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18 Cute Study Table Ideas That Are Perfect For Small Spaces

Looking for study table ideas to create the cutest space where you can be the most productive? Here are some insanely cute study table decor ideas.

This post contains affiliate links. Read my full disclosure here.

If you’re looking for ways to be more productive, you’re probably looking for study table ideas to help you have a comfortable and stylish space to get stuff done.

I’ve gathered some of the CUTEST study table decor inspo to help you decorate your work space!

This post is all about study table ideas.

The Cutest Study Table Ideas

1. pick a theme color.

Recreate this cute pink desk space:

This all pink desk space is SO cute. Picking one color and using that color to accent things in the space makes it look really put-together. Also, the laptop stand on this desk is so cute and great for saving space when you aren’t using your laptop.

2. Add Fake Vines

Recreate this earthy minimalist study space:

One of my favorite ways to decorate a space is with fake ivy . It bring such a fresh, earthy feel to a space. I love how this person also added in a collage wall to pull everything together.

3. Laptop Stand

Recreate this neutral aesthetic study space:

Getting a laptop stand is a great way to make a simple desk space feel a little fancier. This wood laptop stand is awesome because you can store your keyboard under it whenever you aren’t using it.

Related Post: 25 Super Aesthetic Dorm Room Decor Ideas That Will Make Your Dorm Look So Cute

4. Use A Wire Wall Grid

Recreate this boho desk space:

Using a wall grid is a great way to display pictures, hang up sticky notes, or really anything you could need in your study space. It would be awesome for making a vision board to keep you feeling motivated and inspired.

5. Keep It Simple

Recreate this minimalist study area:

I really like the minimalist vibes of this desk. It’s so simple without lots of distractions, and I think the digital 3D alarm clock makes it look so cool and futuristic.

6. Lots Of Plants

Recreate this fairy vibes study space:

Having plants in a work space is proven to increase productivity. Adding in a few plants (real or fake) makes a space feel so much more vibrant and alive, and can help you focus while you’re trying to get work done.

Related Post: 21 Actually Genius Dorm Storage Ideas To Copy In 2024

7. Light Up Elements

Recreate this gamer desk:

The light-up keyboard and lava lamp make this space feel so exciting. Adding some cool elements like this can make a study space feel really stimulating.

8. Add A Cute Vace

Recreate this chic desk space:

This space is simple but the little elements added in, like the little cute face vace , make it feel so inviting and chic.

9. Statement Lamp

Recreate this princess-like study space:

This desk looks so soothing and nice to study at. The pleated lamp is a statement piece that really pulls everything together and gives it such a soft princessy vibe.

Related Post: 23 Genius Dorm Room Kitchen Ideas For Setting Up An Amazing Kitchen Space

10. Add A Cute Mirror

Recreate this cute frilly desk space:

I am OBSESSED with this pink frilly heart mirror . Also, I have literally never considered using a mini easel as an ipad stand, but doesn’t it look so cute?!

11. Cute Candles

Recreate this artsy study table:

Adding in some cute candles, like the bubble candle in this picture, is such a good way to decorate a desk space. If you’re anything like me, you probably won’t ever burn it because it’s too cute to use.

12. Add Cute Plushies

Recreate this cute desk:

Adding some squishies and plushies, like this cute dumpling , to your desk space can be a good way to relieve stress and keep you focused when you’re trying to get stuff done.

Related Post: 16 Super Cute Spring Dorm Decor Ideas That Will Make Your Room So Pretty

13. Neon Light

Recreate this dreamy desk:

Neon lights are such a cute way to decorate a study space. This neon cloud light is perfect for dreamy study vibes.

14. Color Code Your Books

Color coding your books is such a cute, low-maintenance way to make your study space look put together and decorated.

15. Fairy Clip Lights

Recreate this soft lit desk space:

LED photo clips are perfect for a desk space. Not only can you hang up anything you need to, it also gives you the perfect source of soft lighting.

Related Post: 21 Cutest College Dorm Room Ideas For This Year

16. Make It Cozy

Recreate this cozy boho study table:

It’s a good idea to make the space you’ll likely spend a lot of time studying cozy. Adding in a yarn wall tapestry and a chunky knit cushion are a perfect way to make your study space super comfy.

17. Add A Little (Faux) Fur

Recreate this study space:

Adding a faux fur chair cushion is another perfect way to make your space a little more cozy. Plus, it looks super chic.

18. Add Some Flowers

Recreate this classy desk:

Having flowers on my desk helps me be so much more productive. This fake rose bouquet is perfect for a desk because you don’t have to worry about water spilling on your desk and the flowers will never die.

This post was all about the cutest study table ideas.

More posts you’ll love:

• 16 Super Cute Spring Dorm Decor Ideas That Will Make Your Room So Pretty
• 21 Actually Genius Dorm Storage Ideas To Copy In 2024

The Best Dorm Room Ideas To Recreate In 2024

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• 19 Super Easy Dorm Room Ideas For Guys For 2023
• The Best Dorm Room Ideas To Recreate In 2023

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The trouble with Table 101 (Update)

Dan Pashman

(Note: This episode originally ran in 2020 .)

In the restaurant game, you need to make the most of every table every minute you are open. And you need to make sure your guests are happy, comfortable, and want to come back.

If you're a restaurateur, your gut tells you "more seats, more money," but, in this episode, restaurant design expert Stephani Robson upends all that and more. She helps Roni Mazumdar, owner of the casual Indian spot Adda in New York's Long Island City, rethink how a customer behaves at a table, and how small changes can lead to a lot more money.

It's a data-driven restaurant makeover.

This episode was originally produced by Darian Woods and Alexi Horowitz-Ghazi. James Sneed and Sam Yellowhorse Kesler produced this update. Engineering by Isaac Rodrigues and Maggie Luthar. Alex Goldmark originally edited the show and is now Planet Money's executive producer.

Help support Planet Money and get bonus episodes by subscribing to Planet Money+ in Apple Podcasts or at plus.npr.org/planetmoney .

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Music: FirstCom - "Jungle Alibi" and "I'm Dreaming Of Little Italy."

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Jamarl 36'' W Rectangle Writing Desk and Chair Set

by Harriet Bee

Rated 4 out of 5 stars. 4 total votes

FREE Shipping

Get it by Sat. Apr 6

This study desk and chair is specifically designed for children. The children's learning desk and chair set is made of MDF wood, including a table, a chair, and two pen holders. Round edges, non-toxic, odorless paint, the study desk kit is safe enough. The storage capacity of children's learning desks is large, such as open storage, bookshelves, cabinets, and soft wooden boards. Photo frames, alarm clocks, mini plants, dolls, books, or other personal items will all be stored better. The overall size of the study desk is 40 inches (height) X 36 inches (length) X 18 inches (width), and the overall size of the chair is 11 inches (height) X 16 inches (length) X 16 inches (width). The study desk and chair set is an ideal birthday gift for young children, suitable for children aged 3 to 8, and can help them organize their personal belongings.

Axess Desk with Hutch

by South Shore

Rated 4.5 out of 5 stars. 12744 total votes

Get it by Thu. Apr 4

• Top Material: Manufactured Wood
• Base Material: Manufactured Wood
• Assembly Required: Yes
• Number of Drawers: 1
• : Roller Glides

I got this for my daughter. It’s perfect her for and she loves it. Also got the pink Gottwald office chair to go with it and she absolutely loved it!!! Both pretty easy to assemble also. Highly recommend!. Jennifer. Albertville, Al. 2019-01-07 20:56:44

by East Urban Home

Free shipping

Transform Your Study Space with the Modern and Stylish Study Desk Create a study space that inspires productivity and creativity with our modern study desk. Crafted with 100% melamine coated particle board, this desk is not only durable but also adds a touch of elegance to any room. Elevate Your Style with a Unique Design With its modern, novelty, industrial, and Scandinavian concept, this study desk is a perfect blend of style and functionality. The combination of oak and black colors adds a contemporary touch to your space, making it stand out from the crowd. Stay Organized with Ample Storage Featuring two drawers, this study desk provides ample storage space for all your essentials. Keep your books, stationery, and other study materials organized and within reach, allowing you to focus on your work without any distractions. Maximize Your Space with Wall Shelf The included wall shelf not only adds a decorative element to your study space but also helps you maximize your storage options. With its dimensions of 100 cm width, 24 cm height, and 20 cm depth, it offers additional space to display your favorite books, plants, or decorative items. Technical Details: • Material: 100% melamine coated particle board • Thickness: 18 mm • Study Desk Size: Width: 100 cm, Height: 72 cm, Depth: 60 cm • Wall Shelf Size: Width: 100 cm, Height: 24 cm, Depth: 20 cm • Color: Oak and Black • Features: 2 drawers, can be fixed to the wall Revitalize your study space with our modern study desk and experience the perfect blend of style, functionality, and organization. Order now and transform your study space into a place where inspiration thrives.

• Base Material: Metal

43‘’ W Home Office Computer Desk with 2 Drawers, Modern Writing Study Desk

by Zipcode Design™

Rated 4.5 out of 5 stars. 441 total votes

Get it by Fri. Apr 5

This writing desk showcases mixed materials to give your home office or living room a modern industrial vibe. It has an open stainless steel base that features sled legs and a stretcher bar in the back to provide ample support to the engineered wood desktop. Adjust the pads under the legs to get your desk at the ideal height and also protect your floors. Two drawers have carved-out openings to retain this desk's clean-lined silhouette. There's plenty of space inside to store office supplies, while the 43.3" long desktop allows you to organize your workspace and decorate to your heart's content.

• Base Material: Stainless Steel
• Number of Drawers: 2

Wright Starter Private and Compact Study Carrel with Pull-Out Keyboard Tray

by Flash Furniture

Rated 4.5 out of 5 stars. 9 total votes

Whether you're homeschooling, studying for an upcoming exam, or need a quiet space to read, this study carrel can be used in various environments for both students and adults. The solitude of a study carrel makes this the perfect option for libraries, computer labs, training centers, or any other environment where individual concentration is required. This floor carrel features a large work surface to accommodate a computer monitor or laptop with room for books and paperwork and a pull-out keyboard tray. Leveling glides ensure you have a stable work surface. Create a row of study carrels by purchasing add-ons to construct an area for users to have their own personal space for privacy. The possibilities for creating your custom space are endless.

• Overall Height - Top to Bottom: 49.625''
• Overall Width - Side to Side: 32.625''
• Overall Depth - Front to Back: 24.4''
• Overall Product Weight: 76lb.

. Elizabeth. Lake Placid, FL. 2022-06-18 14:29:43

Versa Desk with Hutch

Rated 4.5 out of 5 stars. 1145 total votes

This Computer Desk with Hutch organizes your workspace with office supplies in the two upper drawers and file folders in the bottom one. The three drawers are of varying heights, so items of all sizes can fit and the small fixed shelf under the work surface can hold your laptop when you’re not using it. The other shelf at your feet is intended for books you hardly ever use. A very handy hutch, fixed dividers make the under-shelf space ideal for storing envelopes and paperwork. The top of the hutch is fully open great for keeping the things you like to have close at hand as you work. A traditional desk this computer desk is ideal for those who work from home or as a homework space. The somewhat traditional look, featuring a rounded toe kick and metal handles, will last through the years. This product comes with a clear assembly document that will guide you through all steps.

• Filing Drawer Included: Yes
• Number of Drawers: 3

Love the style, size, and color, it's exactly as the pictures dictate, plus free shipping is a massive bonus! Very disappointed with the shipping and subsequent damage. You pack it well apart from leaving out protection on the long sides where it needs it the most. There was continued damage in one place throughout the layers and I had to tape the damage to prevent it from crumbling even more as we assembled it. Also, the labeling is non-existent or illegible both on the furniture and the hardware. It took some common-sense to understand the unlabelled directions/pictures. This & the packing could definitely be improved.. Emma. NC. 2019-09-17 11:05:12

Barba Children Study Desk with Hutch

by Isabelle & Max™

Rated 4.5 out of 5 stars. 11 total votes

Wood ergonomic adjustable kids study desk drafting table, computer station with a chair.

• : 4 to 15 years old
• Adjustable Height: Yes
• Drawers Included: Yes
• Chair Included: Yes
• Hutch Included: Yes

Hangyu Kids Desk and Chair Set, Wooden Children Study Table with Hutch/Drawer & Bulletin Board, Study Desks

Rated 4.5 out of 5 stars. 16 total votes

Desk for kids is made of safe and high-quality wood, which is strong and durable. The tabletop is smooth and wear-resistant, impervious to water stains, paint, and stains, and easy to clean.

• Package Including: 1* Kids desk, 1* kids chair, 1* Bulletin Board

L-Shape Desk

by Inbox Zero

Rated 4.5 out of 5 stars. 1318 total votes

Get it by Wed. Apr 3

• Top Material: Manufactured Wood; Manufactured Wood + Solid Wood
• Base Material: Steel

L- Shape Executive Desk

by 17 Stories

Rated 4.5 out of 5 stars. 185 total votes

Black and rustic brown wood with an old-time classic appearance that will beautify your home office. Simple but classic design fits perfectly and blends well with houses or offices in any style.CPU stand protects the host from scratching, moisture, and dust. Open shelves of storage provide plenty of room for daily home office use. Closed storage rooms behind the door can maintain your items clean and dry while protecting your privacy. Equipped with adjustable foot pads to protect the floor as well as make the table more stable on uneven floors.

Versalles Writing Desk, Two Superior Shelves, Bookshelf

by Ebern Designs

Rated 4 out of 5 stars. 569 total votes

Enhance your workspace with the Versailles Collection Free Standing Home Office Computer Desk. This modern and space-saving desk is designed to optimize your productivity while adding a touch of contemporary style to your home office. With ample space for a large monitor and a keyboard, it provides a comfortable and efficient working environment. The linked cabinet features four open shelves, perfect for storing books, binders, folders, or computer towers, keeping your essentials organized and easily accessible. The top shelf offers additional space for books or decorative items, allowing you to personalize your workspace.

Kids Media Desk Hutch and Chair Set

by Guidecraft

Rated 4.5 out of 5 stars. 2000 total votes

The Guidecraft Children’s Media Desk & Chair Set is a gorgeous and versatile addition to any child’s bedroom. Designed for children ages five to twelve, this desk provides plenty of elbow room and is a perfect place for your child to do their homework, work on crafts, read, write, do computer research, and more. With a large corkboard panel, five shelves on the hutch, and two slots in the desk, your child will have plenty of room to keep everything organized and available. Comes ready to assemble all hardware and assembly instructions included.

• Beautiful, modern Children’s Media Desk and Chair Set by Guidecraft comes in multiple colors and includes a spacious desk, hutch, and chair.
• Hutch features a corkboard panel for keepsakes, 5 accessible cubbies for storage, and handy cutouts for hiding cords and wires.
• Durable construction of solid and engineered wood with a lacquer-veneered surface
• Measures: 44W x 24D x 40H in., Desktop height: 26 in., Chair: 15.5W x 15.5D x 32H in., Seat height: 15.5 in. Designed for kids 5-12.
• Arrives ready to assemble. All hardware and simple assembly instructions are included.

Study Workstation Desk

Rated 4.5 out of 5 stars. 15 total votes

The multipurpose computer desk features open storage shelf, large drawer, and cabinet, which provide spacious storage space and allow you to classify items orderly. After that, a clean and tidy working environment has a positive effect on your working efficiency. In addition, you can place computers, magazines, cups, alarm clocks, and other decorations on a wide enough desktop. Sitting in front of the computer desk, you will obtain much more comfort due to the specially-designed ergonomic height. Safe as well as durable engineered wood through exquisite craftsmanship will provide long-lasting reliable service. Splayed legs and cabinet touching the ground ensures sturdy and stable construction. All in all, the versatile computer desk is an optimal product worthy of considering and purchasing.

• Base Material: Solid Wood

Taiga 44" W Writing Desk with Hutch and Chair Set

Rated 4.5 out of 5 stars. 202 total votes

Designed for growth, both physical and academic. Created for children from early elementary into secondary school, and provides the perfect balance of design and function. Strong, sturdy, clean lines and multiple storage options help with organization and routines in home-learning environments. Braces on the side and back for additional stability. The sturdy chair allows children to access the desk at the appropriate height for reading, writing, computers, and crafts.

• The drawers move in and out. We advise to not alter items.
• Measures 44" W X 24" D x 40" H. Desktop height 26", seat height 15.7".

Adalyn Study 35.5" Writing Desk

Rated 4 out of 5 stars. 161 total votes

This clean-lined computer desk brings modern style and the right amount of work space to your bedroom. The frame is made from engineered wood with a scratch- and stain-resistant finish, and it rests on sled-style legs for a streamlined look we love. Set on smooth-operating glides, two drawers offer out-of-sight storage for folders, files, and office supplies, while the expansive desktop provides plenty of space for your laptop and accessories. Plus, it measures 35.5" wide, so it works in rooms with a small square footage.

