# NIRUDAK dehydration score (Barry) NIRUDAK Status: LIVE Price: $0.005 USDC `GET /api/calc/nirudak` HTML: https://magentlab.com/docs/nirudak Markdown: https://magentlab.com/docs/nirudak.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum seven caller-assigned Barry 2021 NIRUDAK Table 2 items and return the published total (max 13) and dehydration band (no, some, or severe). ## When to use When an agent has already assigned Barry 2021 Table 2 age, sex, eye level, radial pulse, respirations, skin pinch, and 24-hour vomiting and needs the published integer NIRUDAK total and band, not WHO IMCI/IMAI, the DHAKA child score, PLOS logistic models, or a fluids order. ## When not to use - Not a medical device. Not a WHO IMCI or IMAI algorithm. Not the Levine 2015 DHAKA score. Not PLOS logistic models. - Each clinical sign is caller-assigned. magent does not examine the patient or order fluids. - Age is an integer from 5 to 120 (Barry 2021 NIRUDAK; not the adult 18–120 clamp). - Table 2 integer score only (max 13). Bands: no_dehydration 0–3, some_dehydration 4–6, severe_dehydration 7–13. Skin pinch reference is rapid, not DHAKA normal. ## Formula ``` NIRUDAK = age (>59 0, 20-59 1, <20 2) + sex (female 0, male 1) + eye_level (normal 0, sunken 1) + radial_pulse (strong 0, decreased 1, absent 2) + respirations (normal 0, deep 1) + skin_pinch (rapid 0, slow 2, very_slow 4) + vomiting_episodes_24h (lt_1 0, 1_to_10 1, gt_10 2); Barry 2021 Table 2; max 13 ``` ## Citation [Derivation and Internal Validation of a Score to Predict Dehydration Severity in Patients over 5 Years with Acute Diarrhea](https://doi.org/10.4269/ajtmh.21-0143) Barry MA, Garbern SC, Lee JA, Qu K, Gainey M, Schmid CH, Nasrin S, Alam NH, Nelson EJ, Rosen RK, Levine AC Am J Trop Med Hyg. 2021;105(5):1368-1375 DOI: [10.4269/ajtmh.21-0143](https://doi.org/10.4269/ajtmh.21-0143) ## Worked example ### All-reference elderly female Given: `age=70, eye_level=normal, radial_pulse=strong, respirations=normal, sex=female, skin_pinch=rapid, vomiting_episodes_24h=lt_1` 1. age 70 >59 0 + female 0 + eyes normal 0 + pulse strong 0 + respirations normal 0 + pinch rapid 0 + vomiting lt_1 0 2. Score = 0 (max 13); nirudak_band no_dehydration ### Very slow skin pinch only Given: `age=70, eye_level=normal, radial_pulse=strong, respirations=normal, sex=female, skin_pinch=very_slow, vomiting_episodes_24h=lt_1` 1. skin_pinch very_slow 4; other items 0 2. Score = 4 (max 13); nirudak_band some_dehydration ### Maximum Table 2 score Given: `age=10, eye_level=sunken, radial_pulse=absent, respirations=deep, sex=male, skin_pinch=very_slow, vomiting_episodes_24h=gt_10` 1. age <20 2 + male 1 + sunken 1 + absent 2 + deep 1 + very_slow 4 + gt_10 2 2. Score = 13 (max 13); nirudak_band severe_dehydration ## Also searched as - nirudak score - NIRUDAK Table 2 - Barry dehydration score - acute diarrhea dehydration - over 5 years dehydration - sunken eyes dehydration - skin pinch dehydration - NIRUDAK integer score ## Parameters - `age` (integer, required): Age in years, integer 5–120. Barry 2021 Table 2: >59 scores 0, 20–59 scores 1, <20 scores 2. Not the adult 18–120 clamp. - `sex` (string, required): female (0) or male (1) (Barry 2021 Table 2). - `eye_level` (string, required): Caller-assigned Barry 2021 Table 2 eye level: normal (0) or sunken (1). magent does not examine the patient. - `radial_pulse` (string, required): Caller-assigned Barry 2021 Table 2 radial pulse: strong (0), decreased (1), or absent (2). magent does not examine the patient. - `respirations` (string, required): Caller-assigned Barry 2021 Table 2 respirations: normal (0) or deep (1). Deep scores 1, not DHAKA Table 3's 2. magent does not examine the patient. - `skin_pinch` (string, required): Caller-assigned Barry 2021 Table 2 skin pinch: rapid (0), slow (2), or very_slow (4). Reference is rapid, not DHAKA normal. magent does not examine the