1 10 43 https://repository.horizon.ac.id/files/original/c8b41b8de87909562f9e4a5ebe471d71.pdf 1584b62ee0cbbb861271f33b988b7c41 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource volume 26 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Psychosocial risk factors in primary care workers of the health organizations of Áraba and Basurto (Spain) Subject The topic of the resource Health sector; Occupational stress; Risk factors; Workload/psychology; Workplace/psychology Description An account of the resource Psychosocial factors are one of the main determinants of health in our environment and are considered an emerging risk in this new millennium.The objectivewas to know the psychosocial risk factors with the greatest impact on primary care workers in the integrated health organizations of Áraba and Basurto and to analyze the factors with the greatest impact Creator An entity primarily responsible for making the resource Míriam Luis-Martínez1, Naiara Echevarría-Monrea Source A related resource from which the described resource is derived https://www.ejohn.eu/index.php/et/article/view/46/32 Publisher An entity responsible for making the resource available OHN. Castro Urdiales. Cantabria, Spain.2.OHN. Pamplona. Navarra, Spain Date A point or period of time associated with an event in the lifecycle of the resource March22, 2025 Contributor An entity responsible for making contributions to the resource Fajar Bagus Wijanarko Format The file format, physical medium, or dimensions of the resource pdf Language A language of the resource english Type The nature or genre of the resource text https://repository.horizon.ac.id/files/original/756589aa451ffc314dac2e3b53a923a9.pdf ba96b12d1696993a4814bb365d3fb0ea Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource volume 26 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource ChatGPT-4o assists emergency physicians in enhancing diagnostic accuracy for fever of unknown origin: retrospective analysis Subject The topic of the resource Fever of unknown origin, ChatGPT-4o, Emergency medicine, Artificial intelligence Description An account of the resource Objective To evaluate ChatGPT-4o’s diagnostic accuracy for fever of unknown origin (FUO) compared to emergency physicians and assess its utility as an adjunctive diagnostic tool. Methods This retrospective analysis included 60 adult patients presenting to the emergency department (ED) with FUO (fever≥38.3°C for ≥3 weeks without diagnosis after initial evaluation). Only patients with a confirmed final discharge diagnosis were included; FUO cases remaining undiagnosed at discharge were excluded. ChatGPT-4o and emergency medicine (EM) physicians independently generated preliminary diagnoses and comprehensive diagnoses. Diagnostic accuracy was compared against final discharge diagnoses. EM physicians subsequently revised their diagnoses after reviewing ChatGPT-4o’s output. Statistical analysis employed Welch’s ANOVA. Results ChatGPT-4o significantly outperformed EM residents in both preliminary (70.0% vs. 46.11%; 95% CI, 57.6%-79.9% vs. 34.4%-59.3%, P=0.008) and comprehensive diagnoses (75.0% vs. 55.0%, 95% CI, 62.9%-84.1% vs. 42.5%-66.9%, P=0.002). While numerically higher than EM specialists in both preliminary (70.0% vs. 57.78%) and comprehensive diagnoses (75.0% vs. 68.89%), these differences did not demonstrate consistent statistical superiority. Incorporating ChatGPT-4o’s suggestions significantly improved accuracy for both EM residents (preliminary: 67.78% vs. 46.11%, 95% CI, 55.8%-78.6% vs. 34.4%-59.3%, P=0.002; comprehensive: 78.33% vs. 55.0%, 95% CI, 66.8%-86.6% vs. 42.5%-66.9%, P=0.01) and specialists (preliminary: 70.22% vs. 57.78%, P=0.023), though the improvement in specialists’ comprehensive diagnoses remained non-significant (80.89% vs. 66.67%, P=0.076). Stratified analysis showed that ChatGPT-4o significantly improved diagnostic accuracy across major etiologic categories, including infectious (76.0% vs. 59.4%, P=0.003) and cancer-related causes (72.2% vs. 50.0%, P<0.001). Conclusions ChatGPT-4o demonstrates potential to augment FUO diagnosis, particularly aiding less experienced clinicians. While this study highlights AI’s complementary value, prospective trials are needed to validate its impact on clinical efficiency. Creator An entity primarily responsible for making the resource Hui Long1,2, Guoqing Huang1,2, Xinbo Yin1,2, Xiaojie Zheng1 , Sijia Cao1 , Nan Wang1 , Xiangmin Li1,2 and Xiaokai Wang1,2* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12873-026-01477-z Date A point or period of time associated with an event in the lifecycle of the resource 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Fever of unknown origin, ChatGPT-4o, Emergency medicine, Artificial intelligence https://repository.horizon.ac.id/files/original/724d8d55c00134b046e8d32a0bea6e17.pdf 5040e2ff648c4e7442cb058a1d208eb2 