_name":"Carly","middle_name":"A.","last_name":"Theiler","name_suffix":"","institution":"University of Iowa, Department of Emergency Medicine, Iowa City, Iowa","department":"None"},{"first_name":"Morgan","middle_name":"Bobb","last_name":"Swanson","name_suffix":"","institution":"University of Iowa, Department of Emergency Medicine, Iowa City, Iowa","department":"None"},{"first_name":"Ryan","middle_name":"","last_name":"Squires","name_suffix":"","institution":"Indiana University, Department of Emergency Medicine, Bloomington, Indiana","department":"None"},{"first_name":"Karisa","middle_name":"K.","last_name":"Harland","name_suffix":"","institution":"University of Iowa, Department of Emergency Medicine, Iowa City, Iowa","department":"None"}],"date_submitted":"2022-10-29T02:56:51+02:00","date_accepted":"2022-10-29T02:56:51+02:00","date_published":"2023-08-08T20:33:06+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17605/galley/8982/download/"}]},{"pk":17545,"title":"Social Determinants of Health in EMS Records: A Mixed-methods Analysis Using Natural Language Processing and Qualitative Content Analysis","subtitle":null,"abstract":"Introduction:\n Social determinants of health (SDoH) are known to impact the health and well-being of patients. However, information regarding them is not always collected in healthcare interactions, and healthcare professionals are not always well-trained or equipped to address them. Emergency medical services (EMS) professionals are uniquely positioned to observe and attend to SDoH because of their presence in patients’ environments; however, the transmission of that information may be lost during transitions of care. Documentation of SDoH in EMS records may be helpful in identifying and addressing patients’ insecurities and improving their health outcomes. Our objective in this study was to determine the presence of SDoH information in adult EMS records and understand how such information is referenced, appraised, and linked to other determinants by EMS personnel.\nMethods: \nUsing EMS records for adult patients in the 2019 ESO Data Collaborative public-use research dataset using a natural language processing (NLP) algorithm, we identified free-text narratives containing documentation of at least one SDoH from categories associated with food, housing, employment, insurance, financial, and social support insecurities. From the NLP corpus, we randomly selected 100 records from each of the SDoH categories for qualitative content analysis using grounded theory.\nResults:\n Of the 5,665,229 records analyzed by the NLP algorithm, 175,378 (3.1%) were identified as containing at least one reference to SDoH. References to those SDoH were centered around the social topics of accessibility, mental health, physical health, and substance use. There were infrequent explicit references to other SDoH in the EMS records, but some relationships between categories could be inferred from contexts. Appraisals of patients’ employment, food, and housing insecurities were mostly negative. Narratives including social support and financial insecurities were less negatively appraised, while those regarding insurance insecurities were mostly neutral and related to EMS operations and procedures.\nConclusion:\n The social determinants of health are infrequently documented in EMS records. When they are included, they are infrequently explicitly linked to other SDoH categories and are often negatively appraised by EMS professionals. Given their unique position to observe and share patients’ SDoH information, EMS professionals should be trained to understand, document, and address SDoH in their practice.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"social determinants of health"},{"word":"natural language processing"},{"word":"Qualitative Content Analysis"},{"word":"grounded theory"},{"word":"EMS Documentation"}],"section":"Health Equity","is_remote":true,"remote_url":"https://escholarship.org/uc/item/10n524nx","frozenauthors":[{"first_name":"Susan","middle_name":"J.","last_name":"Burnett","name_suffix":"","institution":"Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Department of Emergency Medicine, Buffalo, New York","department":"None"},{"first_name":"Rachel","middle_name":"","last_name":"Stemerman","name_suffix":"","institution":"ESO, Austin, Texas","department":"None"},{"first_name":"Johanna","middle_name":"C.","last_name":"Innes","name_suffix":"","institution":"Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Department of Emergency Medicine, Buffalo, New York","department":"None"},{"first_name":"Maria","middle_name":"C.","last_name":"Kaisler","name_suffix":"","institution":"Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Department of Emergency Medicine, Buffalo, New York","department":"None"},{"first_name":"Remle","middle_name":"P.","last_name":"Crowe","name_suffix":"","institution":"ESO, Austin, Texas","department":"None"},{"first_name":"Brian","middle_name":"M.","last_name":"Clemency","name_suffix":"","institution":"Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Department of Emergency Medicine, Buffalo, New York","department":"None"}],"date_submitted":"2022-10-01T00:09:45+02:00","date_accepted":"2022-10-01T00:09:45+02:00","date_published":"2023-08-08T20:19:28+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17545/galley/8947/download/"}]},{"pk":17216,"title":"Race, Healthcare, and Health Disparities: A Critical Review and Recommendations for Advancing Health Equity","subtitle":null,"abstract":"An overwhelming body of evidence points to an inextricable link between race and health disparities in the United States. Although race is best understood as a social construct, its role in health outcomes has historically been attributed to increasingly debunked theories of underlying biological and genetic differences across races. Recently, growing calls for health equity and social justice have raised awareness of the impact of implicit bias and structural racism on social determinants of health, healthcare quality, and ultimately, health outcomes. This more nuanced recognition of the role of race in health disparities has, in turn, facilitated introspective racial disparities research, root cause analyses, and changes in practice within the medical community. Examining the complex interplay between race, social determinants of health, and health outcomes allows systems of health to create mechanisms for checks and balances that mitigate unfair and avoidable health inequalities.\nAs one of the specialties most intertwined with social medicine, emergency medicine (EM) is ideally positioned to address racism in medicine, develop health equity metrics, monitor disparities in clinical performance data, identify research gaps, implement processes and policies to eliminate racial health inequities, and promote anti-racist ideals as advocates for structural change. In this critical review our aim was to (a) provide a synopsis of racial disparities across a broad scope of clinical pathology interests addressed in emergency departments—communicable diseases, non-communicable conditions, and injuries—and (b) through a race-conscious analysis, develop EM practice recommendations for advancing a culture of equity with the potential for measurable impact on healthcare quality and health outcomes.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"health disparities"},{"word":"social determinants of health"},{"word":"structural racism"},{"word":"implicit bias"}],"section":"Health Equity","is_remote":true,"remote_url":"https://escholarship.org/uc/item/31g3t8kp","frozenauthors":[{"first_name":"Wendy","middle_name":"L.","last_name":"Macias-Konstantopoulos","name_suffix":"","institution":"Center for Social Justice and Health Equity, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School,Department of Emergency Medicine, Boston, Massachusetts","department":"None"},{"first_name":"Kimberly","middle_name":"A.","last_name":"Collins","name_suffix":"","institution":"Tampa General Hospital, Tampa, Florida","department":"None"},{"first_name":"Rosemarie","middle_name":"","last_name":"Diaz","name_suffix":"","institution":"University of California-Los Angeles, Department of Emergency Medicine, Los Angeles, California","department":"None"},{"first_name":"Herbert","middle_name":"C.","last_name":"Duber","name_suffix":"","institution":"University of Washington School of Medicine, Department of Emergency Medicine, Seattle, Washington; Washington State Department of Health, Tumwater, Washington","department":"None"},{"first_name":"Courtney","middle_name":"D.","last_name":"Edwards","name_suffix":"","institution":"Samford University, Moffett & Sanders School of Nursing, Birmingham, Alabama","department":"None"},{"first_name":"Anthony","middle_name":"P.","last_name":"Hsu","name_suffix":"","institution":"Trinity Health Ann Arbor Hospital, Department of Emergency Medicine, Ypsilanti, Michigan","department":"None"},{"first_name":"Megan","middle_name":"L.","last_name":"Ranney","name_suffix":"","institution":"Yale University, Yale School of Public Health, New Haven, Connecticut","department":"None"},{"first_name":"Ralph","middle_name":"J.","last_name":"Riviello","name_suffix":"","institution":"University of Texas Health San Antonio, Department of Emergency Medicine, San Antonio, Texas","department":"None"},{"first_name":"Zachary","middle_name":"S.","last_name":"Wettstein","name_suffix":"","institution":"University of Washington School of Medicine, Department of Emergency Medicine, Seattle, Washington","department":"None"},{"first_name":"Carolyn","middle_name":"J.","last_name":"Sachs","name_suffix":"","institution":"Ronald Reagan-UCLA Medical Center and David Geffen School of Medicine at University of California-Los Angeles, Department of Emergency Medicine, Los Angeles, California","department":"None"}],"date_submitted":"2022-08-16T06:49:55+02:00","date_accepted":"2022-08-16T06:49:55+02:00","date_published":"2023-08-08T20:09:23+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17216/galley/8703/download/"}]},{"pk":39833,"title":"Areas of endemism conservation hot spots of Paraguay: A study using a multiscale and diverse taxa approach","subtitle":null,"abstract":"Areas of endemism are the basic units for the analysis of historical biogeography, in addition to representing areas of conservation importance. An area of endemism is understood to be the congruence of the distribution areas of two or more species, which are considered primary biogeographic homologies resulting from a presumed common biogeographic history of the taxa that are shared by these areas. The objective of this work was to establish biogeographic patterns in Paraguay through the analysis and identification of areas of endemism. The analyses are based on a matrix composed of 8,117 records of 300 species, including 100 species of Plantae, 50 species of Insecta, 50 species of Amphibia, 50 species of Reptilia, and 50 species of Aves. The analyses performed included an endemicity analysis with cells of 0.3, 0.4, and 0.5 degrees of latitude and longitude. Using the endemicity analysis method, 129 areas of endemism were identified, which were summarized in 13 consensus areas, 2 in the Chaco and 11 in the Eastern Region. By comparing the areas of endemism found, we can identify and propose three hot spot priority areas for conservation based on the endemic richness of the biota.