Testing Strategies Research Articles

Risk factors for Staphylococcus aureus colonization in a general emergency department patient cohort – results of an observational cohort study

Background Testing for Staphylococcus aureus (SA) colonization in emergency department (ED) patients may guide prevention strategies against hospital acquired infections (HAI). This study determined the prevalence of SA carriers in a general ED population, characterized the population, and identified predictors for SA colonization. Methods A prospective monocentric observational cohort study in a tertiary care hospital collected nasopharyngeal swabs in 1,000 adult patients. PCR testing for methicillin resistant and methicillin sensitive SA (MRSA/MSSA) was performed. Risk factor questionnaires and routine data from the clinical information system were captured. Descriptive statistics and binary logistic regression models were applied to report prevalence and outcomes and to identify predictors. Results The prevalence for SA was 33.7% (n = 328; 95%-CI: 30.7-36.8): MSSA 30.9% (n = 301; 95%-CI: 28.0-34.0) and MRSA 2.8% (n = 27; 95%-CI: 1.8-4.0). POC PCR testing in the ED was feasible. Key predictors of SA colonization included having a catheter (OR 2.0, 95%-CI 1.0-4.0, p = 0.044) and requiring nursing care (OR 1.9, 95%-CI: 1.2-2.9, p = 0.007), even after adjusting for age and sex. Conclusion Testing strategies for SA detection in ED need to focus on vulnerable populations with an elevated risk for HAIs and associated adverse outcomes. Individuals requiring nursing care could be a key target population for screening efforts.

Opportunities for More Tailored Approaches to Genotoxicity Testing and Carcinogenicity Strategy for Oligonucleotide Therapeutics: Outcome of an Industry Survey.

The Oligonucleotide Nonclinical Working Group (WG) of the European Federation of Pharmaceutical Industries and Associations conducted an industry survey to understand current practices and regulatory expectations for genotoxicity and carcinogenicity assessment of oligonucleotide therapeutics (ONTs), along with historical genotoxicity testing results. The survey, involving 29 pharmaceutical and biotechnology companies, revealed a consistent absence of genotoxicity across a diverse range of oligonucleotide classes and chemistries, consistent with previous observations. Despite the lack of genotoxicity, companies continue to follow standard testing guidelines, with only limited divergence. The survey data support the view that well-established ONT modifications can be considered "precedented," in terms of negligible genotoxic risk. As such, further testing of new ONT candidates containing only precedented modifications is unwarranted, when defined criteria are met. Further, we propose a pathway for novel ONT chemical modifications to achieve precedented status. The survey results also indicate that alternative strategies for carcinogenicity assessment (e.g., single-species testing) can be accepted by regulatory agencies under certain circumstances. Overall, the survey findings underscore the need for a more tailored approach to the nonclinical safety assessment of ONTs, and the WG proposes development of supplementary questions for International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use S2(R1) guidance to reflect this broad industry experience.

Evaluation of a Machine Learning-Guided Strategy for Elevated Lipoprotein(a) Screening in Health Systems.

While universal screening for Lp(a; lipoprotein[a]) is increasingly recommended, <0.5% of patients undergo Lp(a) testing. Here, we assessed the feasibility of deploying Algorithmic Risk Inspection for Screening Elevated Lp(a; ARISE), a validated machine learning tool, to health system electronic health records to increase the yield of Lp(a) testing. We randomly sampled 100 000 patients from the Yale-New Haven Health System to evaluate the feasibility of ARISE deployment. We also evaluated Lp(a)-tested populations in the Yale-New Haven Health System (n=7981) and the Vanderbilt University Medical Center (n=10 635) to assess the association of ARISE scores with elevated Lp(a). To compare the representativeness of the Lp(a)-tested population, we included 456 815 participants from the UK Biobank and 23 280 from 3 US-based cohorts of Atherosclerosis Risk in Communities, Coronary Artery Risk Development in Young Adults, and Multi-Ethnic Study of Atherosclerosis. Among 100 000 randomly selected Yale-New Haven Health System patients, 413 (0.4%) had undergone Lp(a) measurement. ARISE scores could be computed for 31 586 patients based on existing data, identifying 2376 (7.5%) patients with a high probability of elevated Lp(a). A positive ARISE score was associated with significantly higher odds of elevated Lp(a) in the Yale-New Haven Health System (odds ratio, 1.87 [95% CI, 1.65-2.12]) and the Vanderbilt University Medical Center (odds ratio, 1.41 [95% CI, 1.24-1.60]). The Lp(a)-tested population significantly differed from other study cohorts in terms of ARISE features. We demonstrate the feasibility of deployment of ARISE in US health systems to define the risk of elevated Lp(a), enabling a high-yield testing strategy. We also confirm the low adoption of Lp(a) testing, which is also being restricted to a highly selected population.

