diff --git a/docker-compose.monitoring.yml b/docker-compose.monitoring.yml
index 1603947..460b816 100644
--- a/docker-compose.monitoring.yml
+++ b/docker-compose.monitoring.yml
@@ -10,7 +10,7 @@ services:
loki:
image: grafana/loki:3.4.2
ports:
- - "127.0.0.1:3100:3100"
+ - "127.0.0.1:3101:3100"
command: -config.file=/etc/loki/loki-config.yaml
volumes:
- loki-data:/loki
diff --git a/public/components/calculators.html b/public/components/calculators.html
index 7bc69ee..95fc3be 100644
--- a/public/components/calculators.html
+++ b/public/components/calculators.html
@@ -372,7 +372,9 @@
-
+
+
+
diff --git a/public/js/calculators.js b/public/js/calculators.js
index 5bfa607..c5b41c1 100644
--- a/public/js/calculators.js
+++ b/public/js/calculators.js
@@ -1282,21 +1282,37 @@
// Values read from published nomogram curves at key time points
// NOTE: The AAP 2022 raised thresholds ~2 mg/dL above the 2004 guidelines
- // >= 38 weeks, no neurotoxicity risk factors (Figure 2, upper curve)
+ // AAP 2022 exact phototherapy thresholds (extracted from PediTools/AAP nomograms)
+ // >= 38 weeks, no neurotoxicity risk factors
var photoThresholds38 = {
- 12: 8.0, 24: 12.0, 36: 14.0, 48: 15.5, 60: 17.0, 72: 18.0, 84: 18.5, 96: 19.0, 108: 19.5, 120: 20.0
+ 12: 10.1, 24: 12.3, 36: 14.2, 48: 16.0, 60: 17.5, 72: 18.8, 84: 19.9, 96: 20.7, 120: 20.9
};
- // >= 38 weeks, WITH neurotoxicity risk factors (Figure 2, lower curve)
+ // >= 38 weeks, WITH neurotoxicity risk factors
var photoThresholds38risk = {
- 12: 6.0, 24: 10.0, 36: 12.0, 48: 13.5, 60: 15.0, 72: 16.0, 84: 16.5, 96: 17.0, 108: 17.5, 120: 18.0
+ 12: 8.5, 24: 10.5, 36: 12.4, 48: 14.0, 60: 15.4, 72: 16.6, 84: 17.5, 96: 18.2, 120: 18.2
};
- // 35-37 weeks, no neurotoxicity risk factors (Figure 3, upper curve)
+ // 36 weeks, no neurotoxicity risk factors
+ var photoThresholds36 = {
+ 12: 9.0, 24: 11.2, 36: 13.1, 48: 14.8, 60: 16.2, 72: 17.5, 84: 18.5, 96: 19.3, 120: 19.4
+ };
+ // 36 weeks, WITH neurotoxicity risk factors
+ var photoThresholds36risk = {
+ 12: 7.4, 24: 9.4, 36: 11.2, 48: 12.8, 60: 14.2, 72: 15.4, 84: 16.3, 96: 17.0, 120: 17.1
+ };
+ // 35 weeks, no neurotoxicity risk factors
var photoThresholds35 = {
- 12: 5.5, 24: 9.0, 36: 11.0, 48: 12.5, 60: 14.0, 72: 14.5, 84: 15.0, 96: 15.5, 108: 16.0, 120: 16.0
+ 12: 8.5, 24: 10.6, 36: 12.5, 48: 14.2, 60: 15.6, 72: 16.8, 84: 17.8, 96: 18.6, 120: 18.7
};
- // 35-37 weeks, WITH neurotoxicity risk factors (Figure 3, lower curve)
+ // 35 weeks, WITH neurotoxicity risk factors
var photoThresholds35risk = {
- 12: 4.0, 24: 7.5, 36: 9.0, 48: 10.5, 60: 12.0, 72: 12.5, 84: 13.0, 96: 13.5, 108: 14.0, 120: 14.0
+ 12: 6.9, 24: 8.9, 36: 10.6, 48: 12.2, 60: 13.5, 72: 14.6, 84: 15.5, 96: 16.1, 120: 16.3
+ };
+ // Exchange transfusion thresholds (AAP 2022)
+ var exchangeThresholds38 = {
+ 12: 19.7, 24: 21.4, 36: 22.8, 48: 24.0, 60: 25.1, 72: 25.9, 84: 26.6, 96: 27.0
+ };
+ var exchangeThresholds38risk = {
+ 12: 16.3, 24: 17.7, 36: 19.0, 48: 20.1, 60: 21.2, 72: 22.1, 84: 22.9, 96: 23.5
};
function interpolateThreshold(table, hours) {
@@ -1333,16 +1349,24 @@
var risk = document.getElementById('bili-risk').value;
