Mester LIV Table of Contents
","language":null,"license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"CONTENTS","is_remote":true,"remote_url":"https://escholarship.org/uc/item/17v65791","frozenauthors":[{"first_name":"Icaro","middle_name":"","last_name":"Carvalho","name_suffix":"","institution":"UCLA","department":""}],"date_submitted":"2025-12-12T01:34:40.853000+01:00","date_accepted":"2025-12-12T01:36:40.586000+01:00","date_published":"2025-12-12T02:03:43.843000+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/mester/article/61443/galley/47400/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/mester/article/61443/galley/47400/download/"}]},{"pk":62928,"title":"Flooded Wetland Availability for Breeding Waterfowl in a Mediterranean Climate: Mapping 38 Years of Historical Data in Suisun Marsh, California","subtitle":null,"abstract":"Most managed wetlands in California are ephemeral and are purposefully flooded during the fall and winter for over-wintering waterfowl and are dry during the spring and summer waterfowl breeding season. Only semi-permanent and permanent wetlands remain flooded through the critical summer brood-rearing period for ducklings. We examined flooded wetland availability for breeding waterfowl in the brackish Suisun Marsh (California, USA) annually during the spring (April 27–May 17, during peak nesting) and summer (June 17–July 7, during peak duckling brood rearing), for a 38-year period using Landsat satellite imagery and spectral mixture analysis. Flooded wetland area increased 43% in spring and 48% in summer from 1984 to 2021 but varied among years (spring: 37.6–88.6 km2; summer: 17.7–57.5 km2). This increase in flooded wetland area over the past four decades was due to just a few sites, with only 24% (spring) and 15% (summer) of the 198 land-owner parcels increasing in flooded area. Flooded wetland area in the spring was unrelated to annual precipitation between October and April (range: 25–104 cm) or spring precipitation between January and April (range: 8-65 cm), whereas flooded wetland area in the summer was weakly correlated to both annual and spring precipitation. Flooded wetland area in spring and summer was also weakly correlated with the median daily outflow from the Sacramento-San Joaquin River Delta between March 15 and June 15, which corresponds to a critical period of wetland water management for breeding waterfowl. Our results indicate that spring and summer flooded wetland habitat for breeding waterfowl has slightly increased over the past four decades, varies annually, and is mostly dependent on local wetland management practices rather than on precipitation or Delta outflows. Managing habitats as semi-permanent wetlands would increase flooded wetland habitat in the spring and summer and provide habitat for nesting hens and ducklings.","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":"brood rearing"},{"word":"duckling"},{"word":"remote sensing"},{"word":"spectral mixture analysis"},{"word":"temporal trend"},{"word":"wetland"},{"word":"wetland management"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7qf961z7","frozenauthors":[{"first_name":"Sarah","middle_name":"H.","last_name":"Peterson","name_suffix":"","institution":"US Geological Survey, Western Ecological Research Center, Dixon, CA 95620 USA","department":""},{"first_name":"Austen","middle_name":"A.","last_name":"Lorenz","name_suffix":"","institution":"US Geological Survey, Western Ecological Research Center, Dixon, CA 95620 USA","department":""},{"first_name":"Carley","middle_name":"R.","last_name":"Schacter","name_suffix":"","institution":"US Geological Survey, Western Ecological Research Center, Dixon, CA 95620 USA","department":""},{"first_name":"Mark","middle_name":"P.","last_name":"Herzog","name_suffix":"","institution":"US Geological Survey, Western Ecological Research Center, Dixon, CA 95620 USA","department":""},{"first_name":"Michael","middle_name":"L.","last_name":"Casazza","name_suffix":"","institution":"US Geological Survey, Western Ecological Research Center, Dixon, CA 95620 USA","department":""},{"first_name":"Joshua","middle_name":"T.","last_name":"Ackerman","name_suffix":"","institution":"US Geological Survey, Western Ecological Research Center, Dixon, CA 95620 USA","department":""}],"date_submitted":"2025-11-26T21:30:32+01:00","date_accepted":"2025-11-26T21:30:32+01:00","date_published":"2025-12-11T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62928/galley/48614/download/"}]},{"pk":62929,"title":"Restoring the Heart of a Healthy Estuary: A Review of Restoration in the Sacramento–San Joaquin Delta and Suisun Marsh","subtitle":null,"abstract":"The restoration of native species-dominated ecosystems is critical for improving ecosystem health and meeting policy goals in the Sacramento–San Joaquin Delta and Suisun Marsh (upper San Francisco Estuary, collectively), one of the largest estuarine systems in North America. To accomplish large-scale restoration in this heavily altered system, a variety of projects, programs, and motivations inform restoration planning and implementation. Chapter 4 of the Delta Plan synthesizes restoration goals across these efforts to produce comprehensive ecosystem restoration targets of between 60,000 and 80,000 acres across seven ecosystem types by 2050, but a comprehensive review of restoration progress and planning to date is needed. To fill this gap, this paper analyzes the current state of ecosystem restoration in the upper San Francisco Estuary in the context of the Delta Plan targets. We review current scientific and management literature and implementation approaches, and synthesize acreage totals across completed, in-progress, and planned projects for four ecosystem types where substantial development of restoration in the system has occurred: tidal wetland, non-tidal wetland, riparian, and floodplain. We find that tidal wetland restoration has progressed more rapidly than other ecosystem types, motivated by mitigation requirements related to the federal Endangered Species Act. Across all ecosystem types, we identify both promising progress and clear needs for accelerated planning and implementation of restoration projects to meet Delta Plan 2050 targets, and discuss ongoing needs related to science, funding, and implementation.","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":"California, ecosystem restoration, Delta Plan, tidal wetland, non-tidal wetland, riparian, floodplain, mitigation"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6qm300mc","frozenauthors":[{"first_name":"Dylan","middle_name":"","last_name":"Chapple","name_suffix":"","institution":"Delta Stewardship Council, Delta Science Program,\nSacramento, CA 95814 USA","department":""},{"first_name":"Jennica","middle_name":"","last_name":"Moffat","name_suffix":"","institution":"Oyster Recovery Partnership, Annapolis, MD 21401 USA","department":""},{"first_name":"Ron","middle_name":"","last_name":"Melcer","name_suffix":"","institution":"California State Parks, Sacramento, CA 95814 USA","department":""},{"first_name":"Margot","middle_name":"","last_name":"Mattson","name_suffix":"","institution":"Delta Stewardship Council, Delta Science Program, Sacramento, CA 95814 USA","department":""},{"first_name":"Kaylee","middle_name":"","last_name":"Griffith","name_suffix":"","institution":"California Natural Resources Agency, Sacramento, CA 95814 USA","department":""},{"first_name":"Kate","middle_name":"","last_name":"Anderson","name_suffix":"","institution":"California Department of Transportation, Sacramento, CA 95814 USA","department":""},{"first_name":"Annika","middle_name":"","last_name":"Keeley","name_suffix":"","institution":"Center for Large Landscape Conservation, Bozeman, MT 59715 USA","department":""},{"first_name":"Cheryl","middle_name":"","last_name":"Patel","name_suffix":"","institution":"San Francisco Baykeeper, Oakland, CA 94612 USA","department":""}],"date_submitted":"2025-11-27T05:22:03+01:00","date_accepted":"2025-11-27T05:22:03+01:00","date_published":"2025-12-11T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62929/galley/48615/download/"}]},{"pk":63898,"title":"It's Not Us, It's Them: Advancing Your Career Despite Decision-Makers' Struggle to Recognize Latina Potential","subtitle":null,"abstract":"","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":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/37z8v15z","frozenauthors":[{"first_name":"Nubia","middle_name":"","last_name":"Willman","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-11T00:11:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_cllr/article/63898/galley/49027/download/"}]},{"pk":63897,"title":"\"No, I Can't Leave Political Conversations at the Door\": From a Mixed-Status Household to Undocumented College Student Advocacy","subtitle":null,"abstract":"","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":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6bm333bf","frozenauthors":[{"first_name":"Stephen","middle_name":"","last_name":"Santa-Ramirez","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-11T00:05:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_cllr/article/63897/galley/49026/download/"}]},{"pk":63896,"title":"Latinx Heritage Preservation: Challenges, Successes, and Solutions","subtitle":null,"abstract":"Texas’ Mexican heritage is an integral yet often overlooked part of its history. Despite the state’s origins as part of México, the preservation of Latinx historical sites remains inadequate, as many sites are neglected, destroyed, or forgotten. This Comment explores the challenges and opportunities in preserving Latinx heritage in Texas, focusing on the legal and policy frameworks at both federal and state levels. Through a comparative case study of two segregated “Mexican Schools”—the Roosevelt School in Mission, Texas, which was demolished, and the Blackwell School in Marfa, Texas, now a national historic site—this Comment highlights the disparities in preservation efforts and the factors that contribute to its success or failure.
\nThis Comment begins by examining federal Latinx heritage initiatives, such as early National Park Service designations misconstruing Spanish heritage sites as Latinx sites and imposing the Spanish Black Legend onto Latinx people. It also examines the Park Service’s Latino Heritage Theme Study, which has made strides in its recognition of Latinx contributions but remains limited by narrow eligibility criteria for historic designation. At the state level, the Texas Historical Commission has focused predominantly on Spanish colonial narratives, often overshadowing the broader Latinx experience. The Comment identifies key barriers to preservation, including legal challenges, insufficient funding, and a lack of public awareness about available resources. For instance, the Roosevelt School’s demolition underscores the consequences of inadequate local preservation ordinances and community engagement, while the Blackwell School’s success demonstrates the power of organized advocacy and federal recognition.
\nThis Comment proposes several solutions to advance Latinx heritage preservation. These include amending federal and state laws to broaden eligibility criteria for historic designation, expanding tax incentives to include public entities like school districts, and increasing outreach and education to empower communities to protect their heritage. By addressing these issues, Texas and the nation can better preserve Latinx heritage, ensuring that the stories and contributions of Latinx communities are recognized and celebrated as part of the broader United States narrative. Such efforts are not only vital for historical accuracy, but also for fostering a more inclusive understanding of the identities of Texas and the nation as a whole.
","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":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2dq6w1cq","frozenauthors":[{"first_name":"Alán","middle_name":"","last_name":"Díaz-Santana","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-11T00:02:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_cllr/article/63896/galley/49025/download/"}]},{"pk":63895,"title":"\"El Oro No Se Toma, El Agua, Si:\" Environmental Defense and the Task of Transnational Solidarity Among the Salvadoran Diaspora","subtitle":null,"abstract":"","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":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5q43k0hp","frozenauthors":[{"first_name":"Yvette","middle_name":"","last_name":"Borja","name_suffix":"","institution":"","department":""},{"first_name":"Jorge","middle_name":"E.","last_name":"Cuéllar","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-10T23:54:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_cllr/article/63895/galley/49024/download/"}]},{"pk":63894,"title":"The Latino Electorate: Shaping Texas Politics","subtitle":null,"abstract":"","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":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3jv4z1fj","frozenauthors":[{"first_name":"Armand","middle_name":"J.","last_name":"Avila","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-10T23:51:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_cllr/article/63894/galley/49023/download/"}]},{"pk":63893,"title":"Volume 41.1 Front Matter","subtitle":null,"abstract":"","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/17q0n2c2","frozenauthors":[],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-10T23:47:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_cllr/article/63893/galley/49022/download/"}]},{"pk":47332,"title":"Ewing Sarcoma in the Cervical Spine Causing Left Lower Extremity Hemiparesis and Left Upper Extremity Hemiplegia: A Case Report","subtitle":null,"abstract":"Introduction: Ewing sarcoma is a relatively common neoplasm occurring in pediatric patients 10-20 years of age, commonly presenting with bone fracture, fever, and pain and swelling at the site of the primary tumor. Here we present an unusual case of Ewing sarcoma in the cervical spine leading to neurological symptoms including left lower extremity hemiparesis and left upper extremity hemiplegia.
\nCase Report: A 19-year-old Bengali-speaking male presented to the emergency department with a three-week history of left lower extremity hemiparesis and left upper extremity hemiplegia. Due to concern for spinal cord compression, a computed tomography of the cervical spine without contrast was obtained, which revealed a lucent lesion in the left fifth cervical (C5) vertebral body. Magnetic resonance imaging of the cervical spine revealed a left cervical extradural mass present from C3-C7. The patient subsequently underwent C3-C7 laminectomy with tumor decompression and fusion one week later. Surgical pathology revealed Ewing sarcoma. Following chemotherapy two months later the patient
regained complete recovery of motor and sensory function in the left lower and left upper extremities.
Conclusion: It is important for emergency physicians to broaden their differential diagnosis when the physical examination reveals neurological deficits as exhibited in this case. A broader workup must be obtained that does not solely consist of head imaging but also includes imaging of the spine to prevent missing the diagnosis.
","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":"Ewing Sarcoma"},{"word":"Neurological Examination"},{"word":"upper motor neuron signs"},{"word":"case report"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1ns354pg","frozenauthors":[{"first_name":"Alexander","middle_name":"","last_name":"Adler","name_suffix":"","institution":"Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan","department":""},{"first_name":"Anne","middle_name":"","last_name":"Messman","name_suffix":"","institution":"Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan","department":""}],"date_submitted":"2025-05-02T22:10:12.290000+01:00","date_accepted":"2025-10-16T23:34:17.010000+01:00","date_published":"2025-12-10T21:30:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/47332/galley/48082/download/"}]},{"pk":47265,"title":"Implanted in the Scar: A Case Report of Diagnosis and Management of Cesarean Scar Ectopic Pregnancy","subtitle":null,"abstract":"Introduction: Ectopic pregnancy is a serious pregnancy complication that occurs when a gestational sac implants outside the uterus, most commonly in the fallopian tubes. However, a rare form of ectopic pregnancy, the cesarean scar ectopic pregnancy, occurs within a prior cesarean section scar and is becoming more common as cesarean delivery rates continue to rise. Cesarean scar ectopic pregnancies are challenging to diagnose and pose significant risks, including rupture and hemorrhage, which can lead to maternal death.
\nCase Report: A 27-year-old woman presented to the emergency department with a 16-day history of abdominal pain and vaginal bleeding, initially believed to be her menstrual period. She had a history of one previous lower uterine segment cesarean section. On examination, her beta-human chorionic gonadotropin (β-hCG) levels were elevated, and transvaginal ultrasound revealed an empty uterus with a gestational sac within a cystic area of the cesarean scar. The patient was diagnosed with a cesarean scar ectopic pregnancy. Given the high rupture risk, she underwent laparoscopic surgery with dilation and curettage. Postoperative management included methotrexate, antibiotics, and analgesics. A follow-up β-hCG test showed a significant decline, confirming resolution of the ectopic pregnancy. At her two-week follow-up, the patient remained asymptomatic with no bleeding, and ultrasound confirmed no retained products of conception.
\nConclusion: Cesarean scar ectopic pregnancies are a rare and life-threatening complication of pregnancy that require timely diagnosis and intervention. Early detection through transvaginal ultrasound and appropriate multidisciplinary management are critical to prevent adverse outcomes. This case highlights the importance of early recognition, classification, surgical decision-making, and standardized diagnostic protocols to improve outcomes and save lives
","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":"cesarean scar ectopic pregnancy"},{"word":"ectopic pregnancy"},{"word":"transvaginal ultrasound"},{"word":"maternal morbidity and mortality"},{"word":"women’s health"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1nk255m4","frozenauthors":[{"first_name":"Hanna","middle_name":"","last_name":"Schindler","name_suffix":"","institution":"Orlando College of Osteopathic Medicine, Winter Garden, Florida","department":""},{"first_name":"Leila","middle_name":"","last_name":"Keeler","name_suffix":"","institution":"Orlando College of Osteopathic Medicine, Winter Garden, Florida","department":""}],"date_submitted":"2025-04-17T22:01:20.341000+01:00","date_accepted":"2025-09-18T21:20:55.211000+01:00","date_published":"2025-12-10T21:09:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/47265/galley/48083/download/"}]},{"pk":47943,"title":"Potassium Overdose in Patient with Chronic Kidney Disease on Losartan: A Case Report","subtitle":null,"abstract":"Introduction: Hyperkalemic emergencies can present with weakness, paralysis, sensorimotor deficits, and potentially fatal cardiac conduction abnormalities even in the absence of an elevated serum potassium. Common antihypertensive medications, such as angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, are associated with serum potassium elevations and can exacerbate hyperkalemia, especially in patients with renal impairment.
\nCase Report: We report a 49-year-old patient who presented to the emergency department six hours following an intentional ingestion of potassium supplements totaling 600 milliequivalents (mEq). The patient also reported chronic use of ibuprofen and losartan 50 mg. Symptoms on presentation included weakness, chest pain, and shortness of breath. Initial labs revealed a potassium > 10 mEq/L which was beyond the upper limit of assay detection for metabolic testing. Calcium gluconate, insulin with dextrose, albuterol, sodium bicarbonate, calcium chloride, fluids, and furosemide were sequentially administered. Initial electrocardiogram (ECG) showed tachycardia, a widened QRS complex without discernible P waves, and non-specific ST-segment changes. Following treatment, a repeat ECG demonstrated decreased heart rate, normal axis, and a decreased QT interval. Creatinine at presentation was 1.67 mg per deciliter (patient’s baseline) with repeat labs revealing a potassium of 9.6 mEq/L. Definitive treatment with placement of a central venous catheter for emergent dialysis was initiated.
\nConclusion: This case illustrates how a patient’s regularly prescribed medication may complicate the management of an acute overdose. Prompt identification of a patient’s medications and supplements may expedite potentially life-saving interventions in a hyperkalemic emergency.
","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":"Hyperkalemic emergency"},{"word":"case report"},{"word":"chronic kidney disease"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/41h5t3zv","frozenauthors":[{"first_name":"Ahmed","middle_name":"","last_name":"Naseem","name_suffix":"","institution":"McLaren Oakland Hospital, Department of Emergency Medicine, Pontiac, Michigan","department":""},{"first_name":"Mark","middle_name":"","last_name":"Schoenborn","name_suffix":"","institution":"J.W. Ruby Memorial Hospital, Department of Emergency Medicine, Morgantown West Virginia","department":""},{"first_name":"James","middle_name":"","last_name":"Scheidler","name_suffix":"","institution":"J.W. Ruby Memorial Hospital, Department of Emergency Medicine, Morgantown West Virginia","department":""},{"first_name":"William","middle_name":"","last_name":"Barclay","name_suffix":"","institution":"West Virginia University School of Medicine, Morgantown, West Virginia","department":""},{"first_name":"Garrett","middle_name":"","last_name":"Volk","name_suffix":"","institution":"J.W. Ruby Memorial Hospital, Department of Emergency Medicine, Morgantown West Virginia","department":""}],"date_submitted":"2025-05-28T04:38:05.725000+01:00","date_accepted":"2025-08-27T20:43:41.810000+01:00","date_published":"2025-12-08T22:15:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/47943/galley/48079/download/"}]},{"pk":56993,"title":"Editors’ Introduction: New Editors, New Directions in Writing Assessment","subtitle":null,"abstract":"The JWA 18.2 editors’ introduction contains a welcome by the new journal editors, Mathew Gomes, Lizbett Tinoco, and Stacy Wittstock. It also provides an overview of the two articles and symposium in the issue: Bradley Queen, Kate Kirby, Maryam Eslami, and Kameryn Denaro’s (2025) exploration of ePortfolios as instruments of fairness; Daniel Ernst’s (2025) examination of the use of automated writing evaluation (AWE) technology in writing assessment; and Megan Von Bergen’s (2025) critique of labor-based grading discussions by Kryger and Zimmerman (2020) and Carillo (2021), followed by responses from Griffin X. Zimmerman (2025) and Ellen Carillo (2025).