Seroprevalence of Borrelia burgdorferi sensu lato antibodies in English adult blood donors: A nationwide cross-sectional study, 2021-2022.

Estimates of Lyme disease incidence in England are based on reporting of cases with a laboratory-confirmed diagnosis only, underestimating total cases. In 2017 - 2018, two independent reviews commissioned by the UK Government highlighted the lack of official data on Lyme disease prevalence and incidence as a critical knowledge gap. To estimate the prevalence of IgG antibodies in the English adult population specific for Borrelia burgdorferi sensu lato (Bbsl), the causative agent of Lyme disease. The prevalence of Bbsl-specific antibodies in the English population was estimated in a cross-sectional cohort, selected from an archive of residual NHS blood donor plasma samples (age range 17 - 84, collected between 2021 - 2022). 10,000 samples were randomly selected proportionate to the population size of each of the nine English administrative regions. 9,994 samples were tested using a standard two-tiered testing strategy, with an IgG/IgM ELISA followed by an IgG immunoblot (array) test for any sera with positive or indeterminate reactivity in the ELISA. Out of the 9,994 samples tested, 482 were seroreactive by screening ELISA. After two-tier testing, 49 were confirmed positive. Regional and demographic differences in seroprevalence were observed after two-tier testing, but due to the low overall seroprevalence, were not significant upon multivariable analysis. The seroprevalence of Borrelia burgdorferi sensu lato-specific IgG in the English adult population (2021 - 2022), determined using two-tier testing was estimated at 0.49 % (95 % CI 0.36 - 0.65). This is lower than neighbouring UK nation Scotland and other northern European countries.

A proposed screening strategy for evaluating the genotoxicity potential of botanicals and botanical extracts.

Botanicals have long been used to promote health and treat diseases, but the safety of many currently marketed botanicals has not been adequately evaluated. Given the chemical complexity of botanicals, which often contain numerous unknown constituents, and their widespread use, comprehensive toxicity assessments are needed. The Botanical Safety Consortium was established to address this challenge. This international group of experts in toxicology, chemistry, bioinformatics, and pharmacognosy is developing a toolkit of assays to generate reliable toxicological profiles for botanicals. Genotoxicity assessment is especially critical, because, unlike other toxicities, genotoxicity is not adequately identified by adverse event and history-of-use reports, and genotoxicity is directly linked to health consequences such as cancer and birth defects. The Consortium's Genotoxicity Technical Working Group is exploring a genotoxicity testing strategy based on the use of in silico modeling and the bacterial reverse mutation and in vitro micronucleus assays and including several options for additional tests to further characterize genotoxicity and mode of action when indicated. The effectiveness of this testing strategy is being evaluated using 13 well-characterized botanicals with existing toxicological data as case studies. A brief overview of each of these 13 botanicals is provided. The final strategy for developing comprehensive genotoxicity profiles of botanicals will incorporate published genotoxicity data, chemical composition information, in silico and in vitro test data, and human exposure data, reducing the need for animal testing.

Review and meta-analysis of gene expression biomarkers predictive of chemical-induced genotoxicity in vivo.

There is growing recognition across broad sectors of the toxicology community that gene expression biomarkers have the potential to identify genotoxic and nongenotoxic carcinogens through a weight-of-evidence approach, providing opportunities to reduce reliance on the 2-year bioassay to identify carcinogens. In August 2022, a workshop within the International Workshops on Genotoxicity Testing (IWGT) was held to critically review current methods to identify genotoxicants using various 'omics profiling methods. Here, we describe the findings of a workshop subgroup focused on the state of the science regarding the use of biomarkers to identify chemicals that act as genotoxicants in vivo. A total of 1341 papers were screened to identify those that were most relevant. While six published biomarkers with characterized accuracy were initially examined, four of the six were not considered further, because they had not been tested for classification accuracy using additional sets of chemicals or other transcript profiling platforms. Two independently derived biomarkers used in conjunction with standard computational techniques can identify genotoxic chemicals in vivo (rat liver or both rat and mouse liver) on different gene expression profiling platforms. The biomarkers have predictive accuracies of ≥92%. These biomarkers have the potential to be used in conjunction with other biomarkers in integrated test strategies using short-term rodent exposures to identify genotoxic and nongenotoxic chemicals that cause cancer.

