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With the advent of rapid automated in silico identification of biosynthetic gene clusters (BGCs), genomics presents vast opportunities to accelerate natural product (NP) discovery. However, prolific NP producers, Streptomyces, are exceptionally GC-rich (>80%) and highly repetitive within BGCs. These pose challenges in sequencing and high-quality genome assembly which are currently circumvented via intensive sequencing. Here, we outline a more cost-effective workflow using multiplex Illumina and Oxford Nanopore sequencing with hybrid long-short read assembly algorithms to generate high quality genomes. Our protocol involves subjecting long read-derived assemblies to up to 4 rounds of polishing with short reads to yield accurate BGC predictions. We successfully sequenced and assembled 8 GC-rich Streptomyces genomes whose lengths range from 7.1 to 12.1 Mb with a median N50 of 8.2 Mb. Taxonomic analysis revealed previous misrepresentation among these strains and allowed us to propose a potentially new species, Streptomyces sydneybrenneri. Further comprehensive characterization of their biosynthetic, pan-genomic and antibiotic resistance features especially for molecules derived from type I polyketide synthase (PKS) BGCs reflected their potential as alternative NP hosts. Thus, the genome assemblies and insights presented here are envisioned to serve as gateway for the scientific community to expand their avenues in NP discovery.

PurposeRefractory materials are now used in all major industries that demand high-temperature resistance, including petrochemicals, steel, cement and aviation. Businesses must decrease operating costs, enhance product technology, sell well and manage corporate risks in decision-making, notably supplier selection, to be more competitive. The study aims to determine the key criteria and factors of supplier selection and to evaluate the importance of the key factor of the supplier selection criteria for the refractory materials manufacturers in Taiwan.Design/methodology/approachAnalytical hierarchy process (AHP) is used to rank these factors for the decision maker. The AHP method is suitable for verifying refractory supplier selection criteria and providing references. The weighted loss scores for each supplier are then determined using the relative importance as the weights. Supplier selection criteria are ranked using their aggregate weighted loss scores. The provider with the lowest loss score should be chosen.FindingsProduct quality is the most significant of the five criteria: product quality, production technology, logistics capacity, service capability and supplier background. Professionalism is the most significant aspect of product quality, whereas equipment and capacity are vital in manufacturing techniques. The studies also show that the delivery rate is essential for logistics and service capabilities.Practical implicationsThis research has important implications for refractory suppliers in promptly fine-tuning the production and service to enhance customer satisfaction, which is key to business sustainability.Originality/valueThe application of an AHP technique to a real-world industrial issue is what makes this research unique. This research addressed one of the most critical topics in supply chain operations by offering better judgement for supplier selection via the use of suitable quantitative methodologies.

Compared to ordinary gastroscopy, painless gastroscopy has more advantages due to the application of anesthesia techniques such as sedation and analgesia, providing patients with comfort and a quick recovery. However, patients undergoing painless gastroscopy are often at risk of hypoxia, which can result in serious complications. Fortunately, more anesthesia providers have recognized this problem. Therefore, it is essential for anesthesia providers to identify risk factors to prevent hypoxemia. In conclusion, this review highlights the assessment of risk factors for hypoxemia in painless gastroscopy and common airway management methods to prevent and treat hypoxemia in high-risk populations during painless endoscopy.

