The mission of the Department of Emergency Medicine at the University of Massachusetts Medical School is to be the preeminent Department of Emergency Medicine in the country by delivering excellent healthcare, with respect and dignity to all patients needing emergent or urgent care services; conducting ground breaking research that enhances public health; and developing innovative educational programs for all levels of health care providers. This collection showcases journal articles and other publications written by faculty and researchers of the Department of Emergency Medicine.

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Publications from 2019

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Abscess Incision and Drainage With or Without Ultrasonography: A Randomized Controlled Trial, Romolo Joseph Gaspari, Alexandra Sanseverino, and Timothy P. Gleeson

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Assessment of Physician Well-being, Part Two: Beyond Burnout, Michelle D. Lall, Theodore J. Gaeta, Arlene S. Chung, Sneha A. Chinai, Manish Garg, Abbas Hussain, Cara Kanter, Sorabh Khandelwal, Caitlin S. Rublee, Ramin R. Tabatabai, James Kimo Takayesu, Mohammad Zaher, and Nadine T. Himelfarb

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Delayed Recognition of Acute Stroke by Emergency Department Staff Following Failure to Activate Stroke by Emergency Medical Services, Joseph Tennyson, Sean S. Michael, Marguerite N. Youngren, and Martin A. Reznek

Publications from 2018

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Which Chart Elements Accurately Identify Emergency Department Visits for Suicidal Ideation or Behavior, Sarah A. Arias, Edwin D. Boudreaux, Elizabeth Chen, Ivan Miller, Carlos A. Camargo Jr, Richard N. Jones, and Lisa Uebelacker

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System-Level Process Change Improves Communication and Follow-Up for Emergency Department Patients With Incidental Radiology Findings, Steven J. Baccei, Sneha A. Chinai, Martin A. Reznek, Scott Henderson, Kevin Reynolds, and David Eric Brush

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Sex Differences in Poisonings Among Older Adults: An Analysis of the Toxicology Investigators Consortium (ToxIC) Registry, 2010 to 2016, Gillian A. Beauchamp, Jennifer L. Carey, Tyler Adams, Amy Wier, Manuel F. Colon, Matthew Cook, Robert Cannon, Kenneth D. Katz, and Marna Rayl Greenberg

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Global Emergency Medicine: A review of the literature from 2017, Torben K. Becker, Payal Modi, and Global Emergency Medicine Literature Review (GEMLR) Group

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Beyond Test Scores and Medical Knowledge: The Standardized Video Interview, an Innovative and Ethical Approach for Holistic Assessment of Applicants, Steven B. Bird, Andra Blomkalns, Nicole M. Deiorio, and Fiona E. Gallahue

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Applying Computer Adaptive Testing Methods to Suicide Risk Screening in the Emergency Department, Edwin D. Boudreaux, Derek P. De Beurs, Tam H. Nguyen, Brianna L. Haskins, Celine Larkin, and Bruce A. Barton

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Predictive utility of an emergency department decision support tool in patients with active suicidal ideation, Edwin D. Boudreaux, Celine Larkin, Nisha Kini, Lisa Capoccia, Michael H. Allen, Julie Goldstein Grumet, Morton M. Silverman, Richard McKeon, Bruce A. Barton, Ivan Miller, Scott W. Formica, and Carlos A. Camargo

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Usability and Reliability of Smart Glasses for Secondary Triage During Mass Casualty Incidents, John Broach, Alexander Hart, Matthew Griswold, Jeffrey T. Lai, Edward W. Boyer, Aaron B. Skolnik, and Peter R. Chai

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mHealth for the Detection and Intervention in Adolescent and Young Adult Substance Use Disorder, Stephanie Carreiro, Peter R. Chai, Jennifer L. Carey, David A. Smelson, and Edward W. Boyer

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Faculty member writing groups support productivity, Peter R. Chai, Stephanie Carreiro, Jennifer L. Carey, Katherine L. Boyle, Brittany Chapman, and Edward W. Boyer

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Taking Advantage of the Teachable Moment: A Review of Learner-Centered Clinical Teaching Models, Sneha A. Chinai, Todd Guth, Elise Lovell, and Michael Epter

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Wearable Biosensors to Evaluate Recurrent Opioid Toxicity After Naloxone Administration: A Hilbert Transform Approach, Keerthi Kumar. Chintha, Premananda Indic, Brittany Chapman, Edward W. Boyer, and Stephanie Carreiro

