Journal of Emergency Management https://wmpllc.org/ojs/index.php/jem <h2>The Most Respected Name in Emergency Management</h2> <p>The <em><strong><span class="italic">Journal of Emergency Management</span> </strong></em>is edited, written, and peer-reviewed by an internationally recognized team of the foremost, hands-on EM experts. They include top professionals from the public and private sectors who offer real-world experience and practical solutions and leading academics who provide perspective and analysis on the latest research and studies. Together, they bring you the most thorough, relevant, and useful source of information on emergency management.</p> <h2><span class="bluetext">The Most Important Thing You Can Do for Yourself and Your EM Team</span></h2> <h4><strong>Published bi-monthly, every issue of the Journal of Emergency <span class="italic">Management</span> is peer-reviewed and packed with invaluable information and insight. Topics include:</strong></h4> <ul> <li>Emergency planning and response</li> <li>Disaster recovery and business continuity planning</li> <li>Emergency preparedness and response legislation</li> <li>Risk management</li> <li>Emergency management today, tomorrow, and in the future</li> <li>Severe weather, flood, and hurricane studies</li> <li>Emergency communications</li> <li>Continuity of operations and infrastructure protection</li> <li>Preparation and evacuation for the disabled</li> <li>Cross-training in emergency management</li> <li>And much more, including a special focus on EM training and higher education</li> </ul> Weston Medical Publishing, LLC en-US Journal of Emergency Management 1543-5865 <p>Copyright 2007-2023, Weston Medical Publishing, LLC and Journal of Emergency Management. All Rights Reserved</p> Special Issue on Climate Change and Sustainability in Emergency Management https://wmpllc.org/ojs/index.php/jem/article/view/3616 <p>Volume 22, Number 7</p> Journal of Emergency Management Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 1 122 10.5055/jem.0857 Climate change and health: The case of mapping droughts and migration pattern in Iran (2011-2016) https://wmpllc.org/ojs/index.php/jem/article/view/3615 <p><em>Introduction: Migration and mobility of population have been reported as a common reaction to drought. There is historical evidence to suggest the health effects of droughts and human migration linkage in Iran. This study aimed to map the drought and migration patterns in Iran in 2011 and 2016 and explore their possible health impacts.</em></p> <p><em>Methods: This sequential explanatory mixed-method study was done in two stages of spatial analysis and qualitative study. Data mapping was conducted through the equal interval classification and using drought, migration, and agriculture occupation data based on provincial divisions in Iran in 2011 and 2016. This qualitative study was conducted using the content analysis approach.</em></p> <p><em>Results: The in-migration rate was higher in 2011 rather than 2016. Migration to cities was much higher than migration to villages in both years. The frequency of male migrants was higher than females in all provinces in 2011 and 2016. Physical and mental diseases as well as economic, sociocultural, education, and environment effects on health were extracted from the qualitative data.</em></p> <p><em>Conclusion: A holistic picture of droughts and migration issues in Iran and their health consequences were achieved by the present research. Further research is needed to explore the determinants of health impacts of climate change in vulnerable groups. Public health problems can be prevented by adaptive and preventive policy-making and planning. This can improve the coping capacity of the population facing droughts and enforced migration.</em></p> Sanaz Sohrabizadeh Iman Farahi-Ashtiani Amirhosein Bahramzadeh Zahra Eskandari Aioub Moradi Ahmad Ali Hanafi-Bojd Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 113 122 10.5055/jem.0814 Rapid assessment of public interest in drought and its likely drivers in South Africa https://wmpllc.org/ojs/index.php/jem/article/view/3614 <p><em>The monthly search volumes for drought were extracted from Google<sup>®</sup> for South Africa using the </em>Keywordseverywhere.com <em>plugin from January 2004 until June 2022. To identify the potential qualitative drivers for such public interest the following data extracted by the plugin were investigated and analysed: the drought-related keywords, the long-tail keywords similar to drought, and the “people also searched for category” from the South African users. The Google Trends monthly score was extracted for South Africa and the Eastern Cape Province, and specific local municipalities</em>/<em>towns</em>/<em>cities in the province. The aim was to assess the relative significance of the drought interest in comparison to public interest in other search terms. The results of the Kruskal–Wallis analyses of variance by ranks showed that there was a statistically