Tinnitus is generally considered to be caused by neuroplastic changes in the central nervous system, triggered by a loss of input from the damaged peripheral system; however, conflicting results on auditory brainstem responses (ABRs) to clicks have been reported previously in humans with tinnitus. This study aimed to compare the effect of tinnitus on ABRs to chirps with those to clicks in normal-hearing young adults with tinnitus. The results showed that the tinnitus group had no significantly poorer hearing thresholds (0.25–16 kHz), click-evoked otoacoustic emissions (1–16 kHz), and speech perception in noise (SPIN) than the control group. Although chirps evoked significantly larger wave I and V amplitudes than clicks, people with tinnitus had no significantly smaller wave I amplitudes for either stimulus. Nevertheless, adults with tinnitus exhibited significantly smaller interpeak interval (IPI) between waves I and V for chirps (IPI–chirp) but not for clicks. In addition, the IPI–chirp correlated significantly with the SPIN for individuals with tinnitus when the signal-to-noise ratio was low. The present results suggest that the chirp-evoked ABR may be a valuable clinical tool for objectively assessing the SPIN in individuals with tinnitus. Further studies should be conducted to investigate possible etiologies of tinnitus.

Remote sensing scene images are characterized by intra-class diversity and inter-class similarity. When recognizing remote sensing images, traditional image classification algorithms based on deep learning only extract the global features of scene images, ignoring the important role of local key features in classification, which limits the ability of feature expression and restricts the improvement of classification accuracy. Therefore, this paper presents a multi-channel attention fusion network (MCAFNet). First, three channels are used to extract the features of the image. The channel "spatial attention module" is added after the maximum pooling layer of two channels to get the global and local key features of the image. The other channel uses the original model to extract the deep features of the image. Second, features extracted from different channels are effectively fused by the fusion module. Finally, an adaptive weight loss function is designed to automatically adjust the losses in different types of loss functions. Three challenging data sets, UC Merced Land-Use Dataset (UCM), Aerial Image Dataset (AID), and Northwestern Polytechnic University Dataset (NWPU), are selected for the experiment. Experimental results show that our algorithm can effectively recognize scenes and obtain competitive classification results.

This review focuses on exploring the defect active sites by determining the location and type and semi-quantitative calculation of defect concentrations by a variety of representational methods.

PurposeThis study aims to investigate the factors that influence young consumers' purchase intention towards dietary supplements (DS) in Malaysia.Design/methodology/approachThe supplement industry in Malaysia has been growing rapidly recently due to a paradigm shift in healthcare management, from curative to prevention. Thus, it has sparked interest to conduct a study on the factors that influence young consumers' purchase intentions towards DS. With a response rate of 74.5%, a survey questionnaire was used to elicit data from 149 Gen-Y respondents who consume supplements on a regular basis.FindingsThe results revealed that the influencing factors towards purchase decisions among these Gen-Y respondents aged between 17 and 25 are based on product knowledge and product quality. The implications of these findings and directions for future research are outlined at the end of this paper.Originality/valueThis study offers empirical insights from the perspective of an emerging digital economy on the factors that influence young consumers' purchase intentions towards DS in Malaysia.

This study tracks the progression of students’ ideas by understanding how ideas are adopted or rejected. Understanding the discourses that lead to idea progression could help illumine sense-making and decision-making processes within student group discussions. Student-generated artefacts in the form of vertical farming prototypes were analysed. These artefacts were from four groups of students who were engaged in an integrated STEM activity to improve existing vertical farming solutions in land-scarce Singapore. In the authors’ analysis to understand how the final prototype came to being, they examined the progression of ideas through lesson phases of envisioning, sketching, collaborative modelling, feedback, and evaluation. A coding scheme was used to track whether ideas were rejected, improved, or assimilated in the final prototype. Idea maps were generated to track key developments of ideas. The findings revealed that groups that took greater risks in generating more ideas had more rejected ideas and were also more engaged in the feedback process. This resulted in richer idea development. Idea fluency was highly varied across all four groups. This suggests that group engagement and a culture of reflection and monitoring could significantly improve idea quality, although the lack of curriculum time could limit desired divergent idea generation.