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Point-of-Care Ultrasound in Trauma, Timothy P. Gleeson and David J. Blehar

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Harmonization of delirium severity instruments: a comparison of the DRS-R-98, MDAS, and CAM-S using item response theory, Alden L. Gross, Doug Tommet, Madeline D'Aquila, Eva Schmitt, Edward R. Marcantonio, Benjamin Helfand, Sharon K. Inouye, and Richard N. Jones

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The nursing home elder microbiome stability and associations with age, frailty, nutrition and physical location, John P. Haran, Vanni Bucci, Protiva Dutta, Doyle V. Ward, and Beth A. McCormick

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Macrolide Resistance in Cases of Community-Acquired Bacterial Pneumonia in the Emergency Department, John P. Haran and Gregory A. Volturo

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Deviating from IDSA treatment guidelines for non-purulent skin infections increases the risk of treatment failure in emergency department patients, John P. Haran, E. Wilsterman, T. Zeoli, Melissa Goulding, Emily McLendon, and Melissa A. Clark

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Intuitive versus Algorithmic Triage, Alexander Hart, Elias Nammour, Virginia B. Mangolds, and John Broach

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Universal Suicide Risk Screening in the Hospital Setting: Still a Pandora's Box?, Lisa M. Horowitz, Edwin D. Boudreaux, Michael Schoenbaum, Maryland Pao, and Jeffrey A. Bridge

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The Practitioner's Guide to Global Health: an interactive, online, open-access curriculum preparing medical learners for global health experiences, Gabrielle A. Jacquet, Rachel A. Umoren, Alison S. Hayward, Justin G. Myers, Payal Modi, Stephen J. Dunlop, Suzanne Sarfaty, Mark Hauswald, and Janis P. Tupesis

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Lower Endoscopic Diagnostic Yields Observed in Non-hematemesis Gastrointestinal Bleeding Patients, Salmaan Jawaid, Neil B. Marya, Bilal Gondal, Louise S. Maranda, Christopher Marshall, Joseph Charpentier, Abbas Rupawala, Muhammad Al-Sayid, Anupam Singh, Anne Foley, Gregory A. Volturo, and David R. Cave

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Low-energy Bluetooth for detecting real-world penetrance of bystander naloxone kits: a pilot study, Jeffrey T. Lai, Brittany Chapman, Katherine L. Boyle, Edward W. Boyer, and Peter R. Chai

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Evaluating the Patient with Reported Gadolinium-Associated Illness, Tatyana Lyapustina, Charlotte Goldfine, Sean Hyun Rhyee, Kavita M. Babu, and Matthew K. Griswold

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A randomized controlled trial comparing efficacy of early video capsule endoscopy with standard of care in the approach to non-hematemesis gastrointestinal bleeding (with videos), Neil B. Marya, Salmaan Jawaid, Anne Foley, Samuel Han, Krunal Patel, Louise Maranda, Daniel Kaufman, Kanishka Bhattacharya, Christopher Marshall, Joseph Tennyson, and David R. Cave

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Effect of a Data-Driven Intervention on Opioid Prescribing Intensity Among Emergency Department Providers: A Randomized Controlled Trial, Sean S. Michael, Kavita M. Babu, Christopher Androskl Jr., and Martin A. Reznek

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Code Help: Can This Unique State Regulatory Intervention Improve Emergency Department Crowding?, Sean S. Michael, John Broach, Kevin A. Kotkowski, David Eric Brush, Gregory A. Volturo, and Martin A. Reznek

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Development and pilot study of simple suicide risk rulers for use in the emergency department, Laurel O'Connor, Celine Larkin, Ameer F. Ibrahim, Michael Allen, Bo Wang, and Edwin D. Boudreaux

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Outcomes of Prehospital Chemical Sedation With Ketamine Versus Haloperidol and Benzodiazepine or Physical Restraint Only, Laurel O'Connor, Matthew Rebesco, Conor Robinson, Karen Gross, Andrew Castellana, Mark J. O'Connor, and Marc C. Restuccia

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Using support vector machines on photoplethysmographic signals to discriminate between hypovolemia and euvolemia, Natasa Reljin, Gary Zimmer, Yelena Malyuta, Kirk Shelley, Yitzhak Mendelson, David J. Blehar, Chad E. Darling, and Ki H. Chon