• : 29.73'' H x 35.44'' W x 17.72'' D
• : Manufactured Wood

Transform your study space with the perfect desk are you tired of studying at a cluttered and uninspiring desk? Upgrade your study space with our study desk, designed to bring both functionality and style to your room. Crafted with 100% pine solid wood, this desk is not only durable but also adds a touch of elegance to any space. Quality craftsmanship for long-lasting durability the study desk features a sturdy leg material made from 100% beech wood, ensuring stability and strength. With its environmentally friendly construction, you can feel good about your purchase knowing that it is sustainably made. Assembly is required, but the process is simple and hassle-free. A perfect fit for any room with a width of 110 cm, height of 73 cm, and depth of 60 cm, this desk is designed to fit seamlessly into any room. Whether you have a small study nook or a spacious home office, our study desk will be the perfect addition. The desk comes in a beautiful oak color, adding a touch of warmth and sophistication to your space. Choose your style the study desk is designed with a modern concept, offering a range of styles to suit your taste. Whether you prefer a novelty, hotel-inspired, rustic, Scandinavian, or country look, this desk can easily adapt to your desired aesthetic. Technical details: • product type: study desk • material: 100% pine solid wood • leg material: 100% beech wood • assembly: required • width: 110 cm • height: 73 cm • depth: 60 cm • color: oak upgrade your study space today with our study desk and experience the perfect blend of functionality, durability, and style. Order now and transform your study routine into a productive and inspiring experience.

• 100% PINE SOLID WOOD
• Leg Metarial: 100% BEECH WOOD
• Environmentally FriendlyAssembly Needed
• Width: 110 cm Height: 73 cm Depth: 60 cm
• Desk Type: Writing desk

Plovdiv 55" Large Computer Desk L-Shaped Desk with Wireless Charging and Bookshelf for Home Office

Rated 4.5 out of 5 stars. 86 total votes

This reversible desk features a wireless charger on the work surface to allow you to charge your phone easily without a cable mess.

Bisa 36'' Writing Desk Chair Set

Rated 4.5 out of 5 stars. 214 total votes

Whether your child needs to work on homework, read a book, or work on some crafts, they’ll love the ample workspace of this desk. The traditional classic frame of this piece features two shelves, and one drawer to store all your little one's favorite pens, markers, and papers, at arm’s length. It also includes a matching chair. This desk and chair, designed for a child 5 to 10 years old, are constructed from pine and rubber wood. This piece requires assembly upon arrival.

• : Ages 5 to 10
• Overall: 27'' H x 36'' W x 22'' D
• Overall Product Weight: 34.7lb.
• Exterior Shelves Included: Yes

Brehana Reversible L-Shape Desk

by Latitude Run®

This desk has a unique design that the bookcase is not the traditional bookcase and the connection desk could rotate around the bookcase. There are casters under the desk, so it would be easy to rotate the desk. You could decide to rotate the connection desk to any location, parallel or straight angle is all your choice. There is also a button on the caster to lock it in case of slippery. The main material is manufactured wood which is anti-scratch and water-proof. The metal frame is rust-free. The desk has three colors for your choice, you could pick up your favorite one.

Annexe Desk with Hutch

Rated 4.5 out of 5 stars. 892 total votes

Need a hand organizing your workspace? This desk, with its many compartments, gives you a world of options for putting things away more easily. The hutch was designed to hold a computer screen, which will free up your workspace. It has 3 open spaces and a shelf, so you can organize all your materials and also put a printer under the shelf. Under the desk are 5 open spaces, where you can keep binders, notebooks, papers, and books. There’s also a small drawer for keeping anything that doesn’t have a home out of sight. Finally, we’ve added a hole for passing cords through, along with 4 USB ports, for simple, efficient cord management. You’ll get your work done more quickly than before – and you’ll find you’ve never been so motivated! Add this Contemporary style computer desk to your office to give it an elegant, professional look. We like the long metal handle, which adds a touch of character. This desk also has so many storage shelves, you can personalize it by adding some decorative items or framed pictures. When you’re not working, the kids can use it to do their homework or DIY projects. Add this Contemporary style computer desk to your office to give it an elegant, professional look. We like the long metal handle, which adds a touch of character. This desk also has so many storage shelves, you can personalize it by adding some decorative items or framed pictures. When you’re not working, the kids can use it to do their homework or DIY projects.

• Built-In Electrical Outlet: Yes

Perfect amount of storage ! A little hard to put to monitors and have workspace but I pulled up a side table next to me to write on if I need to . Kind of a pain to put together and honestly I’m not sure how sturdy it is with my skills but it’s lasted me the whole pandemic and still going strong as my hidden office oasis ) it easily blends with decor because of all the shelves up too which I love .. Liz. Rockville, MD. 2022-02-02 03:32:05

Crooke Desk

by Gracie Oaks

Rated 5 out of 5 stars. 179 total votes

Elevate your workspace with our spacious computer desk. This large desk makes a great piece of furniture in your study room or workspace. It features a clean-lined design for a sleek look, giving your office a charming and contemporary style.

Compact Computer Desk Study Table for Home Office 43"

Rated 4.5 out of 5 stars. 32 total votes

• This desk has 1 drawer and 1 door so you can easily organize your working stuff, this desk has no paint finish at the back.
• The engineered wood boards give it a solid structure as well as a beautiful appearance.
• Size: 30” H x 17” D x 43” L - 77 H x 45 D x 110 L cm

Gud one though I used as a study table for my son.he just loved it. Gud product. Anonymous. Anonymous. 2023-05-08 14:44:52

Rotating L Shaped Desk with Bookshelf

Rated 4.5 out of 5 stars. 72 total votes

The desk comes equipped with a rotating design and 5 shelves bookshelf. It can be rotated to a 90-degree L-shaped or 180-degree straight line-shaped according to your individual needs and home space requirements. Pairing space to work and spots for storage, this computer desk is an ideal anchor for small-scale offices and multi-purpose rooms.

Cubberly 42.63'' Writing Desk

Rated 4.5 out of 5 stars. 806 total votes

Whether your child needs to work on homework, read a book, or work on some crafts, they’ll love the ample workspace of this desk. The traditional clean-lined frame of this piece features one drawer and one open cabinet to keep all your little one’s favorite pens, markers, and papers at arm’s length. Made in the USA, this piece boasts a neutral white hue that blends effortlessly with any color scheme and comes backed by a five-year warranty.

• : 3 to 12 years old
• Overall: 28.9'' H x 42.63'' W x 19.37'' D
• Overall Product Weight: 62lb.

Childcraft Wood Study Carrel

by Childcraft

Rated 5 out of 5 stars. 2 total votes

This student reading manufactured wood study carrel creates a semi-private atmosphere that is conducive to learning. Simple leg assembly required, hardware and instructions included. Dado and rabbet construction adds strength and durability.

• Country of Origin: United States

Nice and sturdy desk. Love it.. Jeong. Cambridge, MA. 2022-07-29 02:53:52

Wright Add-On Study Carrel

Rated 5 out of 5 stars. 7 total votes

Whether you're homeschooling, studying for an upcoming exam, or just need a quiet space to read, this add-on study carrel can be used in a variety of environments for both students and adults. The solitude of a study carrel makes this the perfect option for libraries, computer labs, training centers, or any other environment where individual concentration is required. This floor carrel features a large work surface to accommodate a computer monitor or laptop with room for books and paperwork and a pull-out keyboard tray. Leveling glides ensure you have a stable work surface. Create a row of study carrels by purchasing the starter unit and then adding multiple add-ons to construct an area for users to have their own personal space for privacy. The possibilities for creating your custom space are endless.

• Overall Product Weight: 58lb.

Just what i expected worked perfectly. Angellena. Johns Island, SC. 2022-04-06 10:55:27

Madeline Desk with Hutch

by Three Posts™ Baby & Kids

Rated 4.5 out of 5 stars. 159 total votes

This writing desk is only 31" wide, just right for creating a cozy office area in an unused corner of your living room, or for a child who needs their own study space. It comes with a hutch that has two drawers and two open shelves, but you have the option to remove the hutch if you’d prefer a more work surface. This desk itself has two larger drawers; it’s made from engineered wood with a water-resistant finish and stands on four gently curving legs. We love that this versatile piece could also work as a vanity or an entryway table.

• Top Material: Manufactured Wood + Solid Wood
• Base Material: Manufactured Wood + Solid Wood
• Number of Drawers: 4

Love this desk! Took about 15 minutes to put together. I am a female in her 60s and I did it alone. Only had to screw the legs to the desk.. Brenda. CO. 2022-05-14 03:18:33

Thure 47.5'' Art Desk

by Mack & Milo™

Rated 4.5 out of 5 stars. 314 total votes

This art desk gives your kid a spot to create, draw, and much more. It not only has a large work surface, but it also comes with a side hutch for additional storage potential. Six shelves in total provide plenty of space to keep books, binders, and craft supplies. The back panel on the top bookcase is reversible, so you're able to display the hue that best matches your little one's style. Made from engineered wood, it shows off a two-tone finish that matches almost any aesthetic.

• : 4-12 years
• Overall: 55.47'' H x 47.5'' W x 23.6'' D
• Overall Product Weight: 94.16lb.

Labelle 55" W Writing Study Computer Table Workstation with Keyboard Tray

by Steelside™

Rated 4.5 out of 5 stars. 784 total votes

This home office desk pairs function and fashion with its spacious surface and mixed-material look. It has a frame that's crafted from metal and engineered wood with a weathered, two-toned finish for plenty of rustic style and modern flair in your home office or living room. Two side drawers and a cubby shelf are ideal spots to tuck away files, binders, and other office accessories. There's also a keyboard tray to make your WFH experience hassle-free. The desktop measures just over 55" wide, giving you ample room for your computer, a reading lamp, and much more.

Rated 4.5 out of 5 stars. 3363 total votes

Computer writing desk, school student desk, home office desk for small space, study kids desk with headphone hook.

Glenden Computer Desk

Rated 4.5 out of 5 stars. 359 total votes

Give you a spot to prep in upscale style with this must-have double workstation desk. Crafted from a 25mm Particle Board and PVC Edge, it showcases a delicately rectangular shape with clean lines and features a large desktop surface and 2-tier shelves, which provide ample storage space to hold books, your laptop or desktop PC, and all of your office accessories. The simple and classic design perfectly integrates any style of house or office. It's ideal for a corner of your home and office.

Rated 4.5 out of 5 stars. 81 total votes

This comfortable, simple, and practical office desk can make it easy for you to work anywhere in your home or office. Thanks to its ergonomic design, this beautiful desk serves to satisfy your work and study needs. Thanks to its design, this desk can fit anywhere, and it will look stunning. Its natural style gives a sense of freedom, simplicity, and style. If you are looking for a desk that doesn't take up much space and looks nice anywhere, you've found it. The Aurora computer desk is a classic piece that will have your back when it comes to today's needs of remote learning or working from home. Standing at 28.7" inches high and 47.5" wide, this desk is perfect and has a straightforward design for spaces with little room available.

Montserat Desk

Rated 4.5 out of 5 stars. 157 total votes

Revamp your home office or workspace with this striking industrial-style computer desk. Featuring a desktop and a sleek black frame, it seamlessly blends form and function. The desk provides ample space for your computer, paperwork, and other essentials. Constructed from top-quality materials, it is both sturdy and durable. Assembly is a breeze, so you'll be up and running in no time. Elevate your work environment today with this stylish and practical computer desk.

• Industrial-style design that enhances any workspace
• The spacious desktop measures the perfect height for comfortable typing and working
• Constructed from top-quality materials, ensuring durability and longevity engineered wood desktop with a sleek black metal frame.
• Adjustable leg pads for stability and scratch prevention on floors. Easy to assemble with included hardware.
• Please Note: The desktop is composed of spliced boards rather than a single piece

Akiyoshi Computer Desk

by Winston Porter

Rated 4.5 out of 5 stars. 51 total votes

Computer desk with 7 drawers, wooden legs Product Description Home office furniture computer desk Simple yet stylish Contemporary style writing desk, sophisticate your home or office with classic style and incredible functionality Spacious workplace The 7 drawers & 3 storage provide ample space for your workspace and storage Multipurpose An wonderful furniture for your study, bedroom, living room, and office to take care of your needs. Please check whether the size meets your requirements before buying Features Multi-use. The product is a versatile desk and study table with an extra large desktop area. Tabletop 36.2" can hold a computer and some materials for learning or working. In addition,7 drawers with 3 storage rooms which provide you with plenty of added room allow you to store books, pens, cosmetics, daily necessities, and necessities necessary for work, study, and life. Say goodbye to the mess! Detachable design? The table uses two-layer design kitchen utensils, which can be disassembled at any time as needed. The storage room between the table and the detachable kitchenware can perfectly fit an unfolded laptop. The unique design increases the practicality of the table and expands the practical area of the table to a greater extent. Whether it is used for study, office, or makeup, this table has enough space to meet all your needs the best choice. Safe and durable? The writing desk is constructed with long-lasting MDF which features high durability, four legs are made of New Zealand pine wood which is solid enough to give strong support to the whole frame, it has passed the certification of carb, and the surface makes it look more beautiful, and it is very sturdy. Easy to maintain & assemble? With the smooth surface, you can easily clean the desk with a duster cloth. All of the hardware for assembly and instructions are included in the package. It's easy to put together with instructions. This product is very simple to install, and most people usually only need 20 minutes to assemble it with the help of our manual. Save space? Overall dimensions: 36.2”(L)x18.9”(W)x43”(H) it is highly suitable for being placed in the corner or next to any wall, which is perfect for smaller spaces, fully using the most space in your room and making the room look organized, bringing great convenience to your life. Product dimensions Overall dimension: 36.2”(L)x18.9”(W)x43”(H) N. W.: 30.9 lbs G. W.: 37.5 lbs Middle drawer measuring: 10x11.2x3.2 (LxWxH) Side drawer measuring:5.8x11.2x3.2 (LxWxH) Small cubby drawers measuring:7.87x3.3x2.4(LxWxH)

• Number of Drawers: 7

Transform Your Study Space with the Modern and Stylish Study Desk Upgrade your study space with our sleek and contemporary study desk. Designed with a modern and novelty concept, this desk combines industrial and Scandinavian styles to create a unique and eye-catching piece of furniture. Create an Inspiring and Productive Environment With its spacious design and numerous shelves, our study desk provides ample storage space for all your books, stationery, and study essentials. Stay organized and keep your workspace clutter-free, allowing you to focus on your tasks and boost productivity. Premium Quality and Durability Crafted from 100% melamine coated particle board, this study desk is built to last. The 18 mm thickness ensures sturdiness and stability, while the metal legs provide additional support. Rest assured that this desk will withstand the test of time and serve you for years to come. Enhance Your Room's Aesthetic The combination of oak and black colors gives this study desk a sophisticated and elegant look. Whether your room has a modern or traditional decor, this desk will seamlessly blend in and enhance the overall aesthetic. Versatile and Space-Saving Design Our study desk can be easily fixed to the wall, saving valuable floor space and providing a secure and stable setup. This feature is especially beneficial for smaller rooms or apartments where space is limited. Technical Details: • Material: 100% melamine coated particle board • Thickness: 18 mm • Legs: Metal • Width: 100 cm • Height: 60 cm • Depth: 104 cm • Color: Oak and Black • Shelves: Numerous • Concept: Modern - Novelty, Industrial, Scandinavian

LIBRE D 240 E Writing Desk

by George Oliver

Rated 4.5 out of 5 stars. 25 total votes

Thanks to its Scandinavian style, our LIBRE D 240 E corner desk has exactly the lightness and functionality that your home needs: floating design with light wooden feet and extra thick, rounded top boards and drawer blinds. With its 3 drawers, the large open compartment with an adjustable shelf, and the open compartment, the table also offers plenty of storage space. You can wonderfully place the desk in a corner or place it anywhere in the room. And the best: It can be mounted left or right-sided!

• product can be assembled left or right-sided
• Also usable in a corner
• Aluminum handles
• Extra big working area
• Extra strong material

Martha Stewart Living and Learning Writing Desk, Hutch and Chair Set

by Martha Stewart

Rated 4.5 out of 5 stars. 30 total votes

The chair set creates a bridge between living and learning spaces, pioneering the concept of a child’s home office space. Flexible, organized, and open, the collection is defined by quality materials and uniquely designed storage solutions and workspaces that inspire children to create, collect, and curate. Constructed from a durable combination of easy-to-clean birch and engineered wood, the chair is designed for physical and academic growth, providing your child with a personal, intentional place to work, learn and create for years. Details like the large flat workspace, storage shelf, and convenient cord are cut out to keep learning materials organized and accessible in home-based learning environments. The upper shelf and corkboard on the hutch serve as the perfect place for children to curate meaningful treasures and photos, creating a special, personalized area. The ergonomically designed chair allows children to access the desk at just the right height for reading, writing, computer work, and crafts.

