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Improved nonlinear conductivity and high breakdown strength of all-organic nonlinear resistive field grading material filled by organic molecules with electron-donating groups

An organic molecule of poly(propylene glycol) bis(2-aminopropyl ether) (ATPE) with electron-donating groups is blended with low-density polyethylene (LDPE) to prepare all-organic nonlinear resistive field grading material. Quantum chemical results show that ATPE has an electron-donating ability. Experimental results demonstrate that, compared with traditional inorganic SiC particles, ATPE reduces the LDPE composite's percolation threshold and improves the nonlinear conductivity, achieving much lower filler loading, which is attributed to the electron-donating groups of ATPE. In addition, ATPE also provides higher breakdown strength and surface flashover voltage as well as better toughness for LDPE composites than SiC particles. It provides the basis for high-performance all-organic nonlinear resistive field grading material.

24-hour movement behaviours and mental health in non-clinical populations: A systematic review

The 24-hour movement guidelines consider movement behaviours (sleep, exercise, sedentary time) together within the frame of our 24-hour limit to provide recommendations on how a physically healthy day should look. There is increasing evidence that daily movement behaviours are associated with mental health. However the research into the relationship between 24-hour-movement and mental health, particularly in adults, is still to be systematically reviewed. The aim of this systematic review was to synthesise the current state of knowledge regarding movement behaviours and mental health in non-clinical child, adolescent and adult samples. systematic literature search of PubMed, Scopus and Embase was conducted in 2022, and updated in 2024. The review was preregistered (PROSPERO: CRD42022312717). Due to heterogeneity of methods and analyses, narrative synthesis of the results was employed. Of 103 eligible studies, one was a randomised controlled trial and the remainder were observational. In children 19/27 studies (70%) found at least one significant positive relationship between movement behaviour and mental health, in adolescents 38/41 (93%) and in adults 41/46 (89%). Certainty of evidence was low. More controlled studies are needed to make causal conclusions, but it is evident that the composition of movement behaviours is associated with mental health, and these associations may be differentially manifest in different age groups. This has implications for public health and mental health campaigns.

Néel vector rotation driven by spin–orbit torque in amorphous ferrimagnetic GdCo

Spin superfluidity, a phenomenon enabling low-dissipative spin transport, has remained a theoretical concept. To realize spin superfluidity in an antiferromagnet, it is necessary to excite a Néel vector rotation within the magnetic easy-plane, which has been elusive so far due to the large magnetocrystalline anisotropy of antiferromagnets. In this study, we demonstrated spin–orbit torque-driven Néel vector rotation in amorphous ferrimagnetic GdCo. A pseudo-magnetic easy-plane is formed in a spin-flop state under an external magnetic field in the vicinity of the magnetization compensation temperature, and we observed stochastic binary switching in the anomalous Hall resistance, directly attributed to Néel vector rotation. Furthermore, homodyne detection confirmed rotation frequencies in the GHz range as expected from atomic spin simulations, providing evidence of dynamic Néel vector behavior. These findings demonstrate the continuous rotation of Néel vector driven by spin–orbit torque.

Aldo-keto reductase family 1 member C3 (AKR1C3) gene polymorphism (rs12529) is associated with breast cancer in Bangladeshi population: A case-control study and computational investigation