patient. - `vomiting_episodes_24h` (string, required): Caller-assigned Barry 2021 Table 2 vomiting episodes in 24 hours: lt_1 (0; <1), 1_to_10 (1), or gt_10 (2; >10). ## Bulk (POST) POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/nirudak` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "age": "70", "eye_level": "normal", "radial_pulse": "strong", "respirations": "normal", "sex": "female", "skin_pinch": "rapid", "vomiting_episodes_24h": "lt_1" }, { "age": "70", "eye_level": "normal", "radial_pulse": "strong", "respirations": "normal", "sex": "female", "skin_pinch": "rapid", "vomiting_episodes_24h": "lt_1" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/nirudak Example 200: ```json { "count": 2, "path": "/api/calc/nirudak", "items": [ { "components": [ { "value": 70, "factor": "age", "points": 0, "present": true }, { "value": "female", "factor": "sex", "points": 0, "present": true }, { "value": "normal", "factor": "eye_level", "points": 0, "present": true }, { "value": "strong", "factor": "radial_pulse", "points": 0, "present": true }, { "value": "normal", "factor": "respirations", "points": 0, "present": true }, { "value": "rapid", "factor": "skin_pinch", "points": 0, "present": true }, { "value": "lt_1", "factor": "vomiting_episodes_24h", "points": 0, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Barry MA, Garbern SC, Lee JA, Qu K, Gainey M, Schmid CH, Nasrin S, Alam NH, Nelson EJ, Rosen RK, Levine AC", "doi": "10.4269/ajtmh.21-0143", "id": "barry-2021", "pmid": "34398821", "source": "Am J Trop Med Hyg. 2021;105(5):1368-1375", "title": "Derivation and Internal Validation of a Score to Predict Dehydration Severity in Patients over 5 Years with Acute Diarrhea" }, "formula": "nirudak", "formula_expression": "NIRUDAK = age (>59 0, 20-59 1, <20 2) + sex (female 0, male 1) + eye_level (normal 0, sunken 1) + radial_pulse (strong 0, decreased 1, absent 2) + respirations (normal 0, deep 1) + skin_pinch (rapid 0, slow 2, very_slow 4) + vomiting_episodes_24h (lt_1 0, 1_to_10 1, gt_10 2); Barry 2021 Table 2; max 13", "age_years": 70, "max_score": 13, "score": 0, "sex": "female", "respirations": "normal", "skin_pinch": "rapid", "eye_level": "normal", "nirudak_band": "no_dehydration", "radial_pulse": "strong", "vomiting_episodes_24h": "lt_1" }, { "components": [ { "value": 70, "factor": "age", "points": 0, "present": true }, { "value": "female", "factor": "sex", "points": 0, "present": true }, { "value": "normal", "factor": "eye_level", "points": 0, "present": true }, { "value": "strong", "factor": "radial_pulse", "points": 0, "present": true }, { "value": "normal", "factor": "respirations", "points": 0, "present": true }, { "value": "rapid", "factor": "skin_pinch", "points": 0, "present": true }, { "value": "lt_1", "factor": "vomiting_episodes_24h", "points": 0, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Barry MA, Garbern SC, Lee JA, Qu K, Gainey M, Schmid CH, Nasrin S, Alam NH, Nelson EJ, Rosen RK, Levine AC", "doi": "10.4269/ajtmh.21-0143", "id": "barry-2021", "pmid": "34398821", "source": "Am J Trop Med Hyg. 2021;105(5):1368-1375", "title": "Derivation and Internal Validation of a Score to Predict Dehydration Severity in Patients over 5 Years with Acute Diarrhea" }, "formula": "nirudak", "formula_expression": "NIRUDAK = age (>59 0, 20-59 1, <20 2) + sex (female 0, male 1) + eye_level (normal 0, sunken 1) + radial_pulse (strong 0, decreased 1, absent 2) + respirations (normal 0, deep 1) + skin_pinch (rapid 0, slow 2, very_slow 4) + vomiting_episodes_24h (lt_1 0, 1_to_10 1, gt_10 2); Barry 2021 Table 2; max 13", "age_years": 70, "max_score": 13, "score": 0, "sex": "female", "respirations": "normal", "skin_pinch": "rapid", "eye_level": "normal", "nirudak_band": "no_dehydration", "radial_pulse": "strong", "vomiting_episodes_24h": "lt_1" } ] } ``` ## Response fields - `formula` (string): nirudak - `formula_expression` (string): Exact