• Overall: 41'' H x 44'' W x 24'' D
• Overall Product Weight: 65lb.

Reversible L-Shape Desk

Rated 4.5 out of 5 stars. 471 total votes

This desk breaks away from the traditional cubical and desk office environment and flaunts a modern design to create a simple and attractive workspace. The side station with two open bookshelves and a wide desktop, keeping everything you need at work within reach, and three fixed-ground drawers for books, and magazines which keep you productive.

• Top Material: Medium Density Fibreboard (MDF)

Create Your Perfect Study Space with our Bohemian Industrial Study Desk Transform your study space into a haven of creativity and inspiration with our Bohemian Industrial Study Desk. Crafted with passion and designed to perfection, this study desk is the epitome of style and functionality. Unleash Your Creativity Let your imagination run wild as you sit at this beautifully designed study desk. The combination of oak and black colors creates a stunning visual contrast that will instantly uplift your mood and enhance your productivity. Stay Organized With two spacious drawers and numerous shelves, you'll never have to worry about clutter again. Keep your books, stationery, and other essentials neatly organized and within arm's reach. Durable and Sturdy Constructed with 100% melamine coated particle board and supported by metal legs, this study desk is built to last. Its 18mm thickness ensures stability and durability, making it the perfect companion for your academic journey. Customize to Your Liking This study desk can be easily fixed to the wall, allowing you to create a space that is uniquely yours. Whether you prefer a minimalist or bohemian aesthetic, this desk will seamlessly blend into any interior style. Technical Details: • Material: 100% melamine coated particle board • Thickness: 18mm • Legs: Metal • Width: 105 cm • Height: 79 cm • Depth: 55 cm • Leg Height: 67 cm • Features: 2 drawers, numerous shelves • Color: Oak and Black

Koryn Work Desk

Rated 3 out of 5 stars. 1 total vote

A businesswoman has to have a desk that reflects her talent. This professional desk gives you the functional, ergonomic workspace you deserve. A power bar is hidden under a trapdoor on the melamine surface, for a more discreet look. The desk has two regular outlets and two USB ports, which means you can also use your smartphone and other electronics all day while charging them. Your other work supplies can be stored in the large middle drawer or the two drawers , one on either end of this computer desk. You can organize all your pencils, papers, notebooks, and binders, for a neat and tidy workspace.

Coleshill 70.9'' W Rectangle Executive Desk

by The Twillery Co.®

Rated 4.5 out of 5 stars. 111 total votes

Featuring clean lines and a sleek overall look, this executive desk exudes a simple, modern style to your home office space. Crafted from engineered wood, it comes in a distressed finish of your choice to bring a hint of rustic charm to your work area. Two large sled-inspired legs have iron trim lining their interior, while diagonal supports provide extra stability. The rectangular desktop measures a hair over 70" wide, giving you a spacious spot to keep your laptop, important binders, and other supplies within reach.

• Measuring 70.9" W x 31.5" D, this large computer desk provides enough space to keep all your essentials within reach.
• Whether used for writing, studying, or working on a computer, there is plenty of room to spread out and stay focused.
• Designed with your comfort in mind, this desk is built at the optimal height for an executive's convenience, reducing strain on your back and neck.

Pifer 39.4'' White Rattan Writing Desk With Drawer Cabinet Laptop Computer Work Study Table

by Bay Isle Home™

Rated 4.5 out of 5 stars. 10 total votes

This home office desk is chic and versatile. The rattan worked on the desk is expertly woven by hand for a texture, which beautifully balances the sleek, airy profile of each piece. Resting on a sturdy, solid wood tapered leg frame in a white finish, the golden dipping legs are a great way to add just a bit of glamour. Two side drawers and a cubby shelf are ideal spots to tuck away files, binders, and other office accessories. The desktop measures just over 39" wide, giving you ample room for your computer, a reading lamp, and much more. All dimensions 30.7"H*39.4" W*18.9"D. The cabinet dimensions 17.3"H*14.6" W*18"D.

Kempst 43 Inch Computer Desk with Storage Shelves, Home Office Writing Desk, Study Table for Small Space

by Trent Austin Design®

Rated 4.5 out of 5 stars. 945 total votes

This product is ideal for working from home, in kid's rooms, campus housing, or anywhere you need a simple, minimalist desk. With a look fit for any room, this vintage-style computer desk has enough space for your laptop, books, and more. The stable metal frame ensures the desk won't wobble with every movement you make, giving you a comfortable workstation to be productive throughout the day.

• Base Material: Iron

Aralee 4 U-Shaped Computer Desk Office Set with Hutch

by Wade Logan®

Rated 4 out of 5 stars. 519 total votes

Designed to be the ultimate productivity station in your workspace, this 4-piece office set helps keep you focused and organized. Crafted from engineered wood, this set includes a 65'' U-shaped desk, a desktop hutch, a 72'' bookcase, and a vertical filing cabinet. We love that the desk offers ample room for spreading out your projects and organizing your office essentials. A desktop hutch features two exterior shelves for storage, while three drawers on ball-bearing glides provide additional space. The filing cabinet accommodates hanging files, and the bookcase is ideal for your work essentials and decorative touches.

• Keyboard Tray Included: Yes
• Overall Product Weight: 528lb.
• Cable Management: Yes
• Lockable Drawer: Yes

Curto L-Shaped Metal Base Executive Desk

Rated 4.5 out of 5 stars. 36 total votes

Make a professional statement while maximizing the potential of your home office with this executive desk. This expansive workspace offers plenty of room to spread out and complete large projects. Create your remote work headquarters with space for a computer, phone, printer, and more. Quality construction and commercial-grade materials can withstand the rigors of daily use in a busy professional office.

Walbrook Reversible L Shaped Computer Desks, Work Desk with Adjustable Shelves

Rated 4.5 out of 5 stars. 1261 total votes

Two size options - The 29.14" H x 47.24" W x 35.43" D L-shaped desk fits perfectly in the corner or small space, compact but not tiny. Besides, the look matches well with home office furniture and floor. The 29.1" H x 55.12" W x 35.4" D writing surface is a decent size to accommodate 2 monitors, a laptop, a keyboard, and desk accessories, providing more spacious storage space.

Akiyoshi Desk

by Lark Manor™

Rated 4.5 out of 5 stars. 1861 total votes

Pairing a clean-lined silhouette with distinctively carved legs, this writing desk adds plenty of classic character as it anchors your home office setup. Crafted from solid rubberwood with birch veneers, this piece has ample surface space (42" wide) to tackle your to-do list or work on DIY projects. Two drawers down below offer a bit of concealed storage for pens, sticky notes, and other WFH essentials. A variety of solid hue options makes it a cinch to match your space's style and color scheme.

• Base Material: Manufactured Wood; Solid Wood

Desk with Hutch

Rated 4.5 out of 5 stars. 88 total votes

If you are looking for a mid-sized desk that combines functionality, durability, and affordability, this might be the one. Constructed from high-quality manufactured wood, this desk is sturdy and durable. A handy hutch provides room to hold books and other supplies, and 2 drawers create ample storage space. and is perfect for students and small offices. Clean and simple design with pure color will always be on trend and is versatile enough to go with various design styles.

• Designed for Small Spaces: Perfect size for a small office, bedroom, or guest room.
• With the smooth drawer rails, you can open and close the drawers easily.

Similar Items with Reviews

Rated 5 out of 5 stars.

I looked through literally thousands of possibilities and had narrowed down to two dozen things in my cart when I finally chose this one. Thrilled that I did! -- My problem: I wanted a make-up vanity for my new bedroom closet/sitting area, but not a traditional one with an attached mirror, because I wanted to use my own plug-in lighted mirror, and it was going to sit in front of a window I did not want blocked. Solution: I searched through Wayfair's console tables and small writing desks. This one was a bit larger than I had first planned (42" Long x 24" Deep), but I had the space, and the Marine Green color kept pulling me away from the 'aged grays' that I had planned on (bed/bath area is mixed Victorian/Art Deco in style and color scheme is lilac & gray, with splashes of purple). The Marine Green is a green leaning (rather than blue leaning) turquoise, and is true to the pictured color (on my monitor). The turned legs add the charm needed to keep this from being 'too plain,' but I also did a simple change out (already planned) of the drawer knobs to a more elaborate Victorian knob style. I have to say this inexpensive piece of furniture was the most professionally packed thing I have ever purchased, including many expensive pieces! The inside perimeter of the box was first framed on all sides with hard fiber boards, then perfectly fitted styrofoam panels, leaving absolutely no room for 'movement/shifting.' It was tight! On top of that, the box of 'legs' and the two drawers were strapped down with canvas like straps. Never have seen anything like this packing job! The desk itself was in great condition. That is, there were no scratches, chipped through paint, or damaged areas. However, there are some small flaws under the paint, in the actual wood, but I fully expected this at this price point and wood type used. In my opinion, it just adds to the 'historical period,' making it more authentic and less cheap looking (I know, that sounds crazy, but people who like aged, distressed, or lovingly used/imperfect pieces will get what I mean.) Putting this together was a breeze, as all parts were accounted for and you only had to attach the four legs. Most of the bolt holes were so well aligned that I simply screwed them in with my bare fingers and only used the wrench provided for the final tightening. Plus, all four legs were exactly the same length! This piece is solid and strong, with absolutely no 'wobble.' The drawers do not have the 'glide' of those on rollers, because they are on wooden guides with plastic side guides, but they are adequately smooth for frequent use, and they are a good depth and size for holding a lot of stuff. I paired this 'vanity' with the Louella vanity chair (in gray), also from Wayfair and it's a match made in Heaven. The only 'con' is that I wish the sharp 90 degree corners on the top had been a bit rounded. Those cheapen the piece slightly, in my opinion. Overall, an outstanding piece of furniture at a great price!

Deltona, FL

Verified Buyer

I recently purchased this desk from Wayfair, and I couldn't be more thrilled with my choice. From the moment I unboxed it, it was clear that this product was a cut above the rest. Assembly: First things first, the assembly was a breeze. All the components were neatly packaged, and the instructions were straightforward and easy to follow. I was pleasantly surprised to find that all the hardware was included and even had some spares. Within an hour, the desk was assembled and ready to become the centerpiece of my home office. Design: The design is sleek and modern, yet it has a timeless appeal that integrates seamlessly with various décor styles. The finish is smooth, and the quality of the wood is apparent. It's not just a desk; it's a statement piece. Functionality: Don't let its good looks fool you—this desk is as functional as it is beautiful. The drawers slide out smoothly and are spacious enough to store all my office essentials. The surface area is expansive, offering plenty of room for my dual-monitor setup, keyboard, mouse, and even some decorative items. The built-in cable management system is a godsend for keeping my workspace clutter-free. Durability: I was initially concerned about the desk's stability, but those worries were unfounded. This desk is rock solid and feels like it will last for years to come. The quality of the materials and the craftsmanship are top-notch. Customer Service: I must also commend Wayfair's customer service. When I had a question about the delivery, their team was prompt, courteous, and went above and beyond to ensure I was satisfied. In summary, this desk has exceeded all my expectations. It's stylish, functional, and built to last, all while providing exceptional value for the price. If you're in the market for a new desk, do yourself a favor and consider this one—you won't be disappointed!

There were a LOT of pieces and putting it together was VERY time consuming. However, it went together quite nicely and once it was complete seems to be very sturdy. The desk height was taller than I anticipated based on review and measurements. I’m not sure where I went wrong measuring but we were pleased that it was higher than we expected. It is the perfect desk for my 11 year old son. It fit wonderfully in his small room. Basic cloth storage cubes fit great in the shelves. The desk top isn’t huge, basically just big enough for a laptop or an iPad with a notebook. It suited our needs just right. Take your time building it and pay careful attention to the orientation of the piece when you are placing the cams and the pieces that work with them. Follow the directions exactly and don’t attempt to put it together out of order. After I had most of the hutch assembled I was concerned I had done something wrong so I placed the upper 3 piece shelf in place, thinking that I could easily attach the other parts. WRONG. I had to take that off and redo every thing as per the instructions. FYI the outer/right hand piece of the three bookshelves of the hutch is LONGER than the left side. This measurements looked off to me and this is where I made my mistake. It was correct but I don’t have the best depth perception. One part of the assembly was missing but thankfully a small packet of extra parts was sent. This was my first purchasing experience with Wayfair and I had my doubts as to whether or not the item would be quality. I am very pleased with this purchase, price and durability of item. Pretty darn sturdy for what it is. I’m sure it would get wobble after several moves but much better suits us just fine.

Leesville, SC

Rated 4 out of 5 stars.

The desk is fairly nice for what I paid, I got the black coloured unit. Definitely not a 5/5 product and it was a bit smaller then I expected (course that's my fault not the product listing or anything) . I would have rated it a 3/5 because the desk is wobbly, it seems like the wood is mishaped a bit, not that big of an issue honestly but annoying. I like the finish tho, it came in very good condition no scratches whatsoever or anything just the bit of the bent wood but that will likely correct in time now that it's put together and in use, it was easy to set up, and for the price I got it for it really is not a bad product. The desk material quality itself is a 3/5 but the desk came in 4.5/5 shape, it's 5/5 what's promised, price is 4/5 , and lastly the design I would also give a 4/5. So 4/5, if your looking for a nice cheaper lighter weight desk and you aren't bigger then 6ft1 (even that is just starting to push it a bit but I'm tall so that's common honestly) this is not a bad option. My only big-ish issue is that the keyboard slide out is so low it's hard to get my legs under there but I'm tall and getting a chair specifically for it can deal with that fairly easily, and only other issue at all is the slightly mishapen wood causing it to wobble but again easily fixed and I am relatively positive that will fix itself in time. Overall I am happy with this product and would consider it a fairly good bargain at the price, if you read this review and it sounds like what you want you will likely not be disapointed and I would recommend it. Best for people 5' 11" and under, but as it works for me max I'd say is 6' 1".

Justin Alexander Thibault

Vaudreuil-Dorion, QC, Canada

Unfortunately, I cant add pictures right now to back me up ( but I LOVE this desk! Im a digital artist that uses a pen tablet (not the one with a screen, just a little black square basically), desktop, monitor, and laptop. This is the perfect height to keep my arm at an ergonomic level, and my chair fits right under it with no issue! Im able to fit all of my tech up on the desk and STILL have the entirety of the long side free for all sorts of fun hobbies in the future. Plus, the little table fits over my desktop and was perfect to keep my laptop at a nice elevated height for my neck. Additionally, I do like the hook, and bag this desk came with, its nice that they are interchangeable, and I dont know how much Ill actually use them, but if I do im sure theyd work wonderfully. The desk itself is not that thick, so if you are planning to put any attachments underneath (like mounting a desktop under), Id keep that in mind, but this thing is beautiful! Plus it feels pretty sturdy, and was easy to build. I did it myself without issue, directions are a breeze so long as you are aware of directions and what parts you are holding. Overall, Im really happy with my purchase, and it has made working from home that much more enjoyable. I think the only other downside is there arent really options for cord management, except buying more stuff elsewhere. Its not the companys fault for sure, since thats not what they are advertising for, just a thought for other prospective buyers!

The desk took me about 2-3 hrs by myself, so be sure to have some patience and take breaks if you need them. I was pretty worried what the parts were going to look like from what the box looked like on the outside and as I was unboxing. Fortunately, everything looked okay. The pkg came in 2 boxes, understandable as it’s a heavy product. Wish the wood parts were more solid, I think I would’ve given it a 5 if it was. I can see in the future, wood parts can break. It would be nice if I were to move, I can take this down easily, but it doesn’t seem it would be. I’ll find out when the time comes! Otherwise, I like the mix of metal and wood. I’m very pleased with how it came out. What kind of bothered me was the leftover metal I can hear inside the metal parts. I’m assuming they were from making the holes and got stuck in the frame. Some of my time was trying to remove them carefully from the frame. I didn’t get them all, so I just kept going. The rolling L part of the desk moves smoothly, so it helps angle where I need it, like shown in my photo. It’s not exactly a 90 degree angle, but it gives me the space I need. Directions were very clear and parts nicely label. The parts bag however ended up tearing and all the individual parts bag broke and basically all the parts looked like they came in only one bag. So maybe change the plastic material used for the parts (screws). Otherwise I’d recommend this desk!Otherwrecommend

Neighbors Program

• Open access
• Published: 28 March 2024

Adding spontaneity to organizations – what hospice volunteers contribute to everyday life in German inpatient hospice and palliative care units: a qualitative study

• Armin Nassehi 1 ,
• Irmhild Saake 1 ,
• Christof Breitsameter 2 ,
• Anna Bauer 1 ,
• Niklas Barth 1 &
• Isabell Reis 1  

BMC Palliative Care volume  23 , Article number:  81 ( 2024 ) Cite this article

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Volunteers have always been integral to hospice and palliative care. However, their roles have been left relatively undefined and broad.

