A5029316595- Emergency and Acute Care Studies
- Trauma and Emergency Care Studies
- Global Maternal and Child Health
- COVID-19 Clinical Research Studies
- SARS-CoV-2 and COVID-19 Research
- Intimate Partner and Family Violence
- Innovations in Medical Education
- Healthcare professionals’ stress and burnout
- Migration, Health and Trauma
- Viral Infections and Outbreaks Research
- COVID-19 and healthcare impacts
- Sex work and related issues
- Global Health and Surgery
- Adolescent Sexual and Reproductive Health
- Artificial Intelligence in Healthcare and Education
- Ethics in Clinical Research
- SARS-CoV-2 detection and testing
- Healthcare cost, quality, practices
- Patient Safety and Medication Errors
- Cardiac Arrest and Resuscitation
- Food Security and Health in Diverse Populations
- Workplace Violence and Bullying
- Immune responses and vaccinations
- Microbial infections and disease research
- Racial and Ethnic Identity Research
Stanford University
2016-2025
Stanford Health Care
2021
Palo Alto Institute
2020
Medical University of South Carolina
2020
GVK Emergency Management and Research Institute
2020
Stanford Medicine
2016-2020
Medical Teams International
2016
Ministry of Health
2016
Alameda Health System
2016
Highland Hospital
2016
Our understanding of protective versus pathological immune responses to SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is limited by inadequate profiling patients at extremes severity spectrum. Here, we performed multi-omic single-cell 64 COVID-19 across full range severity, from outpatients with mild fatal cases. transcriptomic, epigenomic, and proteomic analyses revealed widespread dysfunction peripheral innate immunity in severe COVID-19, including prominent...
Abstract Type III interferons have been touted as promising therapeutics in outpatients with coronavirus disease 2019 (COVID-19). We conducted a randomized, single-blind, placebo-controlled trial (NCT04331899) 120 mild to moderate COVID-19 determine whether single, 180 mcg subcutaneous dose of Peginterferon Lambda-1a (Lambda) within 72 hours diagnosis could shorten the duration viral shedding (primary endpoint) or symptoms (secondary endpoint). In both 60 patients receiving Lambda and...
At this stage in the COVID-19 pandemic, most infections are "breakthrough" that occur individuals with prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure. To refine long-term vaccine strategies against emerging variants, we examined both innate and adaptive immunity breakthrough infections. We performed single-cell transcriptomic, proteomic, functional profiling of primary to compare immune responses from unvaccinated vaccinated during SARS-CoV-2 Delta wave....
Dialogue and policy surrounding healthcare reform have drawn increasing interest to the social factors, accountable for nearly one-third of annual deaths in United States,1 that affect health populations. The Affordable Care Act (ACA) includes provisions systems address determinants health, but how this is be accomplished remains uncertain. If we are make progress as a system addressing must open dialogue practice reaches patients at front lines medical population – including emergency...
Abstract Background The determinants of coronavirus disease 2019 (COVID-19) severity and extrapulmonary complications (EPCs) are poorly understood. We characterized relationships between severe acute respiratory syndrome 2 (SARS-CoV-2) RNAemia severity, clinical deterioration, specific EPCs. Methods used quantitative digital polymerase chain reaction (qPCR dPCR) to quantify SARS-CoV-2 RNA from plasma in 191 patients presenting the emergency department with COVID-19. recorded patient...
Abstract Background Precision health is a burgeoning scientific discipline that aims to incorporate individual variability in biological, behavioral, and social factors develop personalized solutions. To date, emergency medicine has not deeply engaged the precision movement. However, rapid advances technology, data science, medical informatics offer new opportunities for realize promises of health. Methods In this article, we conceptualize as an emerging paradigm identify key drivers its...
Abstract Background Precision medicine promises to revolutionize health care by providing the right patient at time. However, emergency department’s unique mandate treat “anyone, anywhere, anytime” creates critical tensions with precision medicine’s requirements for comprehensive data and computational analysis. As departments serve as care’s safety net provide a growing proportion of acute in America, identifying addressing ethical challenges implementing this setting is crucial prevent...
Domestic violence (DV) is a public health problem in the United States. Emergency physicians are often first providers to see patients needing acute care for injuries sustained secondary DV and an important part of healthcare workforce underserved populations seeking help. While much has been published about need better identification this population, little known current prevalence characterization curricula accredited emergency medicine residency programs. Cross-section survey program...
Objectives The purpose of this study was twofold: (1) establish the prevalence safety threats and workplace violence (WPV) experienced by emergency medical technicians (EMTs) in a low/middle-income country with new prehospital care system, India (2) understand which EMTs are at particularly high risk for these experiences. Setting from four Indian states (Gujarat, Karnataka, Tamil Nadu Telangana) were eligible to participate during period July through November 2017. Methods Cross-sectional...