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"biodiversity"},{"word":"Areas of Endemism"},{"word":"ecoregions"},{"word":"biogeography"},{"word":"Analysis of endemicity"},{"word":"Paraguay"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3h91w7h0","frozenauthors":[{"first_name":"Ruben","middle_name":"Ignacio","last_name":"Avila-Torres","name_suffix":"","institution":"Universidad Nacional de Asunción, Facultad de Ciencias Exactas y Naturales","department":"None"},{"first_name":"Guillermo","middle_name":"","last_name":"D'Elia","name_suffix":"","institution":"Instituto de Ciencias Ambientales y Evolutivas, Facultad de Ciencias, Universidad Austral de Chile, Valdivia","department":"None"},{"first_name":"Christian","middle_name":"","last_name":"Vogt","name_suffix":"","institution":"Universidad Nacional de Asunción, Facultad de Ciencias Exactas y Naturales, Departamento de Biología, Campus UNA, San Lorenzo","department":"None"},{"first_name":"Bolivar","middle_name":"","last_name":"Garcete-Barrett","name_suffix":"","institution":"Universidad Nacional de Asunción, Facultad de Ciencias Exactas y Naturales, Departamento de Biología, Campus UNA, San Lorenzo","department":"None"},{"first_name":"Sara","middle_name":"","last_name":"Escobar","name_suffix":"","institution":"Universidad Nacional de Asunción, Facultad de Ciencias Exactas y Naturales, Departamento de Biología, Campus UNA, San Lorenzo","department":"None"},{"first_name":"Gabriela","middle_name":"","last_name":"Maldonado","name_suffix":"","institution":"Universidad Nacional de Asunción, Facultad de Ciencias Exactas y Naturales, Departamento de Biología, Campus UNA, San Lorenzo","department":"None"}],"date_submitted":"2022-09-29T23:07:48+02:00","date_accepted":"2022-09-29T23:07:48+02:00","date_published":"2023-08-06T21:58:48+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/biogeographia/article/39833/galley/30003/download/"}]},{"pk":39843,"title":"Diversity of Platyhelminthes Proseriata in Western Mediterranean sandy beaches: a database of species occurrences and traits","subtitle":null,"abstract":"We present here a first comprehensive database on the diversity of proseriate flatworms (Platyhelminthes: Rhabditophora: Proseriata) on Western Mediterranean microtidal, wave dominated beaches. We sampled 116 stations in two years, through Spain (22 beaches, including Balearic Islands), France (25 beaches, including Corsica), Italy (63 beaches, including Sardinia, Sicily, and Lampedusa), and Tunisia (6 beaches). In each beach, we sampled at three depths, corresponding to the swash, shoal, and subtidal zones. For each sample, we obtained environmental data. The research yielded a total of 152 species, of which 93 were new to science. For each of the species found, we coded and described 16 functional traits. We discuss the functional meaning of the selected traits, as well as on diversity patterns and emerging biogeographic signals across the investigated regions. We particularly focused on the most widespread and dominant species in our dataset, concentrating on their putative adaptations to high energy environments; as well as the high number (58) of the species only found once. Finally, we discussed the coverage of our sampling by estimating the diversity at each investigated region and comparing it to the actual diversity. All information provided is available through the Global Biodiversity Information Facility (GBIF) and the Open Science Framework (OSF) following the Darwin Core Standard.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"sandy beaches"},{"word":"meiofauna"},{"word":"meiobenthos"},{"word":"open data"},{"word":"biogeography"},{"word":"biodiversity"}],"section":"Data Papers","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0001n5qb","frozenauthors":[{"first_name":"Marco","middle_name":"","last_name":"Curini-Galletti","name_suffix":"","institution":"University of Sassari","department":"None"},{"first_name":"Diego","middle_name":"","last_name":"Fontaneto","name_suffix":"","institution":"National Research Council of Italy","department":"None"},{"first_name":"Alejandro","middle_name":"","last_name":"Martinez","name_suffix":"","institution":"National Research Council of Italy","department":"None"}],"date_submitted":"2023-06-05T11:57:37+02:00","date_accepted":"2023-06-05T11:57:37+02:00","date_published":"2023-08-06T21:44:03+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/biogeographia/article/39843/galley/30009/download/"}]},{"pk":35179,"title":"A Khowar-English glossary [HL Archive 12]","subtitle":null,"abstract":"This is a roman-based Khowar-English vocabulary/glossary/dictionary which I have chosen to call \"glossary\" since it makes no claim to completeness. It includes contextual and cultural notes when such information was supplied by the people who contributed to it.  Each entry consists of a headword, English gloss or definition, and sources.  Many entries include example sentences with English translations, derivational notes, or etymological notes. Sources for each entry (the persons who have contributed the item) are given for each entry.\nThe two main target audiences for this work are speakers of Khowar and all kinds of linguists.","language":"en","license":null,"keywords":[{"word":"Khowar, linguistics, Dardic"}],"section":"Archives","is_remote":true,"remote_url":"https://escholarship.org/uc/item/955239w9","frozenauthors":[{"first_name":"Elena","middle_name":"","last_name":"Bashir","name_suffix":"","institution":"University of Chicago","department":"None"}],"date_submitted":"2022-05-04T21:20:03+02:00","date_accepted":"2022-05-04T21:20:03+02:00","date_published":"2023-08-05T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/himalayanlinguistics/article/35179/galley/26188/download/"}]},{"pk":63431,"title":"Racial Control and Student Labor","subtitle":null,"abstract":"The exploitation of labor has occupied a central role in historical analysis of race and racism. In considering schooling as a site of institutional racism, however, the exploitation of student labor is seldom considered seriously. This is all the more surprising given the extent to which school is organized around the efficient extraction of student work, and the amount of thought which goes into maximizing productivity, achievement, and success. Here, I discuss schooling in two ways: first, as an institution of racial control; second, as a structure of labor exploitation. I first discuss problems with dominant scholarship dealing with economic reproduction in schooling, and then highlight the historical dimensions of schooling as a site of racial labor exploitation. Next, I describe the utilities (corporate and social) of student labor in contemporary racial capitalism. Finally, I suggest that looking at schooling as a site of labor exploitation enables us to locate a ‘general strike’––that is, the ways in which students of color refuse and disrupt the daily operations of an oppressive structure. Such an analytic encourages teachers to reimagine classroom management in order to: (1) read student disruption as a radical and political move toward freedom; and (2) cede the means of production of schooling to the students themselves. This is necessary, I argue, in order to produce a truly transformational and liberatory educational space.","language":"en","license":null,"keywords":[{"word":"Education"},{"word":"Labor"},{"word":"Marxism"},{"word":"Racial Control"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6fk0g56s","frozenauthors":[{"first_name":"Bennett","middle_name":"","last_name":"Brazelton","name_suffix":"","institution":"Boston Public Schools","department":""},{"first_name":"Bennett","middle_name":"","last_name":"Brazelton","name_suffix":"","institution":"Boston Public Schools","department":""}],"date_submitted":"2020-06-20T21:07:09+02:00","date_accepted":"2020-06-20T21:07:09+02:00","date_published":"2023-08-04T23:29:56+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/bre/article/63431/galley/48863/download/"}]},{"pk":35660,"title":"Circumspector Reads Hominidae, Generatio and Sexus Nexus and It Is About Incest Prohibition and Inbreeding Avoidance","subtitle":null,"abstract":"","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Kinship, Terminology, Incest"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2mj9m2h7","frozenauthors":[{"first_name":"Avatar","middle_name":"","last_name":"Circumspector 1","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2023-08-02T21:38:17+02:00","date_accepted":"2023-08-02T21:38:17+02:00","date_published":"2023-08-02T21:38:37+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/kinship/article/35660/galley/26529/download/"}]},{"pk":35659,"title":"Introduction