Role of Population Based Studies in Advancing our Knowledge of Myelodysplastic Syndromes.

Myelodysplastic syndromes (MDS) are myeloid neoplasms characterized by high molecular and genomic heterogeneity. Accordingly, efforts in risk assessment and therapeutic intervention mostly target unique profiles that individualize specific MDS subtypes. In this review, we explored the contributions of population based studies accounting for MDS as a group. Large population based studies have been critical to define important details of our current knowledge of the disease. We summarized the most important population research contributions in MDS, focusing on its epidemiology, population risk factors, and relevant clinical associations. We discuss how these population data can provide vital insights to inform prevention measures, testing strategies, and treatment decisions. Population studies play an important role in guiding clinical and research efforts in MDS. Despite its complex molecular and genomic landscape, population data is integral to define the burden of disease, identify risk factors and clinical associations, and can help elucidate pathogenic mechanisms.

The impact of community pharmacies on equity in access to professional rapid antigen testing for SARS-CoV-2 in Portugal.

Amid the COVID-19 pandemic, various public health measures were adopted to reduce the transmission risk, including the full reimbursement of SARS-CoV-2 professional rapid antigen detection tests (Ag-RDT) conducted in clinical pathology laboratories, community pharmacies (CPs), and other authorized entities. This study aimed to assess the impact of integrating CPs into the Portuguese National Health Service (NHS) testing strategy on the capacity of professional Ag-RDT delivery, and to compare the equity in testing access with and without CPs participation. This analytical cross-sectional study assessed the impact of adding CPs into the testing strategy based on two main outcomes by municipality: (i) average distance (in Kilometres) of the population to the nearest Ag-RDT site; and (ii) the average number of weekly hours available to testing per 1,000 inhabitants, as of January 31, 2022. Two scenarios were considered: with and without CPs. Access inequalities were evaluated using Lorenz curves and Gini coefficients. A subgroup inequality analysis was conducted based on three socio-demographic indicators: population density, aging index, and per capita purchasing power index. A total of 1,369 (65.1 %) pharmacies and 735 (34.9 %) laboratories and other entities provided free Ag-RDT to the population. The average distance to the nearest Ag-RDT location was 3.7 km, which decreased to 1.8 km with the inclusion of CPs. Overall, there were 11.5 weekly hours per 1,000 inhabitants available for testing with CPs, compared to 2.1 h without CPs (p < 0.0001). The Gini coefficient for distance distribution decreased from 0.50 to 0.42 with CPs inclusion (-16.8 %). For the distribution of weekly hours, the Gini coefficient decreased from 0.42 to 0.26 (-38.6 %). The reduction was higher in municipalities with lower population density (-43.3 %), higher aging index (-51.3 %), and lower per capita purchasing power index (-54.6 %). Pharmacies play a crucial role in mitigating geographical and socioeconomic inequalities in healthcare access. Without CPs, the provision of Ag-RDT services would result in significant territorial gaps, exacerbating disparities among already vulnerable population groups.

Comparison of Referral Rates and Costs Using Fibrosis-4 and Enhanced Liver Fibrosis (ELF) Testing Strategies for Initial Evaluation of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in a Veteran Population.

Global metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence is estimated at 30% and projected to reach 55.7% by 2040. In the Veterans Affairs (VA) healthcare system, an estimated 1.8 million veterans have metabolic dysfunction-associated steatohepatitis (MASH). Adult patients at risk for MASLD in a VA healthcare system underwent Fibrosis-4 (FIB-4) and Enhanced Liver Fibrosis (ELF®) testing. Referral rates and cost savings were compared among 6 noninvasive testing (NIT) strategies using these 2 tests independently or sequentially at various cutoffs. Enrolled patients (N = 254) had a mean age of 65.3 ± 9.3 years and mean body mass index (BMI) of 31.7 ± 6, 87.4% male: 78.3% were non-Hispanic/Latino, and 96.5% had type 2 diabetes mellitus (T2DM). Among the 6 evaluated strategies, using FIB-4 followed by ELF at a 9.8 cutoff yielded the highest proportion of patients retained in primary care without need of referral to hepatology clinic (165/227; 72.7%), and was associated with the lowest costs ($407.62). Compared to the FIB-4 only strategy, FIB-4/ELF with a 9.8 cutoff strategy resulted in 26% fewer referrals and 8.47% lower costs. In the subgroup of patients with BMI >32, there were 25.17% fewer referrals and costs were 8.31% lower. Our study suggests that sequential use of ELF with a 9.8 cutoff following indeterminate FIB-4 tests results in lower referral rates and lower care costs in a veteran population at risk of MASLD. Adding ELF as a sequential test after indeterminate FIB-4 might help reduce the number of referrals and overall cost of care.