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivs 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":"fairness"},{"word":"eportfolio"},{"word":"automated writing evaluation"},{"word":"AWE"},{"word":"labor based grading"},{"word":"contract grading"},{"word":"alternative grading"},{"word":"intersectionality"},{"word":"neurodivergence"},{"word":"disability"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1n62d85w","frozenauthors":[{"first_name":"Mathew","middle_name":"","last_name":"Gomes","name_suffix":"","institution":"Santa Clara University","department":"English"},{"first_name":"Lizbett","middle_name":"","last_name":"Tinoco","name_suffix":"","institution":"Texas A&M University-San Antonio","department":"LLA"},{"first_name":"Stacy","middle_name":"","last_name":"Wittstock","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-11-30T23:59:45.676000+01:00","date_accepted":"2025-12-01T00:01:17.545000+01:00","date_published":"2025-12-08T15:10:18.209000+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/56993/galley/47358/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/56993/galley/47358/download/"}]},{"pk":52906,"title":"Troubling Definitions, Expanding Conceptions: A Response","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivs 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":"labor-based contract grading; alternative assessment; ungrading; socially just pedagogy"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/01s2d32g","frozenauthors":[{"first_name":"Griffin","middle_name":"Xander","last_name":"Zimmerman","name_suffix":"","institution":"Princeton University","department":"Princeton Library"}],"date_submitted":"2025-09-18T20:14:00.650000+01:00","date_accepted":"2025-09-19T21:39:56.717000+01:00","date_published":"2025-12-08T15:06:27.366000+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/52906/galley/47360/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/52906/galley/47360/download/"}]},{"pk":49056,"title":"\n\nContinuing the Conversation: A Response to Megan Von Bergen’s “On Neurodivergence/Disability and Labor-Based Grading”\n","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivs 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":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/21t5n34z","frozenauthors":[{"first_name":"Ellen","middle_name":"","last_name":"Carillo","name_suffix":"","institution":"University of Connecticut","department":""}],"date_submitted":"2025-07-18T14:07:26.657000+01:00","date_accepted":"2025-09-19T21:34:15.749000+01:00","date_published":"2025-12-08T15:05:59.305000+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/49056/galley/47363/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/49056/galley/47363/download/"}]},{"pk":1599,"title":"Exploring Fairness and Seeking Social Justice for Writing Assessment: ePortfolios, Language Difference, and Metacognition","subtitle":null,"abstract":"This quantitative validation analysis applies antiracist methods to longitudinal ePortfolio assessment data to study language difference through the lens of a metacognitive literacy construct. With interdisciplinary research reshaping the field of writing assessment using quantitative and intersectional demographic approaches, this essay advances language as a meaningful register of validity evidence and an indicator of fairness across linguistically and racially heterogeneous students sorted into three cohorts that establish comparisons of ePortfolio assessment scores from samples tracking from 2016–2020. To contribute to the critical study of social justice in writing assessment, this exploratory analysis offers nuanced responses to its guiding heuristic question: Can ePortfolios be instruments of fairness in a local assessment ecology? For this formative curricular assessment, rigorous statistical methods complicate claims derived from the ePortfolio assessment results, with post-hoc power calculations and disparate impact analysis used to search for differences between language cohorts and intersectional demographics defined by race/ethnicity, socioeconomic status, and first generation. These quantitative methods further inferences about the ePortfolio instrument’s fairness by problematizing the use of singular demographic aggregations for underrepresented students when attempting to validate assessment constructs and engage in the ongoing study of fairness and social justice in a local writing assessment ecology.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivs 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":"Writing Assessment"},{"word":"anti-racist writing assessment"},{"word":"fairness in writing assessment"},{"word":"ePortfolios"},{"word":"formative curricular assessment"},{"word":"fairness"},{"word":"language difference"},{"word":"antiracist writing assessment"},{"word":"validity"},{"word":"reliability"},{"word":"power analysis"},{"word":"disparate impact"},{"word":"intersectionality"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6m55q8xg","frozenauthors":[{"first_name":"Brad","middle_name":"","last_name":"Queen","name_suffix":"","institution":"U.C. Irvine","department":"English, Composition Program"},{"first_name":"Kate","middle_name":"","last_name":"Kirby","name_suffix":"","institution":"U.C. Irvine","department":"Center for Statistical Consulting"},{"first_name":"Maryam","middle_name":"","last_name":"Eslami","name_suffix":"","institution":"U.C. Irvine","department":"School of Education"},{"first_name":"Kameryn","middle_name":"","last_name":"Denaro","name_suffix":"","institution":"","department":""}],"date_submitted":"2023-08-08T21:13:23.394000+01:00","date_accepted":"2025-06-17T22:40:07.374000+01:00","date_published":"2025-12-08T15:05:37.342000+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/1599/galley/47359/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/1599/galley/47359/download/"}]},{"pk":284,"title":"The Effects of Automated Writing Evaluation Technology on Improving Student Writing","subtitle":null,"abstract":"Advances in automated writing evaluation technology have shifted the aims of the tools from reliably and holistically scoring and ranking essays to providing formative and analytical feedback to users for improving writing. This study uses a quasi-experimental design to test the ability of one automated writing evaluation program to improve college student writing. Using a comparative judgment model of assessment, four college writing instructors evaluated pairs of essays with one per pair treated by the program and selected the better of each pair. The essays treated by the automated evaluation program significantly underperformed the null hypothesis of 50%. Results suggest the automated evaluation program fails to improve student writing in the eyes of instructors. Theories and implications for why are discussed.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivs 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":"formative assessment"},{"word":"automated writing evaluation"},{"word":"Writing Assessment"},{"word":"writing feedback"},{"word":"writing pedagogy"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0q34x1vh","frozenauthors":[{"first_name":"Daniel","middle_name":"","last_name":"Ernst","name_suffix":"","institution":"Texas Woman's University","department":"Language, Culture, and Gender Studies"}],"date_submitted":"2023-02-24T18:40:26.775000+01:00","date_accepted":"2025-05-20T22:44:17.194000+01:00","date_published":"2025-12-08T15:05:03.179000+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/284/galley/47362/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/284/galley/47362/download/"}]},{"pk":251,"title":"On Neurodivergence/Disability and Labor-Based Grading: A Response to Kryger and Zimmerman (2020) and Carillo (2021)","subtitle":null,"abstract":"This essay responds to existing scholarship on neurodivergence/disability and labor-based grading, contending that current critiques define labor-based grading too narrowly and conflate the lack of quantitative grades with a lack of scaffolding. The essay further suggests that labor-based or other alternative assessment approaches, especially those which move away from authoritative, quality-based judgments of student work, invite students to express agency over and open a conversation about expectations around writing processes and habits. The article concludes by calling for additional research and conversation about how labor-based approaches may account for access and accessibility.","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivs 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":"labor-based grading"},{"word":"neurodivergence"},{"word":"accessibility"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4gf435hz","frozenauthors":[{"first_name":"Megan","middle_name":"","last_name":"Von Bergen","name_suffix":"","institution":"","department":""}],"date_submitted":"2023-02-22T22:42:40.718000+01:00","date_accepted":"2025-09-19T16:09:43.338000+01:00","date_published":"2025-12-08T15:04:32.602000+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/251/galley/47361/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jwa/article/251/galley/47361/download/"}]},{"pk":64541,"title":"12.4 Table of Contents and Editors' Note (December 8, 2025)","subtitle":null,"abstract":null,"language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3zs4n60m","frozenauthors":[{"first_name":"AGS Editors","middle_name":"","last_name":"","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-08T10:03:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/analoggamestudies/article/64541/galley/50375/download/"}]},{"pk":64544,"title":"Defining the Miniatures Wargame: Five Pillars","subtitle":null,"abstract":"This article provides a preliminary description and definition of the miniatures wargame. Rather than defining the miniatures wargame via the use of miniatures, which is obvious, it locates the specificity of the miniatures wargame in the centrality of the table to play, the use of non-discrete movement, the prominence of bricolage style craft in customization and terrain building, the order of operations in ludic storytelling, and the centralization of the hybrid industrial/craft miniatures wargames industry. The article aims to spark discussion of the specificity of miniatures wargames as a genre of analog game.","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"miniaturing"},{"word":"miniatures wargames"},{"word":"Warhammer"},{"word":"design"},{"word":"game production"},{"word":"game materials"},{"word":"craft"},{"word":"gaming table"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/87m3x2r6","frozenauthors":[{"first_name":"Ian","middle_name":"","last_name":"Williams","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-08T10:03:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/analoggamestudies/article/64544/galley/50378/download/"}]},{"pk":64543,"title":"Getting in Good Troubles with Mancala","subtitle":null,"abstract":"This paper discusses the term \"mancala \"and the implication of its use as a generic term for all classic African board games with holes, and seeds. We textually analyzed recent literature on classic African board games; we address the use of \"mancala\" in the literature. We focused on the names of three classic African board games and discussed these games names and the historical relationship between the game name and the ethnic group to argue that history, culture, and identity erasure happen when mancala is used as a generic term to classify these games. Mancala reflects the dismissal or neglect of African communities and ethnic groups contribution to the expansion of knowledge about games and gameplay. As shown by the literature of different fields, we contend that precise and appropriate use of names limits ambiguity, and even prevents the erasure of a group’s history, creativity, and game design approach.","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"mancala; African classic board games; names; board games; African games"},{"word":"label"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4d38j21m","frozenauthors":[{"first_name":"Rebecca","middle_name":"Y.","last_name":"Bayeck","name_suffix":"","institution":"Utah State University","department":"Instructional Technology & Learning Sciences"},{"first_name":"Joseph","middle_name":"M.","last_name":"Bayeck","name_suffix":"","institution":"","department":""},{"first_name":"Olu","middle_name":"","last_name":"Randle","name_suffix":"","institution":"University of the Witwatersrand","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-08T10:03:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/analoggamestudies/article/64543/galley/50377/download/"}]},{"pk":64542,"title":"Postcards from the 2025 BIPOC Game Studies Conference","subtitle":null,"abstract":"This collaborative essay brings together seven participants to reflect on their observations and experiences at the 2025 BIPOC Game Studies Conference at The Strong National Museum of Play in Rochester, NY.","language":"eng","license":{"name":"","short_name":"","text":null,"url":""},"keywords":[{"word":"conference"},{"word":"postcards"},{"word":"BIPOC game studies"},{"word":"The Strong Museum"},{"word":"archives"},{"word":"citational justice"},{"word":"Rochester"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/44c281wn","frozenauthors":[{"first_name":"Edmond","middle_name":"Y.","last_name":"Chang","name_suffix":"","institution":"Ohio University","department":"English"},{"first_name":"Megan","middle_name":"","last_name":"Condis","name_suffix":"","institution":"Texas Tech University","department":"Communication Studies"},{"first_name":"Luke","middle_name":"","last_name":"Hernandez","name_suffix":"","institution":"University of Texas at Dallas","department":"Arts, Technology, and Emerging Communication"},{"first_name":"Shelly","middle_name":"","last_name":"Jones","name_suffix":"","institution":"SUNY Delhi","department":"English"},{"first_name":"Amanda","middle_name":"","last_name":"Kporwofa","name_suffix":"","institution":"University of Cincinnati","department":"Communication"},{"first_name":"Mirek","middle_name":"","last_name":"Stolee","name_suffix":"","institution":"University of Central Florid","department":"Texts & Technology"},{"first_name":"Evan","middle_name":"","last_name":"Torner","name_suffix":"","institution":"University of Cincinnati","department":"German Studies, Film & Media Studies"}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-08T10:03:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/analoggamestudies/article/64542/galley/50376/download/"}]},{"pk":62925,"title":"Effects of Flow on Pesticides in Water and Zooplankton in the Northern Sacramento–San Joaquin Delta","subtitle":null,"abstract":"Zooplankton are a key food source for juvenile fishes in estuaries worldwide, including California’s Sacramento–San Joaquin Delta (hereafter Delta); both zooplankton quality and quantity are critical to ecosystem health. Zooplankton may be affected by pesticides in water and the food web, and the Delta is known to contain complex pesticide mixtures. In this study, we evaluated pesticide concentrations in water and zooplankton in the northern Delta during (1) the summer–fall of 2017, 2018, and 2019, which included periods of augmented pulse flows from agriculture tailwater, and (2) across a full seasonal cycle from May 2019 to March 2020. We quantified changes in pesticide concentration in response to environmental factors. We found that zooplankton showed more frequent detections of hydrophobic pesticides compared to more frequent detections of hydrophilic compounds in water. Pesticide concentrations were influenced by flow, pesticide application, and season, but the effects of these environmental factors differed by habitat (Sacramento River or Yolo Bypass Toe Drain). Pesticides in water responded similarly to environmental factors in the Sacramento River and Yolo Bypass, whereas pesticides in zooplankton responded differently. In water, we found more detections and higher concentrations at higher flows in the Yolo Bypass and Sacramento River, but responses to pesticide application varied by habitat. Alternatively, pesticide concentrations in zooplankton increased in the Yolo Bypass with increasing flow (correlated with flow pulses) and changed seasonally; whereas, pesticide concentrations in zooplankton in the Sacramento River decreased at higher flows, and decreased with or did not respond to higher pesticide application in the watershed. Our study suggests that augmented flows—particularly those using agricultural tailwater—may have unintended negative ecological effects that could partially offset benefits to the food web and fishes in the northern Delta, underscoring the complex interplay among factors that drive increased pesticide exposure.","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":"contaminants, pesticides, zooplankton, flow, discharge, season, summer–fall, food web"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0g845881","frozenauthors":[{"first_name":"James","middle_name":"","last_name":"Orlando","name_suffix":"","institution":"US Geological Survey, California Water Science Center, Sacramento, CA 95819 USA","department":""},{"first_name":"Laura","middle_name":"","last_name":"Twardochleb","name_suffix":"","institution":"California Department of Water Resources, Division of Integrated Science and Engineering, Sacramento, CA 95691 USA; and State Water Resources Control Board, Division of Water Rights, Sacramento, CA 95814 USA","department":""},{"first_name":"David","middle_name":"","last_name":"Bosworth","name_suffix":"","institution":"California Department of Water Resources, Division of Integrated Science and Engineering, Sacramento, CA 95691 USA","department":""},{"first_name":"Michelle","middle_name":"L.","last_name":"Hladik","name_suffix":"","institution":"US Geological Survey, California Water Science Center, Sacramento, CA 95819 USA","department":""},{"first_name":"Corey","middle_name":"","last_name":"Sanders","name_suffix":"","institution":"US Geological Survey, California Water Science Center, Sacramento, CA 95819 USA","department":""},{"first_name":"Matthew","middle_name":"","last_name":"De Parsia","name_suffix":"","institution":"US Geological Survey, California Water Science Center, Sacramento, CA 95819 USA","department":""},{"first_name":"Brittany","middle_name":"E.","last_name":"Davis","name_suffix":"","institution":"California Department of Water Resources, Division of Integrated Science and Engineering, Sacramento, CA 95691 USA","department":""}],"date_submitted":"2025-11-26T04:59:21+01:00","date_accepted":"2025-11-26T04:59:21+01:00","date_published":"2025-12-08T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62925/galley/48611/download/"}]},{"pk":62924,"title":"Predicting Sediment Bulk Density for San Francisco Estuary","subtitle":null,"abstract":"Sediment bulk density (ρ-dry) and particle size are two important parameters for predicting sediment bed erosion. ρ-dry, however, is difficult to measure accurately. The units of ρdry have not been consistently reported in the literature, leading to confusion, particularly in the calculation of sediment budgets that typically require integrating mass-based and volumetric components. Relationships between ρdry and sediment composition have been developed for multiple regions and differ between systems. Developing a system-specific predictive model for ρdry can help fill data gaps and improve sediment budgets, model accuracy, and estimates of quantities of sediment needed for restoration. In this study, we investigate whether ρdry in San Francisco Estuary can be predicted from organic carbon content or percent of fines, which are more easily or frequently measured than ρdry. We compiled sediment properties from samples collected over the past decade throughout the intertidal and subtidal regions of San Francisco Bay and the Sacramento–San Joaquin Delta to examine this relationship. Sample composition ranged from 2.18 to 99.97% fines (particles < 0.0625 mm), ρ-dry ranged from 0.22 to 1.60 g cm-3, and organic carbon ranged from 0.06 to 7.98%. Regression analysis indicates that the percent of fines explains 93% of the variation of ρ-dry (\np\n-value < 0.05, \nN\n = 81). The coefficient of determination decreased by ~1% when organic carbon was incorporated in the regression analysis. Comparison of this predictive ρ-dry model to four published models based on samples from other regions supports previous findings that the relationship between ρdry and grain size may vary by system. We also examined additional factors that may affect sediment erodibility, such as hydrographic and oceanographic conditions. Classification of sample sites as intertidal vs. subtidal or wavy vs. non-wavy each significantly explained the residuals from the ρdry model, and both intertidal and wavy conditions were associated with higher ρ-dry values.","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":"dry bulk density, particle size, sediment organic carbon, estuarine sediments, San Francisco Bay, Sacramento–San Joaquin Delta"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/788289nr","frozenauthors":[{"first_name":"Samantha","middle_name":"C.","last_name":"McGill","name_suffix":"","institution":"US Geological Survey, Pacific Coastal and Marine Science Center, Santa Cruz, CA 95060 USA","department":""},{"first_name":"Jessica","middle_name":"R.","last_name":"Lacy","name_suffix":"","institution":"US Geological Survey, Pacific Coastal and Marine Science Center, Santa Cruz, CA 95060 USA","department":""}],"date_submitted":"2025-11-26T04:55:58+01:00","date_accepted":"2025-11-26T04:55:58+01:00","date_published":"2025-12-08T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62924/galley/48610/download/"}]},{"pk":62927,"title":"Synthesizing Relationships Between Winter-Run Chinook Salmon Out-Migration Survival and Water Operations in the Sacramento–San Joaquin Delta","subtitle":null,"abstract":"Sacramento River winter-run Chinook Salmon (\nOncorhynchus tshawytscha\n) are an endangered population that faces numerous challenges across its life cycle, including juvenile out-migration through the heavily anthropogenically modified Sacramento–San Joaquin Delta, or Delta. Water exports from pumping facilities in the Delta can alter local hydrology and influence movement of out-migrating juveniles, some of which are observed in or near pumping facilities. Monitoring and regulations, intended to protect out-migrating fish through restrictions on pumping, are predicated on assumed relationships among fish observations, water operations, and through-Delta migratory survival. In this study, we use a new conceptual model to review the current state of science for winter-run Chinook Salmon out-migration survival in the Delta, and use simulation modeling to address pertinent knowledge gaps. Results of this study highlight varying support for the influence of Sacramento River flow, temperature, and water exports on routing and survival in different regions of the Delta. The contributions of specific routing pathways to the interior Delta (e.g., through Threemile Slough) to survival, and the relationship between fish entrainment at pumping facilities and overall migratory survival, remain uncertain. Recommended future work includes continued fine-scale acoustic telemetry studies throughout the Delta, novel integrated modeling of monitoring data, and contextualizing the relevance of Delta-based survival to population viability by incorporating explicit uncertainties about survival into existing life-cycle 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":"Sacramento River winter-run Chinook Salmon, out-migration, routing, survival, Sacramento–San Joaquin Delta, water operations, simulations"}],"section":"Research Monograph","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6x45n457","frozenauthors":[{"first_name":"Alexander","middle_name":"","last_name":"Jensen","name_suffix":"","institution":"US Bureau of Reclamation,\nScience Division, Bay–Delta Office,\nSacramento, CA 95814 USA","department":""},{"first_name":"Brian","middle_name":"","last_name":"Mahardja","name_suffix":"","institution":"US Bureau of Reclamation,\nScience Division, Bay–Delta Office,\nSacramento, CA 95814 USA","department":""},{"first_name":"Jianchun","middle_name":"","last_name":"Huang","name_suffix":"","institution":"US Bureau of Reclamation,\nSedimentation and River Hydraulics Group,\nTechnical Service Center,\nDenver, CO 80225 USA","department":""},{"first_name":"Samaneh","middle_name":"","last_name":"Saadat","name_suffix":"","institution":"Jacobs,\nSacramento, CA 95833 USA","department":""},{"first_name":"Joshua","middle_name":"","last_name":"Israel","name_suffix":"","institution":"US Bureau of Reclamation,\nScience Division, Bay–Delta Office,\nSacramento, CA 95814 USA","department":""}],"date_submitted":"2025-11-26T05:14:25+01:00","date_accepted":"2025-11-26T05:14:25+01:00","date_published":"2025-12-08T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62927/galley/48613/download/"}]},{"pk":62926,"title":"The Influence of Zooplankton Availability on Delta Smelt Condition and Foraging Across Habitat Contexts","subtitle":null,"abstract":"Strategies for endangered species conservation may have different outcomes depending on the habitat context in which they are implemented. Understanding these context-dependent effects can help optimize and target management efforts. In this analysis, we investigate how environmental and food-web conditions interactively affect condition and foraging of Delta Smelt (\nHypomesus transpacificus\n), an endangered fish endemic to the San Francisco Estuary (the estuary). Food limitation, in terms of pelagic zooplankton availability, is considered a main factor that contributes to the decline in Delta Smelt abundance. Our overarching objective was to examine whether the effect of zooplankton on Delta Smelt depended on habitat context. Specifically, we hypothesized that zooplankton would less positively effect Delta Smelt condition—as measured by hepatosomatic index (HSI)—and foraging success in areas with nearby tidal wetlands, because these adjacent habitats may provide access to prey items from the epibenthos and fringing vegetation. In contrast, in regions with limited proximity to wetlands, we hypothesized that Delta Smelt would rely more on pelagic prey, which would manifest as a more positive effect of zooplankton on body condition and foraging success for Delta Smelt. Using models that accounted for habitat in multiple ways, we found little evidence that zooplankton and habitat interactively influenced Delta Smelt condition or gut fullness. Rather, the influence of zooplankton on HSI and gut fullness was generally positive across habitat contexts. Given the well-documented food limitation in the estuary, promoting the availability of pelagic zooplankton is a rational, albeit complex, management aim. Furthermore, our results suggest that efforts to increase zooplankton would broadly benefit Delta Smelt across a wide range of habitat contexts.","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":"fish, gut fullness, food limitation, hepatosomatic index, zooplankton biomass"}],"section":"Research Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6jg8s05m","frozenauthors":[{"first_name":"Amanda","middle_name":"R.","last_name":"McCormick","name_suffix":"","institution":"University of California–Davis, Aquatic Health Program, School of Veterinary Medicine, Davis, CA 95616 USA","department":""},{"first_name":"Christina","middle_name":"E.","last_name":"Burdi","name_suffix":"","institution":"California Department of Fish and Wildlife, Stockton, CA, 95206 USA (former affiliation); California Department of Water Resources, West Sacramento, CA 95691 USA","department":""},{"first_name":"Brian","middle_name":"","last_name":"Mahardja","name_suffix":"","institution":"US Bureau of Reclamation, Bay–Delta Office, Science Division, Sacramento, CA 95814 USA","department":""},{"first_name":"Denise","middle_name":"M.","last_name":"Goodman","name_suffix":"","institution":"US Fish and Wildlife Service, Lodi, CA 95240 USA","department":""},{"first_name":"Siara","middle_name":"A.","last_name":"Mitchell","name_suffix":"","institution":"University of California–Davis, Aquatic Health Program, School of Veterinary Medicine, Davis, CA 95616 USA","department":""},{"first_name":"Calvin","middle_name":"Y.","last_name":"Lee","name_suffix":"","institution":"ICF, Sacramento, CA 95814 USA","department":""},{"first_name":"Swee","middle_name":"J.","last_name":"Teh","name_suffix":"","institution":"University of California–Davis, Aquatic Health Program, School of Veterinary Medicine, Davis, CA 95616 USA","department":""},{"first_name":"Bruce","middle_name":"G.","last_name":"Hammock","name_suffix":"","institution":"University of California–Davis, Aquatic Health Program, School of Veterinary Medicine, Davis, CA 95616 USA","department":""}],"date_submitted":"2025-11-26T05:08:37+01:00","date_accepted":"2025-11-26T05:08:37+01:00","date_published":"2025-12-08T09:00:00+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/jmie_sfews/article/62926/galley/48612/download/"}]},{"pk":47015,"title":"Acute Hypercapnic Respiratory Failure from Foreign Body Aspiration in a 16-Month-Old: A Case Report","subtitle":null,"abstract":"Introduction: Acute hypercapnic respiratory failure secondary to foreign body aspiration is a rare but severe complication seen in pediatric patients. Foreign body aspiration is one of the leading causes of death in children and requires prompt intervention and stabilization when definitive bronchoscopy is not readily available.
\nCase Report: We describe the case of a 16-month-old male who developed acute hypercapnic respiratory failure following the aspiration of a foreign body. On presentation to the emergency department, the child was in respiratory distress, appeared cyanotic, and had severely impaired oxygenation, all indicating respiratory failure. Initial management involved stabilization, advanced airway management, and ventilatory adjustments. Efficient communication with multiple specialists
coordinated the appropriate transfer of the patient to a tertiary pediatric facility for bronchoscopy and ultimate successful foreign body removal without complications.
Conclusion: The report highlights challenges in the management of pediatric foreign body aspiration leading to severe hypercapnia, the importance of interdisciplinary coordination, and the management techniques used to stabilize the patient for safe transfer to a tertiary care center.