This study aims to examine the role of hospice volunteers in German inpatient hospice and palliative care. The question we seek to answer is: What do hospice volunteers contribute to everyday life in inpatient hospice and palliative care units?

We undertook a multicenter, on-site qualitative interview study, utilizing problem-centered interviews with 16 volunteers from five inpatient hospice units and one hospital palliative care unit. Interviews were analyzed using grounded theory.

Analysis of the interviews revealed three typical characteristics of how hospice volunteers’ describe their own role: (1) performing small acts of kindness, (2) creating a family-like atmosphere, (3) expecting emotional experiences. A common theme across all categories is the emphasis on spontaneous actions and personal experiences. The process of dying becomes an experience interpreted by volunteers as enriching, as a gift, as a “teacher”.

Granting hospice volunteers freedom to act spontaneously and intuitively benefits hospice and palliative care delivery. Organizations should leave sufficient room for spontaneity in order to involve volunteers effectively. Open and unstandardized roles facilitate dynamic work practices.

Peer Review reports

Introduction

Hospice volunteers played a pivotal role in the emergence of the palliative care and hospice movement. Particularly in the early days, when specialized support and care for the dying were not yet commonly available within the established structures of health care systems, volunteers spearheaded the development of alternative care practices, procedures, and philosophies [ 1 ]. In Germany, palliative care has evolved into a professional and integral component of the health care system in recent years [ 2 ]. Despite this professionalization, hospice volunteers continue to be a part of German hospice and palliative care. As such, based on an extensive body of international research literature on hospice volunteers, the following questions may be posed: Who are hospice volunteers? How do they perceive their own role? What contributions do they make to hospice and palliative care?

International studies indicate that volunteers are commonly older, female and middle-class [ 3 , 4 ]. Recent analyses in Germany corroborate these findings [ 5 ]. Numerous studies have explored the motivations behind voluntary commitments to hospice work, often finding that the death of a close relative can act as a catalyst for such volunteer work [ 6 , 7 ]. The motives of volunteers oscillate between altruism and personal interests [ 8 ]; they aim to assist others, while concurrently seeking to learn and grow personally [ 6 , 9 , 10 ]. It’s been observed that volunteers experience ‚personal growth‘ [ 11 ] from their involvement. A recent study furnishes evidence suggesting that volunteers may enhance their psychological well-being through their activities [ 12 ].

Several international studies suggest that volunteers undertake an array of tasks within the hospice context. They assist with care, they go shopping, help with household chores, perform driving duties [ 11 ], support grieving families [ 13 ], prepare meals and beverages, read aloud, engage in board games [ 14 ], keep vigil at the bedside during the night, go for walks, conduct fundraising [ 15 ], manage the reception, run the snack bar [ 3 ], engage in casual conversations, remain simply present [ 16 , 17 ], and perform miscellaneous ‘odd jobs’ [ 3 ]. From this broad range of tasks, it seems impossible to derive a generalizable role description. The enormous variety of tasks has led to debates in the literature concerning the extent to which specialization, professionalization, and standardization of volunteer roles in palliative and hospice care could be necessary and effective [ 15 , 17 , 18 , 19 , 20 ].

This study aims to address the research gap regarding a clear role description for hospice volunteers. In doing so, it also hopes to address the question of whether standardization could potentially be beneficial.

In 2023, there were 1,500 hospice services in Germany with approximately 120,000 people engaged in voluntary hospice work [ 21 ]. Despite 95% of hospice work being funded by health insurance providers, the remaining 5% underscore the connection between hospice and civil society and are said to resist the commodification of palliative care [ 22 ]. Although German hospice care could probably do without volunteers, they explicitly stick to including them. This way, the feature of voluntary work comes to the fore and can be researched in an exemplary manner.

According to the classification scheme provided by the European Association of Palliative Care, hospice volunteers in Germany typically align with the category of ‘C volunteers’ [ 18 ]. These volunteers are characterized as local community members who donate their time to help in palliative care either by being directly involved in patient care and family support or by providing organizational assistance to the professional palliative care team. They diverge from B-volunteers since they do not have professional palliative care training themselves and are not involved in the palliative care institution beyond their volunteer work. Volunteers in Germany usually undergo basic training sessions before they participate in volunteering. The aim of this preliminary training is to promote reflection on death and dying, rather than defining and instructing a specific role of hospice volunteers [ 23 , 24 ].

Study design

The research employs a multicentric qualitative on-site interview study design (see supplement 1 ). Our epistemological position is guided by the sociological assumption of differentiation of roles and contexts [ 25 , 26 ]. Such a position is rooted in a constructivist conceptualization of modern society as being characterized by the emergence of different functional ‘logics’ typical of modern multidisciplinary settings [ 27 ]. This leads to the assumption that in a multi-professional organization such as a hospice unit, different roles emerge for the different professional groups, which can conceivably be understood as functional solutions to correlated problems. From this theoretical perspective, our study investigates the role assumed by volunteers and the issue that it seeks to address. Hence, this study is interested in the emergent patterns within the narratives of hospice workers’ individual perspectives. The viability of this design has already been demonstrated in a similar study focusing on pastoral care workers in hospice and palliative care [ 28 ].

Interviews were carried out in five hospice units and two palliative care units. In Germany, volunteers are more prevalent in hospice units, which typically operate their own hospice services, organizing both inpatient and outpatient palliative care as well as coordinating volunteer activities. For this study, our focus was on volunteers working within inpatient hospice services. When selecting the participating institutions, we attempted to cover different regions to account for regional variations (North, South, East, West). The inclusion criterion for participants in this study was serving as a hospice volunteer with frequent patient contact. Excluded were hospice volunteers with no contact to patients, who only handled administrative tasks. As described above, hospice volunteers with no contact to patients are relatively uncommon in Germany.

To identify characteristics typical for the role, the sample needed to maintain homogeneity, hence our focus on inpatient hospice services. For the recruitment of interviewees, the project was presented during the multi-professional team meetings, in the course of which relevant participants were invited to take part. There were no interactions with the interview partners prior to the study. Opt-outs were infrequent, and primarily due to scheduling conflicts.

Data collection

Data were collected via problem-centered interviews (see Table  1 ) [ 29 ]. Most of the interviews were conducted in-person at the hospice units between 2018 and 2019 by NB, KM and AW. Interviewees did not know the interviewers beforehand. The interviews were digitally recorded and ranged from 40 to 80 min. No one else was present during the interviews. There were no follow-up interviews and the participants were not provided transcripts of the interviews. In addition to the interviews, the project members attended multi-professional team and handover meetings, during which they compiled observation records. Recruitment was ended according to our pre-established project phases.

Interview transcripts were analyzed utilizing MAXQDA 2022. The coding process was based on the grounded theory approach, outlined by Przyborski & Wohlraab-Sahr [ 30 ]. The coding process consisted of two stages: The initial stage was an exploratory reading of the interviews, freely coding the material (open coding). Subsequently, the different codes were condensed into three to five major themes and corresponding subcategories (axial coding). A major theme was defined as a topic mentioned in every interview. For instance, witnessing the dying process was a subject discussed by all hospice volunteers, thereby solidifying it as a major theme. Minor themes also were coded. Although these themes were mentioned repeatedly, they did not appear in all interviews. The coding process saw continuous refinement and adjustment of the themes and subcategories. Table  4 presents the final coding tree. Figure  1 depicts the research process. The analysis was supplemented by recurring data sessions within the research team (see supplement 2 for more information about the team members). There was no feedback on the results from the participants in the study.

Flowchart of the research process

Ethical issues

The study was approved by the ethics commission of the Medical Faculty of LMU Munich (Az-558-15, 30.11.2017). All participants were provided with an information sheet both on the project and on data protection. All participants confirmed in writing that they were willing to participate in the study.

A total of 16 hospice volunteers participated in the study (see Table  2 ). Interviews were conducted at six different institutions (see Table  3 ). At one palliative care unit we were unable to find any volunteers to interview due to two main reasons: (1) Hospice volunteers are relatively uncommon at hospital palliative care units. (2) The specific palliative care unit was located in East Germany (Saxony-Anhalt, former GDR). For historical reasons related to work organization during state socialism, hospice volunteers in this area are still less prevalent than in West Germany. Since our data is referring to the main study (see supplement 1) and we initially expected to be able to interview hospice volunteers, we deem it essential to mention the second palliative care unit.

In order to analyze the role of hospice volunteers, several major themes and subcategories were derived from the data (see Fig.  1 ). To better illustrate our findings, we selected especially striking passages for presentation (see Table  4 ).

Three major themes (categories) emerged from the data analysis, each with several corresponding subcategories (see Table  4 ). Minor themes, which came up frequently, but not in all interviews, revolved around talking about existential fears, the role of non-verbal cues in the communication with patients as well as providing comfort to patients and relatives alike. As this study is primarily interested in patterns that are typical of a certain perspective, these minor themes will not be discussed further.

Performing small acts of kindness (Theme A)

Unlike other professional groups in palliative care, the daily work of volunteers does not adhere to a strict structure. Processes and tasks are not predefined but arise spontaneously, depending on what “is on” (P9, 9, female). However, the tasks of hospice volunteers’ are not completely arbitrary; certain patterns emerge. Some tasks, like preparing lunch or breakfast, are loosely associated with a certain time of the day. Typically, volunteers concentrate on small services which do not require specific qualifications (Table  4 , A.II.). They do not care much about what they do but rather just about being able to contribute something in some way.

"It’s my task, or that’s,- what’s it like here, what’s common here, or, I’d like to say/ how do I say this? I experience myself the way I am. As a maid-of-all-work. And so, I absolutely don’t care about what I’m doing…"(P9, 8, female). "Well, you know, after all I fulfill tasks which don’t require any training. That’s not meant to say that all I do is making coffee but that I do things like preparing breakfast for the people." (P3, 7, male).

Volunteers might also support the nursing staff with their daily tasks. One main objective repeatedly mentioned was just doing something good for someone (Table  4 , A.I.). Typically they focus on patients’ wishes and desires that can’t be readily catered to within organizational routines or on tasks that may have possibly been overlooked by other staff members. An example might be the special preparation of “iced coffee” for a patient. Yet, volunteers acknowledge that there are limitations to their activities (Table  4 , A.III.). Given their completely volunteer nature, they hold the power of choosing which hospice resident to assist, and which they opt not to. They can set boundaries according to their own criteria.

"And [he] was really very, well, nasty to everybody. Or to many, you know? And then, at some time I started setting limits to him and said: You know, what I’m doing here is volunteer work. And I’m not going to let you treat me like this. Well, that was a situation taking me to my limits for once, you know?" (P2, 31, female).

The fact that volunteers may decide on their own which patients they work with emphasizes the voluntary nature of their activity and thereby their differentiation from regular care practice. Hospice residents deemed overly demanding or poorly behaved (“like a spoiled little child”, Table  4 , A.III.) can be sidestepped. However, this freedom to choose as well as establish one’s own limits, inherent to voluntary hospice work, is owed to a division of labor with the non-voluntary professional staff. The latter group, who are not completely free to choose their tasks as well as their preferred hospice residents, consistently undertakes all other essential services, particularly nursing and symptom control.

Creating a family-like atmosphere (Theme B)

The second category further illustrates the intrinsically unpredictable nature of volunteer work in comparison to other roles within organizations. The hospice volunteers in our study show something we call ‘spontaneous understanding’. They may react “really intuitively” (P2, 23, female).

"And then we phoned her, and she came and was extremely upset, and she felt somehow, well, so overwhelmed […] So I just, and it simply happened, you know, then I react really intuitively, and I just hugged her and told her that she had done everything right. After all, she set her mother free. […] Well, such situations are frequent, yes. But it’s not like me mentioning things myself. It’s rather, well, it’s very much simply listening and being there. […] And being there really helps them. Somehow, it’s a family-like, emotional environment." (P2, 23, female).

This fosters a communication approach which allows volunteers to be personal and intimate in their interactions with patients while maintaining a casual tone (Table  4 , B.II.). The way volunteers manage interactions with relatives underscores their ability to react situationally, intuitively, and spontaneously – in their respect – in emotionally appropriate ways. In doing so, they cultivate a somewhat familial atmosphere within the hospice unit.

Another common theme drawn from the interviews revolves around the act of simply being present and devoting time to a resident during the dying process, even if communication is no longer possible (Table  4 , B.I.).

"For me, this is the hardest of all situations. Just being there then, watching, not doing anything. You’ve got to learn this. Many of our colleagues believe that now they have to do something, but often it’s just impossible. And even for me this is a very grave situation. […] Or if, and this is often the case with brain tumors, if this person isn’t at all present any longer when talking. You know, if he is just talking nonsense or, however, still wants a conversation. How are you supposed to handle this?" (P1, 19, female).

Maintaining a personal relationship, even when the dying individual ceases to respond, is often viewed as a significant achievement. Even when there is nothing left to do, hospice volunteers can continue their bedside presence. In organizations, it can be quite challenging to just sit there without doing anything, since doing nothing could be misconstrued as laziness. It is more likely for family members than for nursing staff, to be perceived as justifiably sitting by the bedside without further action.

Expecting emotional experiences (Theme C)

Hospice volunteers follow the dying process very closely. They often attribute great significance to the direct experience of death and the dying process (Table  4 , C.I.). Actually witnessing the moment of death happens mostly by chance. When volunteers are present during a person’s final moments, they typically regard it as a ‘gift’ or as ‘good luck’.

“It’s very rare that we’re around right at the moment of death. Often dying takes a very long time, hours. […] But being around right at the moment of death, that’s also a piece of good luck, and I was lucky one time. Together with a very experienced nurse I helped with nursing an old, aged lady. […] She died in my arms. Of course, that was a really, really great experience […] I never had it again. A very moving experience. Experiencing death this way, so close …” (P1, 15, female).

This profound, almost spiritual experience of being very close to death while sitting at the bedside is intensified by the volunteers’ perception of their role as supportive to the nursing staff (Table  4 , C.II.). In their capacity as volunteers, they can sit at the bedside and accompany the dying and thereby alleviate the nursing staff’s workload. Witnessing the dying process – and more significantly, doing so while providing practical help to nurses – represents a critical objective for volunteers. It affords a sense of involvement in the dying process that creates proximity to those who are in the final stages of their life.

However, from the point of view of the volunteers, one can get even closer. Volunteers frequently portray death and the preceding dying process, which can easily become routine in hospice care, as exceptionally special experiences (Table  4 , C.III.). The dying individual might even evolve into a kind of existential figure.

"Well, just by the way, you know what I see is, and I’ve already said this, that sometimes the dying, and particularly this one I’m talking about, are really teachers for all of us. And that’s very special. And they are aware of it. Then I really address this, and I say: Have you understood what’s going on, after all? He’s our teacher. Although we’re the nursing staff or we serve them, but we’ve been given a great gift. That was a very special soul." (P9, 34, female).

For volunteers, dying is something exceptional, an intimate and individual moment during which they may come particularly close to death. The volunteer cited here describes the dying person as a kind of teacher, educating her about mortality in general and the finitude of life. For her, dying is far from being routine. Despite how unusual it seems that the volunteers mostly focus on their own experiences, it is precisely in doing this that they perform the role of someone who is part of an organization, yet simultaneously distancing themselves from it. For them, death is viewed as a gift, a teacher imparting understanding of life and death. Their willingness to perceive interactions with the dying person as enriching personal experiences contrasts significantly with the routinized approach to death that is inevitable within professional organizations.

Main findings of the study

The findings highlight that hospice volunteers often engage in small acts of kindness that do not necessitate any specific skills or expertise. They participate in casual conversations with patients and relatives, and closely observe dying individuals while sitting at the bedside. At first glance, these actions do not appear to be extraordinary as they could equally be performed by other hospice care staff. However, it is striking how these task descriptions are more commonly attributed to volunteers than other professional groups.

What aspects, then, are unique about volunteer work at inpatient hospice care? What role can be derived from this? Our analysis indicates that the traits articulated in relevant literature, such as a wide range of activities [ 3 ] as well as motivation beyond personal interests [ 8 , 9 , 10 , 11 ], stem primarily from a role that is distinctly characterized by being different from organizational rules and routines. While volunteers perform expected tasks, they also have the latitude – at least in the German care context – to selectively accept or reject these tasks [ 15 ].

This specific organizational ‘anomaly’ makes spontaneous reactions predictable, producing a form of communication evocative of a familial setting. Actions such as unexpectedly hugging someone, responding emotionally or just being present [ 18 , 31 ] contribute elements that are difficult to organize. Simply sitting by the bedside and accompanying the dying is another genuine form of support in a daily routine where professional caregivers are often preoccupied.

