1 10 13010 https://repository.horizon.ac.id/files/original/4246823311a6986dfa4c6f3d3e5739bc.pdf 2c3560437352def72501923772afa559 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 unique case of atraumatic splenic haematoma likely caused by increased intra- abdominal pressure: a case report Subject The topic of the resource Splenic haematoma, Intra-abdominal pressure, Atraumatic Description An account of the resource Abstract Background The spleen is a highly vascular organ, and splenic haematoma is a complication most commonly due to abdominal trauma. Atraumatic splenic haematoma is much rarer and is often associated with underlying pathology such as coagulopathies, malignancies, anatomical abnormalities or use of anticoagulants. This case report highlights a unique case of atraumatic splenic haematoma in a young, healthy male, likely precipitated by increased intra-abdominal pressure from persistent cough and weightlifting. It presents a rare cause of atraumatic splenic haematoma that is not commonly documented in literature. Case presentation The patient is a 21-year-old male, with no known chronic disease. He is a smoker and complained of a persistent cough for the past three months. He presented the day after a gym session, with sudden left hypochondrium tenderness with no history of trauma, vomiting or diarrhoea. Physical exam revealed normal vital signs and generalized involuntary guarding over the entire abdomen. Initial point-of-care ultrasound was negative for free fluid in the abdomen, but a repeat ultrasound three hours later turned positive. Computed tomography scans of the abdomen, pelvis and mesenteric angiogram were then performed. They revealed intraperitoneal blood, a Grade III splenic haematoma involving the superior pole of the spleen towards the inferior pole, but no active bleeding. The patient was admitted for close monitoring. Initial laboratory evaluation did not show any coagulopathy or infection. The patient remained hemodynamically stable throughout his inpatient stay, and was managed conservatively with rest, analgesia, and empirical antibiotics. Serial haemoglobin levels remained stable, and his symptoms resolved with analgesia. As he remained hemodynamically stable, no repeat imaging was performed inpatient. He was subsequently discharged with instructions to avoid strenuous activities for 4 to 6 weeks. An outpatient follow-up was arranged for him, to review symptoms and monitor haemoglobin level. Conclusion This case highlights a rare case of atraumatic splenic haematoma, possibly related to increased intra- abdominal pressure from persistent coughing and weightlifting. Atraumatic splenic haematoma is rare and might be easily overlooked as a diagnosis in the emergency department. Emergency physicians should maintain a high index of suspicion for splenic injury in patients presenting with unexplained left hypochondrium pain, and bedside ultrasonography can aid in assessment and guide the need for further evaluation. Keywords Splenic haematoma, Intra-abdominal pressure, Atraumatic Creator An entity primarily responsible for making the resource Yu Xian Wong1,2*, Yi Wen Mathew Yeo1 and Eleazar Ebreo1 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 Splenic haematoma, Intra-abdominal pressure, Atraumatic https://repository.horizon.ac.id/files/original/797f2394ea18318add4e8eb424cdd4bf.pdf c850734968a9af6317fb2cf7bd2d3d26 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 model for early prediction of in- hospital mortality in seawater drowning: the SNOP score Subject The topic of the resource Drowning, Hospital mortality, Seawater, Sodium, Oxygen saturation, Emergency medicine, Prognostic model Description An account of the resource Abstract Background Drowning is a leading cause of preventable mortality worldwide; however, early in-hospital risk stratification remains limited. Although tools such as the Szpilman score assist in early severity assessment, they may not fully capture the evolving clinical status after admission. This study aimed to develop a simplified and objective model based on readily available parameters to predict in-hospital mortality following seawater drowning. Methods This retrospective study was conducted at a referral emergency department (ED) in northern Turkey between July 1, 2011, and December 31, 2024. Of 190 patients initially included, 166 with complete clinical and laboratory data were analyzed. Data were obtained from institutional and national health information systems. Clinical, physiological, and biochemical variables were assessed. Predictors of in-hospital mortality were identified using receiver operating characteristic (ROC) analysis and multivariable logistic regression. Variables with near-perfect discrimination (e.g., GCS, pH, Szpilman score) were excluded to avoid overfitting. Results Among the 166 patients, 34 (20.5%) died during hospitalization. CPR and endotracheal intubation rates were significantly higher among non-survivors (CPR: 97.1% vs. 0%; intubation: 97.1% vs. 2.3%; both p<0.001). Non- survivors also presented with lower GCS (median 3 vs. 15), lower arterial pH, and higher Szpilman scores (all p<0.001). ROC analysis identified four potential predictors with AUC values between 0.90 and 0.95—pCO2, lactate, SpO2, and sodium—all showing significant discriminatory capacity (p<0.001). These variables were entered into a binary logistic regression model, from which serum sodium (OR=2.110; 95% CI: 1.310–3.401; p=0.002) and SpO2 (OR=0.902; 95% CI: 0.847–0.961; p=0.001) emerged as independent predictors. These formed the basis of the SNOP score (Saturation and Natremia-based Outcome Predictor), a two-parameter logistic model demonstrating excellent performance: AUC=0.996, sensitivity=99.0%, specificity=96.2%, and overall accuracy=98.4%. Conclusion: The SNOP score is a simple, ED-specific tool for early prediction of in-hospital mortality in seawater drowning. It complements existing assessment systems by incorporating objective, admission-based parameters. Prospective multicenter validation is warranted to confirm its clinical applicability and support broader implementation. Creator An entity primarily responsible for making the resource Kıvanç Öncü1* , Özhan Özcan2 , Şeyma Şi̇mşi̇rgi̇l Kara3 , Ayhan Parmaksız4 and Teoman Erşen5 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 Drowning, Hospital mortality, Seawater, Sodium, Oxygen saturation, Emergency medicine, Prognostic model https://repository.horizon.ac.id/files/original/a8a94fe22c03ecb48466ca295d962cc5.pdf feded735a815f2c3a697a0f1f77bbfbf 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 Diagnostic performance of artificial intelligence for dermatological conditions: a systematic review focused on low- and middle-income countries to address resource constraints and improve access to specialist care Subject The topic of the resource Dermatology, Artificial Intelligence, Low- and Middle-Income Countries, Convolutional Neural Networks, Diagnosis Description An account of the resource Abstract Background Artificial Intelligence (AI) has emerged as a transformative tool in dermatology, particularly in Low- and Middle-Income Countries (LMICs), where healthcare systems face challenges such as a shortage of dermatologists and limited resources. AI technologies, including deep learning models like Convolutional Neural Networks (CNNs), have demonstrated potential in improving diagnostic accuracy for skin diseases, which contribute significantly to the global disease burden. However, most research has focused on High-Income Countries (HICs), leaving gaps in understanding AI's applicability and effectiveness in LMICs. Aim/Objective This systematic review critically evaluates the application of AI in dermatological practice within LMICs, assessing the performance of AI technologies across diverse geographic regions. Methodology The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included 19 studies from databases including PubMed, Embase, and Cochrane. Eligible studies evaluated AI applications in dermatology within LMICs, reporting metrics like sensitivity, specificity, precision, and accuracy. Data extraction and quality assessment were performed independently by several reviewers using tools like PROBAST and QUADAS-2. A qualitative synthesis as per SWiM guidelines was conducted due to heterogeneity in study designs and outcomes. Conclusion AI shows significant promise in enhancing dermatological diagnostics and expanding access to dermatologic care in LMICs, with models achieving high accuracy (up to 99%) in tasks like skin cancer and infectious disease detection. However, challenges such as underrepresented skin tones in datasets, limited clinical validation, Creator An entity primarily responsible for making the resource Olivier Uwishema1* , Malak Ghezzawi1,2, Nicole Charbel1,3,4, Shireen Alawieh1,3,4, Subham Roy1,5, Magda Wojtara1,6, Clyde Moono Hakayuwa1,7, Ibrahim Khalil Ja’afar1,8, Gerard Nkurunziza9 and Manya Prasad10 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 Dermatology, Artificial Intelligence, Low- and Middle-Income Countries, Convolutional Neural Networks, Diagnosis https://repository.horizon.ac.id/files/original/7967d4c922e6110814710d16819f22a4.pdf e5c5c32a6411ba21ce16e2d63127be1e 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 Characteristics of patients with ruptured abdominal aortic aneurysm who contacted out-of-hours primary care: a case-control study Subject The topic of the resource Ruptured abdominal aortic