1 10 201 https://repository.horizon.ac.id/files/original/066a6d20b2713bd22d22f929c8ae7f5d.pdf c915f5084332577badee59b4028c83d4 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 18 Issue 1 2025 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 A case of stroke as a unique sign of subclinical infective endocarditis by Abiotrophia defectiva: a case report Subject The topic of the resource Abiotrophia defectiva, Infective endocarditis, Valve replacement, Blood cultures, MALDI-TOF, Case report Description An account of the resource Abstract Purpose Here we describe a patient admitted for a stroke that was unexpectedly correlated with subclinical infective endocarditis attributable to a rarely opportunistic pathogen, Abiotrophia defectiva. Case report A 75-year-old man presented with a stroke. Transesophageal echocardiography suggested vegetation on all aortic valve cusps, despite the absence of clinical or laboratory signs of infection. Surprisingly, three sets of blood cultures collected without fever were positive for A. defectiva. Although the patient did not exhibit classic signs of infection during hospitalization, the severity of the valve condition necessitated replacement with a bioprosthesis. Conclusions This clinical case underscores the importance of investigating the infective origin of endocarditis, even in the absence of clinical or laboratory evidence. Physicians should maintain a high level of suspicion, especially in patients with highly suggestive anamnestic characteristics. Keywords Abiotrophia defectiva, Infective endocarditis, Valve replacement, Blood cultures, MALDI-TOF, Case report Creator An entity primarily responsible for making the resource Silvia Puxeddu1 , Valeria Virdis2 , Daniele Sacco2 , Mario Depau2*, Alessandro M. Atzei3 , Lorella Pisano4 , Marcello Di Rosa2 , Stefania Vacquer2 , Giorgio Accardi5 , Emiliano M. Cirio4 , Aldo Manzin1 , Cristiana Marinelli2 and Fabrizio Angius1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00814-6 Date A point or period of time associated with an event in the lifecycle of the resource 2025 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 Abiotrophia defectiva, Infective endocarditis, Valve replacement, Blood cultures, MALDI-TOF, Case report https://repository.horizon.ac.id/files/original/11dc45d851c0accca1d7780c8d452f28.pdf 78d65d9f3461e309ce37edd699e1189e 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 18 Issue 1 2025 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 A comparison of outcomes between transferred patients versus patients wh o presented directly to the emergency department with necrotizing fasciitis Subject The topic of the resource Necrotizing fasciitis, Operative report, Soft tissue infection, Cellulitis, Skin abscess Description An account of the resource Abstract Introduction Necrotizing Fasciitis (NF) is a rare life-threatening bacterial infection that necessitates emergent resuscitation and operative intervention. Most of the literature has emphasized the need for early surgical intervention. This is problematic for patients being treated at a facility lacking surgical support, with concerns for increasing mortality and morbidity rates. Methods This is a 10-year retrospective study of emergency department (ED) documentation and surgical operative reports of patients seen at Arrowhead Regional Medical Center from January 1, 2011, to December 31, 2020. The patients were divided into two groups: the Transfer Group (TG), consisting of those transferred from another facility, and the Direct Admit Group (DAG), comprising those who presented directly to the ED. A comparison was conducted to identify statistically significant differences between the 2 groups of patients with a final diagnosis of NF, with specific emphasis on mortality rate, hospital length of stay (LOS), and intensive care unit (ICU) LOS. Results A total of 134 patients with a confirmed diagnosis of NF were included in the final analysis. More than half (50.8%, n=68) of the patients presented as transfers from area hospitals. Compared to the DAG, the TG had a significantly higher percentage of patients undergoing surgical intervention within six hours of ED presentation (95.6% vs. 10.6%, respectively; p<0.0001). The TG had a lower mortality rate compared to the DAG (11.8% vs. 22.7%), though the difference did not reach statistical significance. There was no statistically significant difference in hospital LOS (13 days vs. 13.5 days, p=0.9046) or ICU LOS (3 days for both groups, p=0.4845) between these two groups. Conclusion Aggressive management with broad-spectrum antibiotics and intravenous fluid resuscitation may mitigate the effect on mortality in patients with necrotizing fasciitis when prompt surgical intervention is not available. Keywords Necrotizing fasciitis, Operative report, Soft tissue infection, Cellulitis, Skin