","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"},{"word":"foreign body aspiration"},{"word":"acute hypercapnic respiratory failure"},{"word":"pediatric resuscitation"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1xf3f47b","frozenauthors":[{"first_name":"Sabrina","middle_name":"","last_name":"Lee","name_suffix":"","institution":"New York-Presbyterian Queens, Department of Emergency Medicine, Flushing, New York","department":""},{"first_name":"Kallie","middle_name":"","last_name":"Combs","name_suffix":"","institution":"New York-Presbyterian Queens, Department of Emergency Medicine, Flushing, New York","department":""},{"first_name":"Richard","middle_name":"","last_name":"Shin","name_suffix":"","institution":"New York-Presbyterian Queens, Department of Emergency Medicine, Flushing, New York","department":""}],"date_submitted":"2025-03-20T19:31:08.034000+01:00","date_accepted":"2025-08-27T20:51:34.613000+01:00","date_published":"2025-12-07T23:33:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/47015/galley/48086/download/"}]},{"pk":47061,"title":"70-year-old Woman with Chest Tightness and Shortness of Breath","subtitle":null,"abstract":"Chest tightness and shortness of breath are relatively common reasons for presentation to the emergency department (ED), often triggering protocolized workups and dispositions. A good history, however, can reveal additional elements that may dramatically alter the differential diagnosis and management. A 70-year-old woman presented to the ED complaining of subacute chest tightness with dyspnea on exertion. This case offers a thoughtful analysis of how to integrate key findings within a patient’s history, exam, and workup in the ED. The surprising final diagnosis and case outcome are then revealed.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Emergency Medicine"},{"word":"Chagas cardiomyopathy"},{"word":"Clinicopathological case"}],"section":"Clinicopathological Cases from the University of Maryland","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5dk3f72j","frozenauthors":[{"first_name":"Robert","middle_name":"E","last_name":"Dunn","name_suffix":"","institution":"University of Maryland Medical Center, Department of Emergency Medicine, Baltimore, MD","department":""},{"first_name":"Brianna","middle_name":"","last_name":"Klucher","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, MD","department":""},{"first_name":"Laura","middle_name":"J","last_name":"Bontempo","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, MD","department":""},{"first_name":"John","middle_name":"David","last_name":"Gatz","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, MD","department":""}],"date_submitted":"2025-03-22T10:49:11.182000+01:00","date_accepted":"2025-07-11T23:29:48.331000+01:00","date_published":"2025-12-07T23:10:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/47061/galley/48073/download/"}]},{"pk":59805,"title":"List of Authors","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Front Matter","is_remote":true,"remote_url":"https://escholarship.org/uc/item/63q3k8nt","frozenauthors":[],"date_submitted":"2025-12-03T18:00:24.218000+01:00","date_accepted":"2025-12-03T18:04:21.848000+01:00","date_published":"2025-12-07T19:53:00+01:00","render_galley":null,"galleys":[{"label":"Final PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/59805/galley/47568/download/"}]},{"pk":59802,"title":"Front Matter","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Front Matter","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1v66g8xk","frozenauthors":[],"date_submitted":"2025-12-03T17:56:38.246000+01:00","date_accepted":"2025-12-03T18:03:11.498000+01:00","date_published":"2025-12-07T19:52:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/59802/galley/47366/download/"}]},{"pk":59804,"title":"Table of Contents","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Front Matter","is_remote":true,"remote_url":"https://escholarship.org/uc/item/45s2677f","frozenauthors":[],"date_submitted":"2025-12-03T17:58:25.490000+01:00","date_accepted":"2025-12-03T18:03:52.048000+01:00","date_published":"2025-12-07T19:52:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/59804/galley/47367/download/"}]},{"pk":53942,"title":"Sonic Sovereignty: Hip-Hop, Indigeneity, and Shifting Popular Music Mainstreams ","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Review","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1rd7p0r2","frozenauthors":[{"first_name":"Robert","middle_name":"B.","last_name":"Caldwell","name_suffix":"Jr.","institution":"SUNY—University at Buffalo","department":""},{"first_name":"Robert","middle_name":"","last_name":"Pitts","name_suffix":"","institution":"SUNY—University at Buffalo","department":""}],"date_submitted":"2025-11-12T16:56:48.515000+01:00","date_accepted":"2025-11-17T19:49:49.080000+01:00","date_published":"2025-12-07T19:51:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/53942/galley/46246/download/"}]},{"pk":53934,"title":"Woven from the Center: Native Basketry in the Southwest","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Review","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7r86s4xn","frozenauthors":[{"first_name":"Sarah","middle_name":"","last_name":"Greenwell-Scott","name_suffix":"","institution":"University of Arizona","department":"School of Art"}],"date_submitted":"2025-11-11T04:23:21.217000+01:00","date_accepted":"2025-11-11T20:14:42.769000+01:00","date_published":"2025-12-07T19:50:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/53934/galley/46245/download/"}]},{"pk":53797,"title":"Theatre of Chance: Native Celebrities of Nothing in an Existential Colony","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Vizenor"},{"word":"Gerald Vizenor"},{"word":"White Earth"},{"word":"20th century"},{"word":"Puppet Theater"}],"section":"Review","is_remote":true,"remote_url":"https://escholarship.org/uc/item/72h7j5rd","frozenauthors":[{"first_name":"Robert","middle_name":"B.","last_name":"Caldwell","name_suffix":"Jr.","institution":"University of Buffalo","department":"Indigenous Studies"}],"date_submitted":"2025-10-29T19:51:36.557000+01:00","date_accepted":"2025-11-04T18:56:57.774000+01:00","date_published":"2025-12-07T19:49:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/53797/galley/46244/download/"}]},{"pk":53795,"title":"Waiting for Wovoka: Envoys of Good Cheer and Liberty","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Vizenor"},{"word":"Gerald Vizenor"},{"word":"Puppet Theater"},{"word":"White Earth"},{"word":"Century 21 Exposition"}],"section":"Review","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3w39g8q4","frozenauthors":[{"first_name":"Robert","middle_name":"B.","last_name":"Caldwell","name_suffix":"Jr.","institution":"University of Buffalo","department":"Indigenous Studies"}],"date_submitted":"2025-10-29T19:45:00.856000+01:00","date_accepted":"2025-11-04T18:56:21.110000+01:00","date_published":"2025-12-07T19:48:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/53795/galley/46243/download/"}]},{"pk":53257,"title":"Medicine Wheel for the Planet: A Journey toward Personal and Ecological Healing","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Review","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5g94d85x","frozenauthors":[{"first_name":"Natasha","middle_name":"","last_name":"Myhal","name_suffix":"","institution":"University of Illinois Urbana Champaign","department":"American Indian Studies"}],"date_submitted":"2025-10-27T15:54:56.421000+01:00","date_accepted":"2025-11-04T18:59:22.811000+01:00","date_published":"2025-12-07T19:47:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/53257/galley/46234/download/"}]},{"pk":53267,"title":"Métis Matriarchs: Agents of Transition","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Métis Matriarchs colonization"}],"section":"Review","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0g6183n6","frozenauthors":[{"first_name":"Nathalie","middle_name":"","last_name":"Kermoal","name_suffix":"","institution":"University of Alberta","department":""}],"date_submitted":"2025-10-28T23:21:31.235000+01:00","date_accepted":"2025-11-04T18:57:55.547000+01:00","date_published":"2025-12-07T19:47:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/53267/galley/46242/download/"}]},{"pk":53070,"title":"Chitto Harjo: Native Patriotism and the Medicine Way","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Mvskoke Nation"},{"word":"Chitto Harjo"},{"word":"Native patriotism"},{"word":"allotment"}],"section":"Review","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8sg8x48p","frozenauthors":[{"first_name":"Angela","middle_name":"","last_name":"Parker","name_suffix":"","institution":"University of Denver","department":"History"}],"date_submitted":"2025-10-07T21:09:00.982000+01:00","date_accepted":"2025-11-04T18:59:02.291000+01:00","date_published":"2025-12-07T19:46:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/53070/galley/45943/download/"}]},{"pk":50651,"title":"The Worst Trickster Story Ever Told: Native America, the Supreme Court, and the US Constitution","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Law"},{"word":"Constitution"},{"word":"Supreme Court"}],"section":"Review","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8vm369hb","frozenauthors":[{"first_name":"Elizabeth","middle_name":"","last_name":"Georgian","name_suffix":"","institution":"University of South Carolina Aiken","department":"History"}],"date_submitted":"2025-08-14T22:07:49.985000+01:00","date_accepted":"2025-08-25T19:51:51.151000+01:00","date_published":"2025-12-07T19:45:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/50651/galley/45935/download/"}]},{"pk":50623,"title":"The Colonial Construction of Indian Country: Native American Literatures and Federal Indian Law","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Review","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3bm1m79m","frozenauthors":[{"first_name":"Delaney","middle_name":"","last_name":"O'Connell","name_suffix":"","institution":"University at Buffalo","department":"Indigenous Studies"}],"date_submitted":"2025-08-11T15:23:54.358000+01:00","date_accepted":"2025-08-11T15:47:33.480000+01:00","date_published":"2025-12-07T19:44:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/50623/galley/45934/download/"}]},{"pk":50622,"title":"Arguments over Genocide: The War of Words in the Congress and the Supreme Court over Cherokee Removal","subtitle":null,"abstract":"","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Review","is_remote":true,"remote_url":"https://escholarship.org/uc/item/73v9h9tc","frozenauthors":[{"first_name":"Delaney","middle_name":"","last_name":"O'Connell","name_suffix":"","institution":"University at Buffalo","department":"Indigenous Studies"}],"date_submitted":"2025-11-04T15:04:55.169000+01:00","date_accepted":"2025-11-04T18:59:46.409000+01:00","date_published":"2025-12-07T19:43:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/50622/galley/45933/download/"}]},{"pk":31066,"title":"Introduction • Pyroepistomology: Reclaiming Knowledge, Histories, Lands, Relations.","subtitle":null,"abstract":"Introduction to the author, the term pyroepistomology, and this special issue","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Healing"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9ph1w5w5","frozenauthors":[{"first_name":"Paulette","middle_name":"F.","last_name":"Steeves","name_suffix":"","institution":"Algoma University","department":"Sociology Anthropology"}],"date_submitted":"2024-07-22T19:48:14.547000+01:00","date_accepted":"2025-09-10T17:23:17.501000+01:00","date_published":"2025-12-07T19:42:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/31066/galley/45932/download/"}]},{"pk":29336,"title":"Tensioned Territories: Resignifying and Rewriting Indigenous Cultural Heritage in the Chilean Megamining Context—The Case of the Quechua Community of Quipisca, Atacama Desert, Chile","subtitle":null,"abstract":"This paper seeks to present the experience of the Quechua Indigenous Community of Quipisca (CIQQ) regarding the socioenvironmental conflicts of its territory, which has been stressed by the presence of large-scale mining activity. In this sense, we explain how the CIQQ has formed a collaborative and community work plan in which the concept of indigenous cultural heritage has taken a relevant role in the defense of the territory and the ritual landscape of Quipisca, while it has also served to strengthen the identity and recovery of cultural practices. In this way, the presence of different ceremonial apus (sacred hills), different geoglyphs, and caravan routes in the ancestral territory are made visible in the face of Chilean environmental legislation and traditional scientific knowledge that makes invisible the knowledge and feelings of the community regarding these spaces. In this context, we exemplify the territorial tension of the mining advance in the cultural and ritual landscape of Quipisca as a dichotomy around the representations of the world, where, for CIQQ, the hills and ceremonial sites have a relational life between nonhumans and humans, while, for the mining company, they only represent spaces of mineral extraction.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Quechua"},{"word":"heritage"},{"word":"extractivism"},{"word":"collaborative work"},{"word":"Territory"},{"word":"identity"}],"section":"Commentary","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6xx2091t","frozenauthors":[{"first_name":"Juan","middle_name":"Andres","last_name":"Moraga Nova","name_suffix":"","institution":"","department":""},{"first_name":"Cesar","middle_name":"","last_name":"Pinochet","name_suffix":"","institution":"","department":""},{"first_name":"Rodolfo","middle_name":"","last_name":"García","name_suffix":"","institution":"","department":""},{"first_name":"Ornaldo","middle_name":"","last_name":"Bacian","name_suffix":"","institution":"","department":""},{"first_name":"Mario","middle_name":"","last_name":"Bacian","name_suffix":"","institution":"","department":""},{"first_name":"Roger","middle_name":"","last_name":"Hidalgo","name_suffix":"","institution":"","department":""},{"first_name":"Mario","middle_name":"","last_name":"Bacian","name_suffix":"","institution":"","department":""}],"date_submitted":"2024-07-15T15:58:05.925000+01:00","date_accepted":"2025-09-09T17:49:29.956000+01:00","date_published":"2025-12-07T19:41:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/29336/galley/45931/download/"}]},{"pk":25369,"title":"Hatchery’s Child: A Winnemem Wintu History of the Baird Station Salmon Hatchery and the Formation of Fisheries Science","subtitle":null,"abstract":"While it is now common knowledge that Pacific salmon die after spawning, in 1881 American fish culturalists fiercely debated the matter. In a magazine article, US Fish Commission official Livingston Stone surveyed Winnemem Wintu workers at his hatchery on the McCloud River in Northern California. Acknowledging their unique expertise from “having spent their entire lives on the river since time immemorial,” Stone noted, “they were unanimous in saying that all the salmon died. There was not one dissenting opinion.”
\nAfter establishing the salmon hatchery on the McCloud in 1871, Stone would succeed in exporting millions of artificially inseminated salmon eggs around the world. While Stone is still memorialized as a forefather of modern fisheries science, scholars have elided the Winnemem Wintu ecological knowledge he relied upon from their histories. The few that do reference the Winnemem Wintu workers characterize them as helpful but naive servants and laud their partnership with Stone as an exemplar of multicultural cooperation. However, this paper recasts the narrative by foregrounding the oral history of the Winnemem Wintu, who contend Stone learned from them about salmon biology but ignored their most important lessons: that salmon are sentient bearers of ecological wisdom who must be followed rather than controlled and that hatcheries cannot replace the protection of riverine habitat. Their oral history and newly excavated archival documents also reveal how the hatchery facilitated the extra-legal seizure of Indigenous lands and suppression of Winnemem Wintu ceremonies. Written and researched in close collaboration with Winnemem Wintu leadership, this paper connects Stone’s scientific legacy to colonial impulses that continue to influence modern fisheries biology. The tribe argues that rewriting the history of Stone’s operation is an essential intervention to unravel the hatchery-centric culture of wildlife agencies that hampers the tribe’s restoration of wild salmon in their ancestral watershed.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"california"},{"word":"Indigenous"},{"word":"Fisheries"},{"word":"salmon"},{"word":"Traditional Ecological Knowledge"},{"word":"History"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4fk150tv","frozenauthors":[{"first_name":"Marc","middle_name":"T.","last_name":"Dadigan","name_suffix":"","institution":"","department":""},{"first_name":"Caleen","middle_name":"","last_name":"Sisk","name_suffix":"","institution":"Winnemem Wintu Tribe","department":""}],"date_submitted":"2024-07-09T21:11:53.461000+01:00","date_accepted":"2025-07-09T17:57:49.454000+01:00","date_published":"2025-12-07T19:40:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/25369/galley/45930/download/"}]},{"pk":25347,"title":"Living in an Eel’s World","subtitle":null,"abstract":"The global decline of anguillid eels is well-documented across all continents where nineteen related species migrate. In North America, the population decline (and in some cases, extirpation) is related to numerous factors including industrial development. Eels experience violent mortality and migration barriers which have been linked to extractive infrastructure affiliated with settler colonial land occupation. The intricate migration pattern of Anguilla rostrata (American eels) is one of those species, an ecologically significant fish that has ancestral and persistent relevance to First Nations and tribal nations in Canada and the US, respectively. This paper draws from Anishinabe ontological grounding including intergenerational dodem gikendaasowin (clan or kinship knowledge) to suggest that humans are living in a world that includes an aquatic governance mediated by eels. A primary contribution is the suggestion that attention to such framing has applied relevance to intergenerational land-based healing, for extension of ongoing pursuits including Indigenous environmental justice, water governance strategies, and renewed interspecies relations. The application of these nascent concepts affects possibilities for current and future generations to exert reflective capacity and advocate for greater decision-making in matters of water governance. This paper suggests these opportunities be afforded to inheritors of ancestral Anishinabeg legacy dispersed throughout areas in Anishinabe-aki, where eels have resided and migrated and may do so again; to survive, eels benefit from informed policy and governance practices that facilitate physical assistance. New regimes may be built from human reflexivity and the desire to give back to life, an inherent principle of Anishinabe water governance and the application of Nibi Inaakonigewin (water laws).
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Anishinabe"},{"word":"American eel"},{"word":"Anguilla rostrata"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5kj4d3zz","frozenauthors":[{"first_name":"Kristi","middle_name":"Leora","last_name":"Gansworth","name_suffix":"","institution":"York University","department":"Osgoode Hall Law School"}],"date_submitted":"2024-07-05T16:36:23.158000+01:00","date_accepted":"2025-07-30T15:59:44.226000+01:00","date_published":"2025-12-07T19:39:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/25347/galley/45928/download/"}]},{"pk":25349,"title":"Pyroepistemology along the Northern Shores of Lake Ontario: Reinterpreting the Hopewell Tradition and Mound-Builders Theory through Anishinaabeg Perspectives","subtitle":null,"abstract":"This article critically reevaluates the mound-builders theory and the Hopewell tradition (200 BCE–500 CE) along the northern shores of Lake Ontario by incorporating Anishinaabeg perspectives on burial mounds and death practices. Through case studies of the Serpent Mounds (300 BCE–1400 CE, Hiawatha First Nation, Ontario) and the Hasting Mounds site (500 CE, Norwood, Ontario), this paper employs the concept of pyroepistemology, as introduced by Paulette Steeves (2021), to challenge and decolonize established archaeological narratives. Pyroepistemology, which seeks to eradicate colonial ideologies to reveal Indigenous knowledge, is crucial for reinterpreting the Hopewell tradition, traditionally viewed through a eurocentric lens. This study integrates Anishinaabeg oral histories and cultural practices to provide a more holistic understanding of these sites, advocating for an inclusive and respectful archaeological approach that acknowledges Anishinaabeg cultural heritage and calls for educational reforms in Ontario.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Anishinaabeg history"},{"word":"Anishinaabeg Burial Practices"},{"word":"Anishinaabeg Oral History"},{"word":"Anishinaabeg Archaeology"},{"word":"Pyroepistemology"},{"word":"Serpent Mounds"},{"word":"Hasting Mounds"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6dp8w3zg","frozenauthors":[{"first_name":"Jack","middle_name":"C.","last_name":"Hoggarth","name_suffix":"","institution":"Trent University","department":"Indigenous Studies"},{"first_name":"Jackson","middle_name":"","last_name":"Pind","name_suffix":"","institution":"Trent University","department":"Chanie Wenjack School for Indigenous Studies"}],"date_submitted":"2024-07-05T23:32:54.867000+01:00","date_accepted":"2025-05-14T00:42:54.421000+01:00","date_published":"2025-12-07T19:39:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/25349/galley/45929/download/"}]},{"pk":25017,"title":"Tracking the Early History of the Upper Great Lakes Using Anishinaabeg’s Histories: From Ma’iingan (Wolf) to Animosh (Dog)","subtitle":null,"abstract":"The oral traditions of the Anishinaabeg accurately describe the processes that formed the Great Lakes, the mass extinctions that followed, and adaptations made by animals and people from the Younger Dryas (12,600–11,700 YBP) to the Early Holocene (c. 11,700–8,000 YBP) periods. By exploring the geophilosophical tracks of indigenous oral tradition alongside modern academic methodologies, this article highlights the important cultural shift of the Anishinaabeg’s reliance on the ma’iingan (wolf or canis lupus) to the animosh (dog or canis lupus familiaris). The human-wolf relationship was so intrinsic to their survival during this period that it has been preserved within accounts of the Original Man (often depicted as Nanabush). Such accounts describe this mutually beneficial relationship of humans and wolves hunting together, which made hunting more efficient for both humans and wolves. This is an early example of mino bimaadiziwin (living a good life). The contrast between two Anishinaabe stories (the “Original Man and Wolf” and the “Story of Dogs”) in the context of a new world (after a Great Flood) speaks to important shifts. One is the selective breeding of animosh (dog), which distinguishes this species from its cousin the ma’iingan (wolf), recorded in oral traditions that emphasizes the importance of the Anishinaabeg’s connection to their environment and to the animal world. The use of animal patterns, ecological models, and oral traditions therefore helps to demonstrate that the distinct Anishinaabeg-woodland identity began to be formed among the populations on the St. Mary’s River several millennia earlier than generally believed.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/87w4g6kg","frozenauthors":[{"first_name":"Colin","middle_name":"","last_name":"Elder","name_suffix":"","institution":"University of Salford","department":"Centre for Applied Archaeology"}],"date_submitted":"2024-07-01T10:15:02.149000+01:00","date_accepted":"2025-03-10T20:13:43.788000+01:00","date_published":"2025-12-07T19:37:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/25017/galley/45927/download/"}]},{"pk":25013,"title":"Ethnographies of Imperial Extraction: Creating and Cataloguing American Antiquity from Classical Archeology in the Nineteenth Century","subtitle":null,"abstract":"This article seeks to trace historical developments in the American Southwest alongside the professionalization of archeological pursuits between the 1870s and the 1890s, while paying attention to uses of Old World antiquity as models. The bulk of this article will center the movement of the Stevenson collection introduced to the US National Museum (the Smithsonian) in its transition from specimen to cross-cultural currency between institutions and governments. My methodology is primarily decolonial in revisiting the documentation methods, especially cataloging, involved in the collection of Indigenous material culture in the Southwest. The framing of Native materials as imitative served as a key form of Indigenous dispossession that administratively categorized peoples on behalf of colonial governments. The discursive connections drawn between Native American materials and classical antiquity are also worth exploring further, inasmuch as these materials served not just as parts of a hierarchical comparative model but also moved through institutional and international exchanges in the formation of national archaeologies that furthered imperial conceptions of time and history. Unpacking the centrality of nationalism in the pursuit of collecting should serve as a starting point in reconsidering the ethics of material extraction from source communities. Understanding the relationship between salvage ethnography and the cultural exchange of archeological specimens, including through extraction, points to the continued relevance of how institutions continue to view and handle these materials today.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Museums"},{"word":"salvage anthropology"},{"word":"archeology"},{"word":"Pueblo"},{"word":"New Mexico"},{"word":"Southwest United States"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9960s4cf","frozenauthors":[{"first_name":"Kendall","middle_name":"","last_name":"Lovely","name_suffix":"","institution":"UC Santa Barbara","department":"History"}],"date_submitted":"2024-06-30T22:52:55+01:00","date_accepted":"2025-06-17T16:25:42.883000+01:00","date_published":"2025-12-07T19:36:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/25013/galley/45926/download/"}]},{"pk":25000,"title":"Indebted to Thieves","subtitle":null,"abstract":"As a descendant member of the Menominee Indian Tribe of Wisconsin but raised in Phoenix, Arizona, I was culturally and geographically displaced from my tribe while growing up. In this article, I explore the marginal space that I inhabit now as an adult and as a linguistic anthropologist. In this article, I describe my ambivalence at being indebted to the cruel and bloody history of anthropological and linguistic research perpetrated upon Indigenous nations throughout the last 300 years. I analyze the moral and ethical implications of past social scientists’ works, as well as how I navigate my journey through an academic system built on the oppression and subjugation of my people.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Indigenous identity"},{"word":"Linguistic Anthropology"},{"word":"Menominee"},{"word":"American Indian Studies"},{"word":"Marginality"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/25j6j0w3","frozenauthors":[{"first_name":"Rachelle","middle_name":"M.","last_name":"Besaw","name_suffix":"","institution":"Arizona State University","department":""}],"date_submitted":"2024-06-29T01:58:02.632000+01:00","date_accepted":"2025-05-12T16:47:30.132000+01:00","date_published":"2025-12-07T19:35:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/25000/galley/45925/download/"}]},{"pk":24890,"title":"The Ili’i Is Améewi: Recovering Indigenous Environments of the Willamette Valley","subtitle":null,"abstract":"As an indigenous researcher, I have many questions about what has happened to the Willamette Valley, the traditional landscape where my people have lived for more than 16,000 years. The valley is now completely recreated in a settler vision for agriculture leaving little land, about 1 percent of the valley as still a traditional landscape. Generations of settlers have changed their land, drained off the water, and engineered the environment to be an arid landscape.