to Volume 3, Issue 2","subtitle":null,"abstract":"","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Kinship, Avatar debate"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/14g3b973","frozenauthors":[{"first_name":"Fadwa","middle_name":"","last_name":"El Guindi","name_suffix":"","institution":"UCLA","department":"None"},{"first_name":"Dwight","middle_name":"W.","last_name":"Read","name_suffix":"","institution":"University of California, Los Angeles","department":"None"}],"date_submitted":"2023-08-02T21:32:30+02:00","date_accepted":"2023-08-02T21:32:30+02:00","date_published":"2023-08-02T21:33:07+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/kinship/article/35659/galley/26528/download/"}]},{"pk":35661,"title":"SEX, LOVE, INCEST, DEATH, AND SUCCESSION: BEYOND BASIC BIOLOGY","subtitle":null,"abstract":"","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Kinship"},{"word":"Avatar"},{"word":"kinship terminology"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/66b883gp","frozenauthors":[{"first_name":"Avatar","middle_name":"","last_name":"Circumspector 2","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2023-08-02T21:41:43+02:00","date_accepted":"2023-08-02T21:41:43+02:00","date_published":"2023-08-02T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/kinship/article/35661/galley/26530/download/"}]},{"pk":54252,"title":"Capital, Autonomy, and  the Limits of Corporate Critique","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"Book Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6h54g0cx","frozenauthors":[{"first_name":"Tully","middle_name":"","last_name":"Rector","name_suffix":"","institution":"","department":""}],"date_submitted":"2023-05-21T00:31:15+02:00","date_accepted":"2023-05-21T00:31:15+02:00","date_published":"2023-08-01T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/lawandpoliticaleconomy/article/54252/galley/41003/download/"}]},{"pk":54249,"title":"Decentering the “Private” in the World Power System","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"Book Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3p08z23t","frozenauthors":[{"first_name":"Marija","middle_name":"","last_name":"Bartl","name_suffix":"","institution":"","department":""},{"first_name":"Eva","middle_name":"","last_name":"Vermeulen","name_suffix":"","institution":"","department":""}],"date_submitted":"2023-05-21T00:25:10+02:00","date_accepted":"2023-05-21T00:25:10+02:00","date_published":"2023-08-01T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/lawandpoliticaleconomy/article/54249/galley/41000/download/"}]},{"pk":54242,"title":"Front Matter Vol 3 Iss 3","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"Front Matter","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5zc8t0xd","frozenauthors":[{"first_name":"JLPE","middle_name":"","last_name":"Editors","name_suffix":"","institution":"","department":""}],"date_submitted":"2023-05-21T00:01:40+02:00","date_accepted":"2023-05-21T00:01:40+02:00","date_published":"2023-08-01T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/lawandpoliticaleconomy/article/54242/galley/40993/download/"}]},{"pk":54251,"title":"Property: Authority Without Office?","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"Book Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3336q1fw","frozenauthors":[{"first_name":"Rutger","middle_name":"","last_name":"Claasen","name_suffix":"","institution":"","department":""},{"first_name":"Larissa","middle_name":"","last_name":"Katz","name_suffix":"","institution":"","department":""}],"date_submitted":"2023-05-21T00:29:09+02:00","date_accepted":"2023-05-21T00:29:09+02:00","date_published":"2023-08-01T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/lawandpoliticaleconomy/article/54251/galley/41002/download/"}]},{"pk":54254,"title":"Property, Power and Politics Reviewed—A Reply to Critics","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"Book Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3rj1546x","frozenauthors":[{"first_name":"Jean-Philippe","middle_name":"","last_name":"Robe","name_suffix":"","institution":"","department":""}],"date_submitted":"2023-05-21T00:35:30+02:00","date_accepted":"2023-05-21T00:35:30+02:00","date_published":"2023-08-01T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/lawandpoliticaleconomy/article/54254/galley/41005/download/"}]},{"pk":54250,"title":"The Importance of Property, Power and Politics  to Political Science","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"Book Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2x20b68k","frozenauthors":[{"first_name":"Bertjan","middle_name":"","last_name":"Verbeek","name_suffix":"","institution":"","department":""}],"date_submitted":"2023-05-21T00:27:12+02:00","date_accepted":"2023-05-21T00:27:12+02:00","date_published":"2023-08-01T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/lawandpoliticaleconomy/article/54250/galley/41001/download/"}]},{"pk":54253,"title":"What Is Wrong with the World Power System and What Can Accounting Do About It?","subtitle":null,"abstract":"","language":"en","license":null,"keywords":[],"section":"Book Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6vb2z82h","frozenauthors":[{"first_name":"Barbara","middle_name":"","last_name":"Bziuk","name_suffix":"","institution":"","department":""},{"first_name":"Philipp","middle_name":"","last_name":"Stehr","name_suffix":"","institution":"","department":""}],"date_submitted":"2023-05-21T00:33:45+02:00","date_accepted":"2023-05-21T00:33:45+02:00","date_published":"2023-08-01T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/lawandpoliticaleconomy/article/54253/galley/41004/download/"}]},{"pk":42181,"title":"Could ChatGPT Prompt a New Golden Age in Higher Education?","subtitle":null,"abstract":"The public rollout of ChatGPT, a free app that produces uncannily refined responses to users’ questions or prompts, initially had many education professionals up in arms due largely to fears over student cheating. Panic levels receded as a new realization surfaced: rather than simply banning the use of generative artificial intelligence (GenAI or AI) for assignments, we can and should adapt to chatbot-related challenges, reframing them as opportunities. In meeting this new technology with creativity and purpose, we can reorient education’s compass needle back toward process as opposed to product – toward thinking about as opposed to merely recounting what others have said. In other words, higher education must evolve, and the adaptations we create, not ChatGPT, could be the real revolution.","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Chatbot"},{"word":"Generative Artificial Intelligence (Gen-AI, AI)"},{"word":"Higher education"},{"word":"pedagogy"},{"word":"Critical thinking"}],"section":"Commentaries","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5p3048f2","frozenauthors":[{"first_name":"Elisa","middle_name":"","last_name":"Sobo","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2023-02-08T05:20:36+01:00","date_accepted":"2023-02-08T05:20:36+01:00","date_published":"2023-08-01T07:38:37+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/teachinglearninganthro/article/42181/galley/31495/download/"}]},{"pk":2896,"title":"A Review of Program Inquiry for Refugee Adult Education in the United States","subtitle":null,"abstract":"According to the UN Refugee Agency's annual \nGlobal Trends Report\n, 68.5 million people were forcibly displaced worldwide as of June 2018. This humanitarian crisis raises the question of responsibility on host countries to address the dire need for education access. Questions around how existing adult refugee educational programs should be evaluated remain relatively unexplored. The purpose of this review is to examine existing bodies of academic literature on how evaluation is applied in adult educational programming for refugees within community organizations and how programs utilize evaluation to improve their effectiveness in serving adult refugee populations in the United States. This literature review explores two questions: (1) how is evaluation structured in practice in nonformal educational programs for refugee young adults and adults in the United States? (2) What outcomes typically follow the implementation of evaluation within these programs (i.e. does evaluation influence the effectiveness and accessibility of adult educational programming, such as by providing educational and vocational training?). Considerations which emerged from this review include utilizing theory knitting in evaluation to reduce theoretical segregation and accumulate additional theory that may be present within the current literature. Exploring socio-cultural capital frameworks such as Yosso’s Community Cultural Wealth can further categorize and investigate additional experiences based on specific ethnicities in emerging literature within refugee integration in a country of resettlement in addition to Ager and Strang’s Understanding Integration Framework. Lastly, to better identify the approaches on use of evaluation within the scope of nonformal adult educational settings for adult refugees, expanding Alkin &amp; Christie’s Evaluation Theory Tree to include international perspectives from the development sector should be considered.","language":"en","license":null,"keywords":[{"word":"Education, Program Evaluation, Refugees, Migration, Integration, Resettlement,  Adult Education"}],"section":"Literature Reviews","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8b41x24h","frozenauthors":[{"first_name":"Christine","middle_name":"Abagat","last_name":"Liboon","name_suffix":"","institution":"UCLA","department":"None"}],"date_submitted":"2020-01-20T02:19:42+01:00","date_accepted":"2020-01-20T02:19:42+01:00","date_published":"2023-07-31T22:47:44+02:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/gseis_interactions/article/2896/galley/1718/download/"}]},{"pk":126,"title":"RETRACTED: English temporal gestures are spatial gestures","subtitle":null,"abstract":"<font face=\"Arial, sans-serif\"><span style=\"font-size: 14.6667px;\">This article has&nbsp;</span></font><span style=\"font-family: Arial, sans-serif; font-size: 11pt;\">been retracted by mutual agreement of the author and editors. After some investigation, the authors determined that unintentional error led to the presentation of theoretical conclusions that contradict important findings reported in the article, and it was determined that this could not be resolved with a minor correction.