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource volume 26 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Learning from the past: a scoping review of hospital disaster preparedness assessment Subject The topic of the resource Emergency planning, Hospital disaster preparedness, Hospital resilience, Preparedness gaps, Scoping review Description An account of the resource Background Despite the recognized importance of hospital disaster preparedness (HDP), efforts to improve it have been limited. Improvement in HDP will need an in-depth comprehension of the prevailing gaps in addition to evidence of the best practices. However, a comprehensive review that synthesizes the findings from HDP assessments across diverse contexts and translates them into actionable insights is currently lacking. Considering these gaps, this scoping review aims to examine current practices, identify recurring gaps, consolidate best practices, and provide actionable recommendations through an in-depth literature review. Methods A scoping review was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search strategy using keywords related to HDP was carried out in three databases: PubMed, Scopus, and Web of Science. Eligibility criteria were defined according to the population, intervention, comparison, and outcome. The search included studies from January 2015 to December 2024. Screening and data extraction were done by two independent reviewers, and the extracted data were subjected to a narrative synthesis. Data extraction and analysis were manually performed using Excel. Results 46 eligible articles were identified from 10,656 records, the majority from Iran and Saudi Arabia. Cross- sectional studies dominated, and the majority utilized the hospital safety index tool. Two-thirds of hospitals reported a moderate level of preparedness. Substantial variability in hospital safety scores was observed, with structural safety ranging from 28% to 76.16%, nonstructural safety from 17.02% to 73.2%, and functional preparedness from 11.35% to 95%. Most hospitals lacked adequate structural safety, backup communication systems, proper safety measures for furniture and medical equipment, training programs, comprehensive emergency planning, staff welfare strategies, and adequate logistics and supplies. Conclusions HDP should be viewed as an evolving, ongoing process, requiring a balanced HDP framework that addresses all aspects of preparedness, region-specific guidelines tailored to the unique needs and risks of the hospital, and context-driven interventions to enhance hospital resilience. Creator An entity primarily responsible for making the resource Prinka Singh1,2† , Sujan Sapkota3*† , Nebil Achour4 , Luca Ragazzoni1,2 and Hamdi Lamine5 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12873-026-01474-2 Date A point or period of time associated with an event in the lifecycle of the resource 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Emergency planning, Hospital disaster preparedness, Hospital resilience, Preparedness gaps, Scoping review https://repository.horizon.ac.id/files/original/106b30ec2cb4223ca29bf71c49dcb74c.pdf 232dedc45cbad75f93cd748de38e73fe Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource volume 26 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Construction of an index system for assessing emergency department overcrowding in Chinese tertiary hospitals: a Delphi study Subject The topic of the resource Delphi method, Emergency department, Crowding, Assessment, Index system Description An account of the resource Background Emergency department crowding (EDC) is a global public health crisis associated with adverse patient- and physician-related events. Currently, a reliable EDC assessment tool is lacking in China, as existing international models cannot be directly adapted owing to differences in healthcare systems, data accessibility constraints, and national policy contexts. The issue is multifactorial, data are difficult to obtain, and EDC varies regionally and temporally. Therefore, we developed a crowding assessment index system for tertiary hospital emergency departments in China, aiming to support the development of quantitative models suited to local conditions and formulation of related policies. Methods This study used two rounds of Delphi surveys involving a multidisciplinary expert panel from China, with expertise in emergency care crowding research and management. Experts rated 96 presumptive assessment indicators. The index system’s reliability was assessed by evaluating the experts’ enthusiasm, degree of authority, and degree of consistency and coordination in their opinions. The core EDC indicators were screened and optimised based on the boundary value method, with decision rules including coefficient of variation<0.25 and full-score ratio≥50%, referenced from prior Delphi studies. The final assessment system