Gender Distribution Associated With the Journal Wilderness & Environmental Medicine.

INTRODUCTION: Publication and peer review are fundamental to career advancement in science and academic medicine. Studies demonstrate that women are underrepresented in science publishing. We evaluated the gender distribution of contributors to Wilderness & Environmental Medicine (WEM) from 2010 through 2019. METHODS: We extracted author data from ScienceDirect, reviewer data from the WEM Editorial Manager database, and editorial board data from journal records. Gender (female and male) was classified using automated probability-based assessment with Genderize.io software. RESULTS: A total of 2297 unique authors were published over the 10-y span, generating 3613 authorships, of which gender was classified for 96% (n=3480). Women represented 26% (n=572) of all authors, which breaks down to 22% of all, 19% of first, 28% of second, and 18% of last authorships. Women represented 20% of peer reviewers (508/2517), 20% of reviewers-in-training (19/72), and 16% of editorial board members (7/45). The proportion of female authors, first authors, and reviewers increased over time. Women received fewer invitations per reviewer than men (mean 2.1 [95% CI 2.0-2.3] vs 2.4 [95% CI 2.3-2.5]; P=0.004), accepted reviews at similar rates (mean 73 vs 71%; P=0.214), and returned reviews 1.4 d later (mean 10.4 [CI 9.5-11.3] vs 9.0 d [95% CI 8.5-9.6]; P=0.005). CONCLUSIONS: While female representation increased over the study period, women comprise a minority of WEM authors, peer reviewers, and editorial board members. Gender equity could be improved by identifying and eliminating barriers to participation, addressing any potential bias in review processes, implementing strategies to increase female-authored submissions, and increasing mentorship and training.

Emergency department identification and critical care management of a Utah prison botulism outbreak.

STUDY OBJECTIVE: We report botulism poisoning at a state prison after ingestion of homemade wine (pruno). METHODS: This is an observational case series with data collected retrospectively by chart review. All suspected exposures were referred to a single hospital in October 2011. RESULTS: Twelve prisoners consumed pruno, a homemade alcoholic beverage made from a mixture of ingredients in prison environments. Four drank pruno made without potato and did not develop botulism. Eight drank pruno made with potato, became symptomatic, and were hospitalized. Presenting symptoms included dysphagia, diplopia, dysarthria, and weakness. The median time to symptom onset was 54.5 hours (interquartile range [IQR] 49-88 hours) postingestion. All 8 patients received botulinum antitoxin a median of 12 hours post-emergency department admission (IQR 8.9-18.8 hours). Seven of 8 patients had positive stool samples for type A botulinum toxin. The 3 most severely affected patients had respiratory failure and were intubated 43, 64, and 68 hours postingestion. Their maximal inspiratory force values were -5, -15, and -30 cm H2O. Their forced vital capacity values were 0.91, 2.1, and 2.2 L, whereas the 5 nonintubated patients had median maximal inspiratory force of -60 cm H2O (IQR -60 to -55) and forced vital capacity of 4.5 L (IQR 3.7-4.9). Electromyography abnormalities were observed in 1 of the nonintubated and 2 of the intubated patients. CONCLUSION: A pruno-associated botulism outbreak resulted in respiratory failure and abnormal pulmonary parameters in the most affected patients. Electromyography abnormalities were observed in the majority of intubated patients. Potato in the pruno recipe was associated with botulism.