\nUsing ethnographic reports, ethnological fieldwork, oral histories, settler accounts, and tribal intellectual knowledge I reconstruct the original environment of the valley to reveal the character of the land in which the Kalapuyan peoples used to live. Research shows that they lived in a vast landscape of wetlands, the prairies expanding into shallow swales during any season. The majority wetlands of the valley give many clues as to what the original Kalapuyan culture was like, because they had to collect food, hunt, fish, dig roots, and set fall prairie fires, despite the great amount of seasonal moisture.
\nThe Kalapuyans were colonized very early in the history of the West, 1830–1856. Because of this, little information was collected about their traditional lifeways, their villages, or even their houses. Historically, there was rare information preserved about how the valley was changed by settlers to become an arid landscape. The fact that wetlands dominated the valley will change many assumptions made by scholars about tribal cultures, and that water will need to be restored to have successful restoration and decolonization projects.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial 4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"Willamette valley"},{"word":"Kalapuya"},{"word":"wetlands"},{"word":"cultural fire"},{"word":"camas"},{"word":"wapato"},{"word":"molalla"}],"section":"Commentary","is_remote":true,"remote_url":"https://escholarship.org/uc/item/56x9c0kf","frozenauthors":[{"first_name":"David","middle_name":"G.","last_name":"Lewis","name_suffix":"","institution":"Oregon State University","department":"Anthropology"}],"date_submitted":"2024-06-18T01:31:01.534000+01:00","date_accepted":"2025-07-10T23:58:00.139000+01:00","date_published":"2025-12-07T19:32:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/aicrj/article/24890/galley/45924/download/"}]},{"pk":63851,"title":"Childcare and the Burden on the American Family: Can the Tax Code Provide a Solution in a Post-Pandemic World?","subtitle":null,"abstract":"Childcare, and how to pay for it, is one of the central issues facing families and society today. The challenges of childcare adversely impact women who bear the primary responsibility for such care, both paid and unpaid. During the COVID-19 pandemic, women were more likely to bear the professional and personal impact of shuttered preschools and the absence of daycare centers. Even wealthy families faced these same challenges, along with the common concerns of protecting their health and those of vulnerable family members. Post-COVID, all households have seen the rising costs of childcare, as licensed care centers have permanently closed and informal care is in short supply. The unaffordability and unavailability of childcare presents a particular challenge for those in the middle and low-income classes as they also struggle with the high costs of food, healthcare, housing, and other daily expenditures. This Article argues that tax laws should be augmented to elevate the value of care labor while offering greater support for both parents working in the market and those in the home. The tools of tax policy offer powerful potential to open remedial paths for the greater public good. A refundable child dependent care credit, the reinstatement of the per child credit for children under 6 years old, the expansion of the earned income credit for the care provider, a more generous employer family leave credit, as well as new provisions supporting the working parent, the low-income taxpayer, and unpaid caregiver, represent practical initial steps. In addition, tax revenues should be raised in commensurate measure to support this higher valuation of care activities. Attention to this childcare issue will represent an investment in our children, will help assure them equality of opportunity, and provide them the education necessary to make valuable contributions to the nation. Promoting choice through the tax code will help prepare us for a future pandemic.
","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/28g3g0b6","frozenauthors":[{"first_name":"Nancy","middle_name":"E.","last_name":"Shurtz","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-06T20:57:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_jgl/article/63851/galley/49018/download/"}]},{"pk":63850,"title":"The Evolving Landscape of Insurance Law and Assisted Reproductive Technology: Implications for Gay Parenthood","subtitle":null,"abstract":"Starting a family and becoming a parent are major milestones for many people regardless of their sexual orientation. While some people choose not to have children, others face unique challenges in their journey to becoming parents. The legalization of same-sex marriage opened the door for parenthood to many same-sex couples who wished to pursue parenthood; however, that journey would not be easy. The long history of medical institutions pathologizing homosexuality and the legal system’s criminalization of same-sex intimacy created a standard of heterosexuality that entrenched itself in the fabric of American society. This standard would eventually be used against same-sex couples in the healthcare system where they would attempt to access assisted reproductive technology. This Article explains how the centuries-long tradition of associating parenthood with heterosexuality had managed to seep into health insurance policies that can serve as gatekeepers—providing different-sex couples with an ability to become parents while withholding the same opportunity from same-sex couples. After Bostock v. Clayton County supplied the necessary ammunition and the U.S. Department of Health and Human Services promulgated recent regulatory changes, gay people from multiple states brought lawsuits alleging discrimination based on sexual orientation in their health insurance policies. The Article explores an ongoing slew of court battles and synthesizes legal strategy lessons. The Article concludes with future directions for improving the healthcare system and supporting gay parenthood.
","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4j73233k","frozenauthors":[{"first_name":"Mantas","middle_name":"","last_name":"Grigorovicius","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-06T20:53:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_jgl/article/63850/galley/49017/download/"}]},{"pk":63849,"title":"Pathways to the Boardroom for Women","subtitle":null,"abstract":"","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5p36b6hz","frozenauthors":[{"first_name":"Cindy","middle_name":"A.","last_name":"Schipani","name_suffix":"","institution":"","department":""},{"first_name":"Terry","middle_name":"M.","last_name":"Dworkin","name_suffix":"","institution":"","department":""},{"first_name":"Alyse","middle_name":"","last_name":"Geiger","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-06T20:47:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_jgl/article/63849/galley/49016/download/"}]},{"pk":63848,"title":"State-Sponsored Coercion and Control: The Need for Federal Abortion Protections to Safeguard the Autonomy of Survivors of Intimate Partner Violence","subtitle":null,"abstract":"This Note makes the case for federal abortion protections by illustrating the heightened danger of intimate partner violence during pregnancy and highlighting the ways that abusers may use the law and legal systems as tools of abuse against their pregnant partners. To do so, this Note explains how the United States Supreme Court recognized the heightened risk of intimate partner violence during pregnancy in Planned Parenthood v. Casey and used concern for the safety of survivors of intimate partner violence to strike down abortion restrictions. It next discusses how Dobbs v. Jackson Women’s Health Organization toppled critical protections for survivors of intimate partner violence when it ended federal constitutional protections for abortion. The Note explains the ways that bounty-style laws like Texas’s S.B. 8, wrongful death suits, spousal consent laws, and pregnancy criminalization laws can be used to further trap survivors in abusive relationships in a post-Dobbs era. Finally, it concludes that federal abortion protections are critical to keeping survivors of intimate partner violence safe and advocates that the Women’s Health Protection Act be passed with viability ban language removed, for prohibiting notice and consent requirements, and for repealing the Hyde Amendment.
","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/43c9x7r8","frozenauthors":[{"first_name":"Kira","middle_name":"Eidson","last_name":"Phillips","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-06T20:44:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_jgl/article/63848/galley/49015/download/"}]},{"pk":63846,"title":"Between a Rock and a Hard Place: Prenatal Personhood and the Right of Procreation","subtitle":null,"abstract":"","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4x03z3mb","frozenauthors":[{"first_name":"Dominica","middle_name":"","last_name":"Aranaga","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-06T20:40:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_jgl/article/63846/galley/49014/download/"}]},{"pk":63845,"title":"Front Matter","subtitle":null,"abstract":"","language":"eng","license":{"name":"All rights reserved","short_name":"Copyright","text":"© the author(s). All rights reserved.","url":"https://creativecommons.org/licenses/authors"},"keywords":[],"section":"Front Matter","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4kj5b48d","frozenauthors":[],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-06T20:36:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uclalaw_jgl/article/63845/galley/49013/download/"}]},{"pk":41790,"title":"New mammalian herbivore records from the Early to Middle Miocene Castilletes fauna, Colombia and late Neogene environmental change in northern South America","subtitle":null,"abstract":"The Early to Middle Miocene mammal assemblage of the Castilletes Formation, Colombia records a diverse assemblage of mammals in the northern Neotropics prior to the Great American Biotic Interchange. We identify new records of herbivorous mammal taxa, with additional specimens of Huilatherium sp. and the first records of cf. Pericotoxodon sp., Miocochilius cf. M . anomopodus and ‘ Scleromys’ sp. All these genera are shared with other tropical Middle Miocene assemblages, including La Venta (Colombia) and Fitzcarrald (Peru) and increase the faunal similarity among them. Ecometric analysis of dental traits suggests a habitat change between the assemblages of the Castilletes Formation and the Ware Formation (Late Pliocene), consistent with results from other proxies that show increased opening and drying. In combination, these results support the utility of ecometric methods in Neogene South America and emphasise the importance of taxonomic revisions for these taxon-independent methods.
","language":null,"license":{"name":"Creative Commons Attribution-NonCommercial-ShareAlike 4.0","short_name":"CC BY-NC-SA 4.0","text":"\nReaders are free to:
\nUnder the following terms:
\nNotices:
\nYou 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.
\nNo 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.
","url":"https://creativecommons.org/licenses/by-nc-sa/4.0"},"keywords":[{"word":"ecometrics"},{"word":"Neogene"},{"word":"South America"},{"word":"taxonomy"},{"word":"ungulate"},{"word":"rodent"}],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1109w01k","frozenauthors":[{"first_name":"Oscar","middle_name":"Edward","last_name":"Wilson","name_suffix":"","institution":"Other","department":""},{"first_name":"Aldo","middle_name":"F.","last_name":"Rincón","name_suffix":"","institution":"Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia","department":"None"},{"first_name":"Juan","middle_name":"D.","last_name":"Carrillo","name_suffix":"","institution":"Department of Biology, University of Fribourg, and Swiss Institute of Bioinformatics, Chemin du Musée 10, Fribourg, Switzerland","department":"None"},{"first_name":"Catalina","middle_name":"","last_name":"Suarez","name_suffix":"","institution":"Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales (IANIGLA), CCT-CONICET Mendoza, Av. Ruiz Leal s/n, Parque General San Martín, Mendoza, 5500, Argentina","department":"None"},{"first_name":"Juha","middle_name":"","last_name":"Saarinen","name_suffix":"","institution":"Department of Geosciences and Geography, University of Helsinki, P.O. Box 64 (Gustaf Hällströmin katu 2), 00014, Helsinki, Finland","department":"None"}],"date_submitted":"2024-07-23T10:30:53+01:00","date_accepted":"2025-11-09T23:04:13.318000+01:00","date_published":"2025-12-04T21:00:00+01:00","render_galley":null,"galleys":[]},{"pk":59640,"title":"Investor Coalitions Through an Antitrust Lens","subtitle":null,"abstract":"This Article offers a novel—antitrust—perspective on a growing phenomenon in capital markets: institutional investor coalitions. In recent years, a large group of powerful institutional investors, who collectively own significant equity stakes in most public companies, have created alliances on various corporate governance issues. Traditionally, corporate law has encouraged investor cooperation on these issues, regarding it as the solution to the well-known collective-action problem facing shareholders in public companies. As this Article shows, however, the prevailing positive view underscores a crucial point: members of the coalition are not only co-owners of companies but also competitors in capital markets. In the primary markets, institutional investors are competing buyers of shares, vying for share allocation. In the secondary market, they compete as asset managers, using their portfolio performances to attract retail investors and sponsors. The concern raised in this Article is that cooperation among institutional investors—even on seemingly benign governance matters—could facilitate tacit collusion and grant coalition members an unfair advantage in capital markets.
\nFocusing on one powerful investor coalition that emerged in recent years with the goal of limiting the use of dual-class stock in initial public offerings (IPOs), this Article demonstrates that when competing buyers of shares coordinate their response to a governance term at the IPO juncture, they effectively form a buyers’ cartel. Due to the coalition members’ collective dominance over the demand for public offerings, their orchestrated efforts lead to two potential economic distortions. First, abnormal underpricing of dual-class stock, which allows members to buy shares in the primary market below their fair market value. This price distortion explains the significant amounts of money often being “left on the table” by dual-class issuers. Second, the coalition can pressure issuers into adopting suboptimal governance arrangements, such as mandatory time-based sunset provisions, which may be value-decreasing. Both distortions can lead to the same sort of economic harm that antitrust law is designed to prevent.
\nThe potential anticompetitive effects of investor coalitions require an immediate policy response. This Article thus proposes a multi-faceted regulatory reform aimed at curbing institutional investors’ collective actions that may limit competition. The suggestions include restricting collective actions in the primary market and, under certain circumstances, banning communication between institutional investors during IPOs. Furthermore, the Article emphasizes the need for targeted antitrust scrutiny of institutional investor consortia—advocacy groups that coordinate governance initiatives on behalf of their members—given their demonstrated capacity to facilitate communication and sustain collusive practices. The proposed policy measures seek to strike a delicate balance between the goal of corporate law to encourage cooperation among shareholders and the goal of antitrust law to restrain collaboration among competitors.
","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8hn6j3s2","frozenauthors":[{"first_name":"Danielle","middle_name":"A.","last_name":"Chaim","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T09:04:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59640/galley/45612/download/"}]},{"pk":59639,"title":"Patient Autonomy, Public Safety, and Drivers with Cognitive Decline","subtitle":null,"abstract":"With a growing elderly population, cognitive decline in drivers has become a significant public safety concern. Currently, over thirty-two million individuals who are seventy or older have driver’s licenses, and that number is growing quickly. In addition, almost 10 percent of seniors in the United States (those sixty-five and older) have dementia, and an additional twenty-two percent have mild cognitive impairment. Between a quarter and a half of individuals with mild to moderate dementia still drive. As cognitive abilities such as memory, attention, and decision-making skills deteriorate, a driver’s ability to operate a vehicle safely can be compromised. This not only puts the driver at risk but also endangers passengers, other motorists, and pedestrians. As the population ages, the number of drivers experiencing cognitive decline is increasing, escalating the risk of accidents.
\nFor many older adults, however, driving is a key aspect of independence and mobility. Losing the ability to drive can lead to social isolation, dependence on others, and a decline in overall well-being. Understanding and addressing the challenges of cognitive decline in relation to driving is crucial for maintaining elderly individuals’ quality of life. Nonetheless, determining when someone should stop driving due to cognitive decline is especially difficult because cognitive decline often progresses gradually and is challenging to assess.
\nCurrent legal mechanisms fail to resolve the tension between promoting personal autonomy and protecting public safety. Existing approaches to the problem are therefore unsatisfactory. Requiring road tests of every older adult is both overly intrusive and economically inefficient. At the same time, however, revoking driving privileges only after an accident has occurred creates a public safety hazard. Without an effective system of regulation, informal practices emerge. Medical professionals who recognize that a patient’s driving is likely to create a safety risk may either ignore the matter entirely or pressure family members to take away the keys from their loved one. And when accidents do happen, family members are sometimes sued for failing to prevent their loved ones from taking the wheel.
\nThis Article recommends a framework for enhanced medical and regulatory protocols to navigate the intricacies of driving with cognitive decline. It recognizes that earlier efforts to solve the problem have often failed because they relied too heavily on a single point of responsibility. Our proposed framework, by contrast, creates a connection between the medical provider and the motor vehicle regulator and sets out clear lines of responsibility. The Article develops recommendations for effective interventions, analyzing the role that physicians should play and proposing legislative changes. Driving with cognitive decline is a multifaceted challenge that impacts public safety, personal independence, family relationships, legal rights, and healthcare practices. Addressing it effectively requires a balanced and thoughtful approach that considers the needs and rights of all stakeholders.
","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7242t6r8","frozenauthors":[{"first_name":"Sharona","middle_name":"","last_name":"Hoffman","name_suffix":"","institution":"","department":""},{"first_name":"Cassandra","middle_name":"Burke","last_name":"Robertson","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T09:00:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59639/galley/45611/download/"}]},{"pk":59638,"title":"Reevaluating Felon-in-Possession Laws After Bruen and the War on Drugs","subtitle":null,"abstract":"The legal landscape surrounding firearm possession is evolving rapidly. In 2022, the Supreme Court accelerated its expansion of the individual right to bear arms under the Second Amendment in New York Rifle & Pistol Ass’n v. Bruen. Since Bruen, courts around the country have struck down nearly all types of firearm regulations, with a notable exception: felon-in-possession laws. This Article examines the implications of a legal landscape where those who have prior felony convictions, and especially prior drug convictions, are punished harshly for the same behavior—possession of a firearm—that is constitutionally protected for nearly everyone else.
\nI argue that as the Second Amendment expands to protect more and more firearm possession, a dichotomy has arisen in which those who live in the communities most heavily targeted by the War on Drugs of the 1980s and 1990s are increasingly becoming virtually the only Americans for whom firearm possession is illegal. I examine the history and development of felon-in-possession statutes to show that they were not enacted with a clear purpose, and are not narrowly tailored to criminalize the most dangerous behavior. Further, I show how existing federal enforcement priorities and the structure of the United States Sentencing Guidelines compound the harms of the War on Drugs by punishing individuals with prior drug offenses most harshly, even when there is limited evidence to suggest that they pose the greatest danger from firearm possession.
\nThe Supreme Court recently confirmed that the Second Amendment permits individuals who pose a danger to the community to be disarmed in United States v. Rahimi. The question of how to determine who poses such a danger will be the next threshold of Second Amendment jurisprudence. I argue that as our understanding of the Second Amendment evolves, prosecutors and legislators must be cognizant of the lasting effects of the War on Drugs and question the assumption that any prior felony conviction is an accurate proxy for dangerousness.
","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/82x6g60j","frozenauthors":[{"first_name":"Laura","middle_name":"G.","last_name":"Abelson","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T08:57:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59638/galley/45610/download/"}]},{"pk":59605,"title":"The Price of Disinformation","subtitle":null,"abstract":"The general public is misinformed on a broad range of vitally important topics, such as what the true crime rates are, whether the COVID-19 vaccine is part of a conspiracy to control the population, and who won the last presidential election. There are myriad factors contributing to this epistemic crisis wherein large segments of the public form false belief on these and other major issues. One factor is the vast amount of intentionally false speech disseminated to mislead the public, often termed “disinformation.” Leaders in politics, industry, and the media spread disinformation for their own self-serving purposes. These purposes include turning a profit, growing an audience, and getting elected to office. Although the law prohibits “fraud,” the legal definition of that term—that determines to a great extent the scope of which deceptions are actionable and which are protected speech—is narrowly focused on personal fraud. Schemes to defraud that are aimed at the public at large, by contrast, are rarely labeled “fraud” and are often protected under the First Amendment. Accordingly, disinformation is often allowed by law, despite the fact that (1) it is often knowingly false and disseminated for profit or advantage, and (2) it harms individuals or society. These harms include millions of deaths from tobacco, opioids, lead, and sugar; environmental destruction from climate change; and threats to democratic institutions. This Article highlights the difficult First Amendment issues posed by disinformation and argues that, in the search for solutions, we must consider the staggering amount of harm caused by disinformation. No adequate solution has yet been found for the mass proliferation of false and misleading claims, which is worse in today’s digital world than ever before. Indeed, given the complex and multi-faceted nature of the issue, any solution to it must be carefully tailored to regulate only narrow and well-defined categories of speech that are or should be unprotected, while carefully protecting the bedrock constitutional right to freedom of expression. But at the same time, the discussion around how to solve this problem must take into account the injuries caused by allowing unfettered self-serving falsehoods to be spread by those who hold the public megaphone.
","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/98x1w7xg","frozenauthors":[{"first_name":"Wes","middle_name":"","last_name":"Henricksen","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T07:17:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59605/galley/45589/download/"}]},{"pk":59643,"title":"Ethical Horizons: Navigating the Complexities of Team-Based Legal Representation in Large Corporate Firms","subtitle":null,"abstract":"The legal profession requires the best of its members, asking them to act in ways that respect and prioritize the needs of clients, so long as those needs are ethical and legal. However, when an attorney works within a large law firm, they are faced with not only requirements from their clients, but also from their peers, supervisors, and client representatives. This Note focuses on (1) the origins and history of the large law firm structure that is so common today, (2) the ethics of practicing law in large law firms and how it impacts the individual, and (3) how to overcome ethical pitfalls common within the organizational structure. It concludes with a review of the literature that is most likely to find solutions to resolve these ethical dilemmas.
","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6qm42216","frozenauthors":[{"first_name":"Jake","middle_name":"","last_name":"Hermansen","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T07:12:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59643/galley/45615/download/"}]},{"pk":59642,"title":"Rehabilitating the Nonprofit Arts Sector: Healthy Board Governance as a Condition to Federal Tax Exemption","subtitle":null,"abstract":"Americans celebrate the arts and how they increase our economic and collective well-being. Nonprofit arts and culture organizations are the primary vehicle by which individuals create art, attend events, and support millions of jobs in the industry. This has led to a perception that arts organizations have an effective framework for productivity and efficiency. Yet, the COVID-19 pandemic uncovered tumultuous relationships between artists, staff, Board members, and executive leadership within several nonprofit arts organizations.
\nAlthough Americans regularly celebrate, support, and engage with the arts, the nonprofit arts industry is fraught with disconnected leaders, disgruntled staff and artists, and ineffective work environments. This Note explores why those issues persist and what can be done. First, I argue that the failures of nonprofit arts organizations’ Boards of Directors to uphold their responsibilities and manage stakeholder relationships are a key cause of the current destabilization of the nonprofit arts sector. Against that backdrop, I examine the current federal and state regulatory frameworks for tax-exempt organizations and highlight why certain mechanisms are ineffective in supporting accountability and transparency. Finally, as a solution, the Internal Revenue Service (IRS) should enumerate a category for arts and culture in the Internal Revenue Code (IRC). With this newfound designation, I then argue that the IRS should establish minimum governance standards for the boards of nonprofit arts organizations and tie those standards to an organization’s ability to receive and maintain its tax-exempt status.
\nBecause of the immense economic and respected social value of arts and culture in the United States, nonprofit arts organizations must be held to a high standard to maintain public confidence. This Note believes that creating greater standards for nonprofit arts entities to receive federal tax-exemption status will improve organizational accountability and help such organizations in the United States remain the cultural beacon we believe them to be.
","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/37b240k8","frozenauthors":[{"first_name":"Kanome’","middle_name":"","last_name":"Jones","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T02:10:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59642/galley/45614/download/"}]},{"pk":59641,"title":"Algorithmic Personalization Features and Democratic Values: What Regulation Initiatives Are Missing","subtitle":null,"abstract":"2024 was poised to be the largest election year in history, with pivotal elections in Asia, Europe, and the Americas encompassing regional, legislative, and presidential contests, capturing the attention of half the globe. In an era dominated by social media, these elections were influenced by information dissemination through digital platforms.
\nOver the last two decades, the landscape of public discourse in matters of civic concern has undergone a transformative shift, moving from traditional media to personalized digital social media outlets. Algorithmic features now selectively match content to users, fostering engagement but also giving rise to issues such as echo chambers, filter bubbles, and sensationalized content. While much attention has been devoted to the challenges posed by personalized discourse, this paper sheds light on a critical aspect that has been overlooked in regulatory paradigms: the erosion of an open, public sphere for discourse due to individualized manipulated content matching.
\nIn a well-functioning democratic system, an informed citizenry is paramount. However, amplification algorithms and recommendation systems—referred to as “personalization features” here—employ manipulated partial and even contradicting messages designed to targeted audience, while excluding users who may object, correct or protest against them. This paper aims to address the question of whether democratic public discourse can be preserved amidst the individualized flow of manipulated content on social media.