All of this is justified and motivated by a very personal intention—to come as close as possible to death, thereby gaining a deeper understanding of it. This describes the fundamental nature of volunteers’ assistance in this field. There is an aspect of spontaneity once again, this time associated with death, which grants volunteers a profound experience.

The benefit for the organization is that spontaneous elements disrupt a routinized daily life. In inpatient hospice care, routines pose a particular challenge as they render death and dying predictable, subjecting them to trivialization [ 32 ]. Volunteer hospice workers succeed in viewing death as an unexpected gift, understand it as a teacher, and as such, attribute significance that transcends the immediate circumstances.

We consider these results to be transferable to other countries with much more defined job roles for volunteer hospice workers. The more specialized and formalized the unpaid activity, the more it needs to align with the personal interests of volunteers. In this context, the role, as compared to other employees, stabilizes as one that partially deviates from routines, thus allowing room for personal engagement. The desire to come as close as possible to death and dying, and to be emotionally moved by it, is a common theme in international literature, as well as in the German context [ 33 ].

What this study contributes

This study adds insights into the role of hospice volunteers. The results of the study underpin the objective, articulated in the European Association of Palliative Care White Paper, to identify the role of volunteers as ‘being there’ in line with the Asclepian tradition [ 18 , 31 ]. Our data also pinpoints ‘being there’ as a key element in how volunteers describe themselves. Simply through being present, volunteers find opportunities to make spontaneous contributions in their everyday life by offering casual assistance, thereby fostering a familial atmosphere.

In line with previous literature, this study shows that the tasks of volunteers are heterogeneous. While certain studies have proposed that a higher degree of standardization might support volunteers with more confidence in their actions due to a more clearly defined role [ 11 , 17 , 18 ], our findings do not support this assertion. Recent studies cautioned that an overly rigid regulation of the tasks of volunteers might support an unwanted ‘them and us’ mentality between volunteers and the other staff [ 15 ], no longer making volunteers as visible as the other, more accessible ‘face’ of nursing [ 19 ]. Another recent study revealed that standardization efforts have relatively little impact on volunteering practices [ 20 ]. Our study’s results do not reveal such a “them and us” mentality nor do they enable any conclusions regarding the effectiveness of specific standardization efforts.

However, our observations did reveal a crucial conclusion – and this is the most important conclusion to be drawn from our study – that even in the absence of notable standardization efforts, the somewhat ‘unstandardized’ and spontaneous behavior of hospice volunteers has effectively become a standard within German hospice care.

From a sociological point of view, volunteers, owing to the unspecific definition of their role, present a kind of ‘anomaly’. As members of the organization, they contradict everything that usually shapes an organization: their training is not specific, their actions are mostly spontaneous, they devote their personal time to hospice work, and they work without being paid. Yet, this status of an ‘organizational anomaly’ comes about only in the presence of an ‘organizational normality’ that fosters continuity and predictability. In this light, the apparent randomness of the volunteers’ tasks could be seen as an effect of the division of labor within multi-professional hospice care, which they are part of. This way, they can be described as an ‘expectable anomaly’.

Modern palliative care has faced criticism for being subjected to a process of “creeping medicalization” due to professionalization and specialization [ 34 ]. However, our research illuminates that hospice volunteers foster a relaxed, familial atmosphere, infusing the hospice unit with a touch of ‘normality’ [ 35 ]. Consequently, it can be deemed a ‘counter-institution’ [ 4 ], according to its historically rooted self-understanding as described at the beginning of this study. It is worth noting that this is not accomplished in opposition to the institution, but rather through institutional and organizational methods.

Strengths and weaknesses of the study

The strength of this study is rooted in its design, based on the sociological assumption of differentiating contexts and roles [ 25 , 26 ]. As a result of the number of interviews conducted, it was possible to identify a variety of different categories and subcategories. There are limitations due to the focus on Germany. Since only one volunteer working at a palliative care unit was interviewed, the study does not allow for stating in how far the activities of volunteers at hospital palliative care units are different from those at hospice units. This is an interesting topic for future research. A possible future research direction could be how policies might potentially negatively impact this spontaneity or further amplify its benefits. Moreover, we suggest the potential for future research to evaluate the impact of hospice volunteers’ spontaneous work on the emotional well-being of patients and relatives.

As an implication for practical work, we suggest that hospice managers should value the benefits of unstandardized roles and structures as they facilitate dynamic and flexible work practices.

The findings imply that allowing spontaneity to volunteers can be advantageous. Organizations delivering hospice and palliative care should provide these spaces if they aim to involve volunteers effectively. It is also apparent that organizations like inpatient hospices and palliative care units can be adversely impacted by their own organizational formalities. The perspective of volunteers can add depth to the ‘holistic’ self-descriptions of a family-like context. However, such descriptions should not obscure the understanding of the collaborative organizational structures, which are characterized by a division of labor.

Availability of data and materials

The coded interview material is available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank Dipl.-Soz. Katharina Mayr (KM) and Dr. Andreas Walker (AW), who participated in the data collection. We also thank the participants of our study for sharing their valuable experiences with us.

Open Access funding enabled and organized by Projekt DEAL. The authors gratefully acknowledge funding received for this study from the German Research Foundation (DFG): About ‘good dying’. Actor constellations, normative patterns, different perspectives (Project number: 343373350) Project Management: Prof. Dr. Christof Breitsameter, Prof. Dr. Armin Nassehi, Dr. Irmhild Saake. The funding body played no role in the design of the study and collection, analysis, interpretation of data, and in writing the manuscript.

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All authors were involved in reviewing and editing. In addition, AN, IS and CB were responsible for conceptualization, methodology and funding acquisition, NB was involved in data collection, AB and IR wrote the original draft.

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The study was approved by the medical faculty’s ethics commission of Ludwig-Maximilians-University Munich (Az 558 − 15). All participants gave written informed consent to participate in the study. At the start of the interviews, interviewees received information about the study’s objectives and signed the informed consent form for participation. Confidentiality and voluntary withdrawal from the study were approved by the study conductors. All methods utilized in this study complied with relevant national and international guidelines and regulations.

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Nassehi, A., Saake, I., Breitsameter, C. et al. Adding spontaneity to organizations – what hospice volunteers contribute to everyday life in German inpatient hospice and palliative care units: a qualitative study. BMC Palliat Care 23 , 81 (2024). https://doi.org/10.1186/s12904-024-01409-3

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Classification of vasovagal syncope from physiological signals on tilt table testing

• Mahbuba Ferdowsi 1 , 2 ,
• Ban-Hoe Kwan 1 , 2 ,
• Maw Pin Tan 3 ,
• Nor’ Izzati Saedon 3 ,
• Sukanya Subramaniam 4 ,
• Noor Fatin Izzati Abu Hashim 4 ,
• Siti Sakinah Mohd Nasir 4 ,
• Imran Zainal Abidin 5 ,
• Kok Han Chee 5 &
• Choon-Hian Goh 1 , 2  

BioMedical Engineering OnLine volume  23 , Article number:  37 ( 2024 ) Cite this article

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Metrics details

The diagnostic test for vasovagal syncope (VVS), the most common cause of syncope is head-up tilt test (HUTT) assessment. During the test, subjects experienced clinical symptoms such as nausea, sweating, pallor, the feeling of palpitations, being on the verge of passing out, and fainting. The study's goal is to develop an algorithm to classify VVS patients based on physiological signals blood pressure (BP) and electrocardiography (ECG) obtained from the HUTT.

After 10 min of supine rest, the subject was tilted at a 70-degree angle on a tilt table for approximately a total of 35 min. 400 µg of glyceryl trinitrate (GTN) was administered sublingually after the first 20 min and monitoring continued for another 15 min. Mean imputation and K-nearest neighbors (KNN) imputation approaches to handle missing values. Next, feature selection techniques were implemented, including genetic algorithm, recursive feature elimination, and feature importance, to determine the crucial features. The Mann–Whitney U test was then performed to determine the statistical difference between two groups. Patients with VVS are categorized via machine learning models including Support Vector Machine (SVM), Gaussian Naïve Bayes (GNB), Multinomial Naïve Bayes (MNB), KNN, Logistic Regression (LR), and Random Forest (RF). The developed model is interpreted using an explainable artificial intelligence (XAI) model known as partial dependence plot.

A total of 137 subjects aged between 9 and 93 years were recruited for this study, 54 experienced clinical symptoms were considered positive tests, while the remaining 83 tested negative. Optimal results were obtained by combining the KNN imputation technique and three tilting features with SVM with 90.5% accuracy, 87.0% sensitivity, 92.7% specificity, 88.6% precision, 87.8% F1 score, and 95.4% ROC (receiver operating characteristics) AUC (area under curve).

Conclusions

The proposed algorithm effectively classifies VVS patients with over 90% accuracy. However, the study was confined to a small sample size. More clinical datasets are required to ensure that our approach is generalizable.

Introduction

Syncope is characterized by transient loss of consciousness resulting from global disruption in cerebral perfusion [ 1 ]. It strikes quickly followed by rapid, complete recovery. Accounting for 1% to 3% of all consultations at emergency rooms, 40% are then admitted to hospital for etiological investigations [ 2 , 3 ]. While the presence of syncope may herald serious life-threatening conditions, a large number of such cases are attributed to vasovagal syncope (VVS), which is a non-life threatening condition [ 4 , 5 ].

Vasovagal syncope is often triggered by specific actions, such as standing for prolonged periods, urination, or experiencing a frightening event. The underlying pathophysiology of VVS is intricate. To put it briefly, certain proactive situations can cause the vagus nerve to act abnormally, leading to a sudden drop in blood pressure (BP), decreased heart rate (HR) (bradycardia), widening of blood vessels (vasodilation), excessive sweating (diaphoresis), and various symptoms like dizziness, light-headedness, nausea, blurred vision, ultimately resulting in syncope (fainting) [ 6 , 7 , 8 , 9 ]. The exact reasons for this exaggerated response involve various factors, including an overactive parasympathetic response, heightened sensitivity of the blood vessels, and abnormal signalling within the autonomic nervous system (ANS) [ 10 ]. Moreover, these factors contribute to an abnormal reflex response to triggers such as orthostatic stress or emotional stimuli, leading to the characteristic symptoms and fainting episodes associated with VVS [ 11 ]. These physiological changes are a result of the ANS response and can be triggered during the head-up tilt test (HUTT).

The head-up tilt test is a diagnostic test used to identify VVS [ 12 ]. The test is considered positive if there are physiological changes such as bradycardia, cardiac pauses, and hypotension that occur alongside an exact reproduction of symptoms that the patient had previously experienced during their spontaneously occurring episodes [ 13 ]. Therefore, the key requirement for diagnosing VVS using HUTT is to provoke the unpleasant and often distressing symptoms associated with VVS. Additionally, the test is time-consuming and necessitates medical supervision, as positive results may involve prolonged periods of asystole and hypotension, making it resource-intensive in terms of requiring the presence of technicians and physicians.

The aim of the study was to investigate the significance of different physiological indicators in predicting VVS. The hypothesis was that systolic blood pressure (SBP), diastolic blood pressure (DBP), and their time- and frequency-domain variables could be more significant indicators compared to HR and heart rate variability (HRV). The research explored the predictive power of these indicators in detecting VVS. Additionally, the study utilized explainable artificial intelligence (XAI) through partial dependence plot (PDP) analysis to enhance interpretability and assess the impact of input variables on prediction outcomes. By examining multiple physiological indicators and emphasizing the practical relevance of the model, the research contributes to a more comprehensive understanding and potential practical application in VVS prediction. The main objective of the research was to develop an algorithm for categorizing VVS based on electrocardiogram (ECG) and BP signals collected during the HUTT. Therefore, this research study could potentially improve the diagnostic and treatment procedures for VVS, which would benefit both healthcare providers and patients.

This study proposes a novel algorithm for the classification of VVS patients using physiological data, including ECG and BP signals, obtained during HUTT. Our algorithm incorporates a strategic combination of techniques, including data imputation and feature selection, and employs six ML classifiers, namely, SVM, KNN, GNB, MNB, LR, and RF, to achieve a significant improvement in the accuracy of VVS classification. A unique feature of our algorithm is the integration of XAI, as demonstrated by the utilization of PDP analysis. This innovative approach not only enhances the model's performance, but also enriches its comprehensibility. As a result, healthcare providers can gain a deeper understanding of the complex relationships between ECG and BP signals from HUTT and the prediction of VVS. This facilitates the seamless implementation of our model in clinical settings and provides significant benefits to both patients and medical practitioners.

Eighty-three test negative patients, mean age 65.35 ± 19.99 years, and 54 test positive subjects, mean age 66.24 ± 20.77 years were included. The study employed two datasets, dataset one (D1) imputed using the KNN method, and dataset two (D2) using the mean method. Both imputation methods were used to produce all the results. The entire data range is displayed as a mean with a standard deviation (SD). A preliminary preview of our study was presented here [ 14 ].

Selected features and statistical analysis of the proposed methods

The electrocardiographic and BP signals were studied in the time and frequency domains during tilt and while supine, yielding a total of 55 parameters that were utilized to the feature importance (FI) algorithm. Three identical features were chosen using the FI approach from both D1 and D2. They are all tilting features named 'CV_SBPV' (coefficient of variance of systolic BP variability)', CV_DBPV' (coefficient of variance of diastolic BP variability), ' LFnu_SBPV' (low-frequency normalized power of systolic BP variability). The feature importance values for the two imputation methods were different. Our study used several combinations of parameters for the genetic algorithm (GA) and the optimal values for D1 were crossover probability (CP) = 0.5, mutation probability (MP) = 0.1, crossover independent probability (CIP) = 0.4 and mutation independent probability (MIP) = 1. For D2, however, CP = 0.5, MP = 0.2, CIP = 0.5, and MIP = 1 was the most effective (Table  1 ).

The study maintained a constant population size of 100 and generation number of 10 for both D1 and D2. Our algorithm would probably find local optimum conditions when the population size was too small since the population would lose its diversity. Furthermore, the replacement stage involves some challenges. The study had to exclude the impractical solutions since the population size was too small. The general rule is that the larger the population, the better, but the study frequently must make concessions to accomplish our goal in a fair amount of time. The ideal values for many parameters must be conjectured by the study when creating a GA. No satisfactory response exists. In general, our investigation was conducted through trial and error. As per both D1 and D2, the model defined three identical important features. The genetic algorithm method, applied to D1 and D2 data, has successfully identified two set of relevant features (Table  1 ). The parameters, chosen via the recursive feature elimination (RFE) method using both D1 and D2 data, unveiled features like 'DBP' and 'CV_DBPV' in the tilting position, along with 'SBP' in the supine position.

For the application of the Mann–Whitney U Test (MWUT), the parameter should be ordinal or continuous but not necessarily normally distributed, and the two groups must be distinct [ 15 ]. These are the sole prerequisites. In our case, when comparing the supine rested data of test-positive and test-negative subjects (Table  2 ), no statistically significant difference was observed. The tabulated results affirm the absence of noteworthy distinctions between the supine rested findings of the test positive and test negative groups.

The proposed classifiers

The study utilized six distinct ML models namely SVM, KNN, GNB, MNB, LR, and RF for binary classification. Hyperparameter tuning was systematically performed for each model via grid search. This method involved the exploration of parameter combinations to optimize the model configuration, thereby improving predictive accuracy and generalization capabilities. This meticulous process enabled the fine-tuning of hyperparameters for every model, resulting in dependable and resilient outcomes.

Due to random data division for ML model evaluation, imputed data may exist in the test subset, using mean and KNN imputation. With 80% for training and 20% for testing, some imputed instances could be in the test set. While prioritizing unimputed data in testing, the stochastic process can lead to imputed points in the test set. This approach balances rigorous assessment with practicality, providing insights into algorithm performance with authentic and imputed data.

By assessing a ML model's performance on novel data with less bias, the approach assesses its generalizability. The fivefold cross-validation approach verifies the outcomes after the model has been developed using train-test-split. The best results were obtained when the KNN imputation method and three tilting features—CV_SBPV, CV_DBPV, and LFnu_SBPV were combined with SVM. For the support vector machine model, the ideal set of hyperparameters was c = 1, gamma = 0.01, and kernel = RBF. The best result was obtained with 90.5% accuracy, 87.0% sensitivity, 92.7% specificity, 88.6% precision, 87.8% F1 score and 95.4% ROC (AUC) (Table  3 ). In the proposed optimal SVM model, TP (true positive), TN (true negative), FP (false positive), and FN (false negative) are, 47, 77, 6, and 7, respectively.