Breast cancer is defined as the unchecked growth of breast cells, with imbalances in prostaglandin and steroid hormone metabolism contributing to disease risk by altering prostaglandin types and forms (strong and weak) of steroid hormones. The AKR1C3 enzyme plays a key role in managing these metabolic processes. This study investigated the association between the AKR1C3 gene polymorphism (rs12529) and the risk of developing breast cancer in Bangladeshi individuals. A case-control investigation was conducted with a total of 620 samples, involving 310 individuals diagnosed with breast cancer and 310 healthy subjects. Herein, DNA extraction was performed via an organic process, whereas genotyping was employed via the PCR‒RFLP technique. Statistical assessments were conducted to analyze the association of polymorphisms, while molecular dynamics simulation and diverse computational techniques were employed to anticipate the functional and structural impacts of the SNP. Our study discovered that the rs12529 polymorphism of the AKR1C3 gene has an enhanced risk of susceptibility to breast malignancy (p = 0.016, OR = 1.97, 95% CI = 1.22 to 3.16 for the GG genotype in additive model 2). The recessive model (GG vs CC+CG) also showed an enhanced risk of susceptibility to breast malignancy (p = 0.0004, OR = 1.95, 95% CI =  1.40 to 2.73). In both premenopausal women and postmenopausal women, the GG genotype (for the recessive model) significantly increased breast cancer risk by 1.92-fold and 1.95-fold, respectively. However, no significant associations were observed regarding tumor grade or size in breast cancer development. In-silico analyses indicated that the H5Q (rs12529) mutation may decrease protein stability but is typically tolerated or functionally neutral. Molecular dynamics simulations revealed that H5Q leads to increased structural fluctuations and surface exposure, potentially causing the mutant AKR1C3 enzyme to operate differently from the wild type. In conclusion, rs12529 significantly increases the incidence of breast cancer in the population of Bangladesh. Computational analyses further revealed that the H5Q (rs12529) mutation in AKR1C3 leads to decreased stability and altered functional changes with notable conformational changes.

Perpendicularly magnetized synthetic antiferromagnetic Mn<i>x</i>Ga/Co2FeAl bilayers on MgAl2O4 substrate

Magnetic tunneling junctions (MTJs) with MgAl2O4 (MAO) barrier exhibit large tunnel magnetoresistance, comparable to that of MgO barrier. In this study, we grow synthetic antiferromagnetic MnxGa/Co2FeAl (CFA) bilayers on MAO (001) substrates without any buffer layer, where the MnxGa layer includes D022-Mn3Ga and L10-MnGa phases. Our results indicate that the CFA forms antiferromagnetic coupling with both D022-Mn3Ga and L10-MnGa. Moreover, we observe the perpendicular magnetic anisotropy (PMA) in both L10-MnGa/CFA and D022-Mn3Ga/CFA bilayers, which is induced by tetragonal MnxGa and interfacial magnetic coupling. Particularly, the L10-MnGa(10 nm)/CFA(1.5 nm) bilayer exhibits a perpendicular anisotropy field of 72.08 kOe and a perpendicular anisotropy energy of 7.57 × 106 erg/cm3. Similar PMA is also observed in L10-MnGa/Co2MnAl and L10-MnGa/Co2FeGa bilayers on MAO substrates. These results provide a foundation for the development of high-performance perpendicular MTJs with MAO barrier.

Ancient DNA integrates fossil and modern giant salamander taxonomy

Absence of item origin bias on a Brazilian interinstitutional Progress Test examination: A pooled analysis of items approach

Background It has been proposed that the school origin of items for cross-institutional Progress Tests (PTs) may introduce a bias in favour of students from the same school, posing a potential threat to the validity and reliability of PT results and cross-institutional comparisons. The aim of this study was to examine whether origin bias is present in a Brazilian cross-institutional PT examination. Methods This study conducted a cross-sectional analysis of seven schools affiliated with the oldest PT consortium in Brazil, utilising a pooled analysis of differences in students’ performance concerning self and non-self items. A proportional meta-analysis of the items’ rate differences and confidence intervals with random effects was performed, providing an odds ratio (OR) for self and non-self items. Differences between the two groups of items were assessed by scrutinising whether the OR and 95% confidence intervals overlapped. Results The findings indicated no discernible differences in psychometric indices based on the school responsible for item creation. Three schools consistently demonstrate superior performance on items authored by their faculty, however, these they also excelled on non-self items. Furthermore, an overlap in the 95% confidence intervals for both self and non-self items was observed across all seven schools. Conclusions In contrast to prior reports, this study revealed the absence of origin bias, suggesting that adoption of best practices in blueprinting, item writing, and editing may have played a role in mitigating such bias.