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Mortality Associated With Emergency Department Boarding Exposure: Are There Differences Between Patients Admitted to ICU and Non-ICU Settings, Martin A. Reznek, Benjavan Upatising, Samantha J. Kennedy, Natassia T. Durham, Richard M. Forster, and Sean S. Michael

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Time is Money: The True Cost of Helicopter EMS (HEMS), Jerome Rogich, Eike Blohm, and Joseph Tennyson

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What are the physical and psychological health effects of suicide bereavement on family members? An observational and interview mixed-methods study in Ireland, Ailbhe Spillane, Karen Matvienko-Sikar, Celine Larkin, Paul Corcoran, and Ella Arensman

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Twenty-five year trends (1986-2011) in hospital incidence and case-fatality rates of ventricular tachycardia and ventricular fibrillation complicating acute myocardial infarction, Hoang V. Tran, Arlene S. Ash, Joel M. Gore, Chad E. Darling, Catarina I. Kiefe, and Robert J. Goldberg

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Clinically significant ventricular arrhythmias and progression of depression and anxiety following an acute coronary syndrome, Hoang V. Tran, Joel M. Gore, Chad E. Darling, Arlene S. Ash, Catarina I. Kiefe, and Robert J. Goldberg

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Hyperglycemia and risk of ventricular tachycardia among patients hospitalized with acute myocardial infarction, Hoang V. Tran, Joel M. Gore, Chad E. Darling, Arlene S. Ash, Catarina I. Kiefe, and Robert J. Goldberg

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Emergency Department patients with suicide risk: Differences in care by acute alcohol use, Chantel Urban, Sarah A. Arias, Daniel L. Segal, Carlos A. Camargo Jr., Edwin D. Boudreaux, Ivan Miller, and Marian E. Betz

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Online health information seeking by adults hospitalized for acute coronary syndromes: Who looks for information, and who discusses it with healthcare providers, Molly E. Waring, David D. McManus, Daniel J. Amante, Chad E. Darling, and Catarina I. Kiefe

Publications from 2017

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Disparities in Treatment of Older Adults with Suicide Risk in the Emergency Department, Sarah A. Arias, Edwin D. Boudreaux, Daniel L. Segal, Ivan Miller, Carlos A. Camargo Jr, and Marian E. Betz

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Frequency of lethal means assessment among emergency department patients with a positive suicide risk screen, Marian E. Betz, Mack Kautzman, Daniel L. Segal, Ivan Miller, Carlos A. Camargo Jr, Edwin D. Boudreaux, and Sarah A. Arias

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Drug-induced hyperlactatemia, Eike Blohm, Jeffrey T. Lai, and Mark J. Neavyn

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Computer Administered Safety Planning for Individuals at Risk for Suicide: Development and Usability Testing, Edwin D. Boudreaux, Gregory K. Brown, Barbara Stanley, Rajani S. Sadasivam, Carlos A. Camargo Jr, and Ivan W. Miller

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Pediatric Poisonings in a Rural Ugandan Emergency Department, Katherine L. Boyle, Usha Periyanayagam, Kavita Babu, Brian T. Rice, and Mark Bisanzo

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Emergency preparedness training preferences and perceived barriers to training among various healthcare providers and public health practitioners in Massachusetts, John Broach and Mary-Elise Smith

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Use of Facial Recognition Software to Identify Disaster Victims With Facial Injuries, John Broach, Rothsovann Yong, Mary-Elise Manuell, and Constance Nichols

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A dangerous chase: severe neurocognitive impairment and death following smoked heroin, Alessandro Cancelliere, Eike Blohm, and Mark Neavyn

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Drugs and Medical Devices: Adverse Events and the Impact on Women's Health, Jennifer L. Carey, Nathalie Nader, Peter R. Chai, Stephanie Carreiro, Matthew K. Griswold, and Katherine L. Boyle

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Integrating Personalized Technology in Toxicology: Sensors, Smart Glass, and Social Media Applications in Toxicology Research, Stephanie Carreiro, Peter R. Chai, Jennifer Carey, Brittany Chapman, and Edward W. Boyer

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Oxycodone Ingestion Patterns in Acute Fracture Pain With Digital Pills, Peter R. Chai, Stephanie Carreiro, Brendan J. Innes, Brittany Chapman, Kristin L. Schreiber, Robert R. Edwards, Adam W. Carrico, and Edward W. Boyer