Genosensor voltametri untuk pengesanan DNA organisma terubah suai genetik (GMO) telah dibangunkan berasaskan nanozarah emas (AuNPs) dan elektrod pes karbon bercetak skrin (SPE). AuNPs telah dipegunkan pada SPE melalui kaedah pertumbuhan perantara benih dan dicirikan dengan mikroskop elektron pengimbasan (SEM). 6-Mercapto-1-heksanol (MCH) telah digunakan untuk membentuk lapisan mono prob DNA rantai tunggal (ssDNA) pada SPE terubah suai AuNPs (AuNPs-SPE). Biosensor GMO telah dioptimumkan secara elektrokimia menggunakan oligonukleotida sintetik melalui teknik voltametri denyutan pembezaan (DPV). Biosensor GMO yang dioptimumkan kemudiannya digunakan untuk menganalisis sampel sebenar bagi pengesanan khusus urutan DNA dalam virus mozek kubis bunga, iaitu gen CaMV 35S. Isyarat penghibridan DNA dipantau berdasarkan arus puncak pengoksidaan penunjuk redoks asid monosulfonat antrakuinona (AQMS) semasa interkalasinya ke dalam dupleks DNA. Biosensor GMO memberi rangsangan secara linear kepada DNA terubah suai genetik (GM) antara 0.1 nM dan 300.0 nM dan had pengesanan diperoleh pada 0.06 nM. Sisihan piawai relatif (RSD) kebolehulangan biosensor GMO dianggarkan pada 6.7-7.8%. Biosensor GMO berasaskan AuNPs mempamerkan prestasi pengesanan DNA yang lebih baik daripada segi julat linear dinamik dan had pengesanan berbanding dengan biosensor GMO elektrokimia yang dilaporkan sebelum ini. Biosensor DNA elektrokimia ini menyediakan satu platform pengesanan pakai buang untuk aplikasi dalam ujian bahan GMO.

The scaled-up synthesis of organic-free monolayer nanomaterials is highly desirable, especially in obtaining green energy by electrocatalysis. In this study, a method for the scaled-up synthesis of the series of monolayer layered double hydroxides (LDHs) without the addition of organic solvents is reported via the separate nucleation and aging steps process. The resulting monolayer LDHs with the thicknesses of less than 1 nm showed a narrow thickness distribution. X-ray absorption fine-structure revealed that monolayer NiFe-LDH nanosheets have a number of oxygen and metal vacancies defects. As a practical application, monolayer NiFe-LDH nanosheets containing defects showed an enhanced electrocatalytic water oxidation activity compared with that of bulk NiFe-LDH. Density functional theory calculations uncovered that excellent catalytic activity is attributed to vacancies defects. The proposed method is an economical and universally applicable strategy for the scaled-up production of monolayer LDHs.

A potentiometric aspartame biosensor was fabricated by simply depositing the carboxylesterase (CES)-bonded poly(n-butyl acrylate-n-acryloxysuccimide) [CES-poly(nBA-NAS)] microspheres on a Ag/AgCl screen-printed pH selective electrode. The pH transducer was made from non-plasticized polyacrylate membrane containing a hydrogen ionophore and lipophilic salt. The immobilized CES enzyme catalyzed the enzymatic hydrolysis of aspartame to L-aspartic acid (L-Asp), L-phenylalanine and methanol. Potentiometric determination of aspartame concentration was performed by quantifying the hydrogen ion concentration produced from L-Asp. The potentiometric determination of aspartame exhibited good selectivity with near Nernstian response. The sensitivity of the biosensor was closed to the Nernstian value, i.e., 50-52 mV decade-1 with a dynamic linear response range from 10-5 to 10-2 M and detection limit approaching 10-6 M. The aspartame biosensor demonstrated good repeatability and reproducibility with relative standard deviation (RSD) of 1.9% and 1.6%, respectively (n=3). The potentiometric aspartame biosensor was demonstrated to be reliable for determining aspartame content in sweetener samples and was comparable to the conventional high-performance liquid chromatography (HPLC) method for aspartame analysis.