was established after modifying the indicators per the experts’ opinions. Data were summarised using descriptive statistics. Results All 16 invited and eligible panellists participated (response rate, 100% in both rounds); the authority coefficient was 0.85. Most were aged>40 years (14/16 [88%]), and the sex distribution was equal (eight men, eight women). Panellists achieved consensus on 3 primary, 8 secondary, and 56 tertiary indicators for EDC assessment. The three primary indicators included the emergency department ‘input-process-output’ phases. The input indicators included patient (e.g., age) and temporal (e.g., day or night) characteristics. The process indicators covered resource requirements (e.g., intravenous infusions), resource supply (e.g., doctor–patient ratio), and process efficiency (e.g., Creator An entity primarily responsible for making the resource Zhen Ren1†, Nengyuan Xu1†, Yilan Yang1 , Shu Li1 , Hua Zhang2 , Lijun Wang3 , Yessai Negati Mu4 , Wei Chong5 , Ping Zhou6 , Longfei Pan7 , Guoxing Wang8 , Xiaojing Li9 , Yan Li10, Wencao Liu11, Hongxuan Liu12, Bin Xu13, Yinzi Jin14, Li Ma1 , Guilong Feng15* and Qingbian Ma1* Date A point or period of time associated with an event in the lifecycle of the resource 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Delphi method, Emergency department, Crowding, Assessment, Index system https://repository.horizon.ac.id/files/original/b084a230998d0b52b11240fb2e93011f.pdf 7ba569d2a8f60012c4052bc99b78509e Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource volume 26 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Optimal timing of antibiotics administration for sepsis or septic shock in the emergency department Subject The topic of the resource Sepsis, Septic shock, Time to antibiotics (T2A) Description An account of the resource Objectives Early antibiotic administration is considered an important component of sepsis management, yet the optimal time-to-antibiotics (T2A) remains uncertain. This study examined the association between T2A and in-hospital mortality among patients with sepsis and septic shock and explored how this relationship varies across different time intervals. Methods We conducted a retrospective cohort analysis of emergency department patients with sepsis from 1998 to 2022. Patients were dichotomized into two groups (T2A≤1 h vs. T2A>1 h), and clinical characteristics and mortality outcomes were compared. Cox proportional hazards models were used to assess the association between T2A and in-hospital mortality, adjusting for illness severity and other covariates. A non-linear Cox regression model was further applied to characterize the time-dependent relationship between T2A and mortality risk. Results A total of 15,317 patients were included. In-hospital mortality was 35.9% for patients receiving antibiotics within 1 h and 47.4% for those treated after 1 h (P<0.001). After adjustment, T2A≤1 h remained associated with lower mortality (adjusted HR=0.936; 95% CI, 0.891–0.982). Non-linear modeling suggested that mortality risk was generally lower when antibiotics were administered within approximately 3 h, with the lowest estimated hazard observed at around 0.5 h; risk increased more noticeably beyond the 3-hour mark. These patterns were consistent across patients with and without septic shock. Conclusion In this large retrospective cohort, shorter time-to-antibiotics was associated with lower in-hospital mortality, with the most favorable estimates occurring within the first hour and a gradual attenuation of benefit approaching 3 h. These findings provide insight into the time-dependent relationship between antibiotic administration and outcomes in sepsis that warrants further validation before being incorporated into clinical practice recommendations. Creator An entity primarily responsible for making the resource Ming-Shun Hsieh1,2,3,4, Kuan-Chih Chiu5 , Shu-Hui Liao6,7, Vivian Chia-Rong Hsieh8 , Sung-Yuan Hu4,9,10*† and Chorng-Kuang How2,3*† Source A related resource from which the described resource is derived https://doi.org/10.1186/s12873-026-01471-5 Date A point or period of time associated with an event in the lifecycle of the resource 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Sepsis, Septic shock, Time to antibiotics (T2A) https://repository.horizon.ac.id/files/original/4880e1585b58ae16ae7083cca19ab918.pdf 466765ff7276fdc38d424ac05d78d690 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource volume 26 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Performance of a multistate teleradiology service in emergency pediatric and adolescent neuroimaging: a two-year retrospective study Subject The topic of the resource Neuroradiology, Pediatric neuroradiology, Teleradiology, Pediatric imaging, Emergency Description An account of the resource Introduction Pediatric neuroradiology expertise is limited in many healthcare