</span>","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":"Brief Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3hh1475n","frozenauthors":[{"first_name":"Javier","middle_name":"","last_name":"Valenzuela","name_suffix":"","institution":"University of Murcia","department":"English Studies"},{"first_name":"Daniel","middle_name":"","last_name":"Alcaraz-Carrión","name_suffix":"","institution":"University of Murcia","department":"English Studies"}],"date_submitted":"2022-02-19T19:59:39.734000+01:00","date_accepted":"2023-07-19T23:45:21.535000+02:00","date_published":"2023-07-31T20:05:00+02:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/126/galley/1101/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/126/galley/1101/download/"}]},{"pk":1267,"title":"The male bias can be attenuated in reading: on the resolution of anaphoric expressions following gender-fair forms in French","subtitle":null,"abstract":"Despite the increased use of different types of gender-fair forms in French, studies investigating how they are interpreted when presented in a sentence remain few. To fill this gap, we conducted a pre-registered study using a timed sentence evaluation task to examine the possibility of speakers’ establishing an anaphoric relationship between a gendered anaphoric expression (<i>femmes</i> ‘women’ or <i>hommes</i> ‘men’) and non-stereotyped role nouns as antecedents. The antecedents were presented in their masculine form or in one out of three different gender-fair forms (complete double forms: <i>les voisines et voisins</i> ‘the neighbours.<sub>FEM</sub> and neighbours.<sub>MASC</sub>’, contracted double forms: <i>les voisin·es</i> ‘the neighbours.<sub>MASC·FEM</sub>’, or gender-neutral forms: <i>le voisinage</i> ‘the neighbourhood’). In line with previous findings, the masculine form led to a male bias in the participants’ mental representations of gender. All three examined gender-fair forms resolved this bias, but comparisons of the different forms to each other revealed differences between them. The results show that complete double forms lead to equally balanced mental representations of gender while contracted double forms slightly favour representation of women. Finally, gender-neutral forms result in a small male bias, although significantly smaller than the one produced by the masculine form. The results are discussed in relation to the mental models theory and provide new and important insights on how gender-fair forms in French are interpreted.&nbsp;","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":"Regular Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/19d947nw","frozenauthors":[{"first_name":"Julia","middle_name":"","last_name":"Tibblin","name_suffix":"","institution":"Lund University","department":""},{"first_name":"Jonas","middle_name":"","last_name":"Granfeldt","name_suffix":"","institution":"Lund University","department":""},{"first_name":"Joost","middle_name":"","last_name":"van de Weijer","name_suffix":"","institution":"Lund University","department":""},{"first_name":"Pascal","middle_name":"","last_name":"Gygax","name_suffix":"","institution":"University of Fribourg","department":""}],"date_submitted":"2023-04-02T12:01:20.844000+02:00","date_accepted":"2023-06-21T14:46:13.950000+02:00","date_published":"2023-07-31T20:00:00+02:00","render_galley":{"label":"XML","type":"xml","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/1267/galley/1097/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/1267/galley/1096/download/"},{"label":"XML","type":"xml","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/1267/galley/1097/download/"}]},{"pk":192,"title":"No genericity in sight: An exploration of the semantics of masculine generics in German","subtitle":null,"abstract":"<p class=\"p1\" style=\"margin-bottom: 12px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;\">Findings of previous behavioural studies suggest that the semantic nature of what is known as the ‘masculine generic’ in Modern Standard German is indeed not generic but biased towards a masculine reading. Such findings are the cause of debates within and outside linguistic research, as they run counter to the grammarian assumption that the masculine generic form is gender-neutral. The present paper aims to explore the semantics of masculine generics, relating them to&nbsp; those&nbsp; of&nbsp; masculine&nbsp; and&nbsp; feminine&nbsp; explicit&nbsp; counterparts.&nbsp; To&nbsp; achieve&nbsp; this&nbsp; aim,&nbsp; an&nbsp; approach&nbsp; novel&nbsp; to&nbsp; this&nbsp; area&nbsp; of&nbsp; linguistic&nbsp; research&nbsp; is&nbsp; made&nbsp; use&nbsp; of:&nbsp; discriminative&nbsp; learning.&nbsp; Analysing&nbsp; semantic&nbsp; vectors&nbsp; obtained&nbsp; via&nbsp; naive&nbsp; discriminative&nbsp; learning,&nbsp; semantic&nbsp; measures&nbsp; calculated&nbsp; via&nbsp; linear&nbsp; discriminative&nbsp; learning,&nbsp; and&nbsp; taking&nbsp; into&nbsp; account&nbsp; the&nbsp; stereotypicality&nbsp; of&nbsp; the&nbsp; words&nbsp; under investigation, it is found that masculine generics are semantically much more similar to masculine explicits than to feminine explicits. The results presented in this paper thus support the notion of a masculine bias in masculine generics. Further, new insights into the semantic representations of masculine generics are provided and it is shown that stereotypicality does not modulate the masculine bias.</p><p><br></p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Regular Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/44d4x732","frozenauthors":[{"first_name":"Dominic","middle_name":"","last_name":"Schmitz","name_suffix":"","institution":"Heinrich Heine University Düsseldorf","department":"English language and linguistics"},{"first_name":"Viktoria","middle_name":"","last_name":"Schneider","name_suffix":"","institution":"Heinrich Heine University Düsseldorf","department":"English language and linguistics"},{"first_name":"Janina","middle_name":"","last_name":"Esser","name_suffix":"","institution":"Association for Diversity in Linguistics","department":"","country":"Germany"}],"date_submitted":"2022-09-05T15:49:40.627000+02:00","date_accepted":"2023-07-06T16:52:30.961000+02:00","date_published":"2023-07-31T19:50:00+02:00","render_galley":{"label":"XML","type":"xml","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/192/galley/1091/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/192/galley/1090/download/"},{"label":"XML","type":"xml","path":"https://journalpub.escholarship.org/glossapsycholinguistics/article/192/galley/1091/download/"}]},{"pk":52003,"title":"A Case Report of Invasive Mucormycosis in a COVID-19 Positive and Newly-Diagnosed Diabetic Patient","subtitle":null,"abstract":"ABSTRACT:This is a case report of a 46-year-old female with undiagnosed diabetes, COVID-19, and mucormycosis. Mucormycosis is a rare, rapidly progressive disease process characterized by an insidious onset of vague symptoms and is associated with a high mortality rate. The patient initially presented at two outside ophthalmology clinics due to right eye pain and was prescribed steroids. Upon presentation to our institution’s Emergency Department, the patient’s pain had significantly increased along with new symptoms of ptosis and failure to adduct the right eye. Laboratory results demonstrated leukocytosis, hyperglycemia, and a positive SARS-CoV-2 test. Magnetic resonance imaging confirmed a diagnosis of mucormycosis and the patient underwent surgery and began intravenous antifungal therapy. This discussion addresses the presenting features of mucormycosis in the emergency department while highlighting the need for immediate investigation due to the fungi’s rapidly progressive nature.\nTopics: Mucormycosis, mucor, diabetes, COVID-19, ROCM.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Mucormycosis, mucor, diabetes, COVID-19, ROCM"}],"section":"Visual EM","is_remote":true,"remote_url":"https://escholarship.org/uc/item/12c4p941","frozenauthors":[{"first_name":"Konnor","middle_name":"","last_name":"Davis, BS","name_suffix":"","institution":"University of California, Irvine, School of Medicine, Irvine, CA","department":""},{"first_name":"Roy","middle_name":"","last_name":"Almog, MD","name_suffix":"","institution":"University of California, Irvine, Department of Emergency Medicine, Orange, CA","department":""},{"first_name":"Yuval","middle_name":"","last_name":"Peleg, MD, MBA","name_suffix":"","institution":"University of California, Irvine, Department of Emergency Medicine, Orange, CA","department":""},{"first_name":"Lindsey","middle_name":"","last_name":"Spiegelman, MD, MBA","name_suffix":"","institution":"University of California, Irvine, Department of Emergency Medicine, Orange, CA","department":""}],"date_submitted":"2023-08-02T19:33:35+02:00","date_accepted":"2023-08-02T19:33:35+02:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52003/galley/39380/download/"}]},{"pk":51995,"title":"Acute Pulmonary Edema and NSTEMI","subtitle":null,"abstract":"ABSTRACT:Audience: Emergency medicine residents and medical students on emergency medicine rotation.