aneurysm, Triage, Primary care, Out-of-hours primary care services, Emergency medicine Description An account of the resource Abstract Background Ruptured abdominal aortic aneurysm (rAAA) is rare but it is the second most frequently missed diagnosis reported as sentinel adverse event (‘calamity’) at out-of-hours services in primary care (OHS-PC). We aimed to identify characteristics that could be useful for telephone triage of suspected rAAA at the OHS-PC. Methods In a matched case-control study (1:4 ratio), we compared patients with a missed rAAA (cases) to patients with the same age and sex, and with similar entrance complaint (controls). Data were collected from OHS-PC triage call recordings that were re-assessed by researchers blinded to the case-control status. Patient and call characteristics were univariably assessed with conditional logistic regression analysis. Results Twenty cases of missed rAAA between 2013 and 2023 were matched to 80 controls. 40% of the cases presented with abdominal pain, and 35% with back pain. Cases compared to controls more often had a pain onset<12 h (odds ratio (OR) 15.2; 95%CI 1.9-123.8), reported more sweating (OR 10.1; 95% CI 1.2–86.9, p=0.035), more often verbally expressed their concern (OR 13.6; 95%CI 3.0-61.3, p=0.001), and more often called during the night (OR 3.8; 95% CI 1.1–12.7, p=0.029). Conclusions Recognition of rAAA at the OHS-PC remains challenging given its rare occurrence and lack of specific symptoms. Nevertheless, this case-control study identified factors that could be useful in triage of patients calling the OHS-PC with symptoms possibly indicating rAAA. Keywords Ruptured abdominal aortic aneurysm, Triage, Primary care, Out-of-hours primary care services, Emergency medicine Creator An entity primarily responsible for making the resource Carline J. van den Dries1*, Dave A. Dongelmans2 , Maarten J. van der Laan3 , Sonja Oomkens4 , Eva Ouwendijk5 , Annelies Visser6 , Frans H. Rutten1 and Dorien L. M. Zwart1 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 Ruptured abdominal aortic aneurysm, Triage, Primary care, Out-of-hours primary care services, Emergency medicine https://repository.horizon.ac.id/files/original/00ca79e87933fe358765daea09d0da37.pdf e64d269936eab2f19eb6e58bea3418f1 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 Does TXA reduce total volume of 24-hour blood products transfused in post-traumatic hemorrhage in a resource-constrained setting:Secondary analysis of a prospective cohort trauma study in South Africa. Subject The topic of the resource Trauma, Injury, Hemorrhage, Shock, Tranexamic acid, TXA, Blood products, LMIC, South Africa Description An account of the resource Abstract Background Low- and middle-income countries bear a disproportionately large share of the global burden of trauma, with hemorrhage as a leading cause of preventable mortality. Tranexamic acid has been shown to reduce mortality in trauma, but no studies have investigated tranexamic acid’s effect on blood product consumption in resource-constrained settings. Methods A prospective secondary analysis was performed from data collected from ‘The Epidemiology and Outcomes of Prolonged Trauma Care (EpiC)’ study, a multicenter observational study of major trauma patients within the Western Cape of South Africa. Adult trauma patients with major hemorrhage who arrived at an EpiC study site within 24 h of injury between March 2021 and December 2024 were included. The primary outcome was total blood product administration within 24 h of injury. Treatment groups included patients who received tranexamic acid within 3 h compared to those who did not. Multiple regression with inverse probability weighting was performed to mitigate confounding. Subgroup analyses included patients with penetrating injuries, severe shock, presence of intracranial hemorrhage and patients without head injury who received large-volume blood products. Results A total of 1630 patients were included. Median total blood product volume was 760 mL. There was no difference in blood volume between the two groups. There was no significant difference in blood product volumes observed in all subgroup analysis. Conclusion In a cohort of adult trauma patients with major hemorrhage, there was no difference in total blood volume transfused within the first 24 h between patients who received tranexamic acid compared to those who did not. Creator An entity primarily responsible for making the resource Chelsea Dymond1 , Mengli Xiao2 , Lani Finck3 , Hendrick Lategan4 , George Oosthuizen4 , Shaheem de Vries5 , Janette Verster6 , Craig Wylie7 , EpiC Study Site Collaborators8 , Willem Stassen9 , Joseph Maddry10, Steven Schauer11, Julia Dixon3 and Nee-Kofi Mould-Millman3* 