Highly sensitive deep ultraviolet to visible photodetector based on backgate regulated selenophosphate In2P3Se9 material

The metal selenophosphate material In2P3Se9 exhibits significant potential for ultraviolet-to-visible photodetection due to its moderate bandgap and ultra-low dark current characteristics. However, its relatively low photocurrent limits its practical application. In this study, we systematically optimized the material thickness and employed an interdigitated electrode structure to enhance light absorption and carrier collection. The resulting photodetector exhibits a broad spectral response from 254 nm (deep ultraviolet) to 980 nm (near infrared), with a rapid response time of 0.6 ms. Notably, the responsivity and detectivity were significantly enhanced by more than 100 times through the electrode design. Moreover, backgate regulation enhanced the responsivity by up to one order of magnitude. The optimized device demonstrated outstanding photodetection performance with a responsivity of 210 A/W and a specific detectivity of 3.5 × 1011 Jones at 638 nm, enabling high-resolution multi-wavelength imaging. This work offers an effective optimization route for In2P3Se9-based photodetectors and advances their potential for practical optoelectronic applications.

Diabetes rescue, engagement, and management (D-REM) for hypoglycemia: Clinical trial protocol of a community paramedic program to improve diabetes management among adults with severe hypoglycemia

Background Diabetes is among the most prevalent chronic conditions in the United States. Challenges in optimal diabetes care include fragmented care, gaps in diabetes self-management education, and high treatment burden. Severe hypoglycemia, a serious and potentially preventable event, indicates the need for treatment optimization. Inadequate or inaccessible care increases hypoglycemia risk. Community paramedics are well-positioned to fill these care gaps by providing focused diabetes self-management education and improving patient self-efficacy. Integrating community paramedics into care teams offers a novel pathway to improve diabetes outcomes. Methods and analysis We will conduct a pragmatic 2-group, parallel-arm, randomized clinical trial of a community paramedic–led “Diabetes Rescue, Engagement, and Management” program to enhance diabetes self-management in patients with a history of hypoglycemia. The study will enroll 150 adults (≥18 years) with diabetes and a history of level 3 hypoglycemia from 5 counties in Minnesota. Participants identified as having hypoglycemia (from an integrated health system and the primary ambulance service in the area) will be randomly assigned to the program intervention or to usual care. The intervention group will receive community paramedic home visits for approximately 1 month to deliver diabetes self-management education tailored to individual needs. Both groups will receive written diabetes education and resource materials. Outcomes include change in diabetes self-management, hypoglycemia, hyperglycemia, hemoglobin A1c level, diabetes distress, and health-related quality of life, assessed at baseline, 1 month, and 4 months. Qualitative interviews of 16 intervention participants and 16 persons who decline participation will be analyzed to understand the program’s effects and reasons for nonparticipation, to inform future program design. Trial registration ClinicalTrials.gov NCT04874532

Dual-polarized dual-band angle-selective surface based on double-layer FSS

This Letter presents a dual-polarized, dual-band angle-selective surface structure based on a double-layer frequency selective surface (FSS), composed of two identical slotted FSS layers. Both FSS layers consist of a metal layer and a dielectric substrate, and they are separated by an air gap. The proposed structure enables distinct angle-selective transmission at two frequency bands while maintaining polarization insensitivity for both TE and TM modes. Specifically, at 8.5 GHz, electromagnetic waves incident within the angular range of 0°–9° exhibit excellent transmission performance (S21 &amp;gt; −1 dB), whereas at 9.6 GHz, the transmission angle is confined to angles between 30° and 31°. Furthermore, the unit cell size and overall thickness of the structure remain relatively compact. To provide theoretical insight, an equivalent circuit model is employed for analysis, and a prototype is fabricated for experimental validation. The measured results demonstrate strong agreement with the simulated results, confirming the effectiveness of the proposed design. When the target signal and the interference signal reside within the same frequency band, the proposed structure efficiently mitigates electromagnetic interference.