abscess Creator An entity primarily responsible for making the resource Michael M. Neeki1,2,3*, Fanglong Dong1,2,3, Louis Tran1,2,3, Aldin Malkoc1,2,3, Joseph Kim1,2,3, Sarah C. Neeki1,2,3, Suraj Patel1,2,3, Niluk Leon Senewiratne1,2,3, Mariel Ma1,2,3, Cynthis Wong1,2,3, Rodney Borger1,2,3 and David Wong1,2,3 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00848-w Date A point or period of time associated with an event in the lifecycle of the resource 2025 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 Necrotizing fasciitis, Operative report, Soft tissue infection, Cellulitis, Skin abscess https://repository.horizon.ac.id/files/original/aac8ac7d31a5975a870db1760f85c01f.pdf f4e540c6e121bfe3ad108f4648cd3635 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 18 Issue 1 2025 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 A comparison of SIEVE, SORT, and START triage training effectiveness between immersive interactive 3D learning materials using virtual reality (VR-SSST) and traditional methods in mass casualty incidents Subject The topic of the resource Virtual reality, Disaster triage, Sieve triage, Sort triage, Start triage, Mass casualty incidents, ARCS model Description An account of the resource Abstract Introduction Disaster triage is a crucial competency for paramedics. Traditional training methods, such as lectures and tabletop exercises (TTx), may not provide immersive and high-pressure experience necessary for optimal skill development. Virtual reality (VR) is innovative, allowing trainees to engage in realistic triage simulations in a controlled, interactive environment. Objective The study aimed to compare the effectiveness of VR-based triage training and traditional methods by assessing knowledge, learner motivation, and practical skills through pre-and post-tests, the ARCS model, and live simulations. Methods This method-oriented, randomized study was conducted over a 2-week intervention among 83 paramedic students and compared traditional lecture-based (n=41) with VR-based (n=42) training for MCI triage education among paramedic students at the Faculty of Medicine, Ramathibodi Hospital, Mahidol University. Both groups attended lectures. Knowledge was assessed through validated pre- and post-tests in four domains: memory, comprehension, application and analysis. Learner motivation was evaluated using the ARCS model (Attention, Relevance, Confidence, Satisfaction), and practical skills were measured during live simulations, assessing time use and a validated accuracy score that included triage steps, proper sequencing, and the correctness of triage judgment. Results Both groups demonstrated significant improvements in post-test knowledge scores. The VR group scored higher across all ARCS model dimensions: attention (4.78 vs. 4.17, p<0.001), relevance (4.79 vs. 4.37, p<0.001), confidence (4.74 vs. 4.24, p<0.001), and satisfaction (4.71 vs. 4.34, p<0.001). In the practical triage assessment, the VR group achieved higher accuracy in SORT triage (14.39 vs. 12.09, p=0.001) than the traditional group. Creator An entity primarily responsible for making the resource Kritsada Chumvanichaya1 , Chaiyaporn Yuksen1 , Promphet Nuanprom2 and Kasamon Aramvanitch1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00850-2 Date A point or period of time associated with an event in the lifecycle of the resource 2025 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 Virtual reality, Disaster triage, Sieve triage, Sort triage, Start triage, Mass casualty incidents, ARCS model https://repository.horizon.ac.id/files/original/615312723f2492a434b474628b3f22ec.pdf 3befc19c958ec485b8bf20d67d4bbdbb 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 18 Issue 1 2025 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 A dramatic case: fatal air embolism due to intraosseous puncture Subject The topic of the resource Emergency vascular access, Intraosseous puncture, Air embolism Description An account of the resource Abstract Background Intraosseous access is a commonly used method for establishing vascular access in preclinical emergency care. It is often used when peripheral access cannot be established due to shock. Pressure infusions are used to overcome the resistance provided by the medullary cavity in order to achieve high flow rates needed for effective resuscitation. However, the literature to date does not seem to adequately describe the potential risks. In particular, air embolism is a potentially rare short-term fatal complication. The case We report on an elderly woman who lay comatose on the floor for at least six hours before she was found and given medical attention. In the emergency room, a CT scan showed large amounts of air in her venous system. This air came from an intraosseous line in her left tibia and entered the left pelvic vein, the ventral hepatic