\nExisting regulatory approaches—including content regulation, algorithm regulation, and privacy regulation—primarily focus on data profiling, algorithmic content matching, and the nature of discourse within personalized spheres. They prove inadequate in mitigating harm to the public sphere resulting from the selective distribution of individualized manipulated content, hindering open public discussion. Even regulatory initiatives specifically targeting accessible public discourse fall short in addressing both the individualized and manipulated aspects of personalized speech.
\nThe research findings highlight a pressing concern—the inherent contradiction between the individualized manipulated flow of content and the principles of democratic deliberation. Urgent regulatory frameworks are needed to safeguard a public space for deliberation that is accessible to all, facilitating joint decisions and the construction of pluralistic democratic societies. Potential solutions may involve establishing alternative spaces for public discourse and recognizing distinct considerations for issues in the public sphere. Additionally, a multifaceted strategy beyond online discourse or algorithm regulation is proposed, aiming to foster constructive dialogue, respect, and tolerance in the digital ecosystem, complemented by public education.
","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/96b9x2c4","frozenauthors":[{"first_name":"Sharon","middle_name":"","last_name":"Bassan","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T02:08:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59641/galley/45613/download/"}]},{"pk":59637,"title":"The Democratic Value of Transnational Campaign Finance","subtitle":null,"abstract":"Democratic decision-making in the United States does not solely affect U.S. citizens. Indeed, many such decisions impact people living in other countries, as well as noncitizens residing within the United States. Decisions on U.S. policies regarding climate change, immigration, trade, and military aid—to name a few—can have major implications for the lives of many non-Americans. Yet, in being noncitizens, such people effectively have zero representation within the democratic process that results in these decisions. This phenomenon illustrates what has become known as the problem of “democratic externalities.”
\nTheorists have proffered multiple democratic frameworks to resolve this problem—e.g., democratic cosmopolitanism, deliberative democracy, and epistemic aggregative democracy. Ultimately, though, none have managed to adequately mitigate the issue of underrepresentation that democratic externalities produce. Accordingly, this Article considers an alternative, albeit imperfect, route to addressing democratic externalities: transnational campaign finance. Specifically, this Article argues that by permitting foreign nationals to monetarily contribute to, or expend money in support of, political campaigns, a polity can better account for impacted noncitizens in its lawmaking and electoral decisions.
\nOver the past few decades, however, numerous U.S. states and countries have passed laws outright prohibiting transnational campaign finance. While there are certainly legitimate reasons to regulate the practice—e.g., corruption, distortion, misalignment, and national security—this Article contends that these measures have been too drastic in light of the democratic externalities problem. Thus, the latter portion of this Article provides guidance on how to best regulate transnational campaign finance in a way that mitigates its negative consequences without entirely impeding its pro-democratic value.
","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2gk1p576","frozenauthors":[{"first_name":"John","middle_name":"J.","last_name":"Martin","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T01:23:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59637/galley/45609/download/"}]},{"pk":59630,"title":"Unpatenting Product Hops","subtitle":null,"abstract":"On July 9, 2021, President Joseph R. Biden signed Executive Order 14036 (“Promoting Competition in the American Economy”), which directed the U.S. Food and Drug Administration (FDA) and the U.S. Patent and Trademark Office (USPTO) to collaborate on new approaches to increasing competition and lowering prices in the pharmaceutical marketplace. In response, the USPTO outlined several new initiatives, among them an intent to improve the robustness and reliability of issued patents.
\nA major impetus for the Executive Order was the pervasive nature of pharmaceutical product hopping, which occurs when manufacturers introduce new follow-on versions of lucrative pharmaceutical products to the market, versions of low added commercial value like extended-release forms of drugs, or modifications to device components of combination therapeutics. Product hops are usually intended to mitigate lost market share due to generic competition or thwart generic competition entirely. Yet the small benefits of these new products are usually far outweighed by excess costs to payers and patients alike. Product hops remain an essential part of product lifecycle management strategies due to patents, many of which are obtained after the flagship product is on the market and which offer market exclusivity for these incrementally better products. These patents also discourage manufacturers from entering lucrative markets, encourage settlement and delayed generic entry, and result in the prescribing of marginally better product hops at brand-name prices. In doing so, they undermine the fundamental constitutional intent of the patent system—a time-limited exclusive right.
\nElevating patentability standards at the USPTO could mitigate product hopping through the rejection of weaker patents, which should eventually curtail patent applications from manufacturers that attempt to create “new,” yet arguably uninventive, products intended primarily to capture market share from would-be competitors. This article evaluates the core elements of patentability and relevant case law, highlighting opportunities for the USPTO to strengthen its review of pharmaceutical patents. When coupled with regulatory reforms that further mitigate the impact of product hops, pharmaceutical research and development may pivot away from product life cycle management strategies that focus on extending the profitability of older drugs facing the prospect of generic competition and toward transformative innovation that accelerates the development of the next generation of therapeutics and cures.
","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0kg3s9p2","frozenauthors":[{"first_name":"Michael","middle_name":"S.","last_name":"Sinha","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T01:21:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59630/galley/45608/download/"}]},{"pk":59474,"title":"Foreword - Remembering Professor Dan L. Burk","subtitle":null,"abstract":"","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2j06q0mt","frozenauthors":[{"first_name":"Austen","middle_name":"","last_name":"Parrish","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T01:00:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59474/galley/45467/download/"}]},{"pk":59338,"title":"Table of Contents","subtitle":null,"abstract":"","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Prefatory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4z18f4s6","frozenauthors":[],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T00:43:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59338/galley/45344/download/"}]},{"pk":59329,"title":"Mission Statement","subtitle":null,"abstract":"","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Prefatory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4k28s4cd","frozenauthors":[],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T00:42:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59329/galley/45334/download/"}]},{"pk":59321,"title":"Masthead","subtitle":null,"abstract":"","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Prefatory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2wn1s19m","frozenauthors":[],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T00:40:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59321/galley/45326/download/"}]},{"pk":59302,"title":"Cover","subtitle":null,"abstract":"","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Prefatory","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7wz01370","frozenauthors":[],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-03T00:39:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59302/galley/45315/download/"}]},{"pk":59572,"title":"Patent Semiotics","subtitle":null,"abstract":"","language":null,"license":{"name":"","short_name":"","text":null,"url":""},"keywords":[],"section":"Article","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2x17s7nc","frozenauthors":[{"first_name":"Dan","middle_name":"L.","last_name":"Burk","name_suffix":"","institution":"","department":""}],"date_submitted":null,"date_accepted":null,"date_published":"2025-12-02T20:10:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/ucilr/article/59572/galley/45554/download/"}]},{"pk":47012,"title":"Floristic diversity of the Nuratau Mountains: a 150-year retrospective analysis","subtitle":null,"abstract":"The Nuratau Mountains located in the central part of Uzbekistan, in the transitional zone between the Mountain Central Asian and Turan phytogeographical provinces, are recognized as one of Key Biodiversity Areas within the Mountains of Central Asia Global Biodiversity Hotspot. These medium-altitude semiarid mountains are identified as one of centers of endemism and priority areas for conservation of plant diversity. This article provides a retrospective review of a 150-year history of scientific exploration of unique flora of this region, highlighting key publications and findings, herbarium collections and collectors. Overall, 1% of herbarium specimens from the Nuratau Mountains were gathered in the 19th century; 69% of all records were made during the 20th century, and 30% of the data were collected since 2000. An essential source of information on the flora of the Nuratau Mountains and the spatial distribution of species is the National Herbarium of Uzbekistan (TASH), which contains over 6,600 specimens from this region or 59% of all occurrence records. According to the most recent assessment, the flora of the Nuratau Mountains includes 1,283 species of vascular plants belonging to 474 genera and 86 families. Of these, 1,180 species from 444 genera and 81 families are native, 32 species are endemic, and 103 species are alien (occasional or introduced). Nevertheless, the flora of Nuratau Mountains is still insufficiently documented, and an actual checklist remains unpublished to date. Comprehensive botanical studies in this region are crucial because of rapidly increasing rates of biodiversity loss and degradation of ecosystems caused by anthropogenic impact.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"bibliography"},{"word":"biodiversity hotspot"},{"word":"Central Asia"},{"word":"Checklist"},{"word":"collector"},{"word":"endemic species"},{"word":"expedition"},{"word":"flora"},{"word":"herbarium"},{"word":"history of research"},{"word":"nature reserve"},{"word":"Pamir-Alay"},{"word":"phytogeography"},{"word":"Vegetation"},{"word":"Uzbekistan"}],"section":"Articles","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5872r9fm","frozenauthors":[{"first_name":"Natalya","middle_name":"","last_name":"Beshko","name_suffix":"","institution":"","department":""},{"first_name":"Bekhruz","middle_name":"","last_name":"Khabibullaev","name_suffix":"","institution":"Institute of Botany","department":"Conservation and ecology of Plants"},{"first_name":"Khabibullo","middle_name":"","last_name":"Shomurodov","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-03-13T06:14:12.073000+01:00","date_accepted":"2025-10-24T16:00:14.240000+01:00","date_published":"2025-12-02T10:15:00+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/biogeographia/article/47012/galley/44425/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/biogeographia/article/47012/galley/44425/download/"}]},{"pk":41507,"title":"Trends in Proportion of Delirium Among Older Emergency Department Patients in South Korea, 2017-2022","subtitle":null,"abstract":"Introduction: Delirium is a critical neuropsychiatric condition that surged among older adults during the coronavirus disease 2019 (COVID-19) pandemic, likely due to social isolation resulting from distancing measures. In this study we examined trends in delirium-related emergency department (ED) visits before and during the pandemic using nationwide data from South Korea, with a focus on different phases of social distancing, to inform healthcare strategies for older adults during public health crises.
\nMethods: We obtained data from the National Emergency Department Information System (2017-2022). Changes in ED visits were assessed across pre-pandemic (January 2017–January 2020), early pandemic (February 2020–March 2022), and late pandemic (April 2022–December 2022) phases using interrupted time series analysis.
\nResults: A total of 80,442 delirium-related ED visits among adults ≥ 65 years of age were recorded. The interrupted time series analysis showed a significant step increase in ED visits during the early pandemic phase (relative risk [RR] 1.290, 95% CI 1.201-1.386; 29.0% increase), followed by a decrease in the late pandemic phase (RR 0.922, 95% CI 0.868-0.981; 7.8% decrease). The most substantial increase was for individuals 65-74 year of age during the early pandemic period (RR 1.406, 95% CI 1.264-1.564) reflecting a 40.6% increase in visits to the ED. Indirect ED visits, such as institutional referrals, also notably increased (RR 1.275, 95% CI 1.184-1.373) reflecting a 27.5% increase.
\nConclusion: Delirium-related ED visits among older adults showed a notable 7.8% decrease during the late pandemic period, with key risk groups identified, particularly adults 65-74 of age (40.6% increase) and those referred from institutions (27.5% increase) during the early pandemic period. These findings may help inform targeted interventions and public health responses in similar healthcare settings. Despite limitations including reliance on diagnostic codes, lack of subgroup analysis by COVID-19 status, potential duplicate visit counts, and limited regional granularity this study offers important insight into delirium care needs during crisis periods. Further research should further explore causal mechanisms and the specific impact of COVID-19 infection on delirium incidence.
","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":"COVID-19"},{"word":"emergency department visits"},{"word":"Pandemic"},{"word":"Interrupted Time Series Analysis"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7nk3v8w6","frozenauthors":[{"first_name":"Jeongmin","middle_name":"","last_name":"Moon","name_suffix":"","institution":"Research Institute for Public Healthcare, National Medical Center, Seoul, Republic of Korea","department":""},{"first_name":"Seonji","middle_name":"","last_name":"Kim","name_suffix":"","institution":"Yonsei University College of Medicine, Department of Biomedical Systems Informatics, Seoul, Republic of Korea; Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea","department":""},{"first_name":"Daesung","middle_name":"","last_name":"Lim","name_suffix":"","institution":"Seoul Medical Center, Department of Emergency Medicine, Seoul, Republic of Korea","department":""},{"first_name":"Ho Kyung","middle_name":"","last_name":"Sung","name_suffix":"","institution":"National Medical Center, National Emergency Medical Center, Seoul, Republic of Korea","department":""},{"first_name":"Nami","middle_name":"","last_name":"Lee","name_suffix":"","institution":"Seoul National University Hospital, Department of Public Health, Seoul, Republic of Korea; Seoul National University, College of Medicine, Department of Human Systems Medicine, Seoul, Republic of Korea","department":""},{"first_name":"Kyung-Shin","middle_name":"","last_name":"Lee","name_suffix":"","institution":"Center for Public Healthcare Policy, National Medical Center, Seoul, Republic of Korea","department":""}],"date_submitted":"2024-12-20T04:52:00.390000+01:00","date_accepted":"2025-05-25T16:24:58.336000+01:00","date_published":"2025-11-27T07:04:21.374000+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/41507/galley/43187/download/"}]},{"pk":47305,"title":"Pursuit of Optimal Vagal Maneuvers in Stable Supraventricular Tachycardia: A Network Meta-Analysis","subtitle":null,"abstract":"Introduction: Vagal maneuvers are first-line therapy for hemodynamically stable supraventricular tachycardia (SVT), yet the relative efficacy of the standard Valsalva Maneuver (SVM), modified Valsalva maneuver (MVM), carotid-sinus massage (CSM), and head-down deep breathing (HDDB) remains uncertain. We undertook a network meta-analysis (NMA) to define the optimal technique and explore age- and sex-related effect modification.
\nMethods: We searched nine databases from inception to January 2025 for randomized controlled trials involving adults (≥ 18 years of age) with stable SVT treated with at least two of the four maneuvers. Primary outcomes were conversion to sinus rhythm after a single attempt after multiple attempts, and by the end of the trial. Secondary outcomes were the need for rescue intravenous (IV) antiarrhythmic drugs and maneuver-related adverse events (AEs). Bayesian random-effects NMA generated risk ratios (RR) with 95% credible intervals (CrIs); surface under the cumulative ranking curve (SUCRA) quantified hierarchy. We performed consistency, publication bias, and sensitivity analyses, and network meta-regression for mean age and female proportion.
\nResults: Nineteen trials (n = 2,545) formed a connected network. The MVM was more than doubly effective for single-attempt conversion relative to the SVM (RR 2.71, 95% CrI, 2.26-3.31) and outperformed CSM (RR 6.57, 3.33-14.94) and HDDB (RR 1.30, 0.35-4.66); SUCRA = 88.7%. At the end of the trial, the MVM retained superiority over the SVM (RR 1.25, 1.03-1.56) and ranked the highest success rate (SUCRA = 81.3%). The MVM also reduced IV drug use vs the SVM (RR 0.64, 0.55-0.73) and CSM (RR 0.59, 0.37-0.90). No maneuver differed in multiple-attempt success or AEs. The HDDB technique was ranked highest in safety (SUCRA = 82.4%) but was supported only by a single, small study. Meta-regression showed no age or sex interaction. Inconsistency was minimal; the Egger test suggested small-study effects only for the IV-drug endpoint (P = .03).
\nConclusion: The MVM provides the greatest likelihood of rapid sinus rhythm restoration and the least need for rescue pharmacotherapy without increasing AEs, supporting its adoption as the default vagal strategy for SVT. Larger, standardized trials are warranted to confirm safety differentials and long-term outcomes.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Supraventricular tachycardia"},{"word":"Vagal maneuvers"},{"word":"Carotid sinus massage"},{"word":"head-down deep breathing"},{"word":"Modified valsalva manoeuvre"},{"word":"Standard valsalva manoeuvre"},{"word":"network meta-analysis"},{"word":"Sinus rhythm"},{"word":"Randomised controlled trials"}],"section":"Systematic Review (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5h410262","frozenauthors":[{"first_name":"Surya","middle_name":"Sinaga","last_name":"Immanuel","name_suffix":"","institution":"Atma Jaya Catholic University of Indonesia, School of Medicine and Health Sciences, Jakarta, Indonesia","department":""},{"first_name":"Jesslyn","middle_name":"Ellenia","last_name":"Gotama","name_suffix":"","institution":"Atma Jaya Catholic University of Indonesia, School of Medicine and Health Sciences, Jakarta, Indonesia","department":""},{"first_name":"Yeziel","middle_name":"","last_name":"Sayogo","name_suffix":"","institution":"Atma Jaya Catholic University of Indonesia, School of Medicine and Health Sciences, Jakarta, Indonesia","department":""},{"first_name":"Alvin","middle_name":"","last_name":"Sunjaya","name_suffix":"","institution":"Atma Jaya Catholic University of Indonesia, School of Medicine and Health Sciences, Jakarta, Indonesia","department":""},{"first_name":"Gabriel","middle_name":"","last_name":"Tandecxi","name_suffix":"","institution":"Atma Jaya Catholic University of Indonesia, School of Medicine and Health Sciences, Jakarta, Indonesia","department":""},{"first_name":"Clifford","middle_name":"Peter","last_name":"Anthony","name_suffix":"","institution":"Atma Jaya Catholic University of Indonesia, School of Medicine and Health Sciences, Jakarta, Indonesia","department":""},{"first_name":"Stephanie","middle_name":"Aurelia","last_name":"Wirawan","name_suffix":"","institution":"Atma Jaya Catholic University of Indonesia, School of Medicine and Health Sciences, Jakarta, Indonesia","department":""},{"first_name":"Kevin","middle_name":"","last_name":"Wibawa","name_suffix":"","institution":"Rumah Sakit Hasan Sadikin, Department of Cardiology and Vascular Medicine, Bandung, Indonesia","department":""},{"first_name":"Leonardo","middle_name":"Paskah","last_name":"Suciadi","name_suffix":"","institution":"Siloam Hospitals Kebon Jeruk, Siloam Heart Institute, Jakarta, Indonesia","department":""}],"date_submitted":"2025-04-25T11:02:27.703000+01:00","date_accepted":"2025-08-04T22:13:37.636000+01:00","date_published":"2025-11-27T06:33:29.282000+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47305/galley/43179/download/"}]},{"pk":47097,"title":"Intersectional Analysis of Suicide-related Emergency Department Visits in Youth in California, 2018–2021","subtitle":null,"abstract":"Introduction: The COVID-19 pandemic and related anti-Asian political rhetoric had a detrimental impact on the mental health of Asian American and Pacific Islander (AAPI) youth in the United States. Our objective was to quantify trends in suicide-related emergency department (ED) encounters among AAPI youth before and during the COVID-19 pandemic, using an intersectional lens of race and sex and to contextualize these trends on a timeline of political and social events (such as anti-Asian hate crimes) occurring during the same period in California.
\nMethods: Using data from the California State Emergency Department Database (SEDD) from 2018–2021, we evaluated changes in quarterly proportions of suicide-related ED encounters by age, race, and sex subgroups by comparing mean percentage change in proportions before and during the pandemic among patients 8-21 years of age. We evaluated changes in quarterly proportions of suicide-related ED encounters by age, race, and sex subgroups by comparing mean percentage changes as they related to events around the pandemic and spikes in anti-Asian hate crimes. To compare relative disparities during the periods, we used stratified adjusted mixed multilevel logistic regression, with White males as the reference group.
\nResults: The overall increase in suicide-related ED visits for all youth during this period was 49.5% (95% CI 46.7-52.2%), representing 2,637 more suicide-related ED visits in 2021 than 2018. The graphical observational analysis of changes in quarterly proportions of suicide-related ED visits showed some temporal correlation between spikes in rates among AAPI and American Indian and Alaska Native (AI/AN) females and specific events, such as anti-Asian hate crimes and school closings. The largest percentage increase was seen among females of all races, and in particular, AI/AN females (+58.1%, representing 471 more suicide-related ED visits in 2021 than 2018) and AAPI females (+57.5%, representing 1,545 more suicide-related ED visits in 2021 than 2018). During the pandemic, the adjusted odds of a suicide-related ED visit among AAPI females 13-17 years of age compared to White males was 2.01 (95% CI, 1.91-2.13). A total of 131 in-ED deaths occurred during the study period, with no significant year-to-year variation in the number of deaths.
\nConclusion: Suicide-related ED visits increased for all youth during COVID-19, with the sharpest rise among AAPI and AI/AN females. Asian American and Pacific Islander females 8-12 and 13-17 years of age showed especially large increases. While causality cannot be inferred, patterns aligned with pandemic disruptions and anti-Asian hate crimes. Findings highlight the value of intersectional analysis to identify disproportionately impacted subgroups and inform future, culturally responsive suicide prevention efforts.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"pediatric"},{"word":"Suicide"},{"word":"intersectional"},{"word":"gender"},{"word":"Race"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3pg4f5c5","frozenauthors":[{"first_name":"Laura","middle_name":"M","last_name":"Prichett","name_suffix":"","institution":"Johns Hopkins University School of Medicine, Department of Pediatrics, Division of General Pediatrics, Baltimore, Maryland; Johns Hopkins Bloomberg School of Public Health, Center for Suicide Prevention, Baltimore, Maryland","department":""},{"first_name":"Annie","middle_name":"","last_name":"Na","name_suffix":"","institution":"Johns Hopkins University School of Medicine, Department of Pediatrics, Division of General Pediatrics, Baltimore, Maryland; Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, Maryland","department":""},{"first_name":"Hanae","middle_name":"","last_name":"Fujii-Rios","name_suffix":"","institution":"Johns Hopkins Bloomberg School of Public Health, Center for Suicide Prevention, Baltimore, Maryland; Johns Hopkins University School of Medicine, Department of Pediatrics, Division of Pediatric Emergency Medicine, Baltimore, Maryland","department":""},{"first_name":"Emily","middle_name":"E","last_name":"Haroz","name_suffix":"","institution":"Johns Hopkins Bloomberg School of Public Health, Center for Suicide Prevention, Baltimore, Maryland; Johns Hopkins Bloomberg School of Public Health, Department of International Health, Social and Behavioral Health Program, Center for Indigenous Health, Baltimore, Maryland","department":""}],"date_submitted":"2025-03-28T18:02:40.966000+01:00","date_accepted":"2025-07-27T14:41:51.708000+01:00","date_published":"2025-11-27T05:56:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47097/galley/43186/download/"}]},{"pk":46582,"title":"National Survey on Infection Prevention and Control in United States Emergency Departments","subtitle":null,"abstract":"Introduction: In the emergency care setting, implementation of infection prevention and control (IPC) practices can be challenging due to numerous factors including emergency department (ED) crowding and boarding of patients, high staff-turnover rates, and acuity of patient needs. Understanding how the unique nature of the ED environment impacts IPC implementation is essential to reducing healthcare-associated infections and to improving patient safety. In this study we aimed to assess ED leaders’ perceptions of IPC practices to identify areas for potential intervention and inform targeted process improvement initiatives.
\nMethods: Between January–July 2023, ED leaders across the United States were queried about their IPC practices using the National Emergency Department Inventories (NEDI)-USA survey, which is administered annually to all EDs in the US. An expanded survey was administered in a subset of EDs to assess healthcare personnel training for IPC, reported adherence to recommended practices and policies related to disinfection of reusable medical equipment and environment, use of personal protective equipment, hand hygiene practices, patient care space cleaning and disinfection, use of transmission-based precautions signage, risk perceptions of how healthcare personnel practice contributes to healthcare-associated infections and barriers to appropriate room cleaning.