significant difference between individual values of the monthly search volumes for drought in South Africa, as a function of time of data extraction (5 percent level of significance; p-value ≤ 4.7 × 10−14). The monthly search volumes increased with time, which is based on the results of the Mann–Kendall test at a 5 percent level of significance (p-value ≤ 0.0092). Analyses of the Google Trends scores indicate that the relative interest in drought in South Africa and the Eastern Cape Province increased with time between January 2004 and June 2022 (the Mann–Kendall test at a 5 percent level of significance; p-value = 0.0011). The population’s searches for drought were relatively low when compared to other search terms on Google. Drought adaptation of the South African community could be considered a driver of the Google searches for drought, but it is a marginal topic compared to other topics in Google searches. It might be necessary to increase this significance by investigating the “Google-search patterns for droughts” in the areas of Tshikaro, Mafusini, Cofimvaba, and Nxotsheni in the Eastern Cape Province of South Africa. </em></p> Robyn J. Bayne Des Pyle Masterson Chipumuro Roman Tandlich Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 101 112 10.5055/jem.0834 Manufactured housing communities and climate change: Understanding key vulnerabilities and recommendations for emergency managers https://wmpllc.org/ojs/index.php/jem/article/view/3613 <p><em>Manufactured housing communities (MHCs), commonly referred to as mobile home parks, provide an estimated 2.7 million American households with largely unsubsidized, affordable housing. Climate change threatens those who call these communities home by exacerbating known structural and social vulnerabilities associated with this housing type—including but not limited to increased risks to flooding, extreme temperatures, high winds, and wildfires. Climate change requires emergency managers to understand the diverse, integrated, and complex vulnerabilities of MHCs that affect their exposure to climate change risk. This article presents findings from an integrative literature review focused on the climate-related vulnerabilities of these communities described at three levels of scale: household, housing structure, and park community. It then draws on 15 years of engagement and action research with MHC residents and stakeholders in Vermont, including several federally declared flooding disasters, to distill key recommendations for emergency managers for assisting MHCs to prepare for and respond to emergencies. As climate change accelerates, emergency managers can increase efficacy by learning about the MHCs in their jurisdictions by leveraging the best available data to characterize risks, integrating MHCs into planning and mitigation activities, and engaging in conversations with stakeholders, including MHC residents and their trusted partners.</em></p> Kelly A. Hamshaw Daniel Baker Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 87 99 10.5055/jem.0845 Designing user-centered decision support systems for climate disasters: What information do communities and rescue responders need during floods? https://wmpllc.org/ojs/index.php/jem/article/view/3612 <p><em>Flooding events are the most common natural hazard globally, resulting in vast destruction and loss of life. An effective flood emergency response is necessary to lessen the negative impacts of flood disasters. However, disaster management and response efforts face a complex scenario. Simultaneously, regular citizens attempt to navigate the various sources of information being distributed and determine their best course of action. One thing is evident across all disaster scenarios: having accurate information and clear communication between citizens and rescue personnel is critical.</em></p> <p><em>This research aims to identify the diverse needs of two groups, rescue operators and citizens, during flood disaster events by investigating the sources and types of information they rely on and information that would improve their responses in the future. This information can improve the design and implementation of existing and future spatial decision support systems (SDSSs) during flooding events. This research identifies information characteristics crucial for rescue operators and everyday citizens’ response and possible evacuation to flooding events by qualitatively coding survey responses from rescue responders and the public. The results show that including local input in SDSS development is crucial for improving higher-resolution flood risk quantification models. Doing so democratizes data collection and analysis, creates transparency and trust between people and governments, and leads to transformative solutions for the broader scientific community.