expression used - `score` (integer): NIRUDAK Table 2 points 0-13 - `max_score` (integer): Always 13 - `nirudak_band` (string): Barry 2021 Table 2 category: no_dehydration (0-3), some_dehydration (4-6), or severe_dehydration (7-13). A score band, not a fluids order and not WHO IMCI/IMAI. - `age_years` (integer): Age in years used for the >59 / 20–59 / <20 split - `sex` (string): female or male - `eye_level` (string): Caller-assigned token used: normal or sunken - `radial_pulse` (string): Caller-assigned token used: strong, decreased, or absent - `respirations` (string): Caller-assigned token used: normal or deep - `skin_pinch` (string): Caller-assigned token used: rapid, slow, or very_slow - `vomiting_episodes_24h` (string): Caller-assigned token used: lt_1, 1_to_10, or gt_10 - `components` (array): Per-item caller-assigned points - `citation` (object): Barry et al. Am J Trop Med Hyg 2021 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 70, "factor": "age", "points": 0, "present": true }, { "value": "female", "factor": "sex", "points": 0, "present": true }, { "value": "normal", "factor": "eye_level", "points": 0, "present": true }, { "value": "strong", "factor": "radial_pulse", "points": 0, "present": true }, { "value": "normal", "factor": "respirations", "points": 0, "present": true }, { "value": "rapid", "factor": "skin_pinch", "points": 0, "present": true }, { "value": "lt_1", "factor": "vomiting_episodes_24h", "points": 0, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Barry MA, Garbern SC, Lee JA, Qu K, Gainey M, Schmid CH, Nasrin S, Alam NH, Nelson EJ, Rosen RK, Levine AC", "doi": "10.4269/ajtmh.21-0143", "id": "barry-2021", "pmid": "34398821", "source": "Am J Trop Med Hyg. 2021;105(5):1368-1375", "title": "Derivation and Internal Validation of a Score to Predict Dehydration Severity in Patients over 5 Years with Acute Diarrhea" }, "formula": "nirudak", "formula_expression": "NIRUDAK = age (>59 0, 20-59 1, <20 2) + sex (female 0, male 1) + eye_level (normal 0, sunken 1) + radial_pulse (strong 0, decreased 1, absent 2) + respirations (normal 0, deep 1) + skin_pinch (rapid 0, slow 2, very_slow 4) + vomiting_episodes_24h (lt_1 0, 1_to_10 1, gt_10 2); Barry 2021 Table 2; max 13", "age_years": 70, "max_score": 13, "score": 0, "sex": "female", "respirations": "normal", "skin_pinch": "rapid", "eye_level": "normal", "nirudak_band": "no_dehydration", "radial_pulse": "strong", "vomiting_episodes_24h": "lt_1" } ``` ## Errors - HTTP 400 `invalid_nirudak_age`: age must be an integer from 5 to 120 (Barry 2021 NIRUDAK; not the adult 18-120 clamp). Returned before settlement; you are not charged. - HTTP 400 `invalid_sex`: sex must be female or male Returned before settlement; you are not charged. - HTTP 400 `invalid_nirudak_eyes`: eye_level must be normal or sunken (Barry 2021 NIRUDAK Table 2). Returned before settlement; you are not charged. - HTTP 400 `invalid_nirudak_pulse`: radial_pulse must be strong, decreased, or absent (Barry 2021 NIRUDAK Table 2). Returned before settlement; you are not charged. - HTTP 400 `invalid_dhaka_respirations`: respirations must be normal or deep (Levine 2015 DHAKA Table 3). Returned before settlement; you are not charged. - HTTP 400 `invalid_nirudak_skin_pinch`: skin_pinch must be rapid, slow, or very_slow (Barry 2021 NIRUDAK Table 2; rapid is the reference). Returned before settlement; you are not charged. - HTTP 400 `invalid_nirudak_vomiting`: vomiting_episodes_24h must be lt_1, 1_to_10, or gt_10 (Barry 2021 NIRUDAK Table 2). Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [DHAKA](https://magentlab.com/docs/dhaka) — Sum four caller-assigned Levine 2015 DHAKA Table 3 items and return the published total (max 12) and dehydration band (no, some, or severe). ## Payment Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON. - exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.