Publications by authors named "Jin H Han"

Background: Emergency tracheal intubation is a common and high-risk procedure. Ketamine and etomidate are sedative medicines commonly used to induce anesthesia for emergency tracheal intubation, but whether the induction medication used affects patient outcomes is uncertain.

Research Question: Does the use of ketamine for induction of anesthesia decrease the incidence of death among adults undergoing emergency tracheal intubation, compared to the use of etomidate?

Study Design And Methods: The Randomized trial of Sedative choice for Intubation (RSI) is a pragmatic, multicenter, unblinded, parallel-group, randomized trial being conducted in 14 sites (6 emergency departments and 8 intensive care units) in the United States.

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Background: More than 600,000 adults in the United States experience a cardiac arrest each year. After resuscitation from cardiac arrest, most patients receive mechanical ventilation. The oxygenation target that optimizes neurologic outcomes after cardiac arrest is uncertain.

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Objectives: To summarize the delirium treatment trial literature, identify the unique challenges in delirium treatment trials, and formulate recommendations to address each in older adults.

Design: A 39-member interprofessional and international expert working group of clinicians (physicians, nurses, and pharmacists) and nonclinicians (biostatisticians, epidemiologists, and trial methodologists) was convened. Four expert panels were assembled to explore key subtopics (pharmacological/nonpharmacologic treatment, methodological challenges, and novel research designs).

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Background: Timely recognition of acute ischemic stroke (AIS) is essential to identify patients who may be eligible for acute intervention. Protocols to streamline systems-based care, such as "stroke alerts" in the emergency department (ED) can safely reduce time-to-care while enhancing safety. However, clinician adherence to stroke alert criteria is poorly described.

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Creating a sustainable residency research program is necessary to develop a sustainable research pipeline, as highlighted by the recent Society for Academic Emergency Medicine 2024 Consensus Conference. We sought to describe the implementation of a novel, immersive research program for first-year emergency medicine residents. We describe the curriculum development, rationale, implementation process, and lessons learned from the implementation of a year-long research curriculum for first-year residents.

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Introduction: Early identification of traumatic brain injury followed by timely, targeted treatment is essential. We aimed to establish the ability of prehospital Glasgow Coma Scale score alone and combined with vital signs to predict hospital-diagnosed traumatic brain injury.

Methods: This study included adults from the 2017-2020 Trauma Quality Improvement Program data set with blunt mechanism.

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Study Objective: To examine the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt and severe complications during tracheal intubation of critically ill adults in an emergency department (ED) or ICU.

Methods: We performed a secondary analysis of data from 2 multicenter randomized trials in critically ill adults undergoing tracheal intubation in an ED or ICU. Using a generalized linear mixed-effects model with prespecified baseline covariates, we examined the association between the neuromuscular blocking agent received (succinylcholine versus rocuronium) and the incidences of successful intubation on the first attempt (primary outcome) and severe complications during tracheal intubation (secondary outcome).

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Purpose: This study aimed to investigate correlation between the presence of endolymphatic hydrops(EH) and factors such as causes of hearing loss, patient age, duration of deafness, and results of vestibular function tests.

Methods: We retrospectively reviewed medical charts of 128 ears of cochlear implantees who were not considered relevant to Meniere's disease.

Results: When comparing group with genetic variants of GJB2, SLC26A4, LMX1A and other genetic mutation group, the proportion of vestibular EH and cochlear EH found in group with genetic variants of GJB2, SLC26A4, LMX1A was significantly higher than group with other genetic etiology (p < 0.

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Return visit admissions (RVA), which are instances where patients discharged from the emergency department (ED) rapidly return and require hospital admission, have been associated with quality issues and adverse outcomes. We developed and validated a machine learning model to predict 72-hour RVA using electronic health records (EHR) data. Study data were extracted from EHR data in 2019 from three urban EDs.