\nIntroduction: Acute pulmonary edema is a common and potentially fatal presentation in the emergency department. More than 1 million patients are admitted annually with a diagnosis of pulmonary edema secondary to cardiac causes.1 Pulmonary edema is broadly split into two main categories: cardiogenic and noncardiogenic. Cardiogenic pulmonary edema is characterized by acute dyspnea caused by the accumulation of fluid within the lung’s interstitial and/or alveolar spaces, which is the result of acutely elevated cardiac filling pressures.2 Noncardiogenic pulmonary edema is characterized by fluid accumulation within the alveolar space in the absence of elevated pulmonary capillary wedge pressure.2 These patients often present critically ill, and rapid identification and aggressive management is paramount in caring for patients with pulmonary edema. Dyspnea is the most common presentation with a sensitivity of 89% but a low specificity of 51%.3 Workup of pulmonary edema often includes laboratory testing, electrocardiogram (EKG), chest x-ray (CXR), and often bedside ultrasound (US) and echocardiography.4 Pulmonary edema management depends on the etiology but is often focused on preload and afterload reduction. Diuretics, nitrates, and optimizing ventilatory support through non-invasive and invasive strategies are the mainstay of treatment.\nEducational Objectives: At the end of this practice oral boards case, the learner will:1) recognize unstable vital signs (VS) and intervene to stabilize ventilation and oxygenation, 2) demonstrate the ability to obtain a complete medical history including the important characteristics of chest pain, 3) demonstrate an appropriate exam on a patient, 4) order the appropriate evaluation studies for a patient with complaints of dyspnea, 5) interpret the results of diagnostic evaluation and diagnose Non- ST elevation myocardial infarction (NSTEMI) and pulmonary edema, 6) order appropriate management of pulmonary edema and NSTEMI, and 6) demonstrate effective communication with patient and family members.\nEducational Methods: Practice oral boards\nResearch Methods: Immediate Feedback was solicited from the learners and observers participating in the case both by verbal discussion and completion of a rating for the case following the debriefing. The efficacy of the educational content was assessed by comparing scoring measures across residents based on the training year. Scoring measures of the American College of Graduate Medical Education (ACGME) core competencies were performed using a scale from 1 – 8, 1- 4 being unacceptable performance and 5 – 8 being acceptable. Efficacy was assumed based on full completion of the case by the residents who acted as practice oral board candidates, and a debriefing session followed to discuss the key components of the case.\nResults: This case was presented to twelve Emergency Medicine Residents, seven PGY 1 and five PGY 2 at a relatively new residency program. The overall average score for the residents was 5.62. The PGY 1 Residents’ average on the case was 5.56, and the average for the PGY 2 Residents was slightly better at 5.70. The slight improvement noted by the PGY 2 Residents is likely attributable to more clinical experience; however, both classes did not have any prior exposure to the oral board format until this simulated experience. Six residents completed all critical actions in the case. Of those who missed a critical action, failing to diagnose NSTEMI and consulting cardiology were the most common. All learners found educational value in the case with an overall rating of 4.83 (1-5 Likert scale, 5 being excellent).\nDiscussion: Acute pulmonary edema and NSTEMI are common diagnoses that will be frequently encountered for most emergency physicians. This case highlights the need for early identification and aggressive management of the patient presenting with respiratory distress. The differential for respiratory distress is large, but most learners were able to quickly identify pulmonary edema based on the exam findings of jugular vein distention (JVD), rales, and lower extremity edema. Most learners quickly escalated to a non-rebreather mask and ultimately to BPAP (bilevel positive airway pressure) without requesting to intubate the patient. There was notable variation in the approach to administering nitrates, but most ordered an intravenous (IV) nitroglycerin (NTG) drip and requested pharmacy assistance in dosing. Diuretics were ordered by all the learners, but some were hesitant to start early because they felt the effect would be delayed. Some of the residents did not identify ischemic changes on the EKG at first glance but did request to review a second time when the troponin result was positive. All residents gave aspirin after noting the positive troponin, but not all were able to make a clear diagnosis of NSTEMI or consult cardiology. Although the case was relatively straightforward, residents enjoyed early diagnosis and aggressive management of the patient with impending respiratory failure. Many residents are asking for an ultrasound early in the workup of this patient presenting in respiratory distress. Although not a critical action in this case, it highlights the emphasis placed on ultrasonography in the current emergency medicine curriculum.\nTopics: Pulmonary Edema, Cardiovascular emergencies, NSTEMI.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Pulmonary Edema, Cardiovascular emergencies, NSTEMI"}],"section":"Oral Boards","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2sd4n275","frozenauthors":[{"first_name":"Ashley","middle_name":"","last_name":"Pilgrim, MD","name_suffix":"","institution":"Sutter Roseville Medical Center, Department of Emergency Medicine, Roseville, CA","department":""}],"date_submitted":"2023-08-02T05:16:30+02:00","date_accepted":"2023-08-02T05:16:30+02:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/51995/galley/39373/download/"}]},{"pk":52005,"title":"A Homemade, Cost-Effective, Realistic Pelvic Exam Model","subtitle":null,"abstract":"ABSTRACT:Audience: This innovation is intended to instruct medical students, residents of all levels, and mid-level practitioners.\nBackground: Pelvic examinations are essential components to clinical practice but are challenging to teach, learn, and practice on live patients secondary to patient comfort because this is an invasive procedure.1 Resident physicians and medical students traditionally learn these methods through observation while actively working in their department or clinics.2 Simulation models can improve a provider’s competency and confidence performing pelvic examinations which improve patient comfort and exam accuracy.3 One barrier to simulation training is the cost of the pelvic simulator models. A basic pelvic exam simulator costs $365.4 The cost is high, therefore limiting the availability of a simulation model accessible to residency programs across the country. This barrier to pelvic models was overcome by developing a homemade alternative for cervical examination and collection of screening swabs. The model created can be easily manufactured by students, residents, and faculty alike for less than $20 and approximately two hours of manufacturing time. A literature review was conducted to find similar products and other production methods for a pelvic examination model. No comparable models were found.\nThis is a guide to utilizing supplies from a local dollar store combined with home recycling products and a few common crafting tools to create a realistic pelvic examination model.\nEducational Objectives: After utilizing this pelvic examination model, the learner will be able to: 1) demonstrate ability to perform a pelvic examination comfortably and safely, 2) demonstrate ability to obtain a cervical swab on female patients, and 3) show proficient understanding of female anatomy.\nEducational Methods: The pelvic exam model is utilized to effectively teach proper technique for pelvic examinations. This model can be utilized to teach medical students, incoming residents, and new mid-levels. Senior residents, experienced mid-levels, or attendings who are experienced in completing pelvic examinations can easily utilize this model to teach proper technique.\nResearch Methods: The data for this study was collected from a single graduate medical education program in Detroit, Michigan. This was designed as a single blind survey where the reviewer’s identities were kept anonymous from the data collectors. Surveys were collected from attendings, residents, mid-level providers, and medical students across specialties of emergency medicine, family medicine, obstetrics and gynecology.\nResults: A total of 77 individuals tested the homemade model and compared it to a pelvic exam on a live patient as well as a commercial pelvic exam model. Survey results showed the low-cost homemade model was just as effective as a commercially manufactured model, with some respondents saying the DIY model was more effective and more realistic. Comparing the commercial models to the homemade model, 54 of the 77 participants had experience with a commercial model. In the survey when compared to a commercial model, 57% of the participants felt the examination was the same, and 31% indicated the homemade model felt more realistic.\nDiscussion: Overall, the homemade cost-effective model is comparable if not more realistic to more expensive commercial models. The main take away of this innovation, to remember it is possible to create cost-effective models for realistic, educational learning. This model has one limitation because it is not suitable for a bimanual examination, but it can be expanded to allow for bimanual examination.\nTopics: Pelvic examination, cervical examination, creative simulation models.