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 Trauma, Injury, Hemorrhage, Shock, Tranexamic acid, TXA, Blood products, LMIC, South Africa https://repository.horizon.ac.id/files/original/93b7dae4ddc4ed2a9e88975a3463e39f.pdf a69eff6cf454668d57c9fffe7c8ecca8 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 Delayed diagnosis of aortic dissection: the overlooked clues on chest X-ray Subject The topic of the resource Acute chest pain, Acute aortic dissection, Chest radiography, Pleuritis, Differential diagnosis Description An account of the resource Abstract Background Acute aortic dissection (AD) is a life-threatening vascular emergency requiring immediate intervention, with mortality rates increasing by 1–2% per hour post-onset. The pathophysiology involves an intimal tear that permits blood to enter the medial layer, forming a false lumen that may expand and compromise branch vessels and end-organ perfusion. Current guidelines from the European Society of Cardiology (ESC), American College of Cardiology (ACC), and American Heart Association (AHA) highlight the necessity of risk stratification based on clinical features (e.g., tearing pain, pulse deficits), predisposing factors (e.g., hypertension), and D-dimer levels, followed by confirmatory imaging with transthoracic echocardiography (TTE) or computed tomography angiography (CTA). Despite advancements in imaging, chest radiography (CXR) remains underutilized; however, key findings—such as mediastinal widening (≥5 cm at the aortic knob), abnormal aortic contour, and displaced intimal calcifications—can offer critical diagnostic information. Case report A young male patient presented with acute chest pain following strenuous exertion. Initial outpatient evaluation, including complete blood count (CBC), liver function tests (LFTs), renal function tests (RFTs), cardiac enzymes, and chest X-ray (CXR), yielded nondiagnostic results, leading to his discharge with analgesics. Three days later, during a national holiday when outpatient clinics were closed, the patient returned to the emergency department (ED) with persistent chest pain. A meticulous review of the initial CXR by the emergency physician revealed mediastinal widening (measuring 8.5 cm) and an abnormal contour of the aorta. Subsequent emergency computed tomography angiography (CTA) confirmed the diagnosis of a Stanford type B aortic dissection. Conclusions This case underscores two critical learning points: (1) the diagnostic pitfalls associated with atypical early presentations of aortic dissection, and (2) the often underappreciated value of meticulous interpretation of chest X-rays in the evaluation of acute chest pain, particularly when initial studies yield unremarkable results. The three- day diagnostic delay emphasizes the necessity of maintaining a high index of suspicion for aortic dissection, even in young patients lacking classic risk factors. Keywords Acute chest pain, Acute aortic dissection, Chest radiography, Pleuritis, Differential diagnosis Creator An entity primarily responsible for making the resource Yao Chen1 , Wenjin Wang2 , Lian Lin3 and Zhankai Tang2* 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 Acute chest pain, Acute aortic dissection, Chest radiography, Pleuritis, Differential diagnosis https://repository.horizon.ac.id/files/original/6ea14fa03122d26d21e5275515857062.pdf 24ed759caa40185756dbcb2e922a9624 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 Knowledge and experience of local emergency care staff on stroke recognition and acute care in the United Arab Emirates Subject The topic of the resource Acute stroke, Emergency department staff, Stroke symptoms, Risk factors, And knowledge assessment Description An account of the resource Introduction Cerebrovascular diseases are among the top three causes of death in the United Arab Emirates. The acute stroke care survey among emergency care personnel in Alain City aims to assess the experience, knowledge and attitude of emergency department staff about acute stroke care to identify areas for educational and training interventions. Method This is an observational cross-sectional Face-to-Face electronic survey of the Emergency care doctors and nurses across four emergency/urgent care centres in Alain, the United Arab Emirates. The survey was completed between 4th August 2023 to 15th October 2024 using a locally validated survey questionnaire. Results Of the 215 participants in the study, 178 (83%) completed the survey of which 56% were Physicians. Two-thirds (66.1%) of the responders work in a tertiary care centre and about a third 49 (35.4%) of the responders personally cared for more than ten stroke or TIA patients in the past three months. Over 75% of the responders identified facial droop, unilateral arm or leg