\nResults: Of the 289 facilities surveyed, 159 (55%) responded, and among responding EDs, 67 (42%) reported seeing ≥ 40,000 patients in the prior year. Regarding healthcare personnel training, 84% (131/156) of ED leaders reported that ≥80% of their ED healthcare personnel were correctly trained in IPC procedures according to their hospital’s policies. Perception of healthcare personnel compliance with IPC practices, however, was lower. Although 75% (118/157) of EDs reported > 80% compliance with correct N95 respirator use, compliance with transmission-based precaution signage was identified as a significant gap, with 30% (47/159) of EDs reporting that they never, rarely, or only sometimes posted signs for patients who required them. Further, 69% (61/89) of EDs reported that they never, rarely, or only sometimes posted transmission-based precaution signs for patients in hallways or overflow treatment spaces.
\nConclusion: This national survey found that ED leaders perceive that their healthcare personnel have a high level of knowledge of IPC policies and compliance with some, but not all, IPC policies in the ED. The overall high perceptions of compliance stand in contrast to prior published observations of poor IPC practice in ED settings, suggesting complex relationships between perception and practice that may impact patient safety outcomes. These findings can guide future targeted interventions to improve IPC compliance, reduce healthcare-associated infections, and improve patient safety in emergency settings.
","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":"infection prevention and control"},{"word":"emergency department"},{"word":"survey"},{"word":"healthcare-associated infection"},{"word":"Compliance"},{"word":"nosocomial"},{"word":"leadership"},{"word":"hand hygiene"},{"word":"portable medical equipment"},{"word":"transmission-based precautions"},{"word":"training"},{"word":"Personal Protective Equipment"},{"word":"crowding"},{"word":"hallways"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0kw634fh","frozenauthors":[{"first_name":"Laya","middle_name":"","last_name":"Dasari","name_suffix":"","institution":"Massachusetts General Hospital, Center for Disaster Medicine, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"Molly","middle_name":"L","last_name":"Paras","name_suffix":"","institution":"Massachusetts General Hospital, Division of Infectious Diseases, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts","department":""},{"first_name":"Samantha","middle_name":"L","last_name":"Pellicane","name_suffix":"","institution":"Massachusetts General Hospital, Center for Disaster Medicine, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"Eileen","middle_name":"F","last_name":"Searle","name_suffix":"","institution":"Massachusetts General Hospital, Center for Disaster Medicine, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"Amy","middle_name":"","last_name":"Courtney","name_suffix":"","institution":"Infection Control, Mass General Brigham, Boston, Massachusetts","department":""},{"first_name":"Julio","middle_name":"","last_name":"Ma Shum","name_suffix":"","institution":"Massachusetts General Hospital, Center for Disaster Medicine, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"Krislyn","middle_name":"M","last_name":"Boggs","name_suffix":"","institution":"Emergency Medicine Network, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts","department":""},{"first_name":"Janice","middle_name":"A","last_name":"Espinola","name_suffix":"","institution":"Emergency Medicine Network, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts","department":""},{"first_name":"Ashley","middle_name":"F","last_name":"Sullivan","name_suffix":"","institution":"Emergency Medicine Network, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts","department":""},{"first_name":"Carlos","middle_name":"A","last_name":"Camargo","name_suffix":"Jr","institution":"Harvard Medical School, Boston, Massachusetts; Emergency Medicine Network, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts; Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"Jeremiah","middle_name":"D","last_name":"Schuur","name_suffix":"","institution":"Lawrence General Hospital, Lawrence, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts","department":""},{"first_name":"Erica","middle_name":"S","last_name":"Shenoy","name_suffix":"","institution":"Massachusetts General Hospital, Division of Infectious Diseases, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Infection Control, Mass General Brigham, Boston, Massachusetts","department":""},{"first_name":"Paul","middle_name":"D","last_name":"Biddinger","name_suffix":"","institution":"Massachusetts General Hospital, Center for Disaster Medicine, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":""}],"date_submitted":"2025-03-07T16:37:26.448000+01:00","date_accepted":"2025-08-27T15:50:04.933000+01:00","date_published":"2025-11-27T05:54:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/46582/galley/43185/download/"}]},{"pk":47198,"title":"Optimizing Fluid Resuscitation Strategies: A Network Meta-analysis of Effectiveness and Safety for Hemorrhagic Shock Patients in Emergency Settings","subtitle":null,"abstract":"Introduction: Hemorrhagic shock is a life-threatening condition and remains a leading cause of death worldwide. Current European guidelines lack recommendations for one fluid type over another in the management of hemorrhagic shock. This study explores the effectiveness and safety of colloids and crystalloids in resuscitation of hemorrhagic shock patients.
\nMethods: We conducted a systematic search in PubMed, Cochrane Cenral Register of Controlled Trials (CENTRAL), Scopus, Web of Science, ProQuest, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) up to January 3, 2024. We performed data analyses using Rstudio v.4.4.1 in Frequentist network meta-analysis with DerSimonian-Laird random-effects model. Subgroup and network meta-regression analyses was also performed in Bayesian methods. We analyzed safety aspects using meta-proportions with generalized linear mixed models models.
\nResults: A total of 3,693 patients from 23 randomized controlled trials were included in this study. Synthetic colloid demonstrated the lowest mortality rate (odds ratio 0.37, 95% CI, 0.15-0.93; P-score = .94) with the lowest fluid input requirement (mean difference -1.02; 95% CI, -1.62 to -0.41; P-score = .75). Subgroup and network meta-regression analysis revealed none of the covariates significantly influenced these two outcomes. Regarding safety aspects, isotonic crystalloid caused the most diverse adverse events, with acute respiratory distress syndrome (prop = 0.067) and overload syndrome (prop = 0.063) being the most common adverse events.
\nConclusion: This study provides robust evidence favoring the initial use of synthetic colloid in the management of patients with hemorrhagic shock.
","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":"colloid"},{"word":"crystalloid"},{"word":"hemorrhagic shock"},{"word":"resuscitation"}],"section":"Systematic Review (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2276z739","frozenauthors":[{"first_name":"Fan","middle_name":"Maitri","last_name":"Aldian","name_suffix":"","institution":"Universitas Airlangga, Faculty of Medicine, Surabaya, Indonesia","department":""},{"first_name":"Visuddho","middle_name":"","last_name":"Visuddho","name_suffix":"","institution":"Universitas Airlangga, Faculty of Medicine, Surabaya, Indonesia","department":""},{"first_name":"Michelle","middle_name":"Vanessa","last_name":"Anggarkusuma","name_suffix":"","institution":"Brawijaya University, Faculty of Medicine, Malang, Indonesia","department":""},{"first_name":"Jesphine","middle_name":"Arbi","last_name":"Wijaya","name_suffix":"","institution":"Brawijaya University, Faculty of Medicine, Malang, Indonesia","department":""},{"first_name":"Anthony","middle_name":"Camilo","last_name":"Lim","name_suffix":"","institution":"Universitas Airlangga, Faculty of Medicine, Surabaya, Indonesia","department":""},{"first_name":"Galen","middle_name":"","last_name":"Chandrawira","name_suffix":"","institution":"Diponegoro University, Faculty of Medicine, Semarang, Indonesia","department":""},{"first_name":"Yan","middle_name":"Efrata","last_name":"Sembiring","name_suffix":"","institution":"Universitas Airlangga, Department of Thoracic Cardiac and Vascular Surgery, Surabaya, Indonesia; Dr Soetomo General Academic Hospital, Department of Thoracic Cardiac and Vascular Surgery, Surabaya, Indonesia","department":""},{"first_name":"Bambang","middle_name":"Pujo","last_name":"Semedi","name_suffix":"","institution":"Universitas Airlangga, Department of Anesthesiology and Intensive Care, Surabaya, Indonesia; Dr Soetomo General Academic Hospital, Department of Anesthesiology and Intensive Care, Surabaya, Indonesia","department":""},{"first_name":"Jeswant","middle_name":"","last_name":"Dillon","name_suffix":"","institution":"Institut Jantung Negara, Department of Cardiology and Department of Cardiothoracic Surgery, Kuala Lumpur, Malaysia","department":""}],"date_submitted":"2025-04-09T02:58:32.029000+01:00","date_accepted":"2025-08-28T04:29:06.229000+01:00","date_published":"2025-11-27T05:51:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47198/galley/43184/download/"}]},{"pk":47221,"title":"Differences in Admission Rates of Children with Pneumonia Between Pediatric and Community Emergency Departments","subtitle":null,"abstract":"Introduction: Pneumonia is the most common cause of pediatric death worldwide. We sought to determine whether the rate of hospital admission of pediatric patients diagnosed with pneumonia at a dedicated pediatric -emergency department (PED) is different than the rate at a community emergency department (CED). This comparison may provide insight into decision-making and factors associated with admission.
\nMethods: In this retrospective cohort study we reviewed patient records from January 1, 2017–December 31, 2019 for pediatric patients diagnosed with pneumonia. We excluded patients who were not prescribed antibiotics, those who did not receive a chest radiograph or had no radiologic signs of pneumonia. In addition, we excluded patients with comorbid conditions such as tracheostomy, supplemental oxygen requirement at baseline, chronic lung disease other than asthma or reactive airway disease, any cancer diagnosis, cystic fibrosis, or congenital heart disease. The primary outcome was the proportion of pneumonia diagnoses that resulted in admission from the PED vs CED. We used logistic regression analyses to evaluate which clinical factors were associated with hospital admission. Significance levels were determined by chi-square test or the Fisher exact test and Cochran-Mantel-Haenszel statistic.
\nResults: We identified 400 pediatric patients with pneumonia, 182 from the PED and 218 from the CED. There was a significant difference in admission rates between the two hospitals: 53 of 182 patients in the PED were admitted (29.1%) vs 27 of 218 patients in the CED (12.4%, P < .001). Patients in the PED were, therefore, 2.35 times more likely to be admitted than those at the CED (odds ratio 5.1, 95% CI, 2.5-10.4). Patients presenting to the PED were more likely to arrive via ambulance (10.7% vs 3.1%, P = .04) and to be hypoxic upon arrival (13.2% vs 3.2%, P < .001). The median age of patients in the PED was significantly higher than the CED (6.0 years vs 2.0 years, P < .001). A significantly greater proportion of patients in the CED identified as Hispanic or Latino (68.6% vs 20.3%, P < .001). Patients in the CED were more likely to be insured (11.0% vs 19.9%, P = .01). There was no significant difference in immunization status between the two groups.
\nConclusion: Patients presenting to a dedicated pediatric ED had a higher admission rate than did those at a community ED. Patients in the PED were more likely to arrive by ambulance and less likely to have active health insurance coverage. Patients at the PED were more likely to be hypoxic than patients at the CED. These findings highlight important practice differences between PEDs and CEDs that may inform strategies to improve patient outcomes, reduce costs, and promote more effective, evidence-based care. Future studies should further investigate the drivers of these variations and evaluate targeted interventions to optimize care across settings.
","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":"Peditrics"},{"word":"Infectious disease"},{"word":"emergency"},{"word":"Bias"},{"word":"pneumonia"},{"word":"Community"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1h80q5qs","frozenauthors":[{"first_name":"Grace","middle_name":"","last_name":"VanGorder","name_suffix":"","institution":"Penn State University College of Medicine, Department of Emergency Medicine, Hershey, Pennsylvania","department":""},{"first_name":"Samuel","middle_name":"","last_name":"Lee","name_suffix":"","institution":"Penn State University College of Medicine, Department of Emergency Medicine, Hershey, Pennsylvania","department":""},{"first_name":"Zachary","middle_name":"","last_name":"Jensen","name_suffix":"","institution":"Penn State University College of Medicine, Department of Emergency Medicine, Hershey, Pennsylvania","department":""},{"first_name":"Susan","middle_name":"","last_name":"Boehmer","name_suffix":"","institution":"Penn State University College of Medicine, Department of Emergency Medicine, Hershey, Pennsylvania","department":""},{"first_name":"Robert","middle_name":"P","last_name":"Olympia","name_suffix":"","institution":"Penn State University College of Medicine, Department of Emergency Medicine, Hershey, Pennsylvania","department":""}],"date_submitted":"2025-04-12T17:23:44.732000+01:00","date_accepted":"2025-08-26T16:31:59.761000+01:00","date_published":"2025-11-27T05:43:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47221/galley/43183/download/"}]},{"pk":47312,"title":"Reduced Functional Bed Capacity Due to Inpatient Boarding Is Associated with Increased Rates of Left Without Being Seen in the Emergency Department\n","subtitle":null,"abstract":"Introduction: We evaluated the relationship between inpatient boarding, measured as functional bed capacity, and left-without-being-seen (LWBS) rates. Functional bed capacity is defined as the mean percentage of ED beds available for new and existing patients over a 24-hour period.
\nMethods: We performed quantile regression models examining the association between LWBS and terciles (low, medium, and high) of functional bed capacity, as well as median admit-to-departure times, controlling for other daily operational metrics. We additionally performed an encounter-level analysis to assess the relationship between functional bed capacity at the time of a patient’s arrival and their likelihood of LWBS. Study sites included one academic, one community, and one pediatric ED in a single, urban medical system.
\nResults: Our study included 373,388 visits. In the adjusted regression at the daily level, low functional bed capacity was associated with an increase of 1.59% in LWBS compared to high functional bed capacity, which represented a 26.5% relative increase (about three patients) compared to median LWBS of 6.0% (P < .001). Larger daily census (+ 0.07% for each additional patient, P <.001), resulted in two additional patients LWBS for every 15-patient increase in daily census from the median. Additionally, longer length of stay of discharged patients (+ 0.05% for each minute increase, P < .001), resulted in two additional patients LWBS for every 20-minute increase in length of stay from the median. Weekdays relative to weekend days were associated with a 1.28% decrease in LWBS (P < .001) (approximately three fewer patients who left without being seen relative to the median LWBS of 6.0%). At the encounter level, functional bed capacity in the low and middle tercile was significantly associated with an increased probability of a patient LWBS (91% and 40% increases, respectively, P < .001). Of the patients who LWBS, 9.3% were high acuity, 59.5% medium acuity, and 31.2% low acuity.
\nConclusion: Functional bed capacity is a new and pragmatic operational metric strongly associated with left-without-being-seen rates and provides an improved way to measure, study, and communicate the impact of inpatient boarding. We propose using functional bed capacity as a metric in future studies of ED operations. Additional studies that incorporate staffing levels to more accurately approximate functional bed capacity and better characterize its true impact on LWBS rates are needed.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"boarding"},{"word":"crowding"},{"word":"LWBS"},{"word":"operations"},{"word":"Patient Safety"},{"word":"Quality"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2nd6d5b2","frozenauthors":[{"first_name":"Yosef","middle_name":"","last_name":"Berlyand","name_suffix":"","institution":"Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island","department":""},{"first_name":"Timmy","middle_name":"","last_name":"Lin","name_suffix":"","institution":"Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island","department":""},{"first_name":"Taylor","middle_name":"D","last_name":"Marquis","name_suffix":"","institution":"Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island","department":""},{"first_name":"Jared","middle_name":"S","last_name":"Anderson","name_suffix":"","institution":"Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island","department":""},{"first_name":"Daniel","middle_name":"J","last_name":"Shanin","name_suffix":"","institution":"Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island","department":""},{"first_name":"Alexis","middle_name":"C","last_name":"Lawrence","name_suffix":"","institution":"Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island","department":""},{"first_name":"Frank","middle_name":"L","last_name":"Overly","name_suffix":"","institution":"Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island","department":""},{"first_name":"David","middle_name":"B","last_name":"Curley","name_suffix":"","institution":"Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island","department":""},{"first_name":"Janette","middle_name":"","last_name":"Baird","name_suffix":"","institution":"Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island","department":""},{"first_name":"Anthony","middle_name":"M","last_name":"Napoli","name_suffix":"","institution":"Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island","department":""}],"date_submitted":"2025-04-28T15:31:34.145000+01:00","date_accepted":"2025-08-24T20:42:03.383000+01:00","date_published":"2025-11-27T05:41:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47312/galley/43182/download/"}]},{"pk":47379,"title":"Triage Temperature and Timeliness of Sepsis Interventions in a Pediatric Emergency Department","subtitle":null,"abstract":"Introduction: Fever as an indicator of infection is frequently used as an aid in triggering concern for sepsis in the emergency department (ED). Adults with sepsis presenting to the ED with a normal temperature have been shown to have delays in treatment and greater mortality. The association between temperature and timeliness of sepsis-related care in the ED remains poorly characterized in children. Our objective in this study was to measure the association between body temperature at the physiologic onset of sepsis and the time to initiation of antibiotic treatment and fluid bolus among children with clinically defined sepsis.
\nMethods: We conducted a retrospective, cohort study of pediatric patients with sepsis presenting to the ED. Data collected from an existing quality improvement database were supplemented via chart extraction. We assessed body temperature at physiologic onset of sepsis (PO-S), the date and time when a patient first met clinical criteria for sepsis as defined by Goldstein et al.1 Our primary outcomes were time from PO-S and administration of antibiotics and fluid bolus. Secondary outcomes included maximum vasoactive-inotropic scores, need for extracorporeal membrane oxygenation (ECMO) within 30 days of presentation, presence and type of organ dysfunction, 30-day hospital- and intensive care unit (ICU)-free days, and mortality. We summarized and compared data by temperature group. Multivariable quantile regression was used to evaluate adjusted associations between body temperature and time to initiation of antibiotic treatment and fluid bolus.
\nResults: Of 928 patients screened, 385 (41%) met inclusion criteria. Median time to antibiotic treatment did not differ between temperature groups at PO-S—≤ 36.0 °C: median (IQR) 48.5, (41.3-104.8); 36.1-37.9 oC: median, 95.5, (41.3-104.8;), and ≥ 38.0 oC: median 84, 45-151; (P = .24). Median time to fluid bolus administration also did not differ between temperature groups at PO-S—≤ 36.0 °C: median 39, (20.8-65.8); 36.1-37.9 oC: median, 42.5 (21.3-86.3); and ≥ 38.0 oC: median, 54 (29-84); (P =.07). In addition, mortality differed by temperature at PO-S (≤ 36.0 °C: 1/22 (4.5%); 36.1-37.9 oC: 4/80 (5.0%); and ≥. 38.0 oC: 3/283 (1.1%), (P = .04); as did organ dysfunction at 72 hours: ≤. 36.0 °C: 15/22 (68.2%); 36.1-37.9 oC: 43/80 (53.8%), ≥ 38.0 oC: 74/283 (26.1%); (P < .001) and median (IQR) 30-day ICU- and hospital-free days—≤ 36.0 °C: median, 24, (20,-26.8); 36.1-37.9 oC: median, 28 (24.8-30), ≥ 38.0 oC: median, 30 (27-30), (P < .001); and at ≤. 36.0°C: median, 22, (17-25); 36.1-37.9 oC: median, 24 (17.8-27); ≥ 38.0 oC: median, 25 (20, 27), (P = .04), respectively. We did not observe an association between temperature and median time to antibiotic administration (β: 2.5, 95% CI, -4.2 to 9.1, P = .50) or first fluid bolus administration (β: 1.7, 95% CI, -1.4 to 4.8, P = .30).
\nConclusion: Time to fluid bolus administration and time to antibiotic administration did not differ statistically by temperature from physiological onset of sepsis. Children presenting with hypothermia (≤ 36.0 °C) had worse outcomes.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"pediatric sepsis"},{"word":"triage"},{"word":"sepsis intervention"},{"word":"hypothermia in pediatric sepsis"},{"word":"clinical outcomes in pediatric sepsis"},{"word":"clinical intervention in pediatric sepsis"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3jv192hp","frozenauthors":[{"first_name":"McKenna","middle_name":"","last_name":"Straus","name_suffix":"","institution":"Johns Hopkins All Children’s Hospital, Office of Medical Education, St. Petersburg, Florida","department":""},{"first_name":"John","middle_name":"M","last_name":"Morrison","name_suffix":"","institution":"Johns Hopkins All Children’s Hospital, Office of Medical Education, St. Petersburg, Florida; Johns Hopkins All Children’s Hospital, Division of Hospital Medicine, St. Petersburg, Florida","department":""},{"first_name":"Racha","middle_name":"","last_name":"Khalaf","name_suffix":"","institution":"University of South Florida Morsani College of Medicine, Department of Gastroenterology, Hepatology and Nutrition, Tampa, Florida","department":""},{"first_name":"Jamie","middle_name":"","last_name":"Fierstein","name_suffix":"","institution":"Johns Hopkins All Children’s Hospital Institute for Clinical and Translational Research, St. Petersburg, Florida","department":""},{"first_name":"Alexandra","middle_name":"","last_name":"Miller","name_suffix":"","institution":"Johns Hopkins All Children’s Hospital Institute for Clinical and Translational Research, St. Petersburg, Florida","department":""},{"first_name":"Diana","middle_name":"","last_name":"Young","name_suffix":"","institution":"Johns Hopkins All Children’s Hospital, Division of Hospital Medicine, St. Petersburg, Florida","department":""},{"first_name":"Elliot","middle_name":"","last_name":"Melendez","name_suffix":"","institution":"Connecticut Children’s Hospital, Department of Pediatric Critical Care, Hartford, Connecticut","department":""}],"date_submitted":"2025-05-09T18:46:50.445000+01:00","date_accepted":"2025-08-24T21:21:29.721000+01:00","date_published":"2025-11-27T05:38:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47379/galley/43181/download/"}]},{"pk":18585,"title":"Completeness and Audibility of Verbal Orders for Medications and Blood Products during Trauma Resuscitation","subtitle":null,"abstract":"Introduction: Resuscitation of critically injured patients requires effective team leadership. Poor communication is the leading cause of sentinel events. Closed-loop communication reduces error during trauma resuscitations. Nonetheless, previous studies show few verbal orders are audible. Verbal orders during trauma resuscitations have not been studied for completeness. In this project we aimed to assess whether verbal orders for medications and blood products during trauma resuscitations were complete, audible, and used closed-loop communication.
\nMethods: This was an observational assessment of a convenience sample of verbal orders that trauma captains gave for medications and blood products during the primary and secondary survey. It was conducted in an academic emergency department (ED) at an adult Level 1 trauma center. We assessed medication orders for the presence or absence of medication name, dose, and route. Blood orders were evaluated for the presence or absence of blood product (packed cells or whole blood) and type (O- or O+). We recorded orders as audible or inaudible. Closed-loop communication was recorded as present or absent. Orders were considered complete if they included all elements. We used descriptive statistics to analyze data.
\nResults: There were 186 verbal orders enrolled: 165 (88.7%) for medications and 21 (11.3% for blood products. For medication verbal orders, 77.9% (n=127) were audible, 73.6% (n=120) included the name, 62.0% (n=101) included the dose, 17.8% (n=29) included the route, and 73.5% (n=111) used closed-loop communication. Overall, 23 (14.1%) medication verbal orders were complete. Regarding verbal orders for blood, 16 (76.2%) were audible, three (14.3%) included the blood product, seven (33.3%) included the blood type, and 13 (61.9%) used closed-loop communication. Overall, 0% (n=0) of the blood product verbal orders were complete.