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Digital Pills to Measure Opioid Ingestion Patterns in Emergency Department Patients With Acute Fracture Pain: A Pilot Study, Peter R. Chai, Stephanie Carreiro, Brendan J. Innes, Rochelle K. Rosen, Conall O'Cleirigh, Kenneth Mayer, and Edward W. Boyer

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Music as an Adjunct to Opioid-Based Analgesia, Peter R. Chai, Stephanie Carreiro, Megan L. Ranney, Ketki Karanam, Marko Ahtisaari, Robert Edwards, Kristin L. Schreiber, Lubabah Ben-Ghaly, Timothy B. Erickson, and Edward W. Boyer

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The 2016 Model of the Clinical Practice of Emergency Medicine, Francis L. Counselman, Kavita Babu, Mary Ann. Edens, Diane L. Gorgas, Cherri Hobgood, Catherine A. Marco, Eric Katz, Kevin Rodgers, Leonard A. Stallings, Michael C. Wadman, Michael S. Beeson, Julia N. Keehbauch, and American Board of Emergency Medicine

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A Robust Motion Artifact Detection Algorithm for Accurate Detection of Heart Rates From Photoplethysmographic Signals Using Time-Frequency Spectral Features, Duy Dao, S M. Salehizadeh A, Yeonsik Noh, Jo Woon Chong, Chae Ho Cho, David D. McManus, Chad E. Darling, and Yitzhak Mendelson

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A Historical Perspective on Presentations of Hypertensive Acute Heart Failure, Chad E. Darling, Jiaoyuan Elisabeth Sun, Jordan Goldberg, Peter Pang, Christopher W. Baugh, Darleen M. Lessard, and David D. McManus

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A Queue-Based Monte Carlo Analysis to Support Decision Making for Implementation of an Emergency Department Fast Track, Kristin Fitzgerald, Lori R. Pelletier, and Martin A. Reznek

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Comparative coagulation studies in hibernating and summer-active black bears (Ursus americanus), Ann-Kristin U. Friedrich, Jahnavi Kakuturu, Peter J. Schnorr, Dean E. Beyer Jr, J. Alexander Palesty, Eric W. Dickson, Giacomo P. Basadonna, and Mitchell A. Cahan

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A retrospective study of pulseless electrical activity, bedside ultrasound identifies interventions during resuscitation associated with improved survival to hospital admission. A REASON Study, Romolo Joseph Gaspari, David J. Blehar, and Michelle Mendoza

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Reply to Letter: Letter to the Editor regarding Gaspari and colleague's "Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest", Romolo Joseph Gaspari, David J. Blehar, and Michelle Mendoza

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Ultrasound-Guided Drainage for Pediatric Soft Tissue Abscesses Decreases Clinical Failure Rates Compared to Drainage Without Ultrasound: A Retrospective Study, Romolo Joseph Gaspari and Alexandra Sanseverino

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Familial Anaphylaxis after Silkworm Ingestion, Marc Gautreau, Marc C. Restuccia, Kevin Senser, and Stacy N. Weisberg

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Development of a Computerized Adaptive Test Suicide Scale-The CAT-SS, Robert D. Gibbons, David Kupfer, Ellen Frank, Tara Moore, David G. Beiser, and Edwin D. Boudreaux

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Unsuspected Clenbuterol Toxicity in a Patient Using Intramuscular Testosterone, Matthew K. Griswold, Eike Blohm, Roderick Cross, Edward W. Boyer, and Jennifer L. Carey

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Self-identification of nonpharmaceutical fentanyl exposure following heroin overdose, Matthew K. Griswold, Peter R. Chai, Alex J. Krotulski, Melissa Friscia, Brittany Chapman, Edward W. Boyer, Barry K. Logan, and Kavita M. Babu

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A Novel Oral Fluid Assay (LC-QTOF-MS) for the Detection of Fentanyl and Clandestine Opioids in Oral Fluid After Reported Heroin Overdose, Matthew K. Griswold, Peter R. Chai, Alex J. Krotulski, Melissa Friscia, Brittany Chapman, Neha Varma, Edward W. Boyer, Barry K. Logan, and Kavita Babu

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Accidental copper sulfate toxicity after flame colorant ingestion, Matthew K. Griswold, Alexandra Nordberg, Kavita M. Babu, Edward W. Boyer, and Peter R. Chai