</em></p> Julia Hillin Bahareh Alizadeh Diya Li Courtney M. Thompson Michelle A. Meyer Zhe Zhang Amir H. Behzadan Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 71 85 10.5055/jem.0741 COVID-19 and climate change concerns: Matters arising https://wmpllc.org/ojs/index.php/jem/article/view/3611 <p><em>Until the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, developing countries, especially countries in the African continent, battled with the impact of climate change on the food value-chain systems and general livelihood. In this study, we discuss climate change concerns post-COVID-19 and argue that the outbreak of the COVID-19 pandemic has exacerbated the vulnerabilities of most developing and emerging economies. This has heightened political tensions and unrest among such developing nations. We suggest enhancement and intensification of efficient and effective locally engineered adaptation strategies in the post-COVID-19 era for countries that have been susceptible to the impact of climate change and other recent shocks.</em></p> Anthony Amoah Peter Asare-Nuamah Andrew Manoba Limantol Abdul-Rauf Malimanga Alhassan Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 63 69 10.5055/jem.0802 Ocean state rising: Storm simulation and vulnerability mapping to predict hurricane impacts for Rhode Island’s critical infrastructure https://wmpllc.org/ojs/index.php/jem/article/view/3610 <p><em>Predicting the consequences of a major coastal storm is increasingly difficult as the result of global climate change and growing societal dependence on critical infrastructure (CI). Past storms are no longer a reliable predictor of future weather events, and the traditional approach to vulnerability assessment presents accumulated loss in largely quantitative terms that lack the specificity local emergency managers need to develop effective plans and mitigation strategies. The Rhode Island Coastal Hazards Modeling and Prediction (RI-CHAMP) system is a geographic information system (GIS)-based modeling tool that combines high-resolution storm simulations with geolocated vulnerability data to predict specific consequences based on local concerns about impacts to CI. This case study discusses implementing RI-CHAMP for the State of Rhode Island to predict impacts of wind and inundation on its CI during a hurricane, tropical storm, or nor’easter. This paper addresses the collection and field verification of vulnerability data, along with RI-CHAMP’s process for integrating those data with storm models. The project deeply engaged end-users (emergency managers, facility managers, and other stakeholders) in developing RI-CHAMP’s ArcGIS Online dashboard to ensure it provides specific, actionable data. The results of real and synthetic storm models are presented along with discussion of how the data in these simulations are being used by state and local emergency managers, facility owners, and others.</em></p> <p><em>&nbsp;</em></p> Samuel Adams Austin Becker Kyle McElroy Noah Hallisey Peter Stempel Isaac Ginis Deborah Crowley Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 47 61 10.5055/jem.0801 A Hegelian approach to resilient communities https://wmpllc.org/ojs/index.php/jem/article/view/3609 <p><em>This theoretical study draws on the insights of Georg Wilhelm Friedrich Hegel to suggest certain aspects of communities and other groups that would tend to make them more resilient in the face of climate change. While Hegel addresses resilient dimensions at the societal level, this study interprets Hegel’s work to derive aspects of groups within society that would tend to make them resilient.</em></p> Richard A. Buck Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 41 45 10.5055/jem.0811 Identifying and assessing corporate employment variables that influence community resilience: A novel model https://wmpllc.org/ojs/index.php/jem/article/view/3608 <p><em>Quantifying the concept of disaster resilience on a local level is becoming more critical as vulnerable communities face more frequent and intense disasters due to climate change. In the United States (US), corporations are often evaluated using social justice or environmental sustainability matrices for financial investment consideration. However, there are few tools available to measure a corporation’s contribution to disaster resilience on a local level. This study includes a focused literature review of employment variables that contribute to community resilience and a national survey that asked US emergency managers to rank the variables they believe have the greatest influence on individual resilience. A novel corporate community resilience model that ranks corporate contributions to disaster resilience in the communities where they operate was developed and then tested against data from five employment sectors from the same area. This model can be used by stakeholders to better understand how corporations can most efficiently contribute to county- and subcounty-level disaster resilience. The metrics used in this study are universal and translative, and thus, the development of this resilience model has global disaster resilience implications.