weakness and slurred speech as symptoms of acute stroke. Only 61% of the responders recognised atrial fibrillation as a risk factor. The overall mean (SD) knowledge score was 59.76 (23.74) for physicians compared with 52.9 (21.35) for nurses (P=0.054). There was a significant difference in the overall mean (SD) knowledge score between responders from tertiary and secondary centres. (59.9 (21.8) versus 51.8 (21.9) respectively, P=0.019. Responders with <2 years of experience achieved a significantly lower mean (SD) score compared with responders with >2 years of experience in all domains (47.1 (27.34) compared with 60.54 (20.1) for those with >10 years of experience, P=0.008). Conclusions This study identified significant knowledge gaps among staff working in our stroke care system. These can be addressed by regular stroke update training for all front-line staff including those working at secondary centres with limited experience of daily stroke care. Keywords Acute stroke, Emergency department staff, Stroke symptoms, Risk factors, And knowledge assessment Creator An entity primarily responsible for making the resource Mohammed Alkuwaiti1,2, Azhar Talal3 , Emad Masuadi3 , Ghada Albluwi1 , Abdulla Alkuwaiti2 and David Olukolade Alao1,4* 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 Acute stroke, Emergency department staff, Stroke symptoms, Risk factors, And knowledge assessment https://repository.horizon.ac.id/files/original/1e0781b26d4b4fc071835b33729d47bd.pdf be132e745069cf1c9708e0e7982f9b75 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 When methylene blue fails: a case of methemoglobinemia induced by azoxystrobin and propiconazole managed by exchange transfusion Subject The topic of the resource (MeSH): azoxystrobin, Exchange transfusion, whole blood, Methemoglobinemia, Methylene blue, Propiconazole Description An account of the resource Abstract Background Methemoglobinemia is a potentially life-threatening condition resulting from the oxidation of hemoglobin’s iron moiety from ferrous (Fe2+) to ferric (Fe3+). Clinical features include cyanosis unresponsive to oxygen therapy, chocolate-colored blood, and a marked saturation gap between pulse oximetry and arterial blood gas. Methylene blue remains the cornerstone of treatment; however, in rare instances, patients may exhibit refractory responses necessitating advanced interventions. Literature documenting methemoglobinemia due to fungicides like azoxystrobin and propiconazole remains scarce. Case presentation A young female presented with altered sensorium, shock, and hypoxia following the ingestion of a fungicide containing azoxystrobin and propiconazole. Despite a PaO2 of 400 mmHg on ABG, pulse oximetry showed 83% oxygen saturation, raising suspicion of dyshemoglobinemia. Methemoglobin levels were elevated at 80.7%. She was treated with intravenous methylene blue. While an initial decline in methemoglobin levels to 4% was observed, relapse occurred within 12 h. On day three, therapeutic red blood cell exchange transfusion was performed resulting in a reduction of methemoglobin levels to 14.2%. Despite aggressive measures, she succumbed to refractory shock on day five of admission. Conclusion This report presents likely the first documented case of fatal methemoglobinemia due to ingestion of azoxystrobin and propiconazole—a combination fungicide widely used in agriculture. The case highlights the limitations of standard therapies like methylene blue in severe poisoning and underscores the need for early consideration of exchange transfusion. With the increasing use of such agents in rural communities, clinicians must maintain vigilance for unusual toxicities and ensure timely escalation in refractory cases. Keywords (MeSH): azoxystrobin, Exchange transfusion, whole blood, Methemoglobinemia, Methylene blue, Propiconazole Creator An entity primarily responsible for making the resource Rajat Goyal1*, Rushabh Bora1 , Anand Jain1 and Gopal Krishana Bohra1,2* 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 https://repository.horizon.ac.id/files/original/7005f0f05bf4f4a1dc67fe98866ea42c.pdf 20001edd47333cce29f58b31b01e5ed9 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 Impact of telemedicine on mortality, hospital admissions, and length of stay in pediatric emergencies: a systematic review and meta- analysis Subject The topic of the resource Telemedicine, Pediatric, Emergency, Admission, Mortality, Meta-analysis Description An account of the resource Abstract Background Pediatric emergencies pose significant challenges in healthcare. Telemedicine offers a promising solution by enabling remote assessments, improving specialist access, reducing unnecessary ER visits and admissions, optimizing resources, and enhancing patient