\nConclusion: Audible, complete verbal orders, and closed-loop communication were underused during trauma resuscitations. Interventions to improve communication of verbal orders warrant evaluation in the ED.
","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":"Patient Safety"},{"word":"injury prevention"},{"word":"Quality Assessment"},{"word":"Trauma"},{"word":"resuscitation"},{"word":"Communication"},{"word":"Verbal Orders"},{"word":"Systems of Care"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/43v303jz","frozenauthors":[{"first_name":"Rebecca","middle_name":"","last_name":"Ryan","name_suffix":"","institution":"Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, Wisconsin","department":""},{"first_name":"Kathleen","middle_name":"","last_name":"Williams","name_suffix":"","institution":"Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, Wisconsin","department":""},{"first_name":"Jamie","middle_name":"","last_name":"Aranda","name_suffix":"","institution":"Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, Wisconsin","department":""},{"first_name":"Nancy","middle_name":"","last_name":"Jacobson","name_suffix":"","institution":"Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, Wisconsin","department":""}],"date_submitted":"2024-01-05T15:43:39+01:00","date_accepted":"2025-08-15T10:23:13.346000+01:00","date_published":"2025-11-27T05:34:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/18585/galley/43180/download/"}]},{"pk":48649,"title":"Insect in the Ear- Response and Treatment of an Uncommon Prehospital Emergency: A Case Report","subtitle":null,"abstract":"Introduction: Foreign bodies in the external auditory canal are an uncommon presentation in emergency settings. Among adults, insects represent a frequent organic foreign body, often causing symptoms such as otalgia, tinnitus, vertigo, and anxiety. Prehospital management of such cases is rarely addressed in the medical literature, with minimal guidance available for emergency medical services (EMS) personnel. In this report we discuss their role in stabilizing patients and reducing discomfort through appropriate interventions.
\nCase Report: A 40-year-old male called EMS after a live insect entered his left ear, causing severe otalgia and distress. Prehospital medical personnel clinically confirmed the presence of the insect and assessed for signs of tympanic membrane perforation. A medical command physician authorized the use of 2% lidocaine to euthanize the insect, which alleviated movement-related discomfort within 20 seconds. Despite initial symptom relief, the patient experienced persistent fullness in the ear and was transported to a tertiary-care hospital. In the emergency department multiple removal attempts were made, with successful extraction using thin dressing forceps. No tympanic membrane perforation was noted, although minor trauma to the external auditory canal was present. The patient was discharged with ciprofloxacin-dexamethasone otic drops and return precautions.
\nConclusion: Prehospital use of lidocaine for a live insect in the auditory canal may provide significant symptom relief while reducing the risk of further auditory canal trauma. This case underscores the importance of command-based support for EMS personnel to provide safe, evidence-based approaches for managing intra-aural insects in the field.
","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":"foreign body"},{"word":"External auditory canal"},{"word":"prehospital care"},{"word":"case report"},{"word":"emergency medical services"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6f29p8pj","frozenauthors":[{"first_name":"Colin","middle_name":"","last_name":"Bashline","name_suffix":"","institution":"Ross/West View EMSA, Pittsburgh, Pennsylvania","department":""},{"first_name":"Matthew","middle_name":"","last_name":"Jester","name_suffix":"","institution":"Allegheny General Hospital, Department of Emergency Medicine, Pittsburgh, Pennsylvania","department":""},{"first_name":"Christopher","middle_name":"","last_name":"Morris","name_suffix":"","institution":"Allegheny General Hospital, Department of Emergency Medicine, Pittsburgh, Pennsylvania","department":""}],"date_submitted":"2025-06-19T01:44:48.773000+01:00","date_accepted":"2025-08-29T18:58:36.068000+01:00","date_published":"2025-11-27T05:12:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/48649/galley/48081/download/"}]},{"pk":48882,"title":"“Predictive Factors and Nomogram for 30-Day Mortality in Heatstroke Patients: A Retrospective Cohort Study”","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":"Letters to the Editor","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0wx2d29k","frozenauthors":[{"first_name":"Jeffrey","middle_name":"R","last_name":"Stowell","name_suffix":"","institution":"Creighton University School of Medicine, Phoenix, Department of Emergency Medicine, Phoenix, Arizona; University of Arizona College of Medicine, Phoenix, Department of Emergency Medicine, Phoenix, Arizona; Valleywise Health, Department of Emergency Medicine, Phoenix, Arizona","department":""},{"first_name":"Geoff","middle_name":"","last_name":"Comp","name_suffix":"","institution":"Creighton University School of Medicine, Phoenix, Department of Emergency Medicine, Phoenix, Arizona; University of Arizona College of Medicine, Phoenix, Department of Emergency Medicine, Phoenix, Arizona; Valleywise Health, Department of Emergency Medicine, Phoenix, Arizona","department":""},{"first_name":"Paul","middle_name":"","last_name":"Pugsley","name_suffix":"","institution":"Creighton University School of Medicine, Phoenix, Department of Emergency Medicine, Phoenix, Arizona; University of Arizona College of Medicine, Phoenix, Department of Emergency Medicine, Phoenix, Arizona; Valleywise Health, Department of Emergency Medicine, Phoenix, Arizona","department":""},{"first_name":"Megan","middle_name":"","last_name":"McElhinny","name_suffix":"","institution":"Creighton University School of Medicine, Phoenix, Department of Emergency Medicine, Phoenix, Arizona; University of Arizona College of Medicine, Phoenix, Department of Emergency Medicine, Phoenix, Arizona; Valleywise Health, Department of Emergency Medicine, Phoenix, Arizona","department":""},{"first_name":"Murtaza","middle_name":"","last_name":"Akhter","name_suffix":"","institution":"Creighton University School of Medicine, Phoenix, Department of Emergency Medicine, Phoenix, Arizona; University of Arizona College of Medicine, Phoenix, Department of Emergency Medicine, Phoenix, Arizona; Valleywise Health, Department of Emergency Medicine, Phoenix, Arizona; Penn State Health Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, Pennsylvania; HCA Healthcare, Department of Emergency Medicine, Miami, Florida","department":""}],"date_submitted":"2025-07-15T06:28:56.916000+01:00","date_accepted":"2025-08-09T04:06:08.336000+01:00","date_published":"2025-11-27T05:08:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/48882/galley/43178/download/"}]},{"pk":47130,"title":"Anticoagulation Treatment in Patients with Septic Thrombophlebitis of the Internal Jugular Vein","subtitle":null,"abstract":"Introduction: Septic thrombophlebitis of the internal jugular vein (STIJV), or Lemierre syndrome, is a rare, life-threatening condition. Anticoagulant use for managing STIJV remains unclear due to ambiguous diagnostic criteria and a lack of robust evidence. We evaluated the clinical benefits and risks of anticoagulants in patients with STIJV.
\nMethods: In this retrospective study we used data from over 1,700 hospitals, retrieved from a nationwide Japanese database. We used multivariate logistic regression and propensity score matching to adjust for confounding variables (age, sex, Charlson Comorbidity Index, level of consciousness, use of mechanical ventilation, use of disseminated intravascular coagulation, admission to intensive care unit, history of diabetes, use of noradrenaline, diagnosis of acute renal failure, and diagnosis of cerebral infarction). We also conducted instrumental variable estimation to account for the impact of unmeasured covariates. The primary outcome was in-hospital mortality; the secondary outcomes were 90-day mortality, major bleeding events, and length of stay (LOS) in hospital.
\nResults: Among the 523 patients diagnosed with STIJV between April 1, 2014–March 31, 2022, 343 (65.6%) were excluded due to lack of appropriate treatment initiation for STIJV. Overall, 180 patients (34.4%) met the inclusion criteria; the data of 156 patients (31.1%) were ultimately analysed. Of these, 86 (55.1%) received anticoagulants, which neither significantly improved nor worsened survival outcomes. The in-hospital mortality was 3.39% and 1.69% and 90-day mortality was 2.54% and 1.69%, respectively, in patients who did and did not receive therapy, (P = .56 and .99, respectively). The adjusted odds ratio (AOR) for in-hospital and 90-day mortality was 0.858 (95% CI, 0.126-5.826, P = .88) and .991 (95% CI, .932-1.055, P = .79), respectively. The LOS was longer in those receiving anticoagulants (mean, 29.2 vs 21.8 days, AOR 11.7 days longer, 95% CI, 4.11-19.20, P < .01), potentially due to dose adjustment or clinical decision-making. Subgroup analysis comparing unfractionated heparin and direct Xa inhibitors showed similar in-hospital mortality outcomes: 4.54% in the unfractionated heparin group (AOR 2.361, 95% CI, 0.32-17.40; P = .40) and 3.03% in the direct Xa inhibitor group (AOR 0.444, 95% CI, 0.032-6.23; P = .55), respectively.
\nConclusion: In the largest study of septic thrombophlebitis of the internal jugular vein to date, we found that early initiation of anticoagulation treatment was not statistically associated with survival. Therefore, anticoagulant use should be determined based on individual patient characteristics. Further research is warranted to improve the quality of evidence for this rare disease.
","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":"Lemierre’s Syndrome"},{"word":"septic thrombophlebitis"},{"word":"internal jugular vein"},{"word":"anticoagulation"},{"word":"Heparin"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/95n8m3k1","frozenauthors":[{"first_name":"Atsushi","middle_name":"","last_name":"Senda","name_suffix":"","institution":"Institute of Science Tokyo, Graduate School of Medical and Dental Sciences, Department of Acute Critical Care and Disaster Medicine, Tokyo, Japan; Toda Chuo General Hospital, Department of Emergency Medicine, Toda, Saitama, Japan","department":""},{"first_name":"Kiyohide","middle_name":"","last_name":"Fushimi","name_suffix":"","institution":"Institute of Science Tokyo, Graduate School of Medical and Dental Sciences, Department of Health Policy and Informatics, Tokyo, Japan","department":""},{"first_name":"Koji","middle_name":"","last_name":"Morishita","name_suffix":"","institution":"Institute of Science Tokyo, Graduate School of Medical and Dental Sciences, Department of Acute Critical Care and Disaster Medicine, Tokyo, Japan","department":""}],"date_submitted":"2025-04-02T04:23:04.747000+01:00","date_accepted":"2025-07-27T00:01:27.580000+01:00","date_published":"2025-11-27T05:05:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47130/galley/43177/download/"}]},{"pk":56954,"title":"WestJEM Full-Text Issue","subtitle":null,"abstract":"","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"WestJEM Full-Text Issue","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0fn2t7q5","frozenauthors":[{"first_name":"Cassandra","middle_name":"","last_name":"Saucedo","name_suffix":"","institution":"","department":""},{"first_name":"Isabelle","middle_name":"","last_name":"Kawaguchi","name_suffix":"","institution":"","department":""},{"first_name":"Isabella","middle_name":"","last_name":"Choi","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-11-27T04:34:30.779000+01:00","date_accepted":"2025-11-27T04:36:38.723000+01:00","date_published":"2025-11-27T03:43:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/56954/galley/43156/download/"}]},{"pk":47110,"title":"A 30-year History of the Emergency Medicine Standardized Letter of Evaluation","subtitle":null,"abstract":"Thirty years ago, education leaders in emergency medicine (EM) developed a standardized letter of recommendation to address limitations of narrative letters of recommendation in the residency selection process. Since then, multiple iterations and improvements with specialty-wide adoption have led to this letter being cited as one of the most essential pieces of a residency application. Based on the experience and success in EM, many other specialties have also now adopted standardized letters of their own. In this paper, we detail the 30-year history of the EM standardized letter including form changes and technological innovations, research and validity evidence, and discussion of research and administrative priorities for the future.
","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":"Standardized Letter of Evaluation"},{"word":"Assessment"},{"word":"Residency selection"}],"section":"Education Special Issue - Expert Commentary","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7s89p06s","frozenauthors":[{"first_name":"Jenna","middle_name":"S","last_name":"Hegarty","name_suffix":"","institution":"Rosalind Franklin University of Medicine and Science, Chicago, Illinois","department":""},{"first_name":"Cullen","middle_name":"B","last_name":"Hegarty","name_suffix":"","institution":"University of Minnesota Medical School, HealthPartners Institute/Regions Hospital, Department of Emergency Medicine, St. Paul, Minnesota","department":""},{"first_name":"Jeffrey","middle_name":"N","last_name":"Love","name_suffix":"","institution":"Georgetown University School of Medicine, Department of Emergency Medicine, Washington, DC","department":""},{"first_name":"Alexis","middle_name":"","last_name":"Pelletier-Bui","name_suffix":"","institution":"Cooper Medical School of Rowan University/ Cooper University Hospital, Department of Emergency Medicine, Camden, New Jersey","department":""},{"first_name":"Sharon","middle_name":"","last_name":"Bord","name_suffix":"","institution":"The Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, Maryland","department":""},{"first_name":"Michael","middle_name":"C","last_name":"Bond","name_suffix":"","institution":"University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland","department":""},{"first_name":"Samuel","middle_name":"M","last_name":"Keim","name_suffix":"","institution":"University of Arizona, Department of Emergency Medicine, Tucson, Arizona","department":""},{"first_name":"Kevin","middle_name":"","last_name":"Hamilton","name_suffix":"","institution":"University of Maryland Medical System Center for Technology Innovation, Baltimore, Maryland","department":""},{"first_name":"Eric","middle_name":"F","last_name":"Shappell","name_suffix":"","institution":"Massachusetts General Hospital / Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts","department":""}],"date_submitted":"2025-04-30T16:12:44.668000+01:00","date_accepted":"2025-11-03T19:55:29.853000+01:00","date_published":"2025-11-26T19:08:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47110/galley/43153/download/"}]},{"pk":47347,"title":"Emergency Department Disposition and Point-of-Care Ultrasound in Biliary Disease: Propensity-Weighted Cohort Study","subtitle":null,"abstract":"Introduction: Biliary tract disease is a frequent cause of abdominal pain among emergency department (ED) patients and accounts for a significant portion of hospital admissions and return visits. Our objective was to compare ED outcomes for patients ultimately diagnosed with biliary tract disease based on the use of point-of-care ultrasound (POCUS) during their initial visit. We specifically analyzed patients admitted after an unscheduled return visit within 72 hours vs those admitted directly from the ED.
\nMethods: In this retrospective cohort study we used propensity score weighting and included 1,228 adults admitted for biliary tract disease, either during their initial ED visit (n = 1,120, 91.2%) or following an unscheduled return visit within 72 hours (n = 108, 8.8%) at a tertiary center in Taiwan between 2021–2023. Outcomes included ED length of stay (LOS), costs, hospital LOS, intensive care unit (ICU) admission, and in-hospital mortality. We used multivariable regression models with inverse probability of treatment weighting adjustment to account for baseline differences.
\nResults: Initial discharge followed by admission after an unscheduled return visit was not associated with worse clinical outcomes compared to direct admission. There were no significant differences in in-hospital mortality (0.93% vs 1.16%; odds ratio [OR] 0.59, P = .56) or ICU admission (0.93% vs 0.71%; OR 1.78, P = .61). While the initial ED LOS was shorter (mean: 4 hours vs 15.6 hours; regression-adjusted difference -6.66 hours, P < .001) and the initial ED costs were lower (mean: NT5477 vs NT$16,269, a 66% savings; regression-adjusted difference: -NT$6,548, P < .001), this reflects an expected early discharge. Among patients ultimately requiring admission after an unscheduled return visit, those who received POCUS at their index visit had a significantly shorter initial ED LOS (mean: 2.97 hours vs 4.78 hours; regression-adjusted difference -1.42 hours, P = .006) and lower initial ED costs (mean: NT$3,248 vs NT$7,149; a 55% saving; regression-adjusted difference -NT$3,271, P < .001) compared to those who did not. This initial POCUS use did not increase adverse events; only one of the 108 patients in the unscheduled return visit group required ICU admission (0.9%, 95% CI, 0.02-5.1%), and no deaths occurred (0%, 95% CI, 0-2.78%).
\nConclusion: Initial discharge following ED assessment appears safe for many low-risk patients ultimately diagnosed with biliary tract disease on repeat visit within 72 hours. Incorporating POCUS during the initial evaluation may shorten ED LOS and reduce costs for patients who later require admission, without apparent measurable negative effects on mortality, hospital, or ICU length of stay.
","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":"ultrasonography"},{"word":"Clinical approach"},{"word":"Mortality"},{"word":"intensive care unit"},{"word":"Return Visit"},{"word":"decision-making"},{"word":"Length of Stay"},{"word":"costs"},{"word":"ED Crowding"},{"word":"computed tomography"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/49s3f5rm","frozenauthors":[{"first_name":"Yamato","middle_name":"","last_name":"Eda","name_suffix":"","institution":"China Medical University Hospital, Department of Emergency Medicine, Taichung, Taiwan; China Medical University, College of Medicine, School of Medicine, Taichung, Taiwan","department":""},{"first_name":"Po-sheng","middle_name":"","last_name":"Wu","name_suffix":"","institution":"China Medical University Hospital, Department of Emergency Medicine, Taichung, Taiwan; China Medical University, College of Medicine, School of Medicine, Taichung, Taiwan","department":""},{"first_name":"Fen-Wei","middle_name":"","last_name":"Huang","name_suffix":"","institution":"China Medical University Hospital, Department of Emergency Medicine, Taichung, Taiwan","department":""},{"first_name":"Sheng-Yao","middle_name":"","last_name":"Hung","name_suffix":"","institution":"China Medical University Hospital, Department of Emergency Medicine, Taichung, Taiwan; China Medical University, College of Medicine, School of Medicine, Taichung, Taiwan","department":""},{"first_name":"Ching-Ting","middle_name":"","last_name":"Hsu","name_suffix":"","institution":"China Medical University Hospital, Department of Emergency Medicine, Taichung, Taiwan; China Medical University, College of Medicine, School of Medicine, Taichung, Taiwan","department":""},{"first_name":"Wei-Kung","middle_name":"","last_name":"Chen","name_suffix":"","institution":"China Medical University Hospital, Department of Emergency Medicine, Taichung, Taiwan; China Medical University, College of Medicine, School of Medicine, Taichung, Taiwan","department":""},{"first_name":"Shih-Hao","middle_name":"","last_name":"Wu","name_suffix":"","institution":"China Medical University Hospital, Department of Emergency Medicine, Taichung, Taiwan; China Medical University, College of Medicine, School of Medicine, Taichung, Taiwan","department":""}],"date_submitted":"2025-05-05T03:49:33.744000+01:00","date_accepted":"2025-07-26T22:18:46.012000+01:00","date_published":"2025-11-26T18:51:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47347/galley/43154/download/"}]},{"pk":48359,"title":"Program Director Perspectives on the Impact of the Proposed 48-Month Emergency Medicine Residency Requirement: A National Survey","subtitle":null,"abstract":"Introduction: In early 2025, the Accreditation Council for Graduate Medical Education (ACGME) announced proposed revisions to emergency medicine (EM) residency training to include substantial changes to the length of training programs, required rotations, and structured experiences. To date, no published national survey has sought to determine how these changes would impact individual programs.
\nMethods: Over a three-week period in April 2025, we anonymously surveyed program directors or their designees online through the Council of Residency Directors in Emergency Medicine listserv. Survey respondents were asked about the impact the changes would have on their programs and their overall opinions of the proposed 48-month minimum requirement.
\nResults: A total of 86 program directors responded to the survey (response rate of 29.9%) with representative samples from current three-year (83.7%, 72/86) and four-year (16.3%, 14/86) programs. Most program directors reported that they would have to make significant revisions in either structured experiences, required rotations, or both. Most survey respondents from three-year programs (52/72) do not support the proposed changes, whereas all respondents from four-year programs (14/14) do support the changes (P<.001).
\nConclusion: Proposed program requirements may require modifications in both three- and four-year programs; 33 of the 86 program directors surveyed reported that would need more than one year to meet the requirements, if adopted. This raises the concern that programs may not be prepared to implement the revisions within the proposed timeline, potentially impacting resident education and the future EM workforce. The ACGME should consider a staged rollout of requirements to allow them to be thoughtfully implemented in a meaningful way.
","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Education Special Issue - Brief Research Report (Limit 1500 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3265g5vn","frozenauthors":[{"first_name":"Richard","middle_name":"","last_name":"Austin","name_suffix":"","institution":"Southern Illinois University, School of Medicine, Department of Emergency Medicine, Springfield, Illinois","department":""},{"first_name":"Chinmay","middle_name":"","last_name":"Patel","name_suffix":"","institution":"Baylor Scott & White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas","department":""},{"first_name":"Kristin","middle_name":"","last_name":"Delfino","name_suffix":"","institution":"Southern Illinois University, School of Medicine, Department of Surgery, Springfield, Illinois","department":""},{"first_name":"Sharon","middle_name":"","last_name":"Kim","name_suffix":"","institution":"Southern Illinois University, School of Medicine, Department of Emergency Medicine, Springfield, Illinois","department":""}],"date_submitted":"2025-06-02T19:25:11.695000+01:00","date_accepted":"2025-10-15T16:28:20.271000+01:00","date_published":"2025-11-26T18:19:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/48359/galley/43151/download/"}]},{"pk":48914,"title":"A Qualitative Study of Senior Residents' Learning Strategies to Prepare for Unsupervised Practice","subtitle":null,"abstract":"Introduction: As emergency medicine (EM) residents prepare for the transition into unsupervised practice, their focus shifts from demonstrating competencies within familiar training environments to anticipating their new roles and responsibilities as attending physicians, often in unfamiliar settings. Using the self-regulated learning framework, we explored how senior EM residents proactively identify goals and enact learning strategies leading up to the transition from residency into unsupervised practice.
\nMethods: In this study we used a constructivist grounded theory approach, interviewing EM residents in their final year of training at two residency programs. Using the self-regulated learning framework as a sensitizing concept for analysis, we conducted inductive, line-by-line coding of interview transcripts and grouped codes into categories. Theoretical sufficiency was reached after 12 interviews, with four subsequent interviews producing no divergent or disconfirming examples.
\nResults: We interviewed16 senior residents about their self-regulated learning approaches to preparing for unsupervised practice. Participants identified two types of gaps that they sought to address prior to entering practice: knowledge/skill gaps, and autonomy gaps. We employed specific workplace learning strategies to address each type of gap, which we have termed cherry-picking, case-based hypotheticals, parachuting, and making the call, and reflection on both internal and external sources of feedback to assess the effectiveness of these learning strategies. This study presents participants’ identification of gaps in their residency training, their learning strategies, and reflections as cyclical processes of self-regulated learning.
\nConclusion: In their final months of training EM residents strategically leverage learning strategies to bridge gaps between their self-assessed capabilities and those they anticipate needing to succeed in unsupervised practice. These findings show that trainees have agency in how they use goal setting, strategic actions, and ongoing reflection to prepare themselves for unsupervised practice. Our findings also suggest tailored approaches whereby programs can support learning experiences that foster senior residents’ agency when preparing for the challenges of future practice.