Volume 08 Issue 01 January 2025 Home January 2025 The Effect of Proactive Personality and Entrepreneurial Leadership on Innovative work Behavior Mediated by work Engagement in State Civil Apparatus at the Cooperative Service in West Sumatera

This study aims to analyze the effect of proactive personality and entrepreneurial leadership on innovative work behavior mediated by work engagement in state civil apparatus at the cooperative service in West Sumatera. The type of research uses explanatory research. While the research approach uses an explanatory survey that emphasizes quantitative research methods. The entire population Civil Service of the Cooperatives Department in West Sumatera totaling 664 people, with a sample size of 250 people. The sampling technique used proportionate stratified random sampling. Data analysis using Partial Least Square (SEM-PLS). The mediation testing strategy uses the path coefficient significance. The results of the study found proactive Personality has a positive and significant effect on work engagement. Proactive Personality has a positive and significant effect on Innovative Work Behavior. Work engagement has a positive and significant effect on Innovative Work Behavior. Entrepreneurial Leadership has a positive and significant effect on work engagement. Entrepreneurial Leadership has a positive and significant effect on Innovative Work Behavior. Work engagement mediates the influence of Proactive Personality and Entrepreneurial Leadership on Innovative Work Behavior with the form of mediation is complementary mediation in the form of partial mediation

Speeding Up Test Automation: Practical Strategies to Cut Execution Times

In today’s fast-paced software development environment, efficient test automation is crucial for accelerating release cycles and ensuring software quality. However, one significant challenge teams face is managing the execution time of automated tests. Long test cycles can slow down development, delay feedback, and impact overall productivity. Fortunately, several strategies can be employed to reduce test automation execution times without sacrificing the reliability and effectiveness of testing. Key techniques include parallel test execution, optimizing test scripts, minimizing setup and teardown overhead, using headless browsers, focusing on essential features, and adopting a modular test design. This article explores these strategies in detail, providing actionable insights on how to streamline test automation, reduce execution times, and enhance overall testing efficiency. As organizations strive to maintain agility and responsiveness, reducing automation test cycles becomes essential not only for quicker feedback but also for improving the overall quality and performance of the software being developed. Keywords: Test Automation, Automated Testing Strategies, Test Execution Time, Parallel Test execution, Test Optimization, Headless Browsers, Selenium Automation, Software Quality Assurance

ATXN2 polyglutamine intermediate repeats length expansions in Malaysian patients with amyotrophic lateral sclerosis (ALS).

Intermediate CAG repeats from 29 to 33 in the ATXN2 gene contributes to the risk of amyotrophic lateral sclerosis (ALS) in European and Asian populations. In this study, 148 ALS patients of multiethnic descent: Chinese (56.1%), Malay (24.3%), Indian (12.8%), others (6.8%) and 100 neurologically normal controls were screened for the ATXN2 CAG repeat expansion. The most common repeat length in both the controls and patients was 22. No familial ALS patients were positive for the intermediate repeat sizes (29-33), while four sporadic patients (2.8%) were positive, with one harbouring a rare ATXN2 homozygous 32 repeat expansion, and a likely pathogenic variant in SPAST. All four patients had limb-onset ALS. Despite representing the smallest ethnic group in our patient cohort, three of the four patients with intermediate repeat sizes were of Indian ancestry. This study, which is the first in Malaysia and Southeast Asia, shows that ATXN2 intermediate risk expansions are relevant to ALS in these populations and will help to inform future genetic testing strategies in the clinic.

Development of a mobile-based application for leaf disease recognition in abaca (Musa textilis)

Abaca is a significant crop valued for its durable fibers, widely used in various industries. However, abaca cultivation is threatened by diseases that can severely impact yields and quality. Hence, timely detection and accurate diagnosis of these diseases are crucial for effective management. Thus, this research tries to develop a tool that can detect and diagnose leaf diseases to aid farmers in disease mitigation. This research utilized the Waterfall model in the development of the application. Ten types of disease image datasets were collected from Kaggle. Three testing strategies namely benchmark, alpha, and beta tests were conducted to evaluate the application using ISO/IEC 25010 software quality metrics. During these tests, the application gained an overall mean of 3.49, 3.76, and 4.52 respectively. The findings revealed that the application is already usable and functional. Additional features may be included for easy mitigation in the widespread of the disease in future studies.