Impact of mtG3PDH inhibitors on proliferation and metabolism of androgen receptor-negative prostate cancer cells: Role of extracellular pyruvate

Mitochondrial glycerol 3-P dehydrogenase (mtG3PDH) plays a significant role in cellular bioenergetics by serving as a rate-limiting element in the glycerophosphate shuttle, which connects cytosolic glycolysis to mitochondrial oxidative metabolism. mtG3PDH was identified as an important site of electron leakage leading to ROS production to the mitochondrial matrix and intermembrane space. Our research focused on the role of two published mtG3PDH inhibitors (RH02211 and iGP-1) on the proliferation and metabolism of PC-3 and DU145 prostate cancer cells characterized by different mtG3PDH activities. Since pyruvate as a substrate of lactate dehydrogenase (LDH) may represent an escape mechanism for the recycling of cytosolic NAD+ via the glycerophosphate shuttle, we investigated the effect of pyruvate on the mode of action of the mtG3PDH inhibitors. Extracellular pyruvate weakened the growth-inhibitory effects of RH02211 and iGP-1 in PC-3 cells but not in DU145 cells, which correlated with higher H-type LDH and lower mitochondrial glutamate-oxaloacetate transaminase in DU145 cells. In the pyruvate-low medium, the strength of inhibition was more pronounced in PC-3 cells, characterized by higher mtG3PDH activities compared to DU145 cells. Pyruvate conversion rates (production in pyruvate-low and consumption in pyruvate-high PC-3 cells) were not impaired by RH02211 and iGP-1, suggesting that the conversion of extracellular pyruvate to lactate was not the primary factor responsible for the weakening effect of extracellular pyruvate on the RH02211-induced inhibition of PC-3 proliferation. In pyruvate-high PC-3 cells, the intracellular glycerol-3-P and dihydroxyacetone-P concentrations were consistent with an inhibition of mtG3PDH. In contrast, in pyruvate-low cells, the concentrations of these metabolites suggested an activation of mtG3PDH in parallel with an impairment of cytosolic G3PDH by RH02211. Of all metabolic characterizations recorded in this study (fluxes, intracellular intermediates, O2 consumption and H2O2 production), the decrease in glutaminolysis correlated best with the RH02211-induced inhibition of proliferation in pyruvate-low and pyruvate-high PC-3 cells.

Size effects and temperature dependence in the thermal conductivity of γ-Ga2O3 films

The thermal conductivities of (100) γ-Ga2O3 films deposited on (100) MgAl2O4 substrates with various thicknesses were measured using frequency-domain thermoreflectance. The measured thermal conductivities of γ-Ga2O3 films are lower than the thermal conductivities of (2¯ 01) β-Ga2O3 films of comparable thickness, which suggests that γ-phase inclusions in the doped or alloyed β-phase may affect its thermal conductivity. The thermal conductivity of γ-Ga2O3 increases from 2.3−0.5+0.9 to 3.5±0.7 W/m K for films with thicknesses of 75–404 nm, which demonstrates a prominent size effect on thermal conductivity. The thermal conductivity of γ-Ga2O3 also shows a slight increase as temperature increases from 293 to 400 K. This increase in thermal conductivity occurs when defect and boundary scattering suppress signatures of temperature-dependent Umklapp scattering. γ-Ga2O3 has a cation-defective spinel structure with at least two gallium vacancies in every unit cell, which are the likely source of defect scattering.