Reduced graphene oxide (rGO) combined with zeolitic imidazolate framework (ZIF), i.e., rGO-ZIF incorporated with polyetherimide (PEI) electrospun nanofiber, was produced using the electrospinning technique. The produced nanofibers had high porosity with enhanced conductivity. The ionic conductivity, porosity, morphology, and diameter of rGO-ZIF nanofiber were optimized by manipulating the weight percentage of rGO-ZIF and PEI in the electrospinning solution. Morphology, porosity, and contact angle analyses revealed that the 30 wt% PEI with 0.3 wt% of rGO-ZIF can produce nanofibers without beads with 136.3 ± 35 nm mean diameter and porosity of around 92.3%. Furthermore, electrochemical impedance spectroscopy (EIS) analysis revealed that with the addition of 0.3 wt% of rGO-ZIF, charge transfer resistance decreased, and the ionic conductivity of PEI nanofibers increased to 5.23 × 10–4 S/cm, nearly 200 times higher than the ionic conductivity of pure PEI nanofibers. The excellent ionic conductivity, low charge transfer resistance, and high porosity of electrospun rGO-ZIF/PEI-based composite nanofibers make them suitable for electrochemical sensing electrode applications.

Background: Coronavirus Disease 2019 (COVID-19) Pandemic is still spreading rampantly in almost every country in the world, causing around 1.5 million dead at the point of time, and the death rate is still going up even though inoculation of vaccine has started. It is widely recognized that this pandemic Covid-19 is caused by infectious pathogens from the animal. Aim: This study investigates the relationship of biodiversity loss and zoonotic disease pandemic. The main reason for this migration is habitat (biodiversity) loss which is primarily caused by deforestation. Subject and Methods: Using Pooled Ordinary Least Square (POLS) models and worldwide data collected by using biodiversity in 170 countries. Results: It was found that biodiversity loss is positively related to the emergence of contagious disease. Conclusion: This verifies once for all that deforestation must be controlled so that the chance of emergent of next pandemic is mitigated.

Facing stiff competition from counterparts and alternative entertainment choice in the entertainment market, individual performing artists try hard to get their name and performance noticed by the audience and investors through personal branding. However, it will be shown that the effects and success of personal branding are contingent on whether the performing artists are volitionally involved in the process. It will then propose how to enhance the performing artists in volition for personal branding.

PurposeThis study aims to investigate the relationships among monetary cost (stimulus), perceived greenwash fear, attitude and perceived behavioural control (organism-related factors) and green hotel patronage intention (response) using the stimulus-organism-response (S-O-R) model.Design/methodology/approachA total of 262 valid questionnaires were collected. Data were collected using the purposive sampling method and tested using the partial least squares (PLS) approach.FindingsMonetary cost is positively related to only one organism-related factor which is perceived greenwash fear. All organism-related factors are positively related to response, which is green hotel patronage intention. Attitude mediates the relationship between perceived greenwash fear and green hotel patronage intention, as well as perceived behavioural control and green hotel patronage intention.Research limitations/implicationsA longitudinal study can be performed in the future to observe the actual green hotel patronage behaviour of customers.Practical implicationsGreen hoteliers should focus on the development of communication strategies to enhance their corporate reputation. Green hoteliers also need to build trust by showing their green initiatives are genuine, identify consumers who are willing to pay more for green hotels and offer promotions with price incentives such as frequency discounts, coupons and rebates to increase interest and trialability.Originality/valueFew studies have focused on the use of monetary cost as a stimulus in the S-O-R model to predict green hotel patronage intention. This study also tested the mediating effect of attitude, one of the organism-related factors, in the model.