Non-Invasive Point-of-Care Detection of Methamphetamine and Cocaine via Aptamer-Based Lateral Flow Test.

Drug abuse is a major public problem in the workplace, traffic, and forensic issues, which requires a standardized test device to monitor on-site drug use. For field testing, the most important requirements are portability, sensitivity, non-invasiveness, and quick results. Motivated by this problem, a point of care (POC) test based on lateral flow assay (LFA) was developed for the detection of cocaine (COC) and methamphetamine (MET) in saliva which has been selected as the matrix for this study due to its rapid and non-invasive collection process. In the design strategy of an LFA test, the use of gold nanoparticles (AuNPs) with strong optical properties has been combined with the advantages of selecting aptamers under in vitro conditions, making it a highly specific and stable recognition probe for the detection of small molecules in saliva. The developed aptamer-based LFA in a competitive format, was able to detect COC and MET in synthetic saliva at concentrations as low as 5.0 ng/mL. After analytical performance studies, the test system also detected COC and MET in real patient samples, which was verified by chromatographic methods.

Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates.

Candida auris screening is one of the crucial components of infection prevention and control measures to curb the spread of C. auris. However, previous research has yielded various results on the effectiveness of C. auris screening according to region, type of healthcare facility, and patient group in the various levels of endemicity. We aimed to assess the clinical effectiveness of routine C. auris screening upon admission to the intensive care unit (ICU). This retrospective study involved 3356 ICU patients during pre-screening (N = 1658, June 2020 to November 2021) and post-screening period (N = 1698, June 2022 to November 2023). Swabs for C. auris screening were taken from axilla and groin, then cultured, and identified using either matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry or VITEK 2 YST identification card. We compared the positivity rates of C. auris during the pre- and post-screening period. Of the 1698 patients who underwent C. auris screening, only 4 (0.2 %) tested positive. The positivity rates before and after the introduction of the screening program were 2.92 cases per 1000 patient days (36/12333) and 2.36 (21/8909), respectively, without significant difference (P = 0.435). Interrupted times series analysis showed no immediate (P = 0.775) or sustained (P = 0.484) effects from the screening program. Subgroup analysis of patients in the medical ICU showed similar results. Universal C. auris screening upon ICU admission identified a small number of cases. Instead, targeted screening and regular point prevalence surveys, along with other infection prevention and control measures may be employed. Further studies in various settings with diverse testing strategies are needed to establish the most effective approach for C. auris screening.

Assessing the Integrity of N95 Mask Elastomer Straps With Decontamination and Reuse

ABSTRACTThe rapid progression of the COVID‐19 pandemic revealed an inability to meet increased demand for N95 respirators. These respirators are designed to be used once and disposed, but throughout the pandemic, there was a need for their decontamination and reuse. This research investigates the effect of various decontamination methods on the chemical and mechanical properties of N95 mask straps made of natural rubber to explore how these straps change after decontamination and what materials characterization techniques are well‐suited to evaluate these changes. Using results from ozone decontamination, tensile testing of mask strap assemblies is identified as the most reliable way to quantify changes in strap properties with decontamination and reuse when compared to other analytical techniques. Additionally, visible strap degradation often precedes both strap failure and material property changes and can be a reasonable indicator to discontinue use. Aside from ozone, decontamination with other methods such as heat and UV light appears to be less damaging to the tested materials. Beyond the specific results presented, this study provides insight on testing strategies that can be employed to move forward with evaluating new materials and decontamination methods for use in future pandemics or in more resource‐limited regions.

Multiple testing for signal-agnostic searches for new physics with machine learning

In this work, we address the question of how to enhance signal-agnostic searches by leveraging multiple testing strategies. Specifically, we consider hypothesis tests relying on machine learning, where model selection can introduce a bias towards specific families of new physics signals. Focusing on the New Physics Learning Machine, a methodology to perform a signal-agnostic likelihood-ratio test, we explore a number of approaches to multiple testing, such as combining p-values and aggregating test statistics. Our findings show that it is beneficial to combine different tests, characterised by distinct choices of hyperparameters, and that performances comparable to the best available test are generally achieved, while also providing a more uniform response to various types of anomalies. This study proposes a methodology that is valid beyond machine learning approaches and could in principle be applied to a larger class model-agnostic analyses based on hypothesis testing.