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Article Synopsis
  • Diuresis is crucial for treating patients with acute decompensated heart failure (ADHF) to relieve fluid buildup, but there's no one-size-fits-all diuretic strategy that has proven to be the best.
  • Current research highlights the connection between urine sodium levels and patient outcomes, suggesting that monitoring urine chemistry could help tailor diuretic treatments.
  • The review aims to consolidate existing studies on diuretic management, identify what we still don't know, and outline ongoing clinical trials that explore urine sodium-guided diuresis in ADHF management.
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  • The study assessed the effectiveness of the updated 2023-2024 COVID-19 vaccine against hospitalization for two variant lineages, XBB and JN, in hospitalized patients across 26 hospitals in the U.S. between October 2023 and March 2024.
  • The results indicated a vaccine effectiveness (VE) of 54.2% against XBB and 32.7% against JN, suggesting that the JN lineage may have some level of immune escape.
  • However, the severity of cases with the JN lineage was not significantly worse compared to those with the XBB lineage, indicating similar risks of severe outcomes like ICU admission and death.
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  • The FDXR gene is linked to a type of hearing loss called auditory neuropathy spectrum disorder (ANSD) and can cause problems with hearing and vision.* -
  • A 35-year-old woman with ANSD underwent cochlear implantation, and after adjusting treatment, her hearing improved a lot over a year.* -
  • Research showed that a change in the FDXR gene affects energy production in cells, leading to hearing loss, but this can be treated by using special stem cells.*
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Article Synopsis
  • * A study conducted between September 2018 and October 2022 in Tennessee and Georgia found that 12.1% of hospitalized adults with CAP had Streptococcus pneumoniae detected, with the most common serotypes being 3, 22F, 19A, and others.
  • * Findings suggest that a significant portion of detected serotypes, approximately one-third, are not covered by current vaccines like PCV15 and PCV20, indicating the need for new vaccines with broader serotype coverage to reduce disease occurrence.
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Purpose: This study aimed to investigate the etiology of hearing loss, including genetic variants, in individuals who underwent cochlear implantation (CI) in their teens to thirties. It also sought to analyze post-CI speech performance and identify prognostic factors affecting CI outcomes in this age group.

Methods: We conducted a retrospective review of 421 cochlear implant patients at Seoul National University Bundang Hospital, focusing on 63 subjects aged 10-39 years who underwent their first CI by a single surgeon between July 2018 and June 2022.

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Introduction: The United States Veterans Health Administration is a leader in the use of telemental health (TMH) to enhance access to mental healthcare amidst a nationwide shortage of mental health professionals. The Tennessee Valley Veterans Affairs (VA) Health System piloted TMH in its emergency department (ED) and urgent care clinic (UCC) in 2019, with full 24/7 availability beginning March 1, 2020. Following implementation, preliminary data demonstrated that veterans ≥65 years old were less likely to receive TMH than younger patients.

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Introduction: Geriatric emergency department (ED) guidelines emphasize timely identification of delirium. This article updates previous diagnostic accuracy systematic reviews of history, physical examination, laboratory testing, and ED screening instruments for the diagnosis of delirium as well as test-treatment thresholds for ED delirium screening.

Methods: We conducted a systematic review to quantify the diagnostic accuracy of approaches to identify delirium.

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Objectives: The recent expansion of eligibility for cochlear implantation (CI) by the U.S. Food and Drug Administration (FDA) to include infants as young as 9 months has reignited debates concerning the clinically appropriate cut-off age for pediatric CI.

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Article Synopsis
  • * After 12 months, follow-up assessments of cognition and quality of life for 501 patients showed no differences among the oxygen target groups in overall cognitive function or related outcomes.
  • * Overall, the study indicates that for critically ill patients, the specific oxygen-saturation target set during ventilation does not influence long-term cognitive performance or quality of life measures.
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  • Epinephrine is crucial for treating anaphylaxis but its cardiovascular side effects may make clinicians hesitant to use it; this study aimed to evaluate the frequency of such cardiotoxic effects.
  • A retrospective study in a Tennessee ED looked at 338 adult patients treated with intramuscular epinephrine for anaphylaxis from 2017 to 2021, primarily assessing cardiotoxicity defined by specific heart-related outcomes.
  • The results showed that about 4.7% of patients experienced cardiotoxicity, with older patients and those with more health issues being at a higher risk, especially if they received multiple doses of epinephrine.
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Purpose: Lithotomy position has been widely used in the various urologic surgery. Occasionally sensory and motor problems of the lower extremities are occurred due to the lithotomy position and these deficits may be related with sciatic nerve injury (SNI). Inflammatory process is a factor to induce functional impairment after SNI.

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Transmembrane and tetratricopeptide repeat 4 (Tmtc4) is a deafness gene in mice. Tmtc4-KO mice have rapidly progressive postnatal hearing loss due to overactivation of the unfolded protein response (UPR); however, the cellular basis and human relevance of Tmtc4-associated hearing loss in the cochlea was not heretofore appreciated. We created a hair cell-specific conditional KO mouse that phenocopies the constitutive KO with postnatal onset deafness, demonstrating that Tmtc4 is a hair cell-specific deafness gene.

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Successfully changing prescribing behavior to reduce inappropriate antibiotic and nonsteroidal anti-inflammatory drug (NSAID) prescriptions often requires combining components into a multicomponent intervention. However, multicomponent interventions often fail because of development and implementation complexity. To increase the likelihood of successfully changing prescribing behavior, we applied a systematic process to design and implement a multicomponent intervention.

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