facilities, especially in the emergency setting. Teleradiology offers a promising solution by providing remote access to subspecialty interpretation. Our study aimed to evaluate the performance and outcomes of a teleradiology service for emergency pediatric neuroradiology across multiple U.S. states. Methods We conducted a retrospective analysis of pediatric head/brain and spine computed tomography (CT) and magnetic resonance (MR) studies transmitted from 107 hospitals across 17 U.S. states to a teleradiology service from January 2023 to December 2024. Primary outcomes included turnaround time (TAT), diagnostic yield, and demographic patterns. Statistical analyses included descriptive statistics, confidence intervals, and comparative testing with appropriate effect size calculations. Results A total of 9,985 scans from 7,958 patients (57.3% male, mean age 11.08 years) were analyzed. CT studies formed 96.8% of cases with mean TAT of 37.5 min (95% CI: 37.1–37.9), while MR studies averaged 61.2 min (95% CI: 57.6–64.8). Overall positive finding rate was 13.4% (95% CI: 12.8–14.1%). Hemorrhage was the most common finding (5.68%), followed by skull fracture (3.17%). Trauma-related findings represented 66.0% of positive cases. Significant differences were observed between CT and MR regarding gender distribution (57.8% vs. 49.4% male, P-value=0.003) and between head versus spine imaging regarding patient age (10.41 vs. 13.43 years, P-value<0.001). Conclusions Teleradiology demonstrated good performance in emergency pediatric neuroradiology with rapid turnaround times and optimal diagnostic yield. Teleradiology successfully bridges expertise gaps across different geographic regions while maintaining high-quality interpretation standards for time-sensitive pediatric neurologic emergencies. Clinical trial registration number Not applicable. Creator An entity primarily responsible for making the resource Mustafa S. Alhasan1,2, Ahmed Y. Azzam3*, James Milburn4,5, Mohammad Khalil6 , Omar A. Alharthi1 , Ayman S. Alhasan1 , Abdullah Almaghraby7 , Neetika Mathur8 and Arjun Kalyanpur2,9 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12873-025-01470-y Date A point or period of time associated with an event in the lifecycle of the resource 2026 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Neuroradiology, Pediatric neuroradiology, Teleradiology, Pediatric imaging, Emergency https://repository.horizon.ac.id/files/original/68609f0050bee7b4c13444e9f6ff0e75.pdf ccbf7f9ac55a9ec7fa068f77b0d61622 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource volume 26 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Association between emergency department bed occupancy rate and in-hospital cardiac arrest in the emergency department: a retrospective study Subject The topic of the resource Emergency department, Crowding, In-hospital cardiac arrest, Bed occupancy rate, EDBOR, Patient safety Description An account of the resource Background In-hospital cardiac arrest (IHCA) is a critical event often preceded by signs of clinical deterioration. Emergency department (ED) overcrowding may compromise timely monitoring and intervention and may be associated with a higher occurrence of IHCA. The ED bed occupancy rate (EDBOR) is a quantifiable indicator of crowding. This study aimed to examine the association between EDBOR and the occurrence of IHCA in the ED. Methods We conducted a retrospective observational study at Thammasat University Hospital from January 2020 to December 2022. EDBOR at the time of IHCA was compared with EDBOR during routine ED operations using a case– control analogue design, with time points as the unit of analysis. Logistic regression was used to assess the association between EDBOR and IHCA occurrence, with additional sensitivity analyses across high-occupancy thresholds. Results During the three-year study period, 54,951 ED visits were recorded. EDBOR at the time of 125 IHCA events and 3,285 control time points was analyzed. Although the mean EDBOR at the time of IHCA was slightly higher than during control periods (75.5% vs. 70.5%), this difference was not statistically significant (p=0.275). Sensitivity analyses across multiple EDBOR thresholds (at least 40%, 50%, 60%, 70%, and 80%) demonstrated a graded association, with a consistently higher likelihood of IHCA at higher occupancy levels. Among time points with EDBOR at least 60%, each 10–percentage-point increase in EDBOR was associated with a 10% increase in the odds of IHCA (adjusted odds ratio 1.10; 95% confidence interval 1.01 to 1.18; p=0.02). Conclusion Elevated EDBOR was significantly associated with an increased occurrence of IHCA in the ED. While causality cannot be inferred from this observational study and the findings should be considered hypothesis- generating, monitoring EDBOR during high-occupancy periods may help inform crowding mitigation strategies and