A Guide to Pediatric Antibiotic Allergy Testing: A Report From the US Drug Allergy Registry.

Pediatric antibiotic labels are common, and unnecessary antibiotic avoidance is associated with negative personal and public health outcomes; as a result, there is an increasing emphasis on the importance of pediatric antibiotic allergy evaluations. Different testing strategies have been advised, including skin testing and challenge testing with varied doses and duration. Established consensus testing protocols are lacking. The US Drug Allergy Registry Pediatrics (USDAR-Peds) is a multisite prospective study designed for epidemiology and outcome evaluations of pediatric drug hypersensitivity reactions. Interpretation of multisite data requires a uniform clinical approach, and the USDAR-Peds standardized protocols were developed in response to this need. This rostrum aims to provide a rationale and framework for standardization for pediatric antibiotic allergy protocols and assessment of positive reactions through a pediatric-specific adaptation of the USDAR immediate reaction grading scale to create consistency for multisite research collaboration efforts such as USDAR-Peds.

Homologous recombination deficiency in ovarian cancer: Global expert consensus on testing and a comparison of companion diagnostics.

Poly (ADP ribose) polymerase inhibitors (PARPis) are a treatment option for patients with advanced high-grade serous or endometrioid ovarian carcinoma (OC). Recent guidelines have clarified how homologous recombination deficiency (HRD) may influence treatment decision-making in this setting. As a result, numerous companion diagnostic assays (CDx) have been developed to identify HRD. However, the optimal HRD testing strategy is an area of debate. Moreover, recently published clinical and translational data may impact how HRD status may be used to identify patients likely to benefit from PARPi use. We aimed to extensively compare available HRD CDx and establish a worldwide expert consensus on HRD testing in primary and recurrent OC. A group of 99 global experts from 31 different countries was formed. Using a modified Delphi process, the experts aimed to establish consensus statements based on a systematic literature search and CDx information sought from investigators, companies and/or publications. Technical information, including analytical and clinical validation, were obtained from 14 of 15 available HRD CDx (7 academic; 7 commercial). Consensus was reached on 36 statements encompassing the following topics: 1) the predictive impact of HRD status on PARPi use in primary and recurrent OC; 2) analytical and clinical validation requirements of HRD CDx; 3) resource-stratified HRD testing; and 4) how future CDx may include additional approaches to help address unmet testing needs. This manuscript provides detailed information on currently available HRD CDx and up-to-date guidance from global experts on HRD testing in patients with primary and recurrent OC.

대학 신입생 대상 학습전략 하위요인에 의한 학업성취 예측 및 군집 분석 사례 연구

Objectives The purpose of this study is to lay the foundation for establishing a customized teaching and learning support system by clustering students based on the Learning Strategy Test (MLST) for freshmen in universities. Methods For this purpose, 1,503 freshmen from A university in G city were diagnosed using the MLST to analyze their personality, motivation, emotion, and behavior characteristics. Descriptive statistics, regression analysis, cluster analysis, and cross-analysis were conducted, focusing on the sub-factors and related variables of the MLST. Results The analysis of MLST sub-factors according to learners' academic achievement revealed that for personality characteristics, the scores for self-efficacy, outcome expectation, and conscientiousness decreased as academic achievement decreased. Learning motivation and competitive motivation also decreased with academic levels, while avoidance motivation was higher in the top academic group. In emotional characteristics, depression was lowest in the lower academic group but higher in the top group compared to the middle groups. Behavior characteristics scores decreased with lower academic achievement, but memory strategy scores were lower in the top group compared to middle groups. Regression analysis showed that MLST sub-factors explained 19.5% of academic achievement, with learning time, personality, and behavior characteristics being significant variables. When all 17 variables were included, the explanatory power increased to 22.9%, with notable contributions from self-efficacy, competitive and avoidance motivation, class listening, and test strategies. Four clusters were modeled based on MLST sub-factors: Yellow Light, Red Light, Blue Light, and Green Light. Cross-analysis showed significant differences when comparing these clusters with types based on study quantity and learning strategies (latent, stagnant, diligent). Conclusions This study holds significance as a foundational study to link the MLST tests conducted for freshmen in universities to more customized learning support