veins, the right ventricle and the pulmonary arteries. Despite all conservative measures, the patient died 18hours later as a result of the air embolism. Discussion To date, there is no meaningful data in the literature on the use of pressure infusions via intraosseous access. The case described here highlights the risk of serious complications, which are probably underrepresented in the literature. There is an urgent need for self-reflection when dealing with this type of access and a necessity to develop clear guidelines regarding the inspection of connected systems and immediate emergency therapeutic measures. Conclusion This case highlights the critical importance of careful use of intraosseous access, especially in situations with numerous other challenges that can cause distractions. Wherever possible, connection to the pressure device should be avoided rather than prescribed as an absolute requirement. Keywords Emergency vascular access, Intraosseous puncture, Air embolism Creator An entity primarily responsible for making the resource Maximilian Muench1 , Luisa Schonhart1 , Konrad Steinestel2 , Daniel Gagiannis1 and Josefine Christine Baudrexl1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01066-0 Date A point or period of time associated with an event in the lifecycle of the resource 2025 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 vascular access, Intraosseous puncture, Air embolism https://repository.horizon.ac.id/files/original/cd85b6d931b6b4cee6df609ba05dea53.pdf 3befc19c958ec485b8bf20d67d4bbdbb 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 18 Issue 1 2025 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 A dramatic case: fatal air embolism due to intraosseous puncture Subject The topic of the resource Emergency vascular access, Intraosseous puncture, Air embolism Description An account of the resource Abstract Background Intraosseous access is a commonly used method for establishing vascular access in preclinical emergency care. It is often used when peripheral access cannot be established due to shock. Pressure infusions are used to overcome the resistance provided by the medullary cavity in order to achieve high flow rates needed for effective resuscitation. However, the literature to date does not seem to adequately describe the potential risks. In particular, air embolism is a potentially rare short-term fatal complication. The case We report on an elderly woman who lay comatose on the floor for at least six hours before she was found and given medical attention. In the emergency room, a CT scan showed large amounts of air in her venous system. This air came from an intraosseous line in her left tibia and entered the left pelvic vein, the ventral hepatic veins, the right ventricle and the pulmonary arteries. Despite all conservative measures, the patient died 18hours later as a result of the air embolism. Discussion To date, there is no meaningful data in the literature on the use of pressure infusions via intraosseous access. The case described here highlights the risk of serious complications, which are probably underrepresented in the literature. There is an urgent need for self-reflection when dealing with this type of access and a necessity to develop clear guidelines regarding the inspection of connected systems and immediate emergency therapeutic measures. Conclusion This case highlights the critical importance of careful use of intraosseous access, especially in situations with numerous other challenges that can cause distractions. Wherever possible, connection to the pressure device should be avoided rather than prescribed as an absolute requirement. Keywords Emergency vascular access, Intraosseous puncture, Air embolism Creator An entity primarily responsible for making the resource Maximilian Muench1 , Luisa Schonhart1 , Konrad Steinestel2 , Daniel Gagiannis1 and Josefine Christine Baudrexl1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01066-0 Date A point or period of time associated with an event in the lifecycle of the resource 2025 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 vascular access, Intraosseous puncture, Air embolism https://repository.horizon.ac.id/files/original/b814b2843ea0fe76db5744514f96d569.pdf 02c3f55fdff9846b8a3dd4bb8f41641e 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 18 Issue 1 2025 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 A fatal case of acute Marchiafava-Bignami disease complicated by acute abdomen– a case report Subject The topic of the resource Chronic alcohol consumption, Ethanol toxicity, Altered mental state, Emergency department Description An account of the resource Abstract Background Marchiafava-Bignami Disease (MBD) is a rare disorder characterized by demyelination and necrosis of the corpus callosum, with only 300 documented cases worldwide. Chronic alcohol consumption