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Global Health and Emergency Care: Defining Clinical Research Priorities, Bhakti Hansoti, Adam R. Aluisio, Meagan A. Barry, Kevin Davey, Brian A. Lentz, Payal Modi, Jennifer A. Newberry, Melissa H. Patel, Tricia A. Smith, Alexandra M. Vinograd, Adam C. Levine, and Global Emergency Medicine Think Tank Clinical Research Working Group

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Medication Exposure and Risk of Recurrent Clostridium difficile Infection in Community-Dwelling Older People and Nursing Home Residents, John P. Haran, Evan Bradley, Emily Howe, Xun Wu, and Jennifer Tjia

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Elderly patients are at increased risk for treatment failure in outpatient management of purulent skin infections, John P. Haran, Eric Wilsterman, Tyler Zeoli, Francesca L. Beaudoin, Jennifer Tjia, and Patricia L. Hibberd

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Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management, Alexander Hart, Peter R. Chai, Matthew K. Griswold, Jeffrey T. Lai, Edward W. Boyer, and John Broach

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Health Evaluation and Referral Assistant: A Randomized Controlled Trial of a Web-Based Screening, Brief Intervention, and Referral to Treatment System to Reduce Risky Alcohol Use Among Emergency Department Patients, Brianna L. Haskins, Rachel Davis-Martin, Beau Abar, Brigitte M. Baumann, Tina Harralson, and Edwin D. Boudreaux

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A systematic review of smartphone applications for smoking cessation, Brianna L. Haskins, Donna Lesperance, Patric Gibbons, and Edwin D. Boudreaux

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Methods for Evaluating the Content, Usability, and Efficacy of Commercial Mobile Health Apps, Danielle E. Jake-Schoffman, Valerie J. Silfee, Molly E. Waring, Edwin D. Boudreaux, Rajani S. Sadasivam, Sean P. Mullen, Jennifer L. Carey, Rashelle B. Hayes, Eric Y. Ding, Gary G. Bennett, and Sherry L. Pagoto

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Association of hospital contact precaution policies with emergency department admission time, Kevin A. Kotkowski, Richard T. Ellison 3rd, Constance Barysauskas, Bruce Barton, Jeroan J. Allison, DeborahAnn Mack, Robert W. Finberg, and Martin A. Reznek

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Carotid Flow Time Test Performance for the Detection of Dehydration in Children With Diarrhea, David C. Mackenzie, Sabiha Nasrin, Bita Atika, Payal Modi, Nur H. Alam, and Adam C. Levine

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Weight loss support seeking on twitter: the impact of weight on follow back rates and interactions, Christine N. May, Molly E. Waring, Stephanie Rodrigues, Jessica L. Oleski, Effie Olendzki, Martinus M. Evans, Jennifer Carey, and Sherry L. Pagoto

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Suicide Prevention in an Emergency Department Population: The ED-SAFE Study, Ivan W. Miller, Carlos A. Camargo Jr, Sarah A. Arias, Ashley F. Sullivan, Michael H. Allen, Amy B. Goldstein, Anne P. Manton, Janice A. Espinola, Richard Jones, Kohei Hasegawa, Edwin D. Boudreaux, and ED-SAFE Investigators

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Retrospective Analysis of Mosh-Pit-Related Injuries, Andrew M. Milsten, Joseph Tennyson, and Stacy Weisberg

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ACMT Position Statement: Determining Brain Death in Adults After Drug Overdose, Mark J. Neavyn, Andrew Stolbach, David M. Greer, Lewis S. Nelson, Silas W. Smith, Jeffrey Brent, Laura M. Tormoehlen, and American College of Medical Toxicology

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Analysis of Emergency Department Length of Stay for Mental Health Patients at Ten Massachusetts Emergency Departments, Mark D. Pearlmutter, Kristin H. Dwyer, Laura G. Burke, Niels Rathlev, Louise S. Maranda, and Gregory A. Volturo

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Door-to-Imaging Time for Acute Stroke Patients Is Adversely Affected by Emergency Department Crowding, Martin A. Reznek, Evangelia Murray, Marguerite N. Youngren, Natassia T. Durham, and Sean S. Michael