</em></p> Erik Xavier Wood Jon C. Lam Monica Sanders Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 27 38 10.5055/jem.0808 Emergency management and sustainability: Understanding the link between disaster and citizen participation for sustainability efforts and climate change https://wmpllc.org/ojs/index.php/jem/article/view/3607 <p><em>The goal of this study is to examine how disaster experience influences local government views on citizen participation in addressing issues of sustainability, such as climate change. This study considers concepts such as wicked problems, the social order, the environment, economic development, and citizen participation where sustainability can be considered a solution to help manage and solve the challenges of disaster, like climate change. The data are taken from a 2015 International City</em>/<em>County Management Association national survey that examines the link between disaster and sustainability. The results show that more than half of the respondents do not view public participation as having much of an impact on sustainability; however, we can expect public participation to increasingly impact sustainability efforts as communities experience more disaster. This suggests that emergency management needs to understand public pressures regarding wicked problems, such as climate change, to collectively address the global influence of environmental, economic, and social issues that have local effects on their communities.</em></p> Brian Don Williams Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 11 23 10.5055/jem.0824 Leveraging technology in emergency management: An opportunity to improve compounding and cascading hazards linked to climate change https://wmpllc.org/ojs/index.php/jem/article/view/3606 <p>The Intergovernmental Panel on Climate (IPCC) Sixth Assessment report concluded that we will see an increase in frequency of extreme environmental events around the world including, hurricanes, droughts, and wildfires.<sup>1</sup> The report further describes cascading hazards when one hazard triggers another in a series such as extreme heat triggering a collapse of the power grid. The IPCC also discusses compounding hazards as multiple disasters occur at the same time for example a hurricane occurring at the same time as COVID-19 and a mass casualty event prompting a Urban Search &amp; Rescue (USAR) response such as the Surfside and the Florida condo collapse.<sup>2</sup> Studies suggest that there are gaps relating to Hazard Mitigation Plans (HMP) in addressing cascading events.<sup>3,4</sup></p> Attila Hertelendy Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 9 10 10.5055/jem.0854 From the publisher https://wmpllc.org/ojs/index.php/jem/article/view/3605 <p>We are excited to bring forth this special issue titled <strong><em>Climate Change and Sustainability in Emergency Management - Research and Applied Science </em>in a Changing World</strong>. Our thanks to the authors and researchers who have brought forth life changing research that can be applied today across the globe. Emergency managers are at the nexus of the climate change-sustainability debate, whether they are aware of it or not! A blurring of the emergency managers job description and responsibilities has been in process for years, much like moss growing on the north side of trees, the change has been slow but persistent.</p> Richard A. DeVito, Jr Copyright (c) 2024 Journal of Emergency Management 2024-04-03 2024-04-03 22 7 7 8 10.5055/jem.0855 Volume 22, Number 1 https://wmpllc.org/ojs/index.php/jem/article/view/3585 <p>January/February 2024</p> Journal of Emergency Management Copyright (c) 2024 Journal of Emergency Management 2024-02-27 2024-02-27 22 7 1 108 10.5055/jem.0844 Compliance to personal hygiene habits in response to COVID-19 pandemic https://wmpllc.org/ojs/index.php/jem/article/view/3584 <p><em>Objective: This study aimed to evaluate the Jordanians’ compliance rates in terms of personal hygiene habits in response to the coronavirus disease 2019 (COVID-19) pandemic.</em></p> <p><em>Methods: A descriptive cross-sectional design was utilized to collect data from 651 Jordanians via an electronic self-report questionnaire. Data was analyzed using Statistical Package for Social Sciences software</em></p> <p><em>Results: The overall compliance rate for personal hygiene habits among Jordanians was 79 percent (11.85</em>/<em>15, SD = 9). Personal hygiene practices differ significantly across age groups (F = 2, 89, p = .04), gender (t = 5.18, p = .003), marital status (F = 3.09, p = .029), and being a member of a healthcare specialty (t = −2.20, p = .028). Gender, educational level, occupation, and living place were statistically significant predictors for compliance with personal hygiene habits. Compliance rates increased drastically (82 percent) in response to the COVID-19 pandemic.