","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":"competency"},{"word":"Capability"},{"word":"Graduate Medical Education"},{"word":"self-regulated learning"}],"section":"Education Special Issue - Original Research (Limit 3500 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3pj1n9sd","frozenauthors":[{"first_name":"Max","middle_name":"","last_name":"Griffith","name_suffix":"","institution":"University of Washington, Department of Emergency Medicine, Seattle, Washington","department":""},{"first_name":"Alexander","middle_name":"","last_name":"Garrett","name_suffix":"","institution":"University of Washington, Department of Emergency Medicine, Seattle, Washington","department":""},{"first_name":"Bjorn","middle_name":"K","last_name":"Watsjold","name_suffix":"","institution":"University of Washington, Department of Emergency Medicine, Seattle, Washington","department":""},{"first_name":"Joshua","middle_name":"","last_name":"Jauregui","name_suffix":"","institution":"University of Washington, Department of Emergency Medicine, Seattle, Washington","department":""},{"first_name":"Mallory","middle_name":"","last_name":"Davis","name_suffix":"","institution":"University of Michigan, Ann Arbor, Department of Michigan, Ann Arbor, Michigan","department":""},{"first_name":"Jonathan","middle_name":"S","last_name":"Ilgen","name_suffix":"","institution":"University of Washington, Department of Emergency Medicine, Seattle, Washington","department":""}],"date_submitted":"2025-07-11T17:12:13.029000+01:00","date_accepted":"2025-10-14T02:53:53.004000+01:00","date_published":"2025-11-26T18:14:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/48914/galley/43150/download/"}]},{"pk":48535,"title":"A Taste of Our Own Medicine: Fostering Empathy in Medical Learners Through Patient Simulation","subtitle":null,"abstract":"Introduction: Residents and medical students spend thousands of hours of medical education learning the physician’s perspective but rarely find themselves on the other side of the stethoscope. In this study we evaluated whether a brief, novel curriculum of simulating the patient experience could improve medical learners’ reported empathy for patients and ability to explain medical interventions.
\nCurricular Design: Fifty-eight medical learners (medical students and resident physicians) participated in a 50-minute didactic session where learners simulated patient experiences such as wearing a patient gown and cervical collar, walking with crutches, and tasting potassium chloride and thickened water. Learners evaluated their perceptions of the curriculum with a survey.
\nImpact/Effectiveness: Participants reported limited experience as patients, with 66.7% never having been hospitalized and 50% not taking any daily medications. Learners rated the curriculum highly on a seven-point Likert scale with 98% expressing it helped them to empathize with patients (90% either agreed or strongly agreed) and 95% expressing that it would help them explain interventions (81% either agreed or strongly agreed). There was no difference between medical students and residents regarding reported effect on empathy (M 6.24 vs 6.44; P = .30) or effect on ability to explain the intervention (M 6.06 vs 6.24; P = .43). This brief curriculum simulating the patient experience was well-received by medical student and resident learners, who overwhelmingly felt it improved their empathy for patients and explanations of common interventions. This approach to fostering empathy could help both medical student and resident learners, many of whom may have limited experience as a patient.
","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":"Simulation"},{"word":"Empathy"},{"word":"education"},{"word":"curriculum"},{"word":"Medical Education"}],"section":"Education Special Issue - Brief Educational Advances (Limit 1500 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4fg4g4jg","frozenauthors":[{"first_name":"Romy","middle_name":"","last_name":"Portieles Peña","name_suffix":"","institution":"The University of Chicago Medical Center, Department of Internal Medicine, Chicago, Illinois","department":""},{"first_name":"William","middle_name":"","last_name":"Weber","name_suffix":"","institution":"Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois","department":""}],"date_submitted":"2025-06-11T22:47:36.042000+01:00","date_accepted":"2025-10-08T14:18:59.613000+01:00","date_published":"2025-11-26T18:05:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/48535/galley/43149/download/"}]},{"pk":46556,"title":"Grouping of Emergency Department-based Cardiac Arrest Patients According to Clinical Features to Assess Patient Outcomes","subtitle":null,"abstract":"Introduction: While research has begun to understand emergency department-based cardiac arrest (EDCA), consensus on what exactly constitutes EDCA remains unknown. In this study we aimed to explore the grouping of EDCA by using an unsupervised machine-learning algorithm and to investigate how these underlying clusters related to patient outcomes.
\nMethods: We retrieved electronic health record data from an ED in a tertiary medical center. The EDCAs were identified via the cardiopulmonary resuscitation log. We used k-means cluster analysis to group EDCAs and t-distributed stochastic neighbor embedding (t-SNE) for visualization. Primary outcomes were ED mortality and ED length of stay (LOS). The analyses were repeated using an independent ED data set, the Medical Information Mart for Intensive Care IV Emergency Department (MIMIC-IV-ED) dataset.
\nResults: From 2019 to 2022, there were 366 EDCA events. Cluster analysis identified three distinct clusters (Cluster 1 or immediate risk, n=54 [15%]; Cluster 2 or early risk, n=274 [75%]; Cluster 3 or late risk, n=38 [10%]). Cluster 1 patients had the shortest median time to EDCA (< 1 hour), followed by Cluster 2 (3 hours) and Cluster 3 (81 hours). Near cardiac arrest at triage was the most common cause of EDCA in Cluster 1, while respiratory illnesses and sepsis were more common in Cluster 3. The causes of EDCA in Cluster 2 were diverse, with predominantly cardiovascular and neurologic emergencies. The t-SNE revealed farther distances from Cluster 1 to the other two clusters, suggesting its most critical nature. Cluster 3 had the highest mortality (58%), followed by Clusters 1 (48%) and 2 (35%) (P = .01). Cluster 1 had the shortest median LOS (median, 4 hours), while Cluster 3 had the longest LOS (81 hours) (P < .001). In the independent data set, Cluster 1 remained, but Clusters 2 and 3 appeared to merge due to a shorter ED LOS overall.
\nConclusion: We identified three novel clusters (immediate, early, and late risk) with distinct patterns in clinical presentation, putative causes of ED-based cardiac arrest, and ED outcomes. Understanding these clinical phenotypes may help develop cluster-specific interventions to prevent EDCA or intervene most appropriately. Cluster 1 patients may benefit from resuscitation efforts, and Clusters 2 or 3 patients can benefit from timely interventions for cardiac, respiratory, and neurologic emergencies. In addition, for patients with prolonged ED boarding, periodic monitoring with an early warning system may prevent a cardiac arrest event.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"emergency department"},{"word":"cardiac arrest"},{"word":"cluster; outcome"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/1j53x2w9","frozenauthors":[{"first_name":"Joshua","middle_name":"","last_name":"Leow","name_suffix":"","institution":"University of Tennessee Health Science Center, College of Medicine, Department of Emergency Medicine, Memphis, Tennessee","department":""},{"first_name":"Po-Chun","middle_name":"","last_name":"Shih","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan","department":""},{"first_name":"Jun-Wan","middle_name":"","last_name":"Gao","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan","department":""},{"first_name":"Chih-Hung","middle_name":"","last_name":"Wang","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan","department":""},{"first_name":"Tsung-Chien","middle_name":"","last_name":"Lu","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan","department":""},{"first_name":"Chien-Hua","middle_name":"","last_name":"Huang","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan","department":""},{"first_name":"Chu-Lin","middle_name":"","last_name":"Tsai","name_suffix":"","institution":"National Taiwan University Hospital, Department of Emergency Medicine, Taipei, Taiwan; National Taiwan University, College of Medicine, Department of Emergency Medicine, Taipei, Taiwan","department":""}],"date_submitted":"2025-04-25T02:52:27.394000+01:00","date_accepted":"2025-08-02T21:43:48.507000+01:00","date_published":"2025-11-26T17:55:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/46556/galley/43148/download/"}]},{"pk":42477,"title":"Patterns in Duration of Emergency Department Boarding and Variation by Sociodemographic Factors","subtitle":null,"abstract":"Introduction: Emergency department (ED) boarding negatively affects patient outcomes, increasing length of stay, hallway care, and mortality. Prior research found disparities in capacity metrics like hallway care based on patient race and ethnicity. However, whether boarding differs by demographics is not well characterized. We examined boarding variation by sociodemographic factors in a hospital with a standardized bed-prioritization process. We hypothesized that a structured inpatient assignment method may be associated with reduced boarding inequity.
\nMethods: This single-center, retrospective, cohort study included adult patients boarding in the ED after admission to the non-intensive care inpatient medicine service between February 2020– February 2023 at an urban, academic, tertiary-care hospital with > 110,000 annual ED visits. Primary outcome was time from admission order to inpatient bed transport. Patient demographics (age, sex, race/ethnicity, language, insurance, and housing status), visit characteristics (Emergency Severity Index, time, and day), and bed request features (telemetry, sitter need, and isolation precaution) were obtained via the medical record. We assessed for bivariate relationships between boarding time and demographics with descriptive statistics and analysis of variance using adjusted and unadjusted regression analyses with generalized estimating equations to account for patient-level correlation.
\nResults: In total, 22,291 encounters were included. Average age was 64 (SD ± 19) years, and 47% were female. Approximately 12% identified as Hispanic, 70% as non-Hispanic White, and 10% as non-Hispanic Black. Most (97%) boarded ≥ 120 minutes. In adjusted analyses, patients with Medicaid waited an additional 85 minutes (95% CI 49-121), and patients with Medicare waited an additional 67 minutes (95% CI 32-103) compared to those with commercial coverage (both P < .001, respectively). Non?Hispanic Black patients boarded 14 minutes longer (95% CI 22-51), and non-English primary language speakers boarded 15 minutes longer (95% CI 17-47) than non-Hispanic White patients and English primary language speakers, respectively, although these two findings were not statistically significant.
\nConclusion: Among adult patients admitted to the inpatient medicine service, non-commercial insurance such as Medicaid and Medicare was significantly associated with longer ED boarding, whereas race/ethnicity and primary language were not. Further study should determine whether these findings are replicated elsewhere, how this impacts patients, and whether targeted intervention can reduce inequities.
","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":"boarding"},{"word":"disparities"},{"word":"Race"},{"word":"Medicaid"},{"word":"Patient Age"},{"word":"Primary Language"},{"word":"wait times"},{"word":"Capacity"},{"word":"Social Determinants"},{"word":"Sociodemographics"}],"section":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3rf0s6kt","frozenauthors":[{"first_name":"Christiana","middle_name":"K","last_name":"Prucnal","name_suffix":"","institution":"Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts; Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"Melissa","middle_name":"A","last_name":"Meeker","name_suffix":"","institution":"Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"Martin","middle_name":"","last_name":"Copenhaver","name_suffix":"","institution":"Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, Maryland","department":""},{"first_name":"Paul","middle_name":"S","last_name":"Jansson","name_suffix":"","institution":"Harvard Medical School, Boston, Massachusetts; Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"Rebecca","middle_name":"E","last_name":"Cash","name_suffix":"","institution":"Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"William","middle_name":"","last_name":"Hillmann","name_suffix":"","institution":"Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Department of Medicine, Boston, Massachusetts","department":""},{"first_name":"Steven","middle_name":"","last_name":"Knuesel","name_suffix":"","institution":"Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Department of Medicine, Boston, Massachusetts","department":""},{"first_name":"Wendy","middle_name":"","last_name":"Macias-Konstantopoulos","name_suffix":"","institution":"Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts","department":""},{"first_name":"Jonathan","middle_name":"D","last_name":"Sonis","name_suffix":"","institution":"Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts; Newton Wellesley Hospital, Newton, Massachusetts","department":""}],"date_submitted":"2025-02-06T21:16:50.243000+01:00","date_accepted":"2025-07-27T16:47:39.485000+01:00","date_published":"2025-11-26T17:41:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/42477/galley/43146/download/"}]},{"pk":47193,"title":"Comparison of Emergency Physicians’ and Hospitalists’ Attitudes Toward Fecal Occult Blood Testing in Gastrointestinal Bleeding","subtitle":null,"abstract":"Introduction: The guaiac fecal occult blood test, originally designed for colorectal cancer screening, is frequently used in emergency departments (ED) to detect occult gastrointestinal (GI) bleeding. However, the test has low sensitivity and specificity, leading to potential false positives and negatives. This study evaluates the current practices and perceptions of emergency physicians and hospitalists regarding the utility of the guaiac test in the setting of suspected GI bleeding in the ED.
\nObjective: Our primary aim in this study was to evaluate the current practice and views of emergency physicians and hospitalists on the utility of the stool guaiac test in the ED.
\nMethods: We conducted a multicenter survey from January 3–April 3, 2024, across four hospital systems, targeting attending physicians in the ED and hospitalists. Participants were asked to rate their agreement with statements about the stool guaiac test on a scale of 1 (strongly disagree) to 5 (strongly agree).
\nResults: Response rates were 47/93 (50.5%) for emergency attendings and 9/18 (50%) for hospitalists. Emergency attendings were significantly less likely than hospitalists to agree that stool guaiac testing is important for evaluating GI bleeding (31% vs 67%, P < .001). More than half of emergency attendings (55%) reported often performing the test, while 44% of hospitalists reported frequently requesting it before accepting a patient. Although 70% of emergency attendings believed that guaiac results influence hospitalists’ admission decisions (P = .02), 67% of hospitalists stated they would accept a patient with suspected GI bleeding even without a result. Despite rating the test as important, only 33% of hospitalists felt that stool guaiac testing frequently changes management during hospitalization. Overall, the groups showed distinct attitudes regarding the utility and impact of stool guaiac testing.
\nConclusion: The guaiac fecal occult blood test remains widely used despite skepticism among emergency attendings regarding its importance. Hospitalists were more likely to request the test but acknowledged it rarely changes patient management. These findings highlight the need for re-evaluation of guaiac testing in acute care settings and improved communication between ED and inpatient teams. Further research should explore the clinical impact of removing routine stool guaiac testing
","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":"Original Research (Limit 4000 words)","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9fr579bg","frozenauthors":[{"first_name":"Doris","middle_name":"","last_name":"Ilic","name_suffix":"","institution":"Saint Joseph’s University Medical Center, Department of Emergency Medicine, Paterson, New Jersey","department":""},{"first_name":"Joseph","middle_name":"","last_name":"Bove","name_suffix":"","institution":"Saint Joseph’s University Medical Center, Department of Emergency Medicine, Paterson, New Jersey","department":""}],"date_submitted":"2025-04-08T03:17:27.878000+01:00","date_accepted":"2025-07-27T04:49:07.869000+01:00","date_published":"2025-11-26T17:24:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/47193/galley/43145/download/"}]},{"pk":54053,"title":"Ecologies of Memory: Memorializing Militarized Environments of the Vietnam War","subtitle":null,"abstract":"This essay proposes ecological forms of memory that unsettle dominant processes of remembering war that privilege nationalist narratives of heroism and conquest in mourning the loss of human life. Instead, we theorize an aesthetic relationship between refugee memory and more-than-human witnessing that offers an avenue to remember militarized landscapes differently. While nationalist practices of memory often demand cohesion around a collective identity or a universal humanism, ecologies of memory prioritize diffuse stories of horizontal kinship that open up new possibilities of making community amongst more-than-human denizens caught in the web of imperial war. In this essay, we examine three incomplete aesthetic inquiries into the memorialization of militarized environments: the community curation of The Missing Piece Project Collective, Tiffany Chung’s installation For the Living, and Binh Danh’s chlorophyll prints One Week’s Dead. These interventions respond to the enduring presence of the Vietnam Veterans Memorial in Washington, DC, as a representation of how memories of scarred psyches and environments are consolidated into a national consciousness. In doing so, these artists complicate forms of memorialization by attending to the diasporic, ephemeral, and inconclusive, creating new forms of collective memory that account for communal relationships with each other and with nonhuman environments.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"JTAS SPECIAL FORUM Thinking With and Beyond \"Vietnam\": 50 Years After the US Wars in Southeast Asia","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2bq6z4r0","frozenauthors":[{"first_name":"Heidi","middle_name":"","last_name":"Amin-Hong","name_suffix":"","institution":"University of California, Santa Barbara","department":"","country":"United States"},{"first_name":"Keva","middle_name":"X.","last_name":"Bui","name_suffix":"","institution":"Northwestern University","department":"","country":"United States"}],"date_submitted":"2025-11-22T14:40:51.478000+01:00","date_accepted":"2025-11-22T16:34:52.779000+01:00","date_published":"2025-11-25T20:06:00+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/54053/galley/40868/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/54053/galley/40868/download/"}]},{"pk":54049,"title":"Introduction: Thinking with and Beyond “Vietnam”: 50 Years after the US Wars in Southeast Asia ","subtitle":null,"abstract":"Coeditors' introduction to the JTAS Special Forum \"Thinking with and Beyond 'Vietnam': 50 Years after the US Wars in Southeast Asia\"
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"JTAS SPECIAL FORUM Thinking With and Beyond \"Vietnam\": 50 Years After the US Wars in Southeast Asia","is_remote":true,"remote_url":"https://escholarship.org/uc/item/694834gq","frozenauthors":[{"first_name":"Christina","middle_name":"","last_name":"Hughes","name_suffix":"","institution":"Macalester College","department":"","country":"United States"},{"first_name":"Karín","middle_name":"","last_name":"Aguilar-San Juan","name_suffix":"","institution":"Macalester College","department":"","country":"United States"}],"date_submitted":"2025-11-22T13:28:45.272000+01:00","date_accepted":"2025-11-22T18:48:50.857000+01:00","date_published":"2025-11-25T19:02:00+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/54049/galley/40874/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/54049/galley/40874/download/"}]},{"pk":54071,"title":"The \"Vietnam\" Corona-Quagmire: Rescripting Forever Wars in a Time of Chronic Crisis","subtitle":null,"abstract":"This essay considers the legacies of the Viet Nam-American War through the lens of contemporary events of global scale such as the COVID-19 pandemic. The fiftieth anniversary since the end of that conflict occurs right after the cessation (but not end) of the worst socio-health crisis facing the planet and humanity in recent times. As a frame for remembering militarized Cold War histories in the face of ongoing crises and political quagmires, I consider how the Cold War specter of Viet Nam has been marshalled against biopolitical threats in the twenty-first century. That cultural and ideological rescripting reinforces racial, colonial, capitalist, and imperialist logics of control that simultaneously invite us to revisit and refashion that infamous war’s meaning. I approach the “war on coronavirus” through the prism of “Vietnam” to conceptualize what I am designating as “corona-quagmire.” By looping conflicts of the past into the cascading crises of the present future, corona-quagmire presents critical opportunities for rethinking the fraught global relations among society, self, subjects and states. From the spread of disinformation to America’s mishandling of the new coronavirus to Viet Nam’s martial response to the problem, the “Vietnam-sized” language mobilized against COVID-19 presents a means to analyze the dialectics of permanent wars, as they are reproduced within an era of endless violence. Corona-quagmire in the end shines light for scholars seeking to disentangle ongoing processes of militarization, nationalism, and empire.
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"JTAS SPECIAL FORUM Thinking With and Beyond \"Vietnam\": 50 Years After the US Wars in Southeast Asia","is_remote":true,"remote_url":"https://escholarship.org/uc/item/0xz0737v","frozenauthors":[{"first_name":"Long","middle_name":"T.","last_name":"Bui","name_suffix":"","institution":"University of California, Irvine","department":""}],"date_submitted":"2025-11-23T03:53:38.489000+01:00","date_accepted":"2025-11-23T03:54:39.629000+01:00","date_published":"2025-11-25T17:39:00+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/54071/galley/40901/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/54071/galley/40901/download/"}]},{"pk":54377,"title":"Polea Loca","subtitle":null,"abstract":"Short story by Horacio Quiroga (1878–1937).
","language":"spa","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[{"word":"Horacio Quiroga"},{"word":"\"Polea Loca\""},{"word":"Spanish literature"}],"section":"Reprise","is_remote":true,"remote_url":"https://escholarship.org/uc/item/84t9588t","frozenauthors":[{"first_name":"Horacio","middle_name":"","last_name":"Quiroga","name_suffix":"","institution":"","department":""}],"date_submitted":"2025-11-25T13:10:43.469000+01:00","date_accepted":"2025-11-25T13:13:37.450000+01:00","date_published":"2025-11-25T13:24:00+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/54377/galley/41065/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/54377/galley/41065/download/"}]},{"pk":43526,"title":"Diagnosing Temporal Lobe Epilepsy in the Emergency Department: A Case Report","subtitle":null,"abstract":"Introduction: Temporal lobe epilepsy is a form of focal epilepsy that originates in the temporal lobes, often presenting with a variety of symptoms including altered consciousness, automatisms, and focal seizures with or without impaired awareness. Given such a diversity of manifesting symptoms, recognizing temporal lobe epilepsy in the emergency department (ED) can be challenging. Early identification is crucial for appropriate management, including timely initiation of antiepileptic therapy and differentiation from other neurological emergencies.
\nCase Report: A 50-year-old male with no prior history of seizures or neurological conditions presented to the ED after experiencing unusual sensations that had begun three days earlier. The patient described an intermittent sensation of warmth rising from his pelvis to his head, accompanied by an experiential déjà vu-like feeling he described as “dream reenactment.” His episodes had become progressively more frequent, occurring approximately once every 90 minutes within the first 24 hours, with two instances of brief loss of consciousness. Diagnostic workup, including neurology consultation and an electroencephalogram in the ED, revealed a 19-second, non-motor focal seizure originating from the left anterior temporal region, consistent with temporal lobe epilepsy. Magnetic resonance imaging showed no acute structural abnormalities. The patient was diagnosed with temporal lobe epilepsy, started on lacosamide, and discharged from the ED.
\nConclusion: This case underscores the importance of recognizing temporal lobe epilepsy in the ED, particularly in patients with recurrent episodes of altered consciousness or unusual sensory experiences. Prompt diagnosis and treatment are critical to preventing further seizures and improving quality of life.
","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":"Seizure"},{"word":"focal seizure"},{"word":"temporal lobe epilepsy"},{"word":"neurological emergency"},{"word":"electroencephalogram"},{"word":"déjà vu"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3pm5r47t","frozenauthors":[{"first_name":"Ashlynn","middle_name":"Alexandria","last_name":"Felker","name_suffix":"","institution":"University of Utah Health, Department of Emergency Medicine, Salt Lake City, Utah","department":""},{"first_name":"Jason","middle_name":"","last_name":"Tanner","name_suffix":"","institution":"University of Utah Health, Department of Emergency Medicine, Salt Lake City, Utah","department":""}],"date_submitted":"2025-02-27T05:26:17.137000+01:00","date_accepted":"2025-07-29T20:32:52.068000+01:00","date_published":"2025-11-23T05:07:00+01:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/43526/galley/48078/download/"}]},{"pk":50558,"title":"Notes on the Contributors","subtitle":null,"abstract":"Author biographies
","language":"eng","license":{"name":"Creative Commons Attribution-NonCommercial-NoDerivatives 4.0","short_name":"CC BY-NC-ND 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNonCommercial — You may not use the material for commercial purposes.\n\nNoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc-nd/4.0"},"keywords":[],"section":"Contributors","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2zz9x86c","frozenauthors":[{"first_name":"Managing","middle_name":"","last_name":"Editor","name_suffix":"","institution":"University of Mainz","department":"","country":"Germany"}],"date_submitted":"2025-08-03T21:05:53.143000+01:00","date_accepted":"2025-11-23T01:40:30.698000+01:00","date_published":"2025-11-23T05:06:00+01:00","render_galley":{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/50558/galley/40909/download/"},"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/jtas/article/50558/galley/40909/download/"}]}]}