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Pelvic examination, cervical examination, creative simulation models"}],"section":"Innovations","is_remote":true,"remote_url":"https://escholarship.org/uc/item/29b319qs","frozenauthors":[{"first_name":"Jessie","middle_name":"","last_name":"Godsey, MD","name_suffix":"","institution":"Ascension Macomb Oakland, Department of Emergency Medicine, Warren, MI","department":""},{"first_name":"Ilya","middle_name":"rkott@hs.uci.edu","last_name":"Kott, MD","name_suffix":"","institution":"Ascension Macomb Oakland, Department of Emergency Medicine, Warren, MI","department":""},{"first_name":"Adrienne","middle_name":"","last_name":"Payden","name_suffix":"","institution":"Ascension Macomb Oakland, Department of Emergency Medicine, Warren, MI","department":""},{"first_name":"Patricia","middle_name":"","last_name":"Ward","name_suffix":"","institution":"Ascension Macomb Oakland, Department of Emergency Medicine, Warren, MI","department":""}],"date_submitted":"2023-08-03T05:36:22+02:00","date_accepted":"2023-08-03T05:36:22+02:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52005/galley/39382/download/"}]},{"pk":51999,"title":"Alcohol Withdrawal with Delirium Tremens","subtitle":null,"abstract":"ABSTRACT:Audience: Emergency medicine (EM) residents (1st year and 2nd year levels), 4th year medical students and advanced practice providers\nIntroduction:\nAlcohol use has played a major role in causing significant morbidity and mortality for patients. In 2016, it was the 7th leading risk factor for deaths and disability-adjusted life years globally.1 Among heavy alcohol users admitted for hospital management, the incidence of alcohol withdrawal syndrome is estimated to be 1.9 to 6.7%.1 Alcohol withdrawal (AW) in the ED has been associated with increased use of critical care resources, and frequent ED visits for alcohol-related presentations have been associated with mortality rates that are about 1-4% when withdrawal progresses to delirium tremens (DTs).1 Patients with alcohol withdrawal can present in many different ways to the ED including anxiety, tachycardia, delirium tremens (DTs), seizures and severe autonomic dysfunction leading to severe sickness and death.2 Therefore, it is extremely important for an EM physician to recognize the signs of AW in patients and to manage the critically ill patients. In addition, Clinical Institute Withdrawal Assessment (CIWA) of alcohol was developed to assess severity of alcohol withdrawal in 1989.3 EM physicians should utilize CIWA to help determine the severity of AW.\nEducational Objectives: By the end of the session, learner will be able to 1) discuss the causes of altered mental status, 2) utilize CIWA scoring system to quantify AW severity, 3) formulate appropriate treatment plan for AW by treating with benzodiazepine and escalating treatment appropriately, 4) treat electrolyte abnormalities by giving appropriate medications for hypokalemia and hypomagnesemia, and 5) discuss clinical progression and timing to AW.\nEducational Methods: This session was conducted using high-fidelity simulation, which was immediately followed by an in-depth debriefing session. The session was run during first year EM resident intern orientation, and it was run during two consecutive years. There was a total of 32 EM residents who participated. There was a total of 16 residents who actively managed the patient while the other 16 were observers. Each session had four learners and was run twice in two separate rooms. There was one simulation instructor running the session and one simulation technician who acted as a nurse.\nResearch Methods: After the simulation and debriefing session was complete, an online survey was sent via surveymonkey.com to all the participants. The survey collected responses to the following questions: (1) the case was believable, (2) the case had right the amount of complexity (based on their Gestalt), (3) the case helped in improving medical knowledge and patient care, (4) the simulation environment gave me a real-life experience and, (5) the debriefing session after simulation helped improve my knowledge. The responses were collected using a Likert scale of 1 to 5 with 1 being “Strongly disagree” and 5 being “Strongly agree.”\nResults: There was a total of 15 respondents from both years. One hundred percent of them either agreed or strongly agreed that the case was beneficial in learning, in improving medical knowledge and in patient care. All of them found the post-session debrief to be very helpful. Two of them felt neutral about the case being realistic. The median response for questions 1, 3 and 5 is 5. The median response for questions 2 and 4 was 4. The range of responses for questions 1, 2, 3 and 5 was 4-5 while the range for question 4 was 3-5.\nDiscussion: This high-fidelity simulation was a cost-effective and realistic way of educating learners on how to manage AW with DTs. Learners are forced to start with a broad differential for the patient who presents with AMS. As they recognize the cause of mental status, the patient quickly decompensates into developing severe agitation and autonomic dysfunction requiring learners to manage the patient and establish an airway. Learners found the case to be beneficial in learning the management of AW.\nTopics: Alcohol withdrawal, delirium tremens, agitation, altered mental status.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"alcohol withdrawal, delirium tremens, agitation, altered mental status"}],"section":"Simulation","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7tg186wr","frozenauthors":[{"first_name":"Courtney","middle_name":"","last_name":"Schwebach, MD","name_suffix":"","institution":"Creighton University School of Medicine Phoenix Program, Valleyhealth Medical Center, Department of\nEmergency Medicine, Phoenix, AZ","department":""},{"first_name":"Amrita","middle_name":"","last_name":"Vempati, MD","name_suffix":"","institution":"Creighton University School of Medicine Phoenix Program, Valleyhealth Medical Center, Department of\nEmergency Medicine, Phoenix, AZ","department":""}],"date_submitted":"2023-08-02T17:53:02+02:00","date_accepted":"2023-08-02T17:53:02+02:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/51999/galley/39377/download/"}]},{"pk":52004,"title":"A Patient with Generalized Weakness – A Case Report","subtitle":null,"abstract":"ABSTRACT:Emphysematous pyelonephritis (EPN) is a rare and life-threatening sequalae of a urinary tract infection marked by a gas-producing necrotizing infection of the renal parenchyma requiring prompt treatment. It has been found to be correlated with uncontrolled diabetes mellitus and is more common in females due to their increased susceptibility to urinary tract infections. Early recognition and treatment of EPN are essential to improve the patient's prognosis and prevent further complications. In this case we highlight a progressive case of pyelonephritis complicated by emphysematous abscess formation requiring surgical management. A 49-year-old female with a history of diabetes, hypertension, asthma, and lupus who presented to the emergency department (ED) for evaluation of generalized weakness. Lactate was elevated and urinalysis was suggestive of infection. A computed tomography (CT) scan of the abdomen and pelvis revealed a large subcapsular fluid collection with multiple gas and air-fluid levels along the right kidney, as well as another suspected fluid collection adjacent to the upper pole of the right kidney. The findings suggested complicated pyelonephritis with emphysematous abscess formation. Urology was consulted and they suggested a perinephric drain be placed by interventional radiology (IR). The patient progressed well and was ultimately discharged days later in stable condition. Despite its rarity, healthcare providers should consider infectious processes such as EPN in the differential for generalized weakness and promptly initiate appropriate diagnostic and therapeutic measures.\nTopics: Weakness, sepsis, urology, CT scan.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"weakness, sepsis, urology, CT scan"}],"section":"Visual EM","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5525v5qr","frozenauthors":[{"first_name":"Darby","middle_name":"","last_name":"Graham, MS","name_suffix":"","institution":"University of California, Riverside, School of Medicine, Riverside, CA","department":""},{"first_name":"Manparbodh","middle_name":"","last_name":"Kaur, MD","name_suffix":"","institution":"Riverside Community Hospital, Department of Emergency Medicine, Riverside, CA","department":""},{"first_name":"John","middle_name":"","last_name":"Costumbrado, MD","name_suffix":"","institution":"University of California, Riverside, School of Medicine, Riverside, CA; Riverside Community Hospital, Department of Emergency Medicine, Riverside, CA","department":""},{"first_name":"Sassan","middle_name":"","last_name":"Ghassemzadeh, MD","name_suffix":"","institution":"University of California, Riverside, School of Medicine, Riverside, CA; Riverside Community Hospital, Department of Emergency Medicine, Riverside, CA","department":""}],"date_submitted":"2023-08-02T19:44:59+02:00","date_accepted":"2023-08-02T19:44:59+02:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52004/galley/39381/download/"}]},{"pk":35133,"title":"Argument Indexation (Verb Agreement) in South Central (Kuki-Chin)","subtitle":null,"abstract":"The South Central languages show two distinct indexation paradigms: a set of postverbal agreement words, incorporating person-number indexation and tense/aspect/polarity marking, inherited from a pre-SC ancestor, and a set of proclitic pronouns, otherwise used as possessive clitics on nouns. The interaction of the two series differs across the branch. Some Northern Peripheral have full competing paradigms, with the choice of one or the other marking register. At the other extreme, languages in the Central group use only the innovative proclitic paradigm, though it may incorporate pieces from the archaic postverbal paradigm. In most Northwestern and some Southern Peripheral languages the paradigms are associated with transitivity and/or polarity, with the proclitic paradigm found in affirmative transitive and the postverbal in negative intransitive clauses. We find great variation across the branch in the interaction of indexation with transitivity. Many languages have innovated object-indexation, a few have developed inverse markers and/or hierarchical indexation patterns.","language":"en","license":null,"keywords":[{"word":"Kuki-Chin, South Central, Tibeto-Burman, Trans-Himalayan, verb agreement, argument indexation"}],"section":"Articles of