</em></p> <p><em>Conclusion: Compliance with personal hygiene habits among Jordanians was encouraging in response to the COVID-19 pandemic. Still, there is a chance for more improvement to reach optimum levels of safe and healthy personal hygiene habits. Healthcare authorities shall adopt change management programs and theories to target personal hygiene habits where opportunities for improvement are found.</em></p> Mohammad Y. Alzaatreh Huthaifah Khrais Mohammad R. Alsadi Obay A. Al-Maraira Copyright (c) 2024 Journal of Emergency Management 2024-02-27 2024-02-27 22 7 101 107 10.5055/jem.0782 Social media-based demographic and sentiment analysis for disaster responses https://wmpllc.org/ojs/index.php/jem/article/view/3583 <p><em>This study explores disaster responses across the United States for Winter Storm Jaxon in 2018 by utilizing demographic and sentiment analysis for Twitter®. This study finds that people show highly fluctuated responses across the study periods and highest natural sentiment, followed by positive sentiment and negative sentiment. Also, some sociodemographic and Twitter variables, such as gender and long text, are strongly related to human sentiment, whereas other sociodemographic and Twitter variables, such as age and the higher number of retweets, are not associated with it. The results show that governments and disaster experts should consider a multitude of sociodemographic and Twitter variables to understand human responses and sentiment during natural disaster events.</em></p> Seungil Yum Copyright (c) 2024 Journal of Emergency Management 2024-02-27 2024-02-27 22 7 89 99 10.5055/jem.0781 Song, wind, and mayhem: The Indiana State Fair stage collapse https://wmpllc.org/ojs/index.php/jem/article/view/3582 <p><em>The study of planning and execution failures resulting in disastrous outcomes for public events often offers much value when preparing for similar future events. While not recent, the lessons learned from the Indiana State Fair stage collapse of 2011 remain especially pertinent, due to thorough technical and managerial forensic investigations and their rigorous examination during subsequent litigation about the fatal event. Continued concern about life safety and inconsistent building code enforcement and design guidance for publicly occupied temporary structures, eg, outdoor stages, recently drew recommended changes by the International Code Council for the 2024 edition of the International Building Code. Codification of technical lessons learned is seldom immediate. Even with checklists and written plans of action, the full context of managerial lessons learned can be forgotten, as people without first-hand experience of earlier disasters plan later events. Salient events of the past can reinforce valuable lessons for today’s practitioners, even to produce building code changes. That is certainly so for the Indiana State Fair stage collapse of August 2011.</em></p> Randy R. Rapp Copyright (c) 2024 Journal of Emergency Management 2024-02-27 2024-02-27 22 7 81 88 10.5055/jem.0821 Best emergency preparedness practices for livestock farmers https://wmpllc.org/ojs/index.php/jem/article/view/3581 <p><em>The American cowboy or cowgirl is someone who possesses a unique set of skills that allows them to contribute to the agricultural economy. From feeding animals to land management to business negotiations, these individuals do so much to support the American family by helping to get food on the table across the country, and even beyond in foreign lands on occasion. Therefore, it is important that these livestock farmers know what they can do in the event of an emergency. Yet, many people in the agriculture industry do not know what the best practices are for securing their livelihoods from emergencies. The research material in this paper answers that question. This paper will start with a literature review that looks at key terms surrounding the world of livestock and emergencies. Then, this paper lays out a list of recommendations that livestock farmers can use to enhance their entire operation.</em></p> Sarah Hipps Copyright (c) 2024 Journal of Emergency Management 2024-02-27 2024-02-27 22 7 71 80 10.5055/jem.0809 A multivariate model for explaining gender differences in commitment to volunteering in the COVID-19 pandemic: The Israeli case https://wmpllc.org/ojs/index.php/jem/article/view/3580 <p><em>This study examined gender differences in commitment to volunteering and its explanatory variables among Israeli volunteers in the first wave of the coronavirus disease 2019 pandemic. Commitment to volunteering was assessed based on tendency to continue volunteering over time, expected intensity of volunteering, and tendency to recommend volunteering to others. The sample included 173 men and 331 women. The social-structural and psychological approaches formed the theoretical basis for explaining commitment to volunteering. Data processing was conducted through path analysis. For both genders, routine volunteering explained commitment to volunteering over time. Instrumental motives for volunteering were stronger for men than for women. A positive correlation was found for both genders between the level of anxiety and motive to escape from reality through volunteering. For women, fear of contracting the coronavirus correlated negatively with expected intensity of volunteering. Recommendations are made to volunteer organizations to adopt a gender-sensitive approach when managing volunteers in an emergency.