Abstract Computational imaging and quantitative biomarkers offer invaluable insights in the pre-symptomatic phase of neurodegenerative conditions several years before clinical manifestation. In recent years, there has been a focused effort to characterize pre-symptomatic cerebral changes in familial frontotemporal dementias using computational imaging. Accordingly, a systematic literature review was conducted of original articles investigating pre-symptomatic imaging changes in frontotemporal dementia focusing on study design, imaging modalities, data interpretation, control cohorts and key findings. The review is limited to the most common genotypes: chromosome 9 open reading frame 72 (C9orf72), progranulin (GRN), or microtubule-associated protein tau (MAPT) genotypes. Sixty-eight studies were identified with a median sample size of 15 (3–141) per genotype. Only a minority of studies were longitudinal (28%; 19/68) with a median follow-up of 2 (1–8) years. MRI (97%; 66/68) was the most common imaging modality, and primarily grey matter analyses were conducted (75%; 19/68). Some studies used multimodal analyses 44% (30/68). Genotype-associated imaging signatures are presented, innovative study designs are highlighted, common methodological shortcomings are discussed and lessons for future studies are outlined. Emerging academic observations have potential clinical implications for expediting the diagnosis, tracking disease progression and optimising the timing of pharmaceutical trials.

To foster students’ learning of critical-thinking skills, we incorporated ill-structured problems in a Human Diseases module for third-year Life Sciences students. Using a problem-solving rubric and working in groups of three, students attempted to solve problems presented to them. We mediated their discussions by asynchronous online discussion forums (AODFs) as part of mass customisation of learning for 40 students where personalised learning was constrained by structure of the module. We examined the quality of students’ discussion, focusing on the feedback group members provided to one another, using an interpreted Structure of Observed Learning Outcomes (SOLO) taxonomy to code students’ feedback. Our analysis indicated that the students were able to provide uni-structural and multi-structural level in relation to solving an ill-structured problem, even though they are not used to solving ill-structured problems. This indicated that in a mid-size class, while personalised-learning is not always easy, it is possible to mass customise learning for students using common ill-structured problems in a class by mediating problem-solving using student discussions as feedback. However, more can be done to scaffold peer feedback on solving ill-structured problems so that the level of collaborative-learning can be improved in a mass customised model that approaches personalised learning.

Mesenchymal stromal cells (MSC) have excellent clinical potential and numerous properties that ease its clinical translation. Mitochondria play a crucial role in energy metabolism, essential for cellular activities, such as proliferation, differentiation, and migration. However, mitochondrial dysfunction can occur due to diseases and pathological conditions. Research on mitochondrial transfer from MSCs to recipient cells has gained prominence. Numerous studies have demonstrated that mitochondrial transfer led to increased adenosine triphosphate (ATP) production, recovered mitochondrial bioenergetics, and rescued injured cells from apoptosis. However, the complex mechanisms that lead to mitochondrial transfer from healthy MSCs to damaged cells remain under investigation, and the factors contributing to mitochondrial bioenergetics recovery in recipient cells remain largely ambiguous. Therefore, this review demonstrates an overview of recent findings in preclinical studies reporting MSC mitochondrial transfer, comprised of information on cell sources, recipient cells, dosage, route of administration, mechanism of transfer, pathological conditions, and therapeutic effects. Further to the above, this research discusses the potential challenges of this therapy in its clinical settings and suggestions to overcome its challenges.

Eicosapentaenoic acid (EPA) could be extracted from diatoms such as Amphora sp. present abundantly in the ecosystems. In view of the key environmental and nutritional factors governing the diatoms growth rate, culture conditions were optimized for the biomass yield, total lipid content, EPA yield, and fatty acid composition under two main cultivation regimes: photoautotrophic and heterotrophic. The fastest growth rate about 0.20 ± 0.02 g/L and the highest EPA yield about 9.19 ± 3.56 mg EPA/g biomass were obtained by adding 10 g/L glucose and sucrose, respectively. Under photoautotrophic culture conditions, Amphora sp. rendered higher EPA yield at 100 rpm and 16:8 light/dark cycle. Total fatty acids produced predominantly comprised of an approximate 40-70% of saturated fatty acids, followed by 10-27% of monounsaturated fatty acids and then 8-25% of polyunsaturated fatty acids. These findings were able to pave a way for huge-scale microalgal biomass production in commercial EPA production.