Special Issue 22.1","is_remote":true,"remote_url":"https://escholarship.org/uc/item/42x5w8h9","frozenauthors":[{"first_name":"Scott","middle_name":"","last_name":"DeLancey","name_suffix":"","institution":"University of Oregon","department":"None"}],"date_submitted":"2021-05-14T21:25:42+02:00","date_accepted":"2021-05-14T21:25:42+02:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/himalayanlinguistics/article/35133/galley/26161/download/"}]},{"pk":35147,"title":"Core case-marking and related phenomena in South Central Tibeto-Burman (Kuki-Chin)","subtitle":null,"abstract":"This paper examines what we currently know about the distribution and characteristics of core case marking and related phenomena in South Central Tibeto-Burman (Kuki-Chin) languages. Markers and their functions are surveyed according to subgroup, and an assessment of their diachrony is formulated. The paper also considers two analytical challenges–potential tonal marking of grammatical information in case marking systems, and the simultaneous presence of other elements which may be confused with case marking.","language":"en","license":null,"keywords":[{"word":"Kuki-Chin, South Central, Tibeto-Burman, Trans-Himalayan, case marking, ergative, agentive, differential marking, optional ergativity, tonal morphology"}],"section":"Articles of Special Issue 22.1","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3s85t2jx","frozenauthors":[{"first_name":"David","middle_name":"A.","last_name":"Peterson","name_suffix":"","institution":"Dartmouth College","department":"None"}],"date_submitted":"2021-06-22T21:33:00+02:00","date_accepted":"2021-06-22T21:33:00+02:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/himalayanlinguistics/article/35147/galley/26172/download/"}]},{"pk":52006,"title":"Everyday Water-Related Emergencies: A Didactic Course Expanding Wilderness Medicine Education","subtitle":null,"abstract":"ABSTRACT:Audience: This small group session is appropriate for any level of emergency medicine resident physicians.\nIntroduction: Drowning is defined as the process of experiencing respiratory impairment from submersion or immersion in liquid. It is the third leading cause of unintentional injury-related deaths worldwide, accounting for 7% of all injury-related deaths.1 Our group sought to improve resident education regarding the basics of water safety and rescues as an event developed by our wilderness medicine (WM) interest group. With the growing number of WM Fellowships, specialty tracks, interest clubs and the regular inclusion of WM topics in residency didactics, exposure to WM topics has increased greatly.2 There is a large overlap between wilderness medicine and the field of emergency medicine. Both require stabilization, improvisation, and the treatment of environmental/exposure illnesses. It is imperative that emergency medicine physicians understand the complex pathophysiology of drowning, as well as recognize and manage potential associated traumatic injuries including fractures and critical hemorrhage. Our goal is to provide additional curricular instruction on prehospital management of water-related emergencies and related injuries to emergency medicine residents.\nEducational Objectives: By the end of the session, the learner will be able to: 1) describe the pathophysiology of drowning and shallow water drowning, 2) prevent water emergencies by listing water preparations and precautions to take prior to engaging in activities in and around water, 3) recognize a person at risk of drowning and determine the next best course of action, 4) demonstrate three different methods for in-water c-spine stabilization in the case of a possible cervical injury, 5) evaluate and treat a patient after submersion injury, 6) appropriately place a tourniquet for hemorrhage control, and 7) apply a splint to immobilize skeletal injury.\nEducational Methods: A group of 16 resident learners received a thirty-minute introduction discussion (with open discussion) regarding water safety, basic water rescue methods, and submersion injury pathophysiology. They then progressed through three stations designed to emphasize select skills and knowledge related to submersion injury management, water rescue, and tourniquet and splint placement.\nResearch Methods: Participants completed a six-item questionnaire after the event designed to help gage participant comfort level of treatment, management, and experience regarding water safety, drowning, and related traumatic emergencies. Each item was ranked from 0 for “strongly disagree” to 10 for “strongly agree.” Total mean scores before and after were compared.\nResults: Sixteen individuals participated in the sessions and survey. The total mean score for the six-item analysis increased following the workshop (26.3 before versus 46.9 after, p = 0.001). The positive improvement in all categories indicated increased comfort in the topics of the small group sessions, with the largest improvement in the question about comfort in effectively evaluating and treating a patient presenting to the ED after a submersion injury.\nDiscussion: Utilizing discussions and hands-on group sessions increased residents’ perceived learning. This model can be applied to an extensive number of wilderness medicine topics for learners of all levels. For individuals with time-restrictive schedules, this model is an efficient mode of learning and teaching drowning and injury management skills with the potential for further topics and future courses.\nTopics: Wilderness medicine, water safety, pathophysiology of drowning, in-water rescues, in-water cervical spine stabilization, management of drowning in the ED, splinting, tourniquets.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Wilderness medicine, water safety, pathophysiology of drowning, in-water rescues, in-water cervical spine stabilization, management of drowning in the ED, splinting, tourniquets"}],"section":"Small Groups","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2xz7d506","frozenauthors":[{"first_name":"Geoffrey","middle_name":"","last_name":"Comp, DO","name_suffix":"","institution":"Creighton University School of Medicine-Phoenix, Valleywise Health Medical Center,\nUniversity of Arizona College of Medicine Phoenix, Department of Emergency Medicine, Phoenix, AZ","department":""},{"first_name":"Erica","middle_name":"","last_name":"Burmood, DO","name_suffix":"","institution":"Creighton University School of Medicine-Phoenix, Valleywise Health Medical Center,\nUniversity of Arizona College of Medicine Phoenix, Department of Emergency Medicine, Phoenix, AZ","department":""},{"first_name":"Molly","middle_name":"","last_name":"Enenbach, DO","name_suffix":"","institution":"Creighton University School of Medicine-Phoenix, Valleywise Health Medical Center,\nUniversity of Arizona College of Medicine Phoenix, Department of Emergency Medicine, Phoenix, AZ","department":""},{"first_name":"Savannah","middle_name":"","last_name":"Seigneur, DO","name_suffix":"","institution":"Creighton University School of Medicine-Phoenix, Valleywise Health Medical Center,\nUniversity of Arizona College of Medicine Phoenix, Department of Emergency Medicine, Phoenix, AZ","department":""}],"date_submitted":"2023-08-03T06:04:22+02:00","date_accepted":"2023-08-03T06:04:22+02:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52006/galley/39383/download/"}]},{"pk":52002,"title":"Headache Over Heels: CT Negative Subarachnoid Hemorrhage","subtitle":null,"abstract":"ABSTRACT:Audience: This simulation is intended for MS4 or PGY-1 learners.\nIntroduction: Both headache and syncope are common chief complaints in the emergency department (ED); however, subarachnoid hemorrhage (SAH) is uncommon (accounting for 1-3% of all patients presenting to the ED with headache), with near 50% mortality.1-3 It is important to recognize the signs and symptoms that point to this specific diagnosis. Once subarachnoid hemorrhage is suspected, it is critical to understand the appropriate workup to diagnose SAH, depending on the timing of presentation. Once SAH is diagnosed, appropriately managing the patient’s glucose, blood pressure, and pain is important.\nEducational Objectives: By the end of this case, the participant will be able to: 1) construct a broad differential diagnosis for a patient presenting with syncope, 2) name the history and physical exam findings consistent with SAH, 3) identify SAH on computer tomography (CT) imaging, 4) identify the need for lumbar puncture (LP) to diagnose SAH when CT head is non-diagnostic &gt; 6 hours after symptom onset, 5) correctly interpret cerebral fluid studies (CSF) to aid in the diagnosis of SAH, and 6) specify blood pressure goals in SAH and suggest appropriate medication management.\nEducational Methods: High-fidelity simulation was utilized since this modality forces learners to actively construct a differential for syncope, recognize the possibility of subarachnoid hemorrhage, recall the need for lumbar puncture, and talk through management considerations in real time as opposed to a more passive lecture format.\nResearch Methods: Twenty emergency medicine residents and medical student learners completed the simulation activity. Each learner was asked to complete an eight question post-simulation survey. The survey addressed the utility and appropriate training level of the simulation activity while also including an open- ended prompt for suggestions for improvement.\nResults: Five PGY3, four PGY2, four PGY1, and seven medical students completed the survey. Ninety-five percent felt that the case was more helpful in a simulation format than in a lecture format. All learners felt that the simulation was an appropriate level of difficulty. Of the comments received, a few learners noted they preferred more complexity.\nDiscussion: Overall, the educational content was effective in teaching about the SAH diagnostic algorithm, CSF interpretation, and blood pressure management in SAH. Overall, learners very much enjoyed the activity and felt it was appropriate for their level of training. The most common constructive feedback was to include more specific neurologic findings on physical examination to help guide the student to the diagnosis of SAH.