and vitamin B-complex deficiencies are contributing factors. Acute cases may present with a range of neurological symptoms, including seizures and coma. Subacute and chronic forms can lead to interhemispheric disconnection syndrome and progressive dementia. Case presentation We present the case of a young male patient’s first hospital admission due to an acute decline in conscious level. A detailed history revealed regular alcohol consumption and substandard living conditions. The deterioration in consciousness was attributed to the diagnosis of MBD based on neurological signs, characteristic brain imaging findings, and a history of alcohol use. In addition, a small bowel perforation was also diagnosed. Supportive therapy and thiamine were initiated, and the patient was transferred to surgery for an operation. After two surgeries, the perforation was covered. The patient’s level of consciousness showed slight improvement; however, the psychiatrist noted severe cognitive deficits. Ultimately, the patient entered a septic state and passed away. Conclusion Acute MBD can potentially cause altered mental state, coma, and death; however, cases can be complicated by other emergency conditions. This case demonstrates the importance of a multidisciplinary approach. Keywords Chronic alcohol consumption, Ethanol toxicity, Altered mental state, Emergency department Creator An entity primarily responsible for making the resource Bence Prohászka1*, Novák Pál Kaposi2 , Zsuzsanna Jánosi2 , Bence Gunda3 , Ildikó Pákozdy1 , Szabolcs Gaál-Marschal1 , Dóra Melicher1 , Bánk G. Fenyves1 and Csaba Varga1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00873-9 Date A point or period of time associated with an event in the lifecycle of the resource 2025 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 Chronic alcohol consumption, Ethanol toxicity, Altered mental state, Emergency department https://repository.horizon.ac.id/files/original/36cd3a853ea5723b053064f8e4f064d6.pdf 19fae088e81df2ecc41a36f86c7545f5 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 18 Issue 1 2025 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 A hidden danger: lung abscess following inhalation of kerosene-based pyrethroid insecticide spray Subject The topic of the resource Chemical pneumonitis, Lung abscess, Hemoptysis, Pyrethroid insecticides, Kerosene Description An account of the resource Abstract Background Pyrethroid insecticides are widely used because of their low toxicity in humans. Spray-type pyrethroids are often formulated with kerosene as a carrier solvent, and inhalation of kerosene-containing products can lead to pneumonitis and the formation of lung abscesses. We report a case of chemical pneumonitis resulting in the development of a lung abscess due to the intentional inhalation of pyrethroids. Case presentation A man in his 50s in a psychiatric hospital for transient psychotic disorder attempted suicide during an overnight leave from the hospital. He drank sodium hypochlorite, put a nylon bag over his head, and sprayed pyrethroid insecticide inside the bag. He was found collapsed and was transported to our emergency room. On arrival, his SpO2 was 100% on O2 at 10 L/min by mask (100% on room air at ambulance arrival), his circulation was stable, and his Glasgow Coma Scale score was 10 (E1V3M6), which improved to 15 (E4V5M6) in about one hour. A chest computed tomography (CT) scan showed ground-glass shading in both lungs. We diagnosed him as having pneumonia and started antimicrobial therapy. On day 13 of hospitalization, we found multifocal hypo- absorptive areas, and a diagnosis of lung abscess was made based on CT imaging, and antimicrobial therapy was continued. During the hospitalization, he expectorated bloody sputum. A contrast chest CT scan obtained on day 71 of hospitalization showed a pseudoaneurysm in the abscess cavity, for which we performed successful transcatheter coil embolization. On day 77, the abscess was shrinking, and he was transferred to another hospital for continued treatment. However, he again had bloody sputum and was transferred back to our hospital on day 113. Another contrast chest CT scan revealed the formation of a new aneurysm, and on day 114, we successfully performed coil embolization again, and he was transferred back to the other hospital on day 116. Conclusion Spray-type pyrethroid insecticides contain the organic solvent kerosene. Inhalation of kerosene has been reported in several cases of chemical pneumonitis leading to lung abscess. Clinicians should pay attention to kerosene contained in insecticides and the circumstances under which they are used. Early recognition and aggressive treatment can likely prevent severe outcomes. Keywords Chemical pneumonitis, Lung abscess, Hemoptysis, Pyrethroid insecticides, Kerosene Creator An entity primarily responsible for