Hereditary spastic paraplegias (HSP) include a clinically and genetically heterogeneous group of conditions. Novel imaging modalities have been increasingly applied to HSP cohorts, which help to develop monitoring markers for both clinical care and future clinical trials.Advances in HSP imaging are systematically reviewed with a focus on cohort sizes, imaging modalities, study design, clinical correlates, methodological approaches, and key findings.A wide range of imaging techniques have been recently applied to HSP cohorts. Common shortcomings of existing studies include the evaluation of genetically admixed cohorts, limited sample sizes, lack of postmortem validation, and a limited clinical battery. A number of innovative methodological approaches have also been identified, such as robust longitudinal study designs, the implementation of multimodal imaging protocols, complementary cognitive assessments, and the comparison of HSP cohorts to MND cohorts. Collaborative multicenter initiatives may overcome sample limitations, and comprehensive clinical profiling with motor, extrapyramidal, cerebellar, and neuropsychological assessments would permit systematic clinico-radiological correlations. Academic achievements in HSP imaging have the potential to be developed into viable clinical applications to expedite the diagnosis and monitor disease progression.

Malaysia is recognized as one of the mega biodiversity countries of the world. However, Malaysia’s biodiversity hotspot experiencing a more pronounce biodiversity loss. Accordingly, the objective of this study is to explore the link between climate change, socio-economic factors and biodiversity loss in Malaysia from 1990 to 2016, with a special focus on different climate change indicators namely rainfall, temperature and carbon dioxide (CO[Formula: see text] emissions. Using the autoregressive distributed lag (ARDL) bounds testing approach, this study provides evidence on long-run relation between each of the indicators of climate change and biodiversity loss. The core threats to biodiversity are growing demand for agricultural land, rapid population, elevated temperature, higher CO2 emissions and rainfall reduction. Interestingly, the biodiversity loss-income nexus is also supportive of the environmental Kuznets curve (EKC) hypothesis; with biodiversity threats increasing with income, beyond a certain level of income, a rise in income reduces the loss of biodiversity. The findings are essential for future studies with a special consideration to reduce the losses of biodiversity.

Nurses act as customer-contact employees who are responsible for providing round-the-clock service to patients. Their empathy and competency skills have a significant impact on the quality of services provided to patients. The purpose of this study is to examine the role of empathy and competency in determining task performance and contextual performance of public hospital nurses in Malaysia. A survey using self-administered questionnaires was used to collect data from a sample of 354 staff nurses working in Malaysian public hospitals. Hypotheses were tested using the partial least square technique. Findings indicated that empathy has a positive relationship with task performance but not with contextual performance. Competency, however, has a positive relationship with task performance and contextual performance respectively. Empathy and competency are essential elements in predicting both task performance and contextual performance. The findings of this study highlighted the importance of empathy and competency in improving job performance among nurses in Malaysian public hospitals.

Sporadic clusters of healthcare-associated coronavirus disease 2019 (COVID-19) occurred despite intense rostered routine surveillance and a highly vaccinated healthcare worker (HCW) population, during a community surge of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) B.1.617.2 δ (delta) variant. Genomic analysis facilitated timely cluster detection and uncovered additional linkages via HCWs moving between clinical areas and among HCWs sharing a common lunch area, enabling early intervention.

South and Southeast Asia is by far the most populous region in Asia, with the greatest number of threatened species. Changes in habitat are a major contributor to biodiversity loss and are more common as a result of land-use changes. As a result, the goal of this study is to use negative binomial regression models to investigate habitat change as one of the important drivers of biodiversity loss in South and Southeast Asian countries from 2013 to 2018. According to the negative binomial estimates, the findings for the habitat change measures are quantitatively similar for the impacts of agricultural land and arable land on biodiversity threats. Agricultural and arable land both have a positive impact on biodiversity loss. We found that, contrary to our expectations, the forest area appears to have an unexpected direct influence on the number of threatened species. A higher number of threatened species is associated with rising per capita income, human population and a low level of corruption control. Finally, the empirical findings are consistent across taxonomic groups, habitat change measures and Poisson-based specifications. Some policy implications that could mitigate biodiversity loss include educating and promoting good governance among the population and increase the conservation effort to sustain green area and national forest parks in each country.