The three selected tilting features, named 'CV_SBPV', 'CV_DBPV' and 'LFnu_SBPV' indeed exhibit a strong relevance to the pathology of VVS, particularly during the HUTT. These features provide valuable insights into the physiological dynamics that underlie VVS and contribute to its classification. 'CV_SBPV' and 'CV_DBPV', which quantify changes in BP during HUTT, align with a critical aspect of VVS pathology. A decrease in BP during HUTT is a well-documented phenomenon in individuals with VVS. This drop in BP can be a primary contributor to VVS episodes. 'LFnu_SBPV', measuring the balance between the sympathetic nervous system (SNS) and parasympathetic nervous system (PNS), further highlights the intricate autonomic involvement in VVS. The role of the SNS and the PNS in regulating HR and BP is pivotal. The observed decrease in SNS activity during HUTT aligns with the pathophysiology of VVS. Such changes can lead to inadequate cardiovascular responses potentially triggering a VVS episode.

The robustness of (CV_SBPV and CV_DBPV) becomes evident, as they provide a normalized assessment of variability through the SD-to-mean ratio. This normalization effectively accounts for mean value differences among individuals—a crucial consideration absent in the standalone SD. The latter’s limitation in capturing the full extent of variability in cross-individual comparisons underscores the significance of (CV_SBPV and CV_DBPV). Moreover, (CV_SBPV and CV_DBPV) outshine ARV due to their dual capability of gauging relative variability and embracing the average value. In contrast, ARV's sole focus on absolute variations between consecutive data points might overlook the intricate autonomic dynamics integral to VVS events. The application of (CV_SBPV and CV_DBPV) in beat-to-beat data analysis plays a pivotal role, capturing dynamic fluctuations in SBP, DBP, and HR over temporal intervals, revealing autonomic regulatory patterns that enhance their diagnostic significance. Meanwhile, LFnu_SBPV offers a unique edge over RMSRV by unveiling the equilibrium between the SNS and PNS. While RMSRV captures sequential differences, LFnu_SBPV delves into the autonomic balance, a vital determinant in syncope assessment. Furthermore, comparing (CV_SBPV and CV_DBPV) against SDRV, the former's normalized measure of variability stands out, effectively highlighting subject distinctions. On the contrary, SDRV's assessment of sequential differences without normalization for mean values might hinder its ability to differentiate subjects optimally. Therefore, the comprehensive and normalized nature of (CV_SBPV, CV_DBPV, and LFnu_SBPV) prevails in contrast to SD, ARV, RMSRV, and SDRV.

These three selected features reveal intricate physiological insights and excel in beat-to-beat analysis, enhancing VVS episode understanding and classification. These quantitative foundations enable a more precise diagnostic approach, potentially improving patient care. Their significance in VVS classification during HUTT underscores their clinical relevance.

Receiver operating characteristics curve

The receiver operating characteristics curve is a technique for evaluating the ability to distinguish between test positive and negative subjects at various threshold levels. A good model will have an area under curve (AUC) near to 1, which denotes a high degree of separability. 90.5% accuracy and 95.4% ROC were found to be ideal in the study employing D1 and FI chosen features (Table  3 ). Employing D2 with GA-selected features yielded the maximum 99.7% ROC (Fig.  1 A), although accuracy was 86.1% (Fig.  1 D). As a result, it is conceivable for an elevated AUC classifier to fail to perform below a lower AUC classifier in a specific area of the ROC space.

Receiver operating characteristics curve by D1 and D2. (Here A  KNN imputation data + FI selected features; B  mean imputation data + FI selected features; C  KNN imputation data + GA selected features; D  mean imputation data + GA selected features; E  KNN imputation data + RFE selected features; F  mean imputation data + RFE selected features.)

Violin plot

The significance of the violin plot in VVS classification lies in its ability to visually represent the data’s probability density, even with non-normally distributed data. Additionally, it enables effective comparison of variable distributions between test-positive and test-negative subjects, aiding in the identification of crucial differences for developing a reliable syncope classification model. Figure  2 represents the violin plot.

Violin plot of effects of test positive and negative subjects on tilting position variables of CV_SBPV (coefficient of variance of systolic BP variability), CV_DBPV (coefficient of variance of diastolic BP variability), and LFnu_SBPV (low-frequency normalized power of systolic BP variability). The estimated likelihood density of the data at test positive and test negative individuals is also displayed on the violin plot, providing a more thorough comprehension of the distribution of the values. Here A  KNN imputation data + FI selected features; B  mean imputation data + FI selected features

The outcome of partial dependence plot

In the partial dependence plot, the expected risk for the initial data, was displayed as a blue curve. PDP values exceeding 0.5 indicated a higher probability of a positive test. Higher CV_SBPV values were associated with positive tests, while lower CV_DBPV values were associated with negative tests. LFnu_SBPV values were conversely lower in those with positive tests (Fig.  3 ).

The partial dependence plot by D1(KNN imputation) data. According to feature importance, three tilting features named "CV_SBPV" (coefficient of variance of systolic BP variability), "CV_DBPV" (coefficient of variance of diastolic BP variability), and "LFnu_SBPV" (Low-frequency normalized power of systolic BP variability) were chosen, and this feature combination produced the best accuracy. Here, x axis CV_SBPV_T, CV_DBPV_T and Lfnu_SBPV_T represent the fixed values of target features and y axis represents the probability of predicted risk of a positive test. The subjects were more likely to test positive with higher CV_SBPV_T and CV_DBPV_T, while positive tests had lower Lfnu_SBPV_T

The significance of predicting VVS occurrence lies in the development of proactive prevention techniques and targeted clinical interventions. By creating an algorithm to classify individuals with VVS based on physiological data, including BP and ECG, acquired during the HUTT features which play a vital role in the classification of VVS test positive and VVS test negative subjects, crucial information about the physiological differences between these two groups has been revealed. The ML models developed are able to classify VVS with high accuracy (over 90%). Previous studies have mainly applied resting state features. For instance, the study by Kostoglou et al. achieved a predictive performance metric of ρ  = 0.952 in forecasting the time to syncope occurrence (TSO) in VVS patients using only resting state features [ 16 ]. Furthermore, Kostoglou et al. focused exclusively on ECG signals, overlooking other vital physiological indicators like HR, which could limit the comprehensiveness of their predictive performance. Another noteworthy difference is that Kostoglou et al. primarily utilized a single ML algorithm (RF), potentially missing the opportunity to explore alternative algorithms that might achieve even better predictive performance. Evangelia Myrovali et al. were able to predict syncope outcomes from resting state clinical data with an accuracy of 89.7% [ 17 ]. The two studies mentioned above had utilized relatively small datasets of 71 and 26 patients, respectively, raising concerns about their applicability to larger and more diverse patient populations. Additionally, their primary goal of predicting syncope outcomes may hinder the direct application of their findings to patient classification, which is a crucial aspect of VVS diagnosis and management.

In contrast, our study overcame these limitations with a more extensive dataset of 137 patients, greatly improving the potential for generalization to a broader VVS patient population compared to the previous studies. Furthermore, we employ a comprehensive approach by incorporating both ECG and BP signals, capturing data from both supine and tilting positions during HUTT, leading to a classification accuracy of 90.5%. Additionally, we addressed the limitation of using a single ML algorithm by evaluating a wide range of methods, including KNN, SVM, GNB, MNB, LR, and RF, ensuring a more robust exploration of classification techniques. Our study stands out for its comprehensive approach to VVS patient classification, incorporating tilting features in the feature selection process, and offering a versatile tool directly applicable to clinical practice for diagnosis and management.

Turning to R. Couceiro et al., their focus on predicting Neurally Mediated Syncope (NMS) in real-time, with high sensitivity and specificity, offers promise for continuous monitoring and wearable systems [ 3 ]. However, their concentration on real-time prediction may not align directly with the need for patient classification, which is essential for diagnosis and management in a clinical setting. Our study distinguishes itself by centering on the classification of VVS patients using data collected during the HUTT, providing practical clinical applications. While R. Couceiro et al. excel in the real-time prediction of NMS episodes, our research broadens its scope by categorizing VVS patients based on their physiological responses during HUTT. Therefore, our study surpasses the limitations of previous research through a more extensive dataset, consideration of multiple physiological signals, and a diverse range of ML algorithms. It offers a comprehensive approach to VVS patient classification and provides clear potential for practical clinical applications in the diagnosis and management of VVS.

Performance evaluation with state-of-the-artwork

Ciliberti, M. A. P., et al. [ 18 ] investigated the potential of resting HRV spectral components to predict VVS in patients referred for HUTT due to unexplained syncope. Their initial findings indicate that HRV analysis could serve as a predictive tool for identifying individuals at risk of VVS. However, it is crucial to emphasize that further research is essential to validate and build upon these initial results, enhancing our comprehension of this predictive mechanism and its clinical significance. The primary limitation of the study is the relatively small sample size, which included only 26 patients. M. Kwok et al. 2020 had investigated ML models to determine whether syncope occurred in persons aged 50 years and older [ 19 ] and M. Carmody et al. 2020, examined younger patients with a mean age of 25 ± 9 years [ 20 ]. We have included age as one of the syncope classification variables which was selected by GA. However, the combination of age and related features (Table  1 ) were unable to yield results with a better accuracy level. Therefore, our study did not suggest age as an indicator of syncope. He, Z., et al. [ 21 ] conducted a study where they recorded various beat-to-beat physiological parameters and developed ML algorithms to achieve early prediction of HUTT outcomes. Their approach successfully reduced the original 35-min tilting duration to just 13 min. However, the study lacks details regarding the specific methods they used to shorten the prediction time during HUTT and how early in the process they were able to predict the occurrence of VVS. This lack of information makes it challenging to assess the full implications and applications of their findings. S. Hussain et al. 2022 had exhibited higher accuracy (98.9%), sensitivity (97.6%), specificity (92.7%), and precision (92.2%), as well as an F1 score (94.9%) and ROC (AUC) (98.3%) than ours. The balance of their dataset is, however, questionable with only 96 test-positive patients and 591 test-negative ones [ 22 ]. Standard classifiers frequently disregard the little classes in these situations because they are too overwhelmed with the large classes. In that case, it would not be a true reflection of the overall picture. Nevertheless, they employed the synthetic minority oversampling technique (SMOTE), which is an effective oversampling methodology. However, SMOTE has three drawbacks: oversampling unhelpful sample sizes, noisy samples are oversampled, and challenges in estimating the number of nearest neighbors with significant blindness in the selection of nearest neighbors for the synthetic samples [ 23 ]. Alternative strategies such as Borderline-SMOTE, RCSMOTE, K-means SMOTE to address these shortcomings had not been utilized [ 22 ]. Previously, S. Hussain et al. 2021 published a SVM-based classification which was restricted to using SVMs for classification and did not explore different supervised ML algorithms that would have produced an improved classification [ 24 ]. Unexpectedly, neither HR nor HRV indices were chosen from our feature selection. There is a considerable difference between this and other studies. In Table  4 , none of the studies provided explanations within their machine learning models regarding how the features influenced their performance. Notably, only our study had incorporated an explainable artificial intelligence (XAI) model known as PDP. This disparity represents a significant difference between our research and the others, as it enhances the transparency and interpretability of our model by illustrating how specific features impact the overall performance. This detailed insight into feature importance sets our study apart, providing a deeper understanding of the underlying mechanisms driving the classification of VVS.

Moreover, our study demonstrates the superior performance of our proposed algorithm in accurately identifying positive cases of VVS, with higher levels of accuracy and sensitivity compared to previous studies, except for the study conducted by S. Hussain et al. [ 22 ] (Table  4 ). The key distinction of our approach is its reliance on just three parameters, setting it apart from others. This simplification of the classification process improves practicality and reduces computational complexity. The study introduces a new algorithm for syncope detection that utilizes only three parameters out of the 55 initially extracted features. This streamlined approach eases integration into existing diagnostic systems and clinical workflows. Additionally, the reduced computational complexity of the algorithm enables faster processing times, making it well-suited for real-time applications. Importantly, the simplified nature of the algorithm enhances interpretability, a crucial factor in the medical field. This allows clinicians to trust and validate the results obtained from the algorithm.

Previous studies have shown that conventional algorithms often necessitate a larger set of features, typically ranging from five to ten, to effectively classify patients with syncope (Table  4 ). However, our study highlights the significance of specific parameters—CV_SBPV, CV_DBPV, and LFnu_SBPV—which contribute to improved performance of our algorithm. This novel approach offers insights into the physiological factors associated with syncope and suggests potential biomarkers for future investigations. The high accuracy and sensitivity demonstrated by our algorithm underscore its practical potential for clinical implementation. By providing healthcare professionals with an efficient and accurate syncope diagnosis, it facilitates timely interventions and improves patient outcomes.

Importance in clinical application

Our research significantly advances the approach to diagnosing and managing VVS, providing a more precise and efficient method for the diagnosis of VVS. By utilizing physiological data, specifically BP and ECG collected during the HUTT, we can accurately categorize individuals with VVS. This categorization allows for the development of personalized treatment plans tailored to each patient's unique physiological characteristics. Furthermore, our study contributes to a deeper understanding of the underlying pathophysiology of VVS, potentially guiding the development of innovative and more efficient treatment approaches. A distinctive aspect of our algorithm involves the incorporation of XAI, illustrated by the application of PDP analysis. This, in turn, has the potential to lead to improved clinical interventions and better outcomes for individuals with VVS.

Limitations

Some individuals with VVS could have had a false negative test, which would not be considered in this classification model. Since all individuals had HUTT because of a clinical suspicion of VVS, those who tested negative would still have suspected syncopal symptoms which could not be attributed to VVS. Nevertheless, this would have been a clinically relevant observation, as using this classifier, unpleasant and distressing symptoms associated with HUTT could potentially be avoided. There could be future utility in differentiating those with non-life threatening VVS from those individuals with more serious causes of syncope from which sudden cardiac death may occur. As the clinical approach towards investigation of syncope would be to first rule out life-threatening causes, additional evaluation will be required before the role of such an approach could be appropriately determined. Moreover, a small sample size was used in the current research study. More clinical datasets are required for the robustness and generalizability of our method.

However, clear clinical and economic benefits exist for this potential approach since the extensive investigative approach currently employed in order to not to miss life-threatening causes, is resource-intensive, and in need of refinement [ 25 ]. Only ECG and BP signals were examined for the investigation. Patients with VVS could also be categorized with the aid of the impedance cardiography (ICG) signal [ 26 ]. It is a safe technology that assesses the total electrical conductivity of the thorax and changes in that conductivity over time to process constantly a few cardiodynamic parameters, including stroke volume, cardiac input, cardiac output, ventricular ejection time, and pre-ejection interval. It is utilized to find changes in impedance brought on by a high-frequency, low-amplitude current running through the thorax between two extra pairs of electrodes outside the measured section.

Conclusion and future work

The significant synergy among three key tilting features—'CV_SBPV', 'CV_DBPV', and 'Lfnu_SBPV'—identified through the FI method along with D1, yielded a 90.5% accuracy when employed with the SVM model. This substantial boost in accuracy underscores the SVM's dominance over alternate classification techniques within our study. Our experimental outcomes considerably fortify the credibility of our methodology, streamlining the proactive and precise categorization of individuals exhibiting positive results in the HUTT. This potential holds considerable promise for averting of VVS through timely intervention. An intriguing facet of our investigation delves into the illumination of PDP, providing valuable insights into how specific traits influence predictions. The robust accuracy attained through the amalgamation of SVM-specific features reinforces the potential of harnessing this methodology to amplify the precision and efficacy of VVS evaluation. Further evaluation of the classification method is required using larger datasets which includes potential safety concerns to avoid missing life-threatening causes of VVS, but the potential exists for refinement of current investigative strategies for the evaluation of VVS using SVM.

Within the framework of our research, predicting VVS incidence holds paramount importance as it underpins the development of effective preventive measures and clinical interventions. In the future stages of our model's development, our focus will shift toward a more detailed analysis of physiological changes that occur in the lead-up to and during syncope incidents within the tilting window. This research direction is expected to provide invaluable insights into our model's predictive capabilities. These insights will serve as a foundation for advancing our understanding of syncope, ultimately playing a pivotal role in the formulation of early intervention and prevention strategies. Our ultimate goal is to enhance patient care and safety through these advancements, and we will delve into these aspects as part of our future work.

System overview

The proposed method was developed with a laptop equipped with Intel (R) Core (TM) i7-6600U 2.60 GHz CPUs and 8 GB of RAM. The python packages that were used included numpy, pandas, scikit-learn, matplotlib, and seaborn. Data collection, experimental setup, data preprocessing on physiological signals, selection of features, missing value imputation, statistical analysis, ML classifiers, and PDP is all demonstrated in this section. Figure  4 represents the proposed model for classification of VVS.