Objectives Characterise the demographics, management and outcomes of obstetric patients transported by emergency medical services (EMS). Design Prospective observational study. Setting Five Indian states using a centralised EMS agency that 3.1 million pregnant women in 2014. Participants This study enrolled convenience sample 1684 third trimester pregnancy calling with ‘pregnancy-related’ problem for free-of-charge ambulance transport. Calls were deemed ‘pregnancy related’ if categorised...
Abstract Background The determinants of COVID-19 disease severity and extrapulmonary complications (EPCs) are poorly understood. We characterise the relationships between SARS-CoV-2 RNAaemia severity, clinical deterioration, specific EPCs. Methods used quantitative (qPCR) digital (dPCR) PCR to quantify RNA from nasopharyngeal swabs plasma in 191 patients presenting Emergency Department (ED) with COVID-19. recorded patient symptoms, laboratory markers, outcomes, a focus on oxygen requirements...
Background Low/middle-income countries carry a disproportionate burden of the morbidity and mortality from thermal burns. Nearly 70% burn deaths worldwide are burns in India. Delays to medical care commonplace an important predictor outcomes. We sought understand role emergency services (EMS) as part healthcare infrastructure for Methods conducted prospective observational study patients using EMS across five Indian states May August 2015. Our primary outcome was at 2, 7 30 days. compared...
Abstract Objectives Severe global shortages in the health care workforce sector have made improving access to essential emergency challenging. The paucity of trained specialists low‐ and middle‐income countries translates large swathes population receiving inadequate care. Efforts expand medicine ( EM ) education are similarly impeded by a lack available appropriate teaching faculty. development comprehensive, online medical courses offers potentially economical, scalable, lasting solution...
Objectives To describe the demographic characteristics and clinical outcomes of neonates born within 7 days public ambulance transport to hospitals across five states in India. Design Prospective observational study. Setting Five Indian using a centralised emergency medical services (EMS) agency that transported 3.1 million pregnant women 2014. Participants Over 6 weeks 2014, this study followed convenience sample 1431 public-private service for ‘pregnancy-related’ problem. Initial calls...
Introduction Miscommunication during patient handoff contributes to an estimated 80% of serious medical errors and, consequently, plays a key role in the five million excess deaths annually from poor quality care low- and middle-income countries (LMICs). Objective The objective this study was assess signout communication handoffs between prehospital personnel hospital staff. Methods This is cross-sectional study, with convenience sample 931 interfacility transfers for pregnant women across...
Introduction Professional wellness is critical to developing and maintaining a health care workforce. Previous work has identified burnout as significant challenge professional facing emergency medical technicians (EMTs) in many countries worldwide. Our study fills gap by assessing the prevalence of among India. Methods This was cross-sectional survey EMTs within largest prehospital organization We used Maslach Burnout Inventory (MBI) measure wellness. All presenting for continuing education...
Clinicians in the emergency department (ED) face challenges concurrently assessing patients with suspected COVID-19 infection, detecting bacterial coinfection, and determining illness severity since current practices require separate workflows. Here, we explore accuracy of IMX-BVN-3/IMX-SEV-3 29 mRNA host response classifiers simultaneously severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection coinfections predicting clinical COVID-19. A total 161 PCR-confirmed (52.2%...
Abstract Objectives Emergency medicine in low‐ and middle‐income countries (LMICs) is hindered by lack of research into patient outcomes. Chief complaints (CCs) are fundamental to emergency care but have only recently been uniquely codified for an LMIC setting Uganda. It not known whether CCs independently predict unit Methods Patient data collected a Ugandan between 2009 2018 were randomized validation derivation sets. A recursive partitioning algorithm stratified 3‐day mortality risk each...
Traumatic injury continues to be a leading cause of mortality and morbidity in low-income middle-income countries (LMIC). The World Health Organization has called for strengthening prehospital care order improve outcomes from trauma. In this study we sought profile traumatic seen the setting India identify predictors patient population.We conducted prospective observational convenience sample patients using single emergency medical services (EMS) system injuries across seven states November...
Abstract Background Globally, half of all years life lost is due to emergency medical conditions, with low- and middle-income countries (LMICs) facing a disproportionate burden these conditions. There an urgent need train the future physicians in LMICs identification stabilization patients Little research focuses on development effective medicine (EM) education resources perspectives students themselves. One emerging tool use electronic learning (e-learning) blended courses. We aimed...
Firefighter first responders and other emergency medical services (EMS) personnel have been among the highest risk healthcare workers for illness during SARS-CoV-2 pandemic. We sought to determine rate of seropositivity IgG antibodies acute asymptomatic infection firefighter in a single county with early exposure