if (!ga || isNaN(hours) || isNaN(tsb)) { showToast('Fill in all fields', 'error'); return; }
+ var gaNum = parseInt(ga);
var table;
- if (parseInt(ga) >= 38) table = risk === 'medium' ? photoThresholds38risk : photoThresholds38;
+ if (gaNum >= 38) table = risk === 'medium' ? photoThresholds38risk : photoThresholds38;
+ else if (gaNum === 36 || gaNum === 37) table = risk === 'medium' ? photoThresholds36risk : photoThresholds36;
else table = risk === 'medium' ? photoThresholds35risk : photoThresholds35;
var threshold = interpolateThreshold(table, hours);
var aboveThreshold = tsb >= threshold;
- var cl = aboveThreshold
- ? { text: 'Above Phototherapy Threshold', color: '#ef4444', bg: '#fee2e2' }
- : { text: 'Below Phototherapy Threshold', color: '#10b981', bg: '#d1fae5' };
+ // Check exchange transfusion threshold too
+ var exchangeTable = gaNum >= 38 ? (risk === 'medium' ? exchangeThresholds38risk : exchangeThresholds38) : null;
+ var exchangeThreshold = exchangeTable ? interpolateThreshold(exchangeTable, hours) : null;
+ var aboveExchange = exchangeThreshold && tsb >= exchangeThreshold;
+
+ var cl;
+ if (aboveExchange) cl = { text: 'ABOVE EXCHANGE TRANSFUSION THRESHOLD', color: '#7f1d1d', bg: '#fecaca' };
+ else if (aboveThreshold) cl = { text: 'Above Phototherapy Threshold', color: '#ef4444', bg: '#fee2e2' };
+ else cl = { text: 'Below Phototherapy Threshold', color: '#10b981', bg: '#d1fae5' };
var resultDiv = document.getElementById('bili-result');
resultDiv.classList.remove('hidden');
@@ -1353,15 +1377,20 @@
'
' +
'' +
'
Patient TSB
' + tsb + '
mg/dL
' +
- '
Threshold
' + threshold.toFixed(1) + '
mg/dL at ' + hours + 'h
' +
- '
Margin
' + (tsb >= threshold ? '+' : '') + (tsb - threshold).toFixed(1) + '
mg/dL ' + (aboveThreshold ? 'above' : 'below') + '
' +
+ '
Photo Threshold
' + threshold.toFixed(1) + '
mg/dL at ' + hours + 'h
' +
+ '
Margin
' + (tsb >= threshold ? '+' : '') + (tsb - threshold).toFixed(1) + '
mg/dL ' + (aboveThreshold ? 'above' : 'below') + ' photo
' +
+ (exchangeThreshold ? '
Exchange Threshold
' + exchangeThreshold.toFixed(1) + '
mg/dL' + (aboveExchange ? ' — EXCEEDED' : '') + '
' : '') +
'
GA ' + ga + ' weeks, ' + (risk === 'medium' ? 'with' : 'without') + ' neurotoxicity risk factors. AAP 2022 CPG. Always use clinical judgment.
';
+ 'GA ' + ga + ' weeks, ' + (risk === 'medium' ? 'with' : 'without') + ' neurotoxicity risk factors. AAP 2022 CPG (exact values from published nomograms). Always use clinical judgment.
';
- // Chart: phototherapy threshold line vs patient
- renderBiliChart(hours, tsb, [
+ // Chart: phototherapy + exchange threshold lines vs patient
+ var chartDatasets = [
{ label: 'Phototherapy Threshold', data: generateThresholdCurve(table), borderColor: '#ef4444', borderWidth: 2, borderDash: [], fill: { target: 'origin', above: 'rgba(239,68,68,0.08)' } }
- ]);
+ ];
+ if (exchangeTable) {
+ chartDatasets.push({ label: 'Exchange Transfusion', data: generateThresholdCurve(exchangeTable), borderColor: '#7f1d1d', borderWidth: 2, borderDash: [6,3], fill: false });
+ }
+ renderBiliChart(hours, tsb, chartDatasets);
});
document.getElementById('btn-clear-bili-aap').addEventListener('click', function() {