A qualitative exploration into the experience of mindfulness in moderate-severe persistent depression

Depression is a common and growing mental health problem, with around 5% of the world’s population experiencing an episode of depression during their lifetime. Relapse rates are high, with around half experiencing more than one depressive episode and a further 10–20% experiencing a chronic and persistent depression. Mindfulness has been incorporated into treatments for depression and several studies have explored the impact of mindfulness training on depressive symptomatology and recurrence. However, to date no studies have looked at the changing relationship between mindfulness and depression in those naïve to mindfulness training. 20 participants with moderate-to-severe persistent depression were interviewed to explore their experience of mindfulness in the context of low mood. Thematic analysis captured six themes highlighting changes in mindfulness relating to the onset of depression. Themes included: behavioural withdrawal; perceptual detachment from one’s experience; intentional reduction in awareness; increased self-criticism; mind racing; impaired cognitive performance. Thematic analysis suggested that mindfulness reduces in the context of moderate-to-severe persistent depression. This appears to occur indirectly as the consequence of depression-related processes, e.g., rumination and experiential avoidance, but also arises as a deliberately instigated self-protective strategy. However, findings seemed to indicate that reduced mindfulness maintains and intensifies depressive experience. Despite growing evidence of the value of mindfulness approaches for those with more chronic and severe depression, study findings suggest that introducing mindfulness to this population may be particularly challenging due to the intensity of symptomatology potentially obstructing access to a mindful perspective. Findings bear important implications for the treatment of depression and can inform future intervention development and delivery.

Topologically transformed CoSe2 for enhanced ethanol electrolysis in high-efficiency water splitting and zinc–ethanol–air batteries

Spin engineering has garnered significant attention due to its ability to modulate the interaction between active sites and reaction intermediates, thereby enhancing catalytic kinetics. In this study, we present a strategy to tune the coordination environment of Co via topological transformation, effectively modulating its spin state. The resulting CoSexOy-200 exhibited enhanced catalytic kinetics toward ethanol oxidation reaction, achieving a current density of 10 mA cm−2 at a low potential of 1.34 V. The improved catalytic performance is attributed to a topochemical transition-induced spin reconstruction, optimizing the adsorption of reaction intermediates. Building on these findings, the catalyst was further applied to a zinc–ethanol–air battery, leading to a decrease in charging voltage and a narrowed charge–discharge voltage window, which is less than 650 mV. This study establishes a controllable spin-state modulation strategy via topochemical transformation, paving the way for the rational design of advanced electrocatalyst for water electrolysis and next-generation zinc–ethanol–air batteries.

Comparison of lesion segmentation performance in diffusion-weighted imaging and apparent diffusion coefficient images of stroke by artificial neural networks

Stroke is the second leading cause of death, accounting for 11% of deaths worldwide. Comparing diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) images is important for stroke diagnosis, but most studies have focused on lesion segmentation using DWI. In this study, we compared the performance of lesion segmentation using DWI and ADC images. This study was conducted using a retrospective design A dataset was constructed using data from 360 patients with ischemic stroke collected from Gachon University Gil Medical Center. Artificial intelligence models, U-Net, and a fully connected network (FCN), were used to train each type of image data. The performance of the models was validated using five-fold cross-validation and evaluated based on metrics such as the dice similarity coefficient (DSC), accuracy, precision, and recall. As a result, the U-Net model demonstrated a DSC of 92.13 ± 0.91% on DWI and 83.68 ± 10% on ADC, whereas the FCN model exhibited a DSC of 82.86 ± 1.56% on DWI and 79.26 ± 1.19% on ADC. These metrics indicated that the trained models were suitable for lesion segmentation. A comparative analysis of DWI and ADC based on the trained models revealed similar results across the models, suggesting that lesion segmentation on ADC images is appropriate. For future research, the accuracy of ADC images is recommended to be imporved by utilizing images with different b-values, or training models with datasets that combe DWI and ADC images based on enhanced data.