departmental planning, pending validation in future studies. Creator An entity primarily responsible for making the resource Kiattichai Daorattanachai1 , Kornrawee Srisiri1 , Winchana Srivilaithon1 , Chitlada Limjindaporn1 , Kumpol Kornthatchapong1 , Intanon Imsuwan1 , Ittabud Dasanadeba1 and Nipon Diskumpon1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12873-025-01467-7 Date A point or period of time associated with an event in the lifecycle of the resource 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Emergency department, Crowding, In-hospital cardiac arrest, Bed occupancy rate, EDBOR, Patient safety https://repository.horizon.ac.id/files/original/575ef2878fc08de22f1218f49bf17cca.pdf 8b9929eefda766a625b6742caead42d6 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource volume 26 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Electrocardiogram sonification accelerates detection of ST elevation myocardial infarction compared to analysis based solely on visual display: a randomized controlled simulation study with medical students Subject The topic of the resource Electrocardiogram, ECG, ST elevation myocardial infarction, STEMI, Sonification, Biosignal monitoring, Acute coronary syndrome Description An account of the resource Purpose A 12 lead electrocardiogram (ECG) is the standard diagnostic method for the detection of an acute coronary syndrome, as it is also used in emergency medical services. A novel sonification method can convert an important part of the ECG signal into an acoustic signal: The ST segment sonification is particularly useful for the detection of transient ST elevations in patients with suspicion of acute coronary syndrome. A quick and accurate detection of transient ECG changes of the ST segment is prerequisite for proper treatment, thus having immediate therapeutic consequences. Methods As part of an emergency training program, a cohort of n = 44 medical students was recruited to participate in a two-part study. Some of them, namely n = 32 of the total 44 subjects, participated in a second part of the study, an RCT, which we report on here. The diagnostic accuracy recently estimated in a classification study involving all 44 subjects with regard to acoustically presented ECG sequences of varying degrees of severity of ST-elevation myocardial infarction forms the background for the RCT described here. The n = 32 subjects who participated in the RCT were randomly assigned in two-person teams to either an intervention (n = 8 teams of two) or a control (n = 8 teams of two) arm, respectively, whereby all teams, except for one dropout due to a technical failure in the intervention arm, went through an emergency simulation where they had to detect an emerging ST elevation myocardial infarction. The intervention group was endowed with a sonification-assisted equipment whereas the control group used standard visual-based ECG diagnosis only. Results An adjusted multivariable regression yielded a statistically significant reduction for the intervention group of the delay time from starting a first ECG to the correct diagnosis by 163 seconds (p = 0.002) corresponding to Creator An entity primarily responsible for making the resource Jens Tiesmeier1*, Friederike Tielking2 , Steffen Grautoff3,4, Jan Persson2 , Hans H. Diebner5*, Thomas P. Weber6 and Thomas Hermann7 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12873-025-01466-8 Date A point or period of time associated with an event in the lifecycle of the resource 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Electrocardiogram, ECG, ST elevation myocardial infarction, STEMI, Sonification, Biosignal monitoring, Acute coronary syndrome https://repository.horizon.ac.id/files/original/5e3a6528a94ecfdb8eb40856e1852c5c.pdf b85c4435e293753cacbeed7e7cb6d434 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource volume 26 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Early prediction of in-hospital deterioration after emergency department admission using machine learning models Subject The topic of the resource Machine learning, Early warning system, In-hospital deterioration Description An account of the resource Background Early prediction of clinical deterioration in patients admitted to general wards from the emergency department (ED) is crucial for timely interventions and improved outcomes. Traditional scoring systems often fail to account for dynamic physiological changes occurring during ED stays. Machine learning (ML) offers a promising alternative by integrating comprehensive patient data for enhanced predictive capabilities. Objective This study aimed to develop and validate an ML-based early warning system to predict adverse events, including cardiac arrest, mechanical ventilation, or intensive care unit (ICU) transfer, within 48 h of hospitalization. Methods This retrospective multicenter study included data from 