</em></p> Liat Kulik Copyright (c) 2024 Journal of Emergency Management 2024-02-27 2024-02-27 22 7 53 70 10.5055/jem.0792 Business continuity plan in the management and operations of hospitals: First experience to certify the PDTA processes with the requirements defined by ISO 22301:2019 in emergency medical services https://wmpllc.org/ojs/index.php/jem/article/view/3578 <p><em>Background: A business continuity plan (BCP) facilitates the performance of primary functions during emergencies or other situations that can disrupt normal operations. If risk management is done analytically, a business impact analysis (BIA), according to ISO 22301 certification, makes it possible to define the best strategy for supporting the company’s assets and image, optimizing the operational efficiency of service recovery and redesigning spaces for health. Since 2015, our healthcare company has embarked on a certification process for all sectors and activities through the implementation and development of diagnostic and therapeutic paths for operational diagnostic-therapeutic-assistance pathways (PDTAs). PDTA processes are all certified by the ISO 9001:2015 management system hospital. Our hospital is the first healthcare company to have obtained ISO 22301:2019 certification concerning PDTA processes, offering patients the highest standards of quality and safety of care in emergency medical services.</em></p> <p><em>Methods: The formal BCP process includes several steps prior to the creation of a BCP: create a BCP team, conduct a BIA, determine the continuity plan by using the results of the analyses, and conduct training and exercises to educate staff and improve the BCP. </em></p> <p><em>Results: From the BIA analysis, the team identified the time-employee PDTAs in company paths under emergency and urgency: acute ST-elevation myocardial infarction (STEMI), TRAUMA, and STROKE, providing for a planning path that took advantage of the duration of approximately 12 months. This path included the creation of structural procedures, the redefinition and updating of the PDTA in the light of the BCP, the preparation of exercises aimed at guaranteeing the business continuity objectives, and, finally, the awareness of our stakeholders regarding its correct application.</em></p> <p><em>Conclusions: With a business continuity management (BCM) system, companies take preventative measures to ensure they can start operations again quickly in an emergency. An exhaustive BIA in a hospital company reveals the effects when processes fail, how critical each process is for the company, and the amount of time required to get up and running again, thus providing the organization with important information for risk management. The measures for handling risks derived from this analysis are incorporated into a BCM system where the emergency plans are defined, too, so that business operations continue even in the event of an emergency.</em></p> Lucio Dell’Atti Roberto Papa Leonardo Incicchitti Maria Katia Zanni Andrea Zampa Michele Caporossi Copyright (c) 2024 Journal of Emergency Management 2024-02-27 2024-02-27 22 7 45 52 10.5055/jem.0791 Hurricane season hindsight 2020: Applying the IDEA model toward local tropical cyclone forecasts https://wmpllc.org/ojs/index.php/jem/article/view/3577 <p><em>Hurricane Laura began as a disorganized tropical depression in August 2020. Early forecast guidance showed that the tropical cyclone could either completely dissipate or strengthen to a major hurricane as it approached the United States Gulf Coast. While this uncertainty was known by meteorologists, it was not necessarily communicated to the public in a direct manner. As it turned out, the worst-case scenario was the correct one. The tropical depression rapidly intensified and made landfall near Cameron, Louisiana, with sustained winds of 150 mph, making Laura a Category 4 hurricane on the Saffir–Simpson scale. Laura’s rapid intensification caught some people off guard. Ideally, weather forecasts would have begun warning Louisiana residents to prepare for the possibility of a devastating hurricane in the early stages of tropical cyclone development. No one is suggesting that meteorologists did anything wrong. However, with the benefit of hindsight and decades of scholarly research in risk communication, we can speculate how an ideal forecast would have been written. This paper demonstrates that there are some simple considerations that could be made that might better alert the public to future hurricane worst-case scenarios, even in uncertain situations. </em></p> Robert Eicher Copyright (c) 2024 Journal of Emergency Management 2024-02-27 2024-02-27 22 7 33 44 10.5055/jem.0817