Designed for simplicity, used for complexity: The systemic pressures shaping walk-in clinic practices and outcomes

Walk-in clinics (WICs), appreciated for their accessibility and convenience, have become an increasingly popular healthcare option in Ontario for patients with and without primary care enrolment. Despite their utility, WICs face criticism for delivering lower-quality care compared to comprehensive, enrolment-based primary care models. Critics argue that WICs contribute to system inefficiencies and encourage practice patterns misaligned with population health goals. This study explored physician perspectives on two key outcomes often associated with low-quality care in WICs: repeat primary care visits and potentially inappropriate antibiotic prescribing. Using a qualitative descriptive approach, semi-structured interviews were conducted with Ontario-based family physicians (N = 19) who had experience practicing in both WICs and enrolment-based primary care. The findings highlight systemic challenges, including limited access to enrolment-based primary care and increasing healthcare demands, which have pushed WICs beyond their intended role. This misalignment has created tensions between their structure and purpose, resulting in visits that participants described as more transactional than those in primary care. These constraints—rooted in a lack of informational and relational continuity—often limited participants’ ability to provide in-depth engagement or follow-up care. Repeat visits were frequently linked to efforts to ensure continuity for complex or chronic conditions. Similarly, participants acknowledged the reality of potentially inappropriate antibiotic prescribing, attributing it to the high patient volume, desire to satisfy patient expectations, and a tendency to “err on the side of caution” when the nature of the illness is in question. The findings underscore how health system pressures and well-intended policies, such as Ontario’s primary care access bonus, can produce unintended consequences, including inequities in access and difficulties with care coordination across settings. Addressing these challenges requires reforms to better integrate WICs with the primary care system, alongside tailored training to support physician decision-making in episodic care contexts.

The impact of wartime conflict on the mental health problems of women in the conflict-hit population in Woldia, Ethiopia

Background Common mental health problems are of significant public health importance, with severe social and economic impacts that adversely affect individuals’ quality of life. The burden of these problems may worsen during wartime. This study aims to assess the prevalence of war-related common mental health problems, including depression, anxiety disorder, phobia, and posttraumatic stress disorder (PTSD), among women in the Woldia district, Amhara, Ethiopia. Methods A community-based cross-sectional survey was conducted from February to March 2023, involving 1,505 eligible women selected from five kebeles using cluster followed by systematic sampling. The study used the Patient Health Questionnaire-9, Generalized Anxiety Disorder scale, and PTSD Checklist-5 to assess common mental health disorders. In addition to descriptive analysis, the study employed binary and multivariable analysis to evaluate sociodemographic correlates and the presence of comorbidity for each mental disorder. Result Almost half of the women exhibited symptoms of common mental health problems, with about 33% experiencing comorbidity of two or more disorders. Depressive symptoms were more prevalent among older, single women and those with spouses using khat, whereas higher wealth and strong social support were protective factors. Similar risk and protective patterns were observed for generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). Older age, single status, and moderate-income increased risk, while a higher wealth index and stronger social support provided some protection. Conclusion The findings from Woldia reveal a severe mental health crisis among women post-conflict, with elevated levels of depression, anxiety, and PTSD far exceeding global averages. This crisis jeopardizes the well-being of women and has far-reaching implications for families and communities, necessitating an urgent and multi-dimensional approach to address risk and protective factors identified in the study.

Comparison of WHO laboratory-based and non-laboratory-based CVD risk charts among hypertensive adults attending primary healthcare centers in West Africa sub-region

Background The World Health Organization (WHO) non-laboratory cardiovascular disease (CVD) risk chart is sub-region-specific and is advocated in resource-constrained settings. However, the extent of agreement with laboratory-based assessment among hypertensive adults attending primary health centers (PHCs) in the West Africa sub-region remains unknown. This study compared 10-year CVD risk among adults with hypertension attending PHCs in Ghana and Nigeria. Materials and methods This cross-sectional study recruited 319 adults with hypertension at PHCs in Ghana and Nigeria. All participants had their blood pressure, anthropometrics, fasting blood sugar, and fasting cholesterol measured following standard procedures. WHO laboratory and non-laboratory CVD risks were assessed and compared using Kappa statistics, correlation, and Bland-Altman Plot, Results The median (interquartile range) for laboratory-based and non-laboratory-based CVD risk scores were comparable [7.0 (4.0 11.0) vs. 7.0 (4.0 to 11.0), p = 0.914]. Of the 319 participants, laboratory-based assessment classified 214 (67.1%) as low risk, while 210 (65.8%) were classified as low risk using the non-laboratory method. Eleven (3.4%) and 14 (4.4%) participants were classified as high-risk using laboratory- and non-laboratory-based methods, respectively. Overall, there was a very good positive correlation between the CVD risk assessment methods (r = 0.948, p&lt;0.001). For all participants combined, there was substantial agreement (Kappa statistics), with K = 0.766. Bland-Altman showed a mean bias of 0.15 (SD = 1.74) in favor of non-laboratory-based assessment of CVD with an upper limit of 3.57 and a lower limit of –3.26. Conclusion There was substantial agreement between laboratory- and non-laboratory-based WHO CVD risk charts in this study. In low-resource settings, such as Ghana and Nigeria, the WHO non-laboratory CVD risk prediction model offers a huge opportunity for primary CVD prevention in adults with hypertension.