169,807 patients across two medical centers to train ML models for predicting adverse events occurring within 48 h of hospitalization. The prediction time origin (T0) was the moment of hospital admission. All ED data obtained before T0 were included as model input, and adverse events were defined as those occurring within 48 h after T0. Three machine learning models were trained and evaluated: logistic regression (LR), random forest (RF), and extreme gradient boosting (XGB). The ML models were evaluated in external test cohorts with 54,515 patients from a regional teaching hospital. Model performance was assessed against traditional early warning scores, including the National Early Warning Score (NEWS) and the Modified Early Warning Score (MEWS), and Modified Sequential Organ Failure Assessment Score (mSOFA) using the area under the curve (AUC). Results In the internal test set, XGB achieved the highest AUC of 0.87 (95% CI: 0.85–0.89), followed by RF 0.85 (95% CI: 0.83–0.87) and LR 0.83 (95% CI: 0.81–0.85), outperforming NEWS (AUC 0.71), MEWS (0.69), and mSOFA (0.69). In the external test set, XGB maintained the best discrimination (AUC 0.82, 95% CI: 0.80–0.83), followed by RF 0.78 (95% CI: 0.77–0.80) and LR 0.77 (95% CI: 0.76–0.79), again exceeding NEWS (0.67), MEWS (0.65), and mSOFA (0.69). SHAP analyses identified respiratory rate and oxygen support as the most influential predictors. Creator An entity primarily responsible for making the resource Chi-Yung Cheng1,2,3†, Ting-Hsuan Hsu1,2†, Yu-Lun Hung1,2, Ting-Yu Hsu1,2, Fu-Jen Cheng1,2, Hsiu-Yung Pan1,2, Chun-Hung Richard Lin3 and I-Min Chiu1,2,3* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12873-025-01464-w Date A point or period of time associated with an event in the lifecycle of the resource 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Machine learning, Early warning system, In-hospital deterioration https://repository.horizon.ac.id/files/original/aad997094e8946f80f978ea67e807173.pdf 1817094a6307a906c0395c9f040ddb42 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource volume 26 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Association between polypharmacy at the emergency department and long-term mortality in critically ill older patients receiving mechanical ventilation: a single- center retrospective cohort study Subject The topic of the resource Polypharmacy, Critical illness, Older adults, Mortality, Emergency medical services Description An account of the resource Background Polypharmacy is increasingly prevalent among older adults, and is associated with adverse health outcomes. However, its prognostic impact in emergency care settings remains unclear, particularly in critically ill older patients requiring mechanical ventilation. Therefore, this study aimed to evaluate the association between polypharmacy at the emergency department and long-term mortality in critically ill older patients who required mechanical ventilation. Methods We conducted a retrospective cohort study of emergency department patients aged≥65 years who received mechanical ventilation at a Japanese university hospital between April 2015 and December 2024. Patients were categorized into a polypharmacy group (≥5 regular medications at admission) or a non-polypharmacy group (fewer medications at admission). Survival was comparatively analyzed using Kaplan–Meier curves and the log-rank test. Cox proportional hazards regression analysis was performed to examine the association between polypharmacy at admission (reference: non-polypharmacy) and long-term mortality while adjusting for age, Charlson comorbidity index, and the Sequential Organ Failure Assessment (SOFA) score modeled as a continuous variable. In addition, we similarly analyzed the association between polypharmacy status at discharge among patients discharged alive and long-term mortality. Results The study cohort comprised 533 patients (non-polypharmacy: 207 patients, polypharmacy: 326 patients). The median follow-up duration was 2.1 months (interquartile range [IQR], 0.6–11.7 months; maximum, 112.7 months). Among patients discharged alive, the median follow-up duration was 3.6 months (IQR, 1.0–19.6 months). After adjustment for age, Charlson comorbidity index, and SOFA score, patients with polypharmacy at admission were not independently associated with all-cause mortality (hazard ratio [HR]: 1.17, 95% confidence interval [CI]: 0.85–1.60). Creator An entity primarily responsible for making the resource Yoshihiro Nakamura1 , Takeshi Umegaki2*, Kota Nishimoto2 , Takashi Muroya1 , Takahiko Kamibayashi2 and Yasuyuki Kuwagata1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12873-025-01463-x Date A point or period of time associated with an event in the lifecycle of the resource 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Polypharmacy, Critical illness, Older adults, Mortality, Emergency medical services