making the resource Kohei Ofune1 , Tomoya Hirose1*, Hiroki Kai1 , Yoshinori Yokono1 , Ryosuke Takegawa1 and Jun Oda1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-00829-z Date A point or period of time associated with an event in the lifecycle of the resource 2025 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 Chemical pneumonitis, Lung abscess, Hemoptysis, Pyrethroid insecticides, Kerosene https://repository.horizon.ac.id/files/original/b2528c2e7dcbe51ab92943df17084db9.pdf 253577c003bd094c33ca1ebe906bd01c 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 18 Issue 1 2025 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 A narrative review of the diabetic ketoacidosis and hyperosmolar hyperglycemic state overlap syndrome Subject The topic of the resource Diabetic ketoacidosis, Hyperosmolar hyperglycemic state, Overlap syndrome, Euglycemic DKA, Hyperglycemic emergencies Description An account of the resource Abstract Background Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are life-threatening acute complications of diabetes. Up to one-third of patients present with overlapping features of both syndromes, complicating diagnosis and management. This overlap is associated with higher mortality than isolated DKA or HHS. Objective This narrative review synthesizes current evidence on the epidemiology, pathophysiology, and management of DKA-HHS overlap in both adult and pediatric populations with either type 1 or type 2 diabetes, highlighting the distinct challenges in recognition, treatment, and outcomes across these groups. Findings While DKA is defined by ketosis and metabolic acidosis, and HHS by profound hyperglycemia and hyperosmolality, overlap presentations combine both abnormalities. These patients face increased risks of cerebral edema, thromboembolism, and acute kidney injury. Standardized management protocols remain lacking, and treatment must balance fluid resuscitation, insulin therapy, and electrolyte correction, with distinct approaches for adults and children. Emerging issues such as SGLT2 inhibitor–induced euglycemic DKA and disparities in outcomes between high- and low-resource settings further complicate care. Conclusion DKA-HHS overlap represents a high-risk clinical phenotype requiring early recognition and individualized therapy. Consensus guidelines, risk stratification tools, and studies of fluid and insulin strategies are urgently needed to improve outcomes in this vulnerable population. Keywords Diabetic ketoacidosis, Hyperosmolar hyperglycemic state, Overlap syndrome, Euglycemic DKA, Hyperglycemic emergencies Creator An entity primarily responsible for making the resource Eslam Abady1 , Panos I. Tamvakologos2 , Marina Ramzy Mourid3 , Salma Tamer Abdelrahman4 , Mayam Mohamed Aziz5 , Shree Rath6 , Lauren A. Carr7 and Mohammed Alsabri8* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01078-w Date A point or period of time associated with an event in the lifecycle of the resource 2025 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 Diabetic ketoacidosis, Hyperosmolar hyperglycemic state, Overlap syndrome, Euglycemic DKA, https://repository.horizon.ac.id/files/original/2d6a59c369f84f5fc8c68b877a171bd2.pdf b8c1a4ffdc6eb1d46c854403fc2eb6ab 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 18 Issue 1 2025 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 A novel scoring algorithm for chest pain can effectively support the diagnosis of acute coronary syndrome in prehospital settings: a cross-sectional study Subject The topic of the resource Acute coronary syndrome, Chest pain, Emergency medical technicians, Optimizing patient transport, Risk assessment Description An account of the resource Abstract Background Early identification of acute coronary syndrome (ACS) in prehospital settings is crucial for optimal patient outcomes. However, existing risk assessment tools require laboratory data, making them unsuitable for prehospital use. Therefore, emergency medical technicians (EMTs) lack appropriate tools for prehospital ACS assessment and must rely on individual diagnostic skills, despite the importance of reducing prehospital time. To address this issue, a novel scoring system—Nagasaki Prehospital Chest Pain Assessment & Risk Determination (N-CARD)—was developed using only prehospital information and validated for use by EMTs, with the aim of improving patient outcomes and optimizing healthcare resource utilization. Methods In total, 584 participants with chest pain or suspected cardiac etiology who underwent a prehospital 12-lead electrocardiogram (ECG) between April 2023 and March 2024 were analyzed. The prehospital diagnostic score for ACS, N-CARD score, was developed using logistic regression based on the following variables: age, pain location, pain type, pain duration, coronary risk factors, and 12-lead ECG findings. Modeling was