Software technical debt prediction based on complex software networks

Technical debt prediction (TDP) is crucial for the long-term maintainability of software. In the literature, many machine-learning based TDP models have been proposed; they used TD-related metrics as input features for machine-learning classifiers to build TDP models. However, their performance is unsatisfactory. Developing and utilizing more effective metrics to build TDP models is considered as a promising approach to enhance the performance of TDP models. Social Network Analysis (SNA) uses a set of metrics (i.e., SNA metrics) to characterize software elements (classes, binaries, etc.) in software from the perspective of software as a whole. SNA metrics are regarded as a compensation of TD-related metrics used in the existing TDP work, and thus are expected to improve the performance of existing TDP models. However, the effectiveness of SNA metrics in the field of TDP has never been explored so far. To fill this gap, in this paper, we propose an improved software technical debt prediction approach. First, we represent software as a Class Dependency Network, based on which we compute the value of a set of SNA metrics. Second, we combine SNA metrics with the TD-related metrics to create a combined metric suite (CMS). Third, we employ CMS as the input features and utilize seven commonly used machine learning classifiers to build TDP models. Empirical results on a publicly available data set show that (i) the combined metric suite (i.e., CMS) can indeed improve the performance of existing TDP models; (ii) XGBoost performs best among the seven classifiers, with an F2 value of 0.77, an MI ratio of approximately 0.10, and a recall close to 0.87. Furthermore, we also reveal the relative effectiveness of different metric combinations.

The effect of laboratory critical value reporting on patient management at Siriraj Hospital – Thailand’s largest national tertiary referral center

Critical laboratory values are life-threatening results that necessitate immediate medical intervention. Reporting these values according to established guidelines is essential for ensuring optimal patient safety and care quality. The aim of this study was to evaluate the laboratory critical value reporting system and the actions taken at Siriraj Hospital – Thailand’s oldest and largest teaching hospital – during January 2018. This study reviewed critical values from hematology, coagulation, and clinical chemistry tests over a one-month period. Patient management actions in response to critical values were classified into five categories: treatment, further investigation, monitoring, treatment combined with investigation, and other. Descriptive statistics were used to analyze the data in Microsoft Excel 2019, calculating the incidence of critical values, notification rates, and management actions. Of the 253,537 tests that were performed, 2,722 critical levels were found, indicating an incidence rate of 1.1%. Hemoglobin and potassium were the most frequently observed critical parameters, accounting for 25.61% and 23.99% of cases, respectively. The rate of notification varied depending on the specific parameter and patient category. For critical glucose and potassium levels, the most common response was close monitoring within 30 minutes, followed by treatment in 80% of cases. Hypermagnesemia, a condition linked to preeclampsia and treated with magnesium sulfate, required particularly careful monitoring. The 1.1% incidence of critical values in this study is high compared to previously published international data; however, this may be explained by the high volume of complex cases referred to our national tertiary referral center. Critical value reporting criteria should be established based on patient conditions and hospital management practices to reduce unnecessary alerts, optimize laboratory workload, and ensure high-quality patient care.