satisfaction. This systematic review and meta-analysis uniquely aimed to quantify the effect of telemedicine on key outcomes in pediatric emergency and post-emergency care. Methods We searched PubMed, Scopus, the Cochrane Library, and Web of Science to identify studies focusing on the impact of telemedicine in pediatric emergency settings. Both single- and double-arm studies were included. Statistical analysis was performed using RevMan and CMA software, with a random-effects model applied to all analyses. We assessed differences in admissions, hospital length of stay (LOS), and mortality. Event rates were calculated for single-arm analyses, and risk ratios and mean differences were used for dichotomous and continuous outcomes in double-arm analyses. Results A total of 23 studies were included. Telemedicine significantly reduced hospital LOS (MD = -1.01, 95% CI: -1.3 to -0.71) and overall mortality (RR=0.17, 95% CI: 0.13 to 0.24). The admission rates to the emergency department, hospital ward, and pediatric intensive care unit (PICU) were comparable between both groups. Single-arm analysis revealed that telemedicine was associated with an ED admission rate of 18% (95% CI: 5.2–47%), a hospital ward admission rate of 16.7% (95% CI: 4.6–45.7%), and a pooled mortality rate of 1.8% (95% CI: 1–3.3%). Conclusions Telemedicine appears to be an effective tool in pediatric emergency care. While our analysis suggests reductions in hospital length of stay and mortality, these findings should be interpreted with caution due to variability and potential confounding across studies. The impact on admission rates remains inconclusive. Nonetheless, telemedicine offers a promising approach to enhancing healthcare delivery and optimizing resource use in pediatric emergency and early post-emergency settings. Keywords Telemedicine, Pediatric, Emergency, Admission, Mortality, Meta-analysis Creator An entity primarily responsible for making the resource Amani N. Alansari1* , Mohamed Sayed Zaazouee2 , Marwa Messaoud3,4,5 , Salma Mani3 , Alaa Ahmed Elshanbary6 and Hanan Youssif Mohamed7 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/30e193827a65ad136147ea6507493452.pdf 4c5e00be397d4517b88f3434d836c294 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 Review of current knowledge regarding usage of pre-hospital heart rate variability and complexity in triage and added value for predicting the need for life-saving interventions Subject The topic of the resource Analysis of heart rate variability metrics has shown added accuracy in pre-hospital trauma triage. Description An account of the resource Abstract Background & aim Analysis of heart rate variability metrics has shown added accuracy in pre-hospital trauma triage. These metrics include heart rate variability (HRV), meaning oscillations in the time interval between heartbeats, and heart rate complexity (HRC), which assesses intricate patterns of heart rate over time. This review article evaluates current knowledge regarding HRV and HRC and prediction of a subsequent life-saving intervention (LSI), an intervention executed by trained medical personnel to prolong the life of the patient. Our primary focus was on pre- hospital patients and the utility of HRV and HRC when added to existing trauma triage scores or vital signs such as heart rate (HR). Methode A literature search was carried out by searching the MEDLINE database via the PubMed website for original research published in English from 2008 to 2023. The combinations of search terms applied yielded 18 original studies of which only six met our criteria. We included another study as it contributed original research beneficial to our article. Results The studies showed a statistically significant increase in the ∆Area Under Curve (AUC) between 0.14 and 0.40 for predicting risk of LSI when adding the two heart rate variability metrics to existing trauma triage scores or vital signs such as HR. Calculation of HRV and/or HRC could be conducted using ECG recording hardware already accessible in most emergency pre-hospital settings with less ECG noise and therefore higher quality ECG data over time. Conclusion Both HRV and HRC showed potential for increasing ∆AUC in predicting risk of LSI when added to existing risk triage scores. Calculation of HRV and HRC could potentially be conducted using a preexisting hardware in most emergency pre-hospital settings. Creator An entity primarily responsible for making the resource Christoffer B. Hedegaard1*, Kasper Iversen1,2,3, Fredrik Folke1,3,4, Morten Lock-Hansen6 , Carolina Malta Hansen1,3,4 and Jannik Pallisgaard5 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 Analysis of heart rate variability metrics has shown added accuracy in pre-hospital trauma triage.