\nTopics: Syncope, subarachnoid hemorrhage, cerebrospinal fluid interpretation, lumbar puncture, intracranial bleed, blood pressure goals and management.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Syncope, subarachnoid hemorrhage, cerebrospinal fluid interpretation, lumbar puncture, intracranial bleed, blood pressure goals and management"}],"section":"Simulation","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7wb8b87g","frozenauthors":[{"first_name":"Sarah","middle_name":"","last_name":"Hogan, MD","name_suffix":"","institution":"Prisma Health Upstate, University of South Carolina School of Medicine Greenville, Department of Emergency Medicine, Greenville, SC","department":""},{"first_name":"Sara","middle_name":"","last_name":"Dimeo, MD, MEHP","name_suffix":"","institution":"Dignity Health East Valley, Department of Emergency Medicine, Chandler, AZ","department":""},{"first_name":"Caroline","middle_name":"","last_name":"Astemborski, MD, MEHP","name_suffix":"","institution":"Prisma Health Upstate, University of South Carolina School of Medicine Greenville, Department of Emergency\nMedicine, Greenville, SC","department":""}],"date_submitted":"2023-08-02T19:19:20+02:00","date_accepted":"2023-08-02T19:19:20+02:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52002/galley/39379/download/"}]},{"pk":52000,"title":"Infant Botulism","subtitle":null,"abstract":"ABSTRACT:Audience: This oral board case is appropriate for emergency medicine residents and medical students (with senior resident assistance) on emergency medicine rotation.\nIntroduction: Although a somewhat rare disease, infant botulism is a true pediatric emergency that carried a 90% rate of mortality prior to the development of an antitoxin.1 While botulism infections can be iatrogenic, foodborne, or involve infected wounds, infant botulism remains the most common presentation of this disease and accounts for approximately 70% of new cases annually.2 Caused by Clostridium botulinum, the inactive spores are ingested by the infant and germinate in the large intestine.3,4 The resulting neurotoxin prevents the release of acetylcholine at the presynaptic membrane which results in flaccid paralysis. Classically, the bulbar musculature is affected before somatic muscular, which results in the typical presentation of “descending paralysis.”2,5 While confirmatory testing is important, it is often delayed by more than 24 hours, making both clinical recognition and implementation of treatment before confirmatory testing of vital importance.6,7 Treatment consists of providing airway, nutritional, and hydration support in addition to administering botulinum-specific antitoxin.8,9 While patients over the age of 12 months are treated with equine botulinum antitoxin, the Food and Drug Administration (FDA) has approved a human-derived immunoglobulin treatment, Botulism Immune Globulin Intravenous (BIG-IV, ie, “Baby BIG”) for pediatric patients less than 12 months of age.1,2,6 Ordering BIG-IV is a complex and multidisciplinary process, requiring the treating physician to discuss any suspicious case with the Infant Botulism Treatment and Prevention Program (IBTPP) which is a branch of the California Department of Public Health.6 With early recognition and implementation of treatment, most infants will make a full recovery.\nEducational Objectives: At the end of this oral board session, examinees will: 1) demonstrate an ability to obtain a complete pediatric medical history, 2) perform an appropriate physical exam on a pediatric patient, 3) investigate a broad differential diagnosis for neuromuscular weakness in a pediatric patient, 4) recognize the classic presentation of infant botulism and implement treatment with botulinum specific antitoxin before confirmatory testing, 5) recognize impending airway failure and intubate the pediatric patient with appropriately dosed medications and ET tube size, and 6) demonstrate effective communication with healthcare team members and parents.\nEducational Methods: This oral board case followed the standard American Board of Emergency Medicine- style case in a tertiary care hospital with access to all specialists and resources needed. This case was tested using 12 resident volunteers ranging from PGY 1-2 in an ACGME (Accreditation Council for Graduate Medical Education) accredited emergency medicine residency program. Learners were debriefed immediately after the case and were given the opportunity to provide feedback.\nResearch Methods: The learners participating in the oral board case provided immediate feedback both by verbal discussion and via a written survey requiring them to rate the efficacy of the exercise. The efficacy of the educational content was assessed by comparing scoring measures of the ACGME core competencies across all learners based on post graduate year (PGY). Scoring measures were determined using a scale from 1-8, with 1-4 being unacceptable performance and 5-8 being acceptable. Efficacy required full completion of the oral board case by the residents as well as a debriefing session during which key educational concepts were discussed.\nResults: The practice oral board candidates consisted of 7 PGY1 and 5 PGY2 level residents. The average score of participating residents for each training level was PGY1: 4.5 and PGY2: 5.7. All except for 2 PGY2 residents missed at least one critical action with the majority of PGY1 residents missing more than one critical action for the case. All participating residents rated the educational value of the case as 4.75 (1-5 Likert scale, with 5 being excellent).\nDiscussion: The educational content of this oral board case and debriefing session were effective for teaching the presentation, evaluation, and appropriate management of infant botulism. Infant botulism is a true pediatric emergency and prompt recognition and treatment is imperative in order to decrease mortality. While mortality was approximately 90% one hundred years ago, today infant botulism carries a much better prognosis due to the advent of antitoxin treatment with a mortality closer to 15%.1 This case highlights several classic physical exam findings including bulbar findings in addition to somatic weakness. Additionally, this case requires definitive airway management with endotracheal intubation, which is true for approximately 50% of infants with botulism.1 While a stool culture or direct toxin assay of the gastric contents, serum, or stool should be performed to confirm the diagnosis, these tests are often performed by the state health department or the Centers for Disease Control (CDC) and often take up to five days to result, during which time the patient will continue to deteriorate. Therefore, the treating physician should seek emergent consultation with the IBTPP to help facilitate the multidisciplinary decision to initiate treatment with human-derived anti-botulinum toxin antibodies.6 If the IBTPP deems that infant botulism is highly suspected based on the history and physical exam, then appropriate treatment should not be delayed and BIG-IV should be administered.6, 7 With early recognition and implementation of treatment, most infants will make a full recovery within several months to a year. Upon discharge, patients will likely require outpatient neurology follow-up in addition to physical therapy to aid in recovery. Because infant botulism is a true pediatric emergency with potentially high mortality, reaching the appropriate diagnosis expeditiously will allow the emergency physician to communicate effectively with worried parents regarding the disease progression and facilitate correct treatment early in order to prevent significant sequela.\nTopics: Pediatric weakness, pediatric neurotoxin, infant botulism, neuromuscular weakness.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Pediatric weakness, pediatric neurotoxin, infant botulism, neuromuscular weakness"}],"section":"Oral Boards","is_remote":true,"remote_url":"https://escholarship.org/uc/item/91c9217b","frozenauthors":[{"first_name":"Ashley","middle_name":"","last_name":"Garispe, DO","name_suffix":"","institution":"Vituity Healthcare and Medical Staffing Services, Saint Agnes Medical Center, Department of Emergency\nMedicine, Fresno, CA","department":""},{"first_name":"Steven","middle_name":"","last_name":"Cherry, MD","name_suffix":"","institution":"Vituity Healthcare and Medical Staffing Services, Sutter Roseville Medical Center, Department of Emergency Medicine, Roseville, CA","department":""}],"date_submitted":"2023-08-02T18:08:01+02:00","date_accepted":"2023-08-02T18:08:01+02:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52000/galley/39378/download/"}]},{"pk":35188,"title":"Introduction to Issues in South Central (Kuki-Chin) linguistics","subtitle":null,"abstract":"This piece briefly introduces this special issue devoted to the investigation of languages of the South Central (Kuki-Chin) subgroup of Tibeto-Burman. The motivations for the special issue and the contents of the papers are reviewed. Terminological, transcription, and interlinear gloss conventions followed in the papers are discussed. The subgrouping schema assumed in a number of the papers is presented in detail.","language":"en","license":null,"keywords":[{"word":"Kuki-Chin, South Central, Tibeto-Burman, Trans-Himalayan, comparative grammar"}],"section":"Introduction to Special Issue 22.1","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3sq9r5bm","frozenauthors":[{"first_name":"David","middle_name":"A.","last_name":"Peterson","name_suffix":"","institution":"Dartmouth College","department":"None"}],"date_submitted":"2022-11-16T13:55:35+01:00","date_accepted":"2022-11-16T13:55:35+01:00","date_published":"2023-07-31T09:00:00+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/himalayanlinguistics/article/35188/galley/26194/download/"}]}]}