The proposed model for classification of vasovagal syncope. A flow diagram showing the proposed model for classification of vasovagal syncope. Features ECG and blood pressure signals from 137 HUTT were first extracted then imputed. Selected features identified using feature selection methods and non-parametric probability testing were performed in order to compare the statistical differences between two groups then cross validated and 80% of the data used as training set for machine learning, with the remaining 20% as testing set. The model performance was evaluated, then prediction classification and partial dependence plot applied. HUTT, head-up tilt test; ML, machine learning; SVM, support vector machine; K-nearest neighbors (KNN) imputation dataset; GNB, Gaussian naïve Bayes; MNB, multinomial naïve Bayes; LR, logistic regression; RF, random forest

Data collection

Data collection was conducted at the Cardiorespiratory Laboratories, University of Malaya Medical Centre (UMMC). Patients were referred for HUTT as an investigation for the symptom of syncope or near syncope. All patients were provided information about the test and informed consent obtained prior to the test. Both the Universiti Tunku Abdul Rahman (UTAR) Scientific and Ethical Review Committee (U/SERC/218/2020) and the UMMC Medical Research Ethics Committee (MREC ID NO: 2,020,913–9066) provided their approval for this cross-sectional study.

Experimental setup

The head-up tilt test was meticulously conducted, employing specialized non-invasive monitoring equipment furnished by CNSystem, with a central focus on the Task Force™ Monitor (CNSystems, Graz, Austria). This sophisticated monitoring system was purpose-built to facilitate comprehensive hemodynamic measurements, enabling seamless real-time data acquisition and subsequent analysis [ 27 ]. Core bio signals, comprising ECG and BP were meticulously recorded on a beat-to-beat basis. It is worth mentioning that the Task Force Monitor was carefully outfitted with a high-resolution two-channel ECG module, proficiently capturing data at a frequency of 1000 Hz. Additionally, a BP module, operating at 100 Hz, further augmented the system's capabilities. Subjects underwent meticulous preparation, entailing the precise attachment of electrodes and sensors to capture pivotal physiological parameters such as BP and HR. These well-prepared subjects were subsequently positioned on an integrated tilt table, thoughtfully designed to enable controlled angle adjustments. The tilt table served as a dynamic platform, allowing subjects to undergo a gradual transition from a supine position to a predetermined 70-degree angle. The protocol HUTT was carried out in a tranquil and carefully managed setting designed to minimize external factors. The substantive phase of the test commenced after a designated 10-min period of supine rest. The substantive phase of the test commenced after a designated 10-min period of supine rest. Subsequently, the tilt table was artfully maneuvered to achieve a consistent 70-degree angle, sustained total a period of 35 min [ 28 ]. Notably, a pharmacological stimulus was introduced after the initial 20 min of tilting, which involved administering 400 µg of glyceryl trinitrate (GTN) sublingually. This deliberate measure aimed to evoke specific physiological responses during the tilt phase. The outcomes of the test are determined based on a rigorous analysis of the observed physical alterations and their correlation with subjects’ prior symptoms during spontaneous incidents. Positive results ensue when discernible physical changes, such as diminished HR, cardiac interruptions, and reduced BP, precisely mirror patients' past symptomatic episodes. In contrast, if physical changes manifest without replicating symptoms, the results are categorized as false positives. Conversely, negative results are established when symptoms fail to align with observed physical changes or when neither symptoms nor physical alterations manifest during the test [ 13 ].

Data preprocessing on physiological signals

Our research integrates various aspects to provide a comprehensive understanding of physiological responses during the study. To begin, the feature extraction approach entails the analysis of two distinct time periods. The initial 10-min segment positions subjects in a supine resting state, followed by a subsequent 15-min period during which they are tilted at a 70-degree angle with administered GTN. This detailed approach allows for a thorough analysis of beat-to-beat HR and BP signals.

In the context of the HUTT, the timing of VVS occurrence varies among subjects and situations. Typically, VVS manifests during the test itself, although the precise timing can differ. Some subjects experience VVS early in the HUTT window, within the first few minutes, while others encounter it later. These variations can be attributed to the unique physiological responses, medical history, and specific test circumstances of the subjects.

As part of the study, an extensive data preprocessing methodology for physiological signals was employed. This involved a thorough examination of time domain parameters of heart rate variability (HRV) and blood pressure variability (BPV). Additionally, an in-depth analysis of the frequency domain variability in heart rate and blood pressure was conducted. This multifaceted data preprocessing approach is crucial for obtaining a comprehensive understanding of the physiological responses throughout the study.

Time domain parameters of HRV and BPV

The modulation of HR involves both the sympathetic and parasympathetic branches of the ANS. Sympathetic activity increases HR but lowers HRV, while parasympathetic activity decreases HR but increases HRV [ 29 ]. The regulation of autonomic output involves interconnected parts of the Central Nervous System (CNS). In certain situations, the vagus nerve can react abnormally, causing a sudden drop in BP, slower HR, widened blood vessels, excessive sweating, and various symptoms like dizziness, nausea, blurred vision, ultimately leading to fainting (syncope) [ 6 , 7 , 8 ]. Moreover, fluctuations in BP result from complex interactions between various cardiovascular systems, including central autonomic regulation, sympathetic vascular modulation, baroreflex, and humoral influences [ 30 ]. In response to PNS activation, BP is lowered through vasodilation and bradycardia to prioritize blood flow to essential organs [ 8 ]. However, in VVS, these normal responses are disrupted or magnified, leading to an excessive drop in BP and HR due to factors such as an overactive PNS, heightened blood vessel sensitivity, and abnormal autonomic signalling [ 10 ]. When it comes to properly assessing the contributions of multiple underlying regulatory mechanisms, time-domain metrics reflecting the entire variability of both HR and BP are rather indiscriminate. The study calculated the standard deviation (SD), average real variability (ARV), root mean square of real variability (RMSRV), coefficient of variation (CV), and standard deviation of real variability (SDRV) in a study of both HRV and BPV in the time domain. These indexes' formulas are listed below [ 31 ]:

Average real variability (ARV): Variations in absolute terms between the subsequent values:

Root mean square of real variability (RMSRV): The sequential difference between the subsequent values expressed as the root mean square:

Standard deviation of real variability (SDRV): Sequential differences between the surrounding values:

Here, x = HR, SBP, and DBP are all measured from beat to beat, \(\overline{x }=\) mean for the relevant variable and n = the overall number of beats for the selected variable.

Frequency domain variability in heart rate and blood pressure

The spectrum analysis plots the variation of spectral power of HRV and BPV as functions of frequency. The adaptable autoregressive coefficients generated with each physiological parameter were utilized to calculate the frequency spectrum in the Task Force Monitor [ 32 ]. The following parameters can be determined via spectral analysis:

LF scale 0.04–0.15 Hz [ 33 ],

HF scale 0.15–0.4 Hz [ 34 ].

Since HF + LF < 100.

The relationship and balance of both sections of the ANS can be determined via spectral analysis, however, absolute levels of HRV and BPV features are not indicators of ANS activity. The HF domain is thought to be mostly influenced by parasympathetic modulation, while the LF is primarily influenced by sympathetic modulation. The LF-to-HF ratio is used to estimate the balance of both components of the ANS’s influence on the heart.

Missing value imputation

In our study, which encompassed data from 137 subjects undergoing HUTT, both test-positive and test-negative subjects were included. Within this group, we identified missing data in a total of 17 subjects—comprising 12 test-negative and 5 test-positive subjects. The specific missing data pertained to features referred to as systolic blood pressure variability in both supine and tilting positions [Hfnu_SBPV (high-frequency normalized power of systolic BP variability), Lfnu_SBPV (low-frequency normalized power of systolic BP variability), LFHF_SBPV (ratio of high frequency to low frequency normalized power of systolic BP variability)] and diastolic blood pressure variability in the same positions (Hfnu_DBPV (high-frequency normalized power of diastolic BP variability), Lfnu_DBPV (low-frequency normalized power of diastolic BP variability), LFHF_DBP (ratio of high frequency to low frequency normalized power of diastolic BP variability) within our dataset. Notably, the pattern of missing data we encountered was not at random. Interestingly, the same set of features exhibited missing data across all 17 subjects, suggesting a non-random and potentially systematic underlying cause for these gaps. These instances of missing data, often represented as "NAN" (Not a Number) values, can be attributed to several contributing factors, which may include cuff-related issues, variations in sensor sensitivity, technical anomalies, and signal saturation. These circumstances can lead to intermittent temporal gaps within our recorded data. It is important to highlight that these factors collectively influence the overall quality and comprehensiveness of our dataset, and they have the potential to impact subsequent analyses and interpretations. Confronted with the presence of "NAN" data during the HUTT, the medical experts chose to move forward, leveraging their clinical expertise. Following a thorough assessment of the situation, they determined that the data gap's impact on the test's reliability was minimal, taking into account considerations such as the patient's health, the test's objectives, and the potential consequences of restarting the test. This decision was bolstered by a robust 10-min supine baseline, a carefully controlled 70-degree tilt maintained for 20 min, and the introduction of a 400 µg GTN potentiation. In essence, their choice exemplified a commitment to patient-centered care, opting to avoid an early test restart in order to prioritize the well-being of the patient.

In this study, missing data were addressed using two methods: KNN imputation and mean imputation. For KNN imputation, implemented with Scikit-learn's KNNImputer function, missing values were determined based on the Euclidean distance to the nearest neighbors. Mean imputation involved using the mean value of each feature, calculated through Python's panda’s library, to fill in missing values. Both techniques were selected for their simplicity, efficiency, and widespread use. While KNN imputation captures underlying relationships for accuracy, mean imputation is widely adopted due to its ease of implementation [ 35 ]. By employing both methods, the study enabled performance comparison and a robust approach to managing missing data [ 36 , 37 ].

Selection of features

Three distinct methods were employed to identify the most significant features within the dataset: FI, GA, and RFE. Independently, all three techniques were utilized, retaining features chosen by the most fitting candidates. For assessing feature importance (FI), the Scikit-learn library's RF approach was adopted. Utilizing the featureimportances attribute, relevance scores were computed for each feature. The top three features were then identified for further analysis, following an averaging process.

The genetic algorithm (GA) approach utilized the LR classifier from Python's Scikit-learn module, with parameters like crossover and mutation probabilities optimized for optimal feature selection. The fitness function was tailored to prevent overfitting, selecting relevant features based on cross-validation accuracy.

In recursive feature elimination ( RFE), the decision tree algorithm from Scikit-learn was employed. With configuration to retain three features, the iterative process recursively eliminated the least significant feature, leaving behind the remaining features for in-depth examination.

Statistical analysis

To ascertain if test positive and test negative are subsets from the same population, the MWUT, a statistical hypothesis test, is performed. An affirmative outcome for a HUTT occurs when symptoms of syncope reoccur alongside a corresponding reduction in HR or BP. Conversely, a negative result pertains to the absence of symptom recurrence, regardless of the HR or BP changes, or when symptoms manifest without a corresponding HR or BP response. Test positivity was determined by the medical expert supervising the HUTT. If the statistical result exceeds 0.05 (P ≤ 0.05), the study rejects the null hypothesis and draws the conclusion that the two samples did not come from the same population [ 15 ].

Machine learning classifiers

In the study, six machine learning classifiers, namely SVM, KNN, MNB, GNB, LR and RF for VVS categorization.

Support vector machine

The study in Support vector machine (SVM) algorithm accustomed the linear or radial basis function (RBF) kernel. C is a penalty parameter with values 0.1,1,10 and 100. Gamma is in the range of 0.1, 0.001, 0.001, and 0.0001.

K-nearest neighbors

The K-nearest neighbors (KNN) algorithm's power parameter for the Minkowski distance metric is denoted by "p". p and n_neighbors in this experiment had values of 1 to 10.

Multinomial naïve Bayes

When it comes to HUTT data, multinomial naïve Bayes (MNB) can be utilized to assess the probability of a patient experiencing VVS. Our study had fine-tuned parameter alpha values such as 0.001,0.01,0.1,0.5,1.0,10.0, and 100.0.

Gaussian naïve Bayes

When working with continuous data, it’s common to assume that each class's continuous values will be distributed in a Gaussian naïve Bayes (GNB). Here the range of var_smoothing was log space (0, − 9, number = 100).

Logistic regression

The frequency of a target attribute is forecasted using a LR. Here log space (-3,3,7) and 11 and 12 were the hyperparameters C and penalty, respectively.

Random forest

Due to the random selection of features, which lowers the correlation between the ensemble's trees, this strategy tends to increase the ensemble’s predictive ability. The random forest (RF) model’s hyperparameters included max_depth ranges of 2 to 10, min_samples_leaf ranges of 5 to 200, and n_estimators range of 10 to 200.

Performance evaluation

The parameters of the models our study generated were altered using GridSearchCV with a fivefold cross-validation for fine-tuning all classifiers. The study employed ML algorithms, all of which were initialized with a random state value of zero. This approach aimed to ensure the reproducibility of results by generating the same sequence of random numbers in each run of the algorithms. The following formulas were used to calculate our proposed models:

where true positives (TP), false positives (FP), false negatives (FN), and true negatives (TN) were all included in the calculation of the confusion matrix. Regarding subjects undergoing testing, when a subject tests positive and the model accurately categorizes them as positive, they are labeled as TP. Conversely, if a subject tests negative but is mistakenly classified as positive by the model, they are referred to as FP. In the same vein, a subject with a genuine negative test result is denoted as TN. On the contrary, if a subject who tests positive is incorrectly categorized as negative, it falls under the FN classification.

• Partial dependence plot

Partial Dependence Plot (PDP) showed the behaviors of the model and assisted in determining which characteristics had the most influence on the outcome of the decision-making process [ 38 , 39 ]. To implement this XAI model, the study employed the Scikit-learn module in Python with a RF classifier, effectively fitting the model.

Availability of data and materials

The study’s data and resources are presently being analyzed and cannot yet be accessed by the public. We are unable to offer more details or access to the data currently due to the ongoing nature of the research.

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This study was funded by UTAR Research Fund from the Universiti of Tunku Abdul Rahman (UTAR) (IPSR/RMC/UTARRF/2020-C1/G01).

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Conception and design of the research: M.F, B.H.K, C.H.G.; acquisition of data: S.S, N.F.I.A, S.S.M.N, I.Z.A, K.H.C.; analysis and interpretation of the data: M.F, B.H.K, C.H.G., M.P.T, I.S.; writing of the manuscript: M.F, B.H.K, C.H.G.; critical revision of the manuscript for intellectual content: M.F, B.H.K, C.H.G., M.P.T, I.S, S.S, N.F.I.A, S.S.M.N, I.Z.A, K.H.C.

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Ferdowsi, M., Kwan, BH., Tan, M.P. et al. Classification of vasovagal syncope from physiological signals on tilt table testing. BioMed Eng OnLine 23 , 37 (2024). https://doi.org/10.1186/s12938-024-01229-9

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Cellular and molecular mechanisms of skin wound healing

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Wound healing is a complex process that involves the coordinated actions of many different tissues and cell lineages. It requires tight orchestration of cell migration, proliferation, matrix deposition and remodelling, alongside inflammation and angiogenesis. Whereas small skin wounds heal in days, larger injuries resulting from trauma, acute illness or major surgery can take several weeks to heal, generally leaving behind a fibrotic scar that can impact tissue function. Development of therapeutics to prevent scarring and successfully repair chronic wounds requires a fuller knowledge of the cellular and molecular mechanisms driving wound healing. In this Review, we discuss the current understanding of the different phases of wound healing, from clot formation through re-epithelialization, angiogenesis and subsequent scar deposition. We highlight the contribution of different cell types to skin repair, with emphasis on how both innate and adaptive immune cells in the wound inflammatory response influence classically studied wound cell lineages, including keratinocytes, fibroblasts and endothelial cells, but also some of the less-studied cell lineages such as adipocytes, melanocytes and cutaneous nerves. Finally, we discuss newer approaches and research directions that have the potential to further our understanding of the mechanisms underpinning tissue repair.

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The authors thank members of their lab for support and reading of various sections of this Review, and their funders the Wellcome Trust, the Medical Research Council and The Scar Free Foundation.

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A cell that supports the metabolism of surrounding cells and tissues by storing and breaking down triglycerides to release fatty acids.

Connection (sometimes temporary) between sprouting vessels.

The directed migration of cells towards a small molecule, chemokine or growth factor cue.

A term that is derived from the Latin word efferre (which means ‘to take to the grave’ or ‘to bury’) and describes a process by which dead cells are removed by professional phagocytes.

A group of inflammatory lipid mediators derived from arachidonic acid, including lipoxins and prostaglandins.

The process whereby some organisms can regrow tissues or organs that completely replicate those that have been lost.

The movement of immune cells from the lumen of a vessel out into the extravascular tissue, generally in response to some inflammatory activator.

A key component of the coagulation cascade activated by exposure to extravascular components, for example, collagen.

A DNA demethylase that may have a role in cellular resilience post inflammation.

HMGB1 is released by damaged cells and may act as an attractant for immune cells.

Lipid mediators that promote inflammation resolution by retarding the recruitment of neutrophils and stimulating efferocytosis.