performed separately for high- risk and low-risk groups based on prior coronary artery disease (CAD) history. The model’s performance was internally validated using bootstrap methods. Results The N-CARD scoring system was developed separately for participants without (N=433) and with (N=151) a history of CAD. The score ranged from −1 to 10 for those without a history of CAD and 0 to 32 for those with a history of CAD. For participants without a history of CAD, scores≥6 suggested ACS (specificity>90%), whereas scores≤3 suggested non-ACS (sensitivity>90%), with an optimism-corrected area under the curve (AUC) of 0.90. For participants with a history of CAD, scores≥24 suggested ACS, whereas scores≤6 suggested non-ACS, with an optimism-corrected AUC of 0.69. Creator An entity primarily responsible for making the resource Keita Iyama1*† , Shuntaro Sato2†, Ryohei Akashi3 , Kensho Baba4 , Koichi Hayakawa1,5, Satoshi Ikeda3 , Koji Maemura3 and Osamu Tasaki1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01019-7 Date A point or period of time associated with an event in the lifecycle of the resource 2025 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 https://repository.horizon.ac.id/files/original/2e8161ec7209dc6cfee38933bc0457af.pdf 08b3eaa9e1aa4706c8798254cf9d76aa 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 18 Issue 1 2025 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 A novel tool for assessing pediatric emergency care in low- and middle-income countries: a pilot study Subject The topic of the resource Pediatric emergency medicine, Pediatric readiness, Low-income countries, Middle-income countries, Health resources / supply and distribution Description An account of the resource Abstract Background Globally, most children seek emergency care at general rather than specialized pediatric emergency departments. There remains significant variation in the provision of pediatric emergency care, particularly in resource- constrained settings. The objective of this study is to pilot a self-assessment tool to evaluate pediatric emergency care capabilities in low- and middle-income country (LMIC) hospitals on the African Continent. Methods This was a prospective cross-sectional descriptive study using a convenience sample of sub-Saharan African hospitals. The assessment tool was developed by operationalizing the technical contents of existing stand- ards and guidelines from international bodies including the World Health Organization and International Federa- tion of Emergency Medicine. The pilot was conducted at emergency departments located across different regions on the African continent. Descriptive statistics were used to evaluate different domains of pediatric emergency care capabilities including pediatric triage, protocols, staffing, training, equipment, consumables, and medicines. Results Sixteen hospitals with emergency departments completed the assessment tool (participation rate of 76%). The hospitals were in nine different countries across four regions of sub-Saharan Africa. National/academic hospitals comprised 56.3% of the participating hospitals. The majority, 44%, of these hospitals saw pediatric patient volumes of 2,000–4,999 patients per year. Dedicated pediatric triage spaces and resuscitation spaces were available at 37.5% and 56.3%, respectively. Formal pediatric resuscitation guidelines were used at 62.5%. Doctors on the self-assessment teams came from primarily pediatrics and general practitioner training backgrounds (both 68.8%). Basic respiratory and airway support equipment (e.g. oxygen, bag-valve mask devices) were available in all participating hospitals, whereas advanced airway equipment (e.g. pediatric intubation equipment) was available in 37.5% of hospitals. Most medicines from the World Health Organization Essential Medicines list were available at participating hospitals. Conclusions To date, this is the first assessment tool dedicated to the comprehensive evaluation of pediatric emergency care in LMICs. This pilot provides a first approach to evaluate pediatric emergency healthcare capabilities in the hospital setting with future directions to improve the tool based on qualitative feedback. Keywords Pediatric emergency medicine, Pediatric readiness, Low-income countries, Middle-income countries, Health resources / supply and distribution Creator An entity primarily responsible for making the resource Sonia Y. Jarrett1*, Andrew Redfern2 , Joyce Li1 , Camilo E. Gutierrez3 , Priyanka Patel4 , Olurotimi Akinola5 and Michelle L. Niescierenko1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-024-00802-2 Date A point or period of time associated with an event in the lifecycle of the resource 2025 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 Pediatric emergency medicine, Pediatric readiness, Low-income countries, Middle-income countries,