Digital polymerase chain reaction (dPCR) technology has provided a new technique for molecular diagnostics, with superior advantages, such as higher sensitivity, precision, and specificity over quantitative real-time PCRs (qPCR). Eight companies have offered commercial dPCR instruments: Fluidigm Corporation, Bio-Rad, RainDance Technologies, Life Technologies, Qiagen, JN MedSys Clarity, Optolane, and Stilla Technologies Naica. This paper discusses the working principle of each offered dPCR device and compares the associated: technical aspects, usability, costs, and current applications of each dPCR device. Lastly, up-and-coming dPCR technologies are also presented, as anticipation of how the dPCR device landscape may likely morph in the next few years.

Evidence-based practice (EBP) is a model that integrates research, education and practice. Although it has been generally promoted and applied in various practice settings, few studies have examined whether EBP is related to service quality in social work. In this study, a sample of 2,987 licensed social workers was drawn from the Chinese Social Workers Survey, and a model that connects familiarity with the EBP process and service quality was tested. Additionally, this study examined the influences of anti-authority culture and professional autonomy on self-perceived service quality. Results showed that the preference for authority-based evidence is prevalent amongst the social workers in this sample. Familiarity with the EBP process is positively related to self-evaluated service quality. Preference for authority-based evidence and professional autonomy partially mediates the relationship between familiarity with the EBP and self-evaluated service quality. These findings provide insights into the EBP process amongst Chinese social workers. Educational implications include promoting high-quality evidence and emphasising critical thinking and accountability in EBP education. Summary This study drew a sample of 2987 licensed social workers from the Chinese Social Workers Survey and tested a model that connects familiarity with EBP process and self-evaluated service quality. The findings revealed that the respondents who are more familiar with the EBP process are more likely to report better service quality Chinese social workers' self-reported service quality is partially built on the professional autonomy and anti-authority culture promoted by the EBP movement.

Background: IDH is a common and serious complication of chronic hemodialysis that can lead to adverse long-term outcomes, including increased cardiovascular and all-cause mortality. Predicting IDH in advance may aid in establishing an intervention plan. Method: This study used 1173783 hemodialysis sessions from 837 patients and 211 features (including time-span varying and basic information features) as datasets. We constructed 21 features (including ion changes before and after dialysis) by clinical physicians from the raw datasets. We selected 89 features by grid search recursive feature elimination (RFE) based on extreme gradient boosting (XGBoost) (Gs-RFE-XGBoost) and XGBoost model to predict IDH. We used the Shapley value to achieve an explainable result for the 20 features. Besides, we used the quartile 2.5 to quartile 97.5 to get the reference range of the important continuous features. Result: We found the most important 20 features that are blood pressure related (including the datasets of 4 features and 4 construct features), platelet count, pathway type, pre-dialysis dry weight, dialyzer type, hematocrit, basophils, platelet distribution width, pre-dialysis uric acid, KT/V, parathyroid hormone (PTH), changes in calcium before and after dialysis, dialysis age. We get 0.8446 of avg recall, 0.9149 of avg F1, 0.9410 of avg PRAUC, 0.8823 of avg precision, and 0.8944 of avg MCC to predict the IDH in real-time. Conclusion: The Gs-RFE-XGBoost-Shapley methods can be applied as a practical, explained, and accurate method to predict IDH. The feature’s reference range can provide hints for the clinical physician to prevent the IDH of maintenance hemodialysis (MHD).