A later leukocytic arriver; macrophages can exhibit a range of phenotypes or behaviours and orchestrate many activities by other cell lineages in the wound.

A process where mechanical cues are converted into biochemical signals by cells.

Key cells in the production of melanin, which is transported to neighbouring keratinocytes and protects skin cells from damage by ultraviolet radiation.

The first type of leukocyte to arrive at a wound; specialized for microbicidal activities.

Also known as SPP1; is both a transcription factor and a matricular protein implicated in inflammation-mediated scarring.

Enables the regulated release of granules containing various mediators of inflammation, including histamine and several growth factors.

Term used to describe the removal of excess vessels (and nerves) after wound repair is complete.

Family of cell adhesion molecules with established roles in immune cell extravasation.

Cooperative behaviour of neutrophils where positive feedback loops and signal amplification promote massive inflammatory recruitment.

A group of lymphocytes specialized in adaptative immunity.

Conversion of one cell type or lineage into another.

Transcription factor component of Hippo pathway signalling.

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Targeted protein degradation in hematologic malignancies: latest updates from the 2023 ASH annual meeting

• Guangcai Zhong 1 , 2 ,
• Ran Kong 3 ,
• Shi Feng 4 ,
• Cong Wang 1 ,
• Qingbo Hao 4 ,
• Weilin Xie 4 &
• Xiangxiang Zhou 1 , 2 , 3 , 5  

Journal of Hematology & Oncology volume  17 , Article number:  14 ( 2024 ) Cite this article

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Protein degraders, emerging as a novel class of therapeutic agents, have gained widespread attention due to their advantages. They have several advantages over traditional small molecule inhibitors, including high target selectivity and ability to target “undruggable” targets and overcome inhibitor drug resistance. Tremendous research and development efforts and massive investment have resulted in rapid advancement of protein degrader drug discovery in recent years. Here, we overview the latest clinical and preclinical updates on protein degraders presented at the 2023 ASH Annual Meeting.

To the editor

Small molecule inhibitors are major therapies used to treat hematologic malignancies in clinic, yet challenges such as drug resistance and off-target effects persist. Proteolysis-targeting chimeras (PROTACs) and molecular glues have emerged as promising therapeutic modality, celebrated for their ability to selectively target and efficiently degrade a wide array of proteins. This report summarizes the latest developments in protein degraders presented at 2023 ASH annual meeting.

Clinical trials

Bruton’s tyrosine kinase (BTK), crucial for B-cell receptor signaling, has been identified as a key therapeutic target in B-cell malignancies. Three preliminary clinical trials assessed the safety and efficacy of BTK PROTAC degraders. In a phase 1 trial, BGB-16673, a potent BTK degrader, showed an overall response rate of 67% (12/18), including a mantle cell lymphoma patient achieving complete response (CR) after a median follow-up of 3.5 months in relapsed or refractory B-cell malignancies. The drug showed profound and enduring reductions of BTK protein even at the lowest doses. Moreover, although with 88.5% of patients experienced treatment-emergent adverse events (TEAEs), there were no discontinuations due to adverse events [ 1 ] (Table  1 ). NX-5948, a novel orally administered BTK PROTAC degrader, exhibited good tolerability with no dose-limiting toxicities or serious TEAEs. Following a median treatment duration of 2.8 months, 1 out of 3 evaluated chronic lymphocytic leukemia (CLL) patient achieved a partial response (PR) [ 2 ] (Table  1 ). NX-2127 is an oral dual-function PROTAC degrader targeting BTK and immunomodulatory factors Ikaros and Aiolos. NX-2127 showed potent and consistent degradation of target proteins. However, there were safety concerns, as some patients discontinued their treatment due to TEAEs. After a median follow-up of 9.5 months, lasting CR were noted in non-Hodgkin’s lymphoma patients [ 3 ] (Table  1 ).

Aberrant activation of phosphorylated signal transducer and activator of transcription 3 (STAT3) underlies various malignancies. KT-333, a STAT3 PROTAC degrader, achieved robust and dose-dependent degradation of STAT3 in a Phase 1a/1b study, with all the mean maximum degradation exceeding 60% across drug doses 1 to 4. Following two treatment cycles, one patient achieved PR. Importantly, no TEAEs were reported, suggesting a good safety profile of KT-333 [ 4 ] (Table  1 ).

Preclinical studies

Several degraders targeting other pathways used alone or in combination, demonstrated good efficacy in pre-clinical tumor models. Many hematological malignancies feature the overexpression of anti-apoptotic proteins, such as BCL-2 and BCL-XL. Xie et al. reported that NXD02, a novel BCL-XL PROTAC degrader, displaying superior degradation of BCL-XL (DC50 of 6.6 vs. 17.4nM) and enhanced anti-tumor efficacy (100% vs. 36%) compared to DT2216, the initial BCL-XL PROTAC degrader [ 5 ](Table  2 ). The BCL-2/BCL-XL-dual degraders, WH25244 and PZ18753b, demonstrated impressive efficacy against venetoclax-resistant (VR) CLL cells [ 6 ] (Table  2 ). Additionally, combination therapy of DT2216 with azacitidine, ruxolitinib, or S63845, revealed synergistic effects against JAK2-mutant acute myeloid leukemia (AML) [ 7 ] (Table  2 ).

In MYC/BCL2-related lymphoma, bromo and extra terminal (BET) inhibitors have shown limited efficacy in suppressing MYC expression. A novel BET PROTAC degrader K-256 effectively degraded bromodomain-containing protein 4 (BRD4) at low concentrations, leading to stronger tumor growth inhibition compared to existing inhibitors and other degraders [ 8 ] (Table  2 ).

STAT3 regulates anti-apoptotic protein MCL-1, which is implicated in VR AML. A STAT3 degrader significantly (> 60%) decreased MCL-1 and STAT3 levels, triggering apoptosis in VR AML cells. It also led to erythroid and myeloid differentiation induction of stem and progenitor cells [ 9 ] (Table  2 ).

Aiolos and Ikaros inhibit anti-tumor immunity through upregulating exhaustion markers in T cells, which blocking T cell activation and its tumor-killing activity. Mezigdomide, an Aiolos/Ikaros molecular glue degrader, effectively reversed the exhaustion of T cells, boosting the efficacy of immunotherapies in multiple myeloma [ 10 ] (Table  2 ).

Casein kinase 1α (CK1α), a multifunctional serine/threonine kinase, is involved in deactivating p53 function. PinA1, a selective CK1α molecular glue degrader, enhances p53 level and induces apoptosis in AML cells with wild-type TP53, while sparing normal cells. Additionally, PinA1 combined with FLT3, BCL-2, or MDM2 inhibitors showed enhanced anti-tumor effects in both in vitro and in vivo settings [ 11 ] (Table  2 ).

Molecular glue degraders such as pomalidomide and lenalidomide have demonstrated remarkable clinical success in treating hematological malignancies including multiple myeloma, and certain lymphomas. In addition to molecular glue, a lot of the recent efforts have been focused on developing PROTACs to overcome tumor resistance to inhibitor drugs. Early clinical studies and preclinical studies mentioned above have shown strong anti-tumor activities, both as standalone treatments and in combination therapies. These protein degraders showed their activities in overcoming resistance, reducing off-target effects, and enhancing treatment efficacy. Interestingly, concerns regarding the possibility of PROTACs resistance have promoted research into looking for alternative strategies, including the use of new E3 ligases other than only cereblon (CRBN) [ 12 , 13 ]. While this is a very interesting concept, much more work is still needed to better define the strategy. We look forward to more comprehensive trial results that would provide further insights into the clinical utility of those novel protein degraders, and hope those degraders currently in preclinic stage will soon get into clinical trials where the therapeutic hypothesis of degrading those targets can be tested in clinic.

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No datasets were generated or analysed during the current study.

Abbreviations

American Society of Hematology

Proteolysis-targeting chimeras

Bruton’s tyrosine kinase

Complete response

Treatment-emergent adverse events

Chronic lymphocytic leukemia

Signal transducer and activator of transcription 3

Venetoclax-resistant

Acute myeloid leukemia

Bromo and extra terminal

Bromodomain-containing protein

Casein kinase 1α

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Shastri A, Feldman EJ, Starodub AN, Feldman T, Rodriguez CP, Epstein-Peterson ZD, et al. Preliminary Safety, Pharmacokinetics, Pharmacodynamics and Clinical Activity of KT-333, a targeted protein degrader of STAT3, in patients with relapsed or refractory lymphomas, large Granular lymphocytic leukemia, and solid tumors. Blood. 2023;142(Supplement 1):3081. https://doi.org/10.1182/blood-2023-181130 .

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Diaz Rohena D, Peris Cuesta A, Slawin B, Ravikrishnan J, Liu C, Williams C, et al. Enriched signalling pathways in Venetoclax-relapsed chronic lymphocytic leukemia (CLL) cells and targeting using a Protac-based Bcl-2/Bcl-Xl degrader. Blood. 2023;142(Supplement 1):4195. https://doi.org/10.1182/blood-2023-188250 .

WANG Z, Zhang Q, Skwarska A, Ramage CL, Zheng G, Gritsman K, et al. Targeting BCL-XL with a novel VHL-Based BCL-XL Degrader DT-2216 in Pre-clinical JAK2-Mutant AML Post-MPN models. Blood. 2023;142(Supplement 1):4154. https://doi.org/10.1182/blood-2023-178813 .

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Chakraborty S, Morganti C, Dey J, Zhang H, Aluri S, Gitego N, et al. A STAT3 degrader demonstrates pre-clinical efficacy in Venetoclax resistant Acute Myeloid Leukemia. Blood. 2023;142(Supplement 1):2787. https://doi.org/10.1182/blood-2023-186947 .

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Acknowledgements

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This work was supported by National Natural Science Foundation (No.82170189, No.81800194); Shandong Provincial Natural Science Foundation (ZR2021YQ51); Taishan Scholars Program of Shandong Province.

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Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, Jinan, 250021, Shandong, China

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Medical Science and Technology Innovation Center, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, 250117, China

Guangcai Zhong & Xiangxiang Zhou

Department of Hematology, Shandong Provincial Hospital, Shandong University, No.324, Jingwu Road, Jinan, 250021, Shandong, China

Ran Kong & Xiangxiang Zhou

Institute of Materia Medica, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China

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National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, 251006, China

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Zhong, G., Kong, R., Feng, S. et al. Targeted protein degradation in hematologic malignancies: latest updates from the 2023 ASH annual meeting. J Hematol Oncol 17 , 14 (2024). https://doi.org/10.1186/s13045-024-01533-w

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DOI : https://doi.org/10.1186/s13045-024-01533-w

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Sweetcrispy L Shaped Computer Desk - Gaming Table Corner Desk 50 Inch PC Writing Desk Study Desks with Wooden Desktop CPU Stand Side Bag Reversible for Home Office Dorm Small Space, Rustic

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• 【Create Your Game Zone!】 This gaming desk offers the flexibility to create a customized gaming or work space. With its modular design, it can be easily assembled in either an L-shaped or U-shaped layout, allowing users to maximize their workspace according to their preferences and needs. Whether you're a gamer looking to optimize your gaming setup or a professional seeking an efficient office workstation, this l shaped desk offers the versatility to accommodate your specific requirements.
• 【Premium Materials】 Crafted with premium materials, this corner desk is built to withstand the rigors of daily use. The metal frame provides excellent stability and durability, ensuring that the l shaped gaming desk remains sturdy during intense gaming sessions or prolonged work hours. Additionally, the desktop is waterproof and easy to clean. Overall Dimension: 49.61”(L)* 41.34”(W)* 29.13”(H).
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• 【User-Friendly Features】 This desk for bedroom is designed with the user's convenience in mind. The inclusion of side storage bag allows for easy organization of essential items such as gaming accessories, office supplies, or personal belongings. The built-in CPU tray at the bottom provides a dedicated space to securely place your computer tower, keeping it off the floor and ensuring proper ventilation.
• 【Easy Installation】 Along with the pc desk, you will receive a comprehensive paper instruction manual that guides you through each step of the installation process. Additionally, detailed installation videos are available, offering visual guidance for a hassle-free assembly experience. Whether you're a DIY enthusiast or a beginner, you can confidently assemble this small corner desk with ease.

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The maximun weight capacity is 176 lbs.

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The height is 29.6".

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Of courser, you can put your gaming set up on it and create your gaming zone!

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Yes, the CPU stand is reversible, as well as the 2 pieces of desk boards.

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Customers say

Customers like the sturdiness, ease of assembly, performance, and quality of the desk. For example, they mention it's well made, works well, and looks fantastic. That said, some complain about the durability, saying that it came in damaged and chipped. Opinions are mixed on size.

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Customers find the desk easy to put together and the instructions simple to understand. They also say the desk is a great product for gamers.

"Desk is very easy to assemble . Instructions are very clear...." Read more

"... Easy to build and sturdy. Worth the buy definitely. He loves it" Read more

"...It is relatively easy to assemble ...." Read more

"The desk is nice. It was very easy to assemble , and came with all the tools needed to construct it. Overall it's a nice desk...." Read more

Customers like the quality of the desk. They say it's a nice desk, table, and gaming desk. Customers also say it improves their workspace and decorates the room. They mention it'll be worth the buy.

"...Easy to build and sturdy. Worth the buy definitely . He loves it" Read more

"...For the price it was definitely worth the purchase ...." Read more

"The desk is nice . It was very easy to assemble, and came with all the tools needed to construct it. Overall it's a nice desk...." Read more

" Table looks great . Is smaller than it looks but is great. The only small (but big) issue is that the hex screws are terrible in quality...." Read more

Customers are satisfied with the sturdiness of the desk. For example, they mention it's good quality, sturdy, and easy to put together. Some say it has a decent gaming space.

"Desk is very easy to assemble. Instructions are very clear. Also, desk is well made , came with all parts clearly labeled and all tools necessary to..." Read more

"...Easy to build and sturdy . Worth the buy definitely. He loves it" Read more

"...The assembly wasn't too difficult. It seems sturdy and it has a pocket slot on the end of the desk where my son keeps none other than all of his..." Read more

"For the price point, it's a very good desk for gaming ...." Read more

Customers are satisfied with the performance of the desk. They mention that it works well for school, has a lot of space, and is simple to set up. Some say that it's a perfect home work station.

"Set up was simple enough, and works great for my husbands PC set up . The white looks sleek, and surprisingly it doesn’t look “cheap”...." Read more

"The desk works so well and has so much space" Read more

"...son wanted more desk room but didn’t have lots of room to spare, this works great " Read more

"...It took me about 30 minutes to fully assemble. Everything works great and it’s super sturdy, my one and only complaint is the little gap between the..." Read more

Customers are satisfied with the organization of the desk. They mention that it was well packaged and organized.

"...The packaging is well thought out and everything is labelled and properly protected. It is relatively easy to assemble...." Read more

"Came very well packaged very well organized would definitely recommend" Read more

"Used as a gaming desk. Quality is as expected and shipping/packaging was appropriate ...." Read more

"...to not be sturdy for the price it’s at but it actually is, and delivery was great it was delivered days before it was supposed to...." Read more

Customers are mixed about the size of the desk. Some mention it's the perfect size they needed and easy to assemble, while others say the pc holder was not big enough for their p.c. and the measurements were wrong. It is sturdy and strong, but cannot accommodate a mid-tower or larger computer.

"...The size is right and provides ample desktop space for a gamer. Height of table is excellent for gaming chair...." Read more

"...he t looked bigger in pics to us however it’s actually the perfect size for his room as you can see. Easy to build and sturdy...." Read more

"...It's not as big as I had hoped . It's a pretty basic set up...." Read more

"...Do not expect to put heavy items onto it, but it is sufficient for a couple of monitors and some other peripherals without any wobbling...." Read more

Customers are dissatisfied with the durability of the desk. They mention that it's easy to assemble, but some pieces came cracked, damaged, and chipped. The product can break very easily, and the second cross support snapped along with the H piece. The wood was very chipped and the bracket came unwelded.

"...But one of the top panels had a chip out of it. Not returning it because I'm not ruining Christmas for an 8 year old...." Read more

"...I was a little disappointed that it came in damaged right in the front also has a chip off the top...." Read more

"It was super easy to assemble, except one of the pieces came cracked . We had to tape it together." Read more

"While putting the desk together the bracket came unwelded and will no longer support the desk or side shelf . Disappointing." Read more

Customers are disappointed that the desk is missing pieces and hardware. They also mention that the product didn't have all the fancy extras such as led lights.

"...I got a really good deal on this one. It didn't have all the fancy extras such as the led lights etc but I figured we could install some on our own...." Read more

"...Great desk, but missing a piece ." Read more

"This was the biggest workout ever, gave me wrong parts ...." Read more

"...Got everything pulled out and began assembling and realized we are missing hardware !!" Read more

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