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Contributions of Academic Emergency Medicine Programs to U.S. Health Care: Summary of the AAAEM-AACEM Benchmarking Data, Martin A. Reznek, James J. Scheulen, Cathi A. Harbertson, Kevin A. Kotkowski, Gabor D. Kelen, and Gregory A. Volturo

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Physical and psychosomatic health outcomes in people bereaved by suicide compared to people bereaved by other modes of death: a systematic review, Ailbhe Spillane, Celine Larkin, Paul Corcoran, Karen Matvienko-Sikar, Fiona Riordan, and Ella Arensman

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A New Mining Method to Detect Real Time Substance Use Events from Wearable Biosensor Data Stream, Jin Wang, Hua (Julia) Fang, Stephanie Carreiro, Honggang Wang, and Edward W. Boyer

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Ecological momentary assessment and first smoking cessation lapse after an acute cardiac event: A pilot study, Chelsea J. Webber, Erin L. O'Hea, Beau Abar, Beth Bock, and Edwin D. Boudreaux

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Altitude-Related Change in Endotracheal Tube Cuff Pressures in Helicopter EMS, Stacy Weisberg, Jonathan C. McCall Jr, and Joseph Tennyson

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Tobacco use disorder and treatment: new challenges and opportunities, Douglas Ziedonis, Smita Das, and Celine Larkin

Publications from 2016

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Substance Use as a Mediator of the Association Between Demographics, Suicide Attempt History, and Future Suicide Attempts in Emergency Department Patients, Sarah A. Arias, Orianne Dumas, Ashley F. Sullivan, Edwin D. Boudreaux, Ivan Miller, and Carlos A. Camargo Jr.

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Screening for Suicidal Thoughts and Behaviors in Older Adults in the Emergency Department, Marian E. Betz, Sarah A. Arias, Daniel L. Segal, Ivan Miller, Carlos A. Camargo Jr, and Edwin D. Boudreaux

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Managing Suicidal Patients in the Emergency Department, Marian E. Betz and Edwin D. Boudreaux

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Lethal Means Access and Assessment among Suicidal Emergency Department Patients, Marian E. Betz, Matthew Miller, Catherine Barber, Brenda Beaty, Ivan Miller, Carlos A. Camargo Jr, and Edwin D. Boudreaux

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Reducing Suicide Risk: Challenges and Opportunities in the Emergency Department, Marian E. Betz, Matthew Wintersteen, Edwin D. Boudreaux, Gregory Brown, Lisa Capoccia, Glenn Currier, Julie Goldstein, Cheryl King, Anne Manton, Barbara Stanley, Christine Moutier, and Jill Harkavy-Friedman

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Pharmacotherapy to protect the neuromuscular junction after acute organophosphorus pesticide poisoning, Steven B. Bird, Predrag Krajacic, Keigo Sawamoto, Naofumi Bunya, Emanuele Loro, and Tejvir S. Khurana

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Case Files of the University of Massachusetts Toxicology Fellowship: Does This Smoke Inhalation Victim Require Treatment with Cyanide Antidote, Eike Blohm, Kavita Babu, and Vikhyat S. Bebarta

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Implementation of a Computerized Screening Inventory: Improved Usability Through Iterative Testing and Modification, Edwin D. Boudreaux, Andrew Christopher Fischer, Brianna Haskins, Zubair Saeed Zafar, Guanling Chen, and Sneha A. Chinai

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The Effect of Parathion on Red Blood Cell Acetylcholinesterase in the Wistar Rat, Naofumi Bunya, Keigo Sawamoto, Hanif Benoit, and Steven B. Bird

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Wearable Biosensors to Detect Physiologic Change During Opioid Use, Stephanie Carreiro, Kelley Wittbold, Premananda Indic, Hua (Julia) Fang, Jianying Zhang, and Edward W. Boyer

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Comparing the Accuracy of Three Pediatric Disaster Triage Strategies: A Simulation-Based Investigation, Mark X. Cicero, Frank Overly, Linda Brown, Jorge D. Yarzebski, Barbara M. Walsh, Veronika Shabanova, Marc Auerbach, Antonio Riera, Kathleen Adelgais, Garth Meckler, David Cone, and Carl R. Baum

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High-Amplitude Atlantic Hurricanes Produce Disparate Mortality in Small, Low-Income Countries, Caleb J. Dresser, Jeroan J. Allison, John Broach, Mary-Elise Smith, and Andrew Milsten