Inertial Effects Research Articles

Mediating Role of the Psychological Contract between Inertia and Organizational Performance of Healthcare Professionals in Radiation Fields

Background/Aim: This study aims to reveal the mediating role of the psychological contract with regard to the effect of inertia on the organizational performance of healthcare workers in radiation. Materials And Methods: The data were collected by using a survey. The questionnaire form consists of four parts. The first part included the “Inertia Scale” second, the “Psychological Contract Scale”, third part “Organization Performance Scale,”, fourth, questions regarding the socio-demographic characteristics of the participants were included. The target population was the 745 healthcare professionals working in the field of radiation from hospitals in the city of Konya, Turkey; thus, no sampling method was selected and an attempt was made to cover the entire population. A total of 419 healthcare professionals agreed to participate in the study. Process Macro Model 4 structural equation model were used in the analyses of data, descriptive statistics, validity and reliability, and correlation. Results: Inertia has a negative effect on the psychological contract (β = - 0.455). The psychological contract has a positive effect on organizational performance (β = 0.823). In addition, inertia has a negative effect on organizational performance (β = - 0.311). This effect increases (β = - 0.143) with the addition of the mediating role of psychological contract. Conclusion: The psychological contract loses its effect and reduces organizational performance due to inertia. Therefore, inertia is one of the issues that merit research to increase organizational performance.

Impact of MHD mixed convection on heat and mass transfer in a typical DCLL breeder blanket

Abstract A typical dual-coolant lead lithium (DCLL) liquid blanket employs eutectic liquid lithium lead alloy (PbLi) as coolant and tritium breeder for Tokamak nuclear fusion reactor, and is responsible for transporting heat and tritium. The blanket is subjected to both strong magnetic field and strong radially non-uniform neutron volume heating. The flow of liquid metal is influenced by the combined effects of magnetohydrodynamics (MHD), buoyancy, and inertial effects, resulting in a complex MHD mixed convection phenomenon. This study employs direct numerical simulation (DNS) based on finite volume method to analyze the flow, heat transfer, and mass transfer within blanket unit. The results demonstrate that mixed convection has a significant impact on the MHD pressure drop and flow characteristics. The complex MHD mixed convection gives rise to a considerable number of vortices, particularly in regions of the turn and the downward poloidal duct. The formation of low-speed zones and jets within the blanket has the potential to significantly impact heat and mass transfer, leading to the accumulation of heat and tritium. On the other hand, the markedly elevated tritium production rate is a significant contributing factor to the obviously elevated tritium concentration in the vicinity of the first wall.

Integrated Dynamic Analysis of Thin-Walled Beams: Coupled Bidirectional Bending, Torsion, and Axial Vibrations Under Axial Loads

This paper proposes a beam model integrating the Timoshenko beam theory with Vlasov beam theory to capture the coupled behavior of bidirectional bending, torsion, and axial vibration in thin-walled beams subjected to axial loads. Our model incorporates the effects of shear deformation, rotational inertia, and axial loads, offering a comprehensive approach to complex dynamic behaviors. By utilizing Hamilton’s principle, we derived a complete set of coupled dynamic equations and boundary conditions. The highlight of this model is its capacity to accurately predict the dynamic response of thin-walled beams under multifaceted loading conditions, surpassing traditional models by integrating coupled axial vibrations. This research significantly advances the understanding of the dynamic behavior of thin-walled beams, providing a precise analytical tool for structural design and safety assessment. The robustness and accuracy of the proposed model were validated through extensive theoretical analysis and empirical validation, equipping engineers with critical insights to optimize the design of engineering structures subjected to complex dynamic loads.

Inertia-induced mixing and reaction maximization in laminar porous media flows

Solute transport and biogeochemical reactions in porous and fractured media flows are controlled by mixing, as are subsurface engineering operations such as contaminant remediation, geothermal energy production, and carbon sequestration. Porous media flows are generally regarded as slow, so the effects of fluid inertia on mixing and reaction are typically ignored. Here, we demonstrate through microfluidic experiments and numerical simulations of mixing-induced reaction that inertial recirculating flows readily emerge in laminar porous media flows and dramatically alter mixing and reaction dynamics. An optimal Reynolds number that maximizes the reaction rate is observed for individual pore throats of different sizes. This reaction maximization is attributed to the effects of recirculation flows on reactant availability, mixing, and reaction completion, which depend on the topology of recirculation relative to the boundary of the reactants or mixing interface. Recirculation enhances mixing and reactant availability, but a further increase in flow velocity reduces the residence time in recirculation, leading to a decrease in reaction rate. The reaction maximization is also confirmed in a flow channel with grain inclusions and randomized porous media. Interestingly, the domain-wide reaction rate shows a dramatic increase with increasing Re in the randomized porous media case. This is because fluid inertia induces complex three-dimensional flows in randomized porous media, which significantly increases transverse spreading and mixing. This study shows how inertial flows control reaction dynamics at the pore scale and beyond, thus having major implications for a wide range of environmental systems.

Digital Capabilities and Ambidextrous Innovation: Evidence from Chinese Technology-Based SMEs

Ambidextrous innovation is key to the high-quality and sustainable development of enterprises, but it remains unclear how digital capabilities affect knowledge management and ambidextrous innovation in the digital economy era. Based on organizational learning theory, this paper explores the impact pathways of digital capabilities on knowledge management and ambidextrous innovation, while also analyzing the moderating effect of knowledge inertia. Empirical research on 253 technology-based small and medium-sized enterprises (SMEs) demonstrates that digital capabilities have a significant positive effect on both exploitative and exploratory innovation, and they influence both types of innovation through the mediating role of knowledge management. Furthermore, knowledge inertia negatively moderates the impact of digital capabilities on knowledge management and exploratory innovation. This study reveals the internal mechanism by which digital capabilities drive ambidextrous innovation through knowledge management, providing theoretical support for enterprises to deepen digitalization and carry out ambidextrous innovation.

Estimation of Quantitative Inertia Requirement Based on Effective Inertia Using Historical Operation Data of South Korea Power System

In low-inertia systems with a high penetration of renewable energy, the rotational kinetic energy and inertia constant are significant factors in determining frequency stability. The energy released owing to the frequency decrease during contingency represents a portion of the inertia that a synchronous machine possesses in the normal state. However, when securing inertia or planning additional resources to secure frequency stability, inertia in the normal state is analyzed as the standard rather than the amount of energy released during a fault. Therefore, in this paper, we define the actual energy emitted from a synchronous machine as Effective inertia. In order to evaluate Effective inertia in various operating conditions, we conducted a comprehensive review on approximately 24,627 cases from the years 2019, 2020, and 2021. As a result, in systems with low rotational kinetic energy, both low- and high-frequency nadirs were observed, indicating high uncertainty. However, Effective inertia presented a consistent trend regarding the energy release aligned with the minimum frequency. For instance, the rotational kinetic energy required to satisfy the frequency standard was 23 GWs, while the required Effective inertia was 858 MWs. We emphasize that securing inertia based on rotational kinetic energy includes additional imaginary energy that does not contribute to frequency, resulting in an energy requirement greater than that needed for Effective inertia. Therefore, in order to secure the frequency stability of the future system, the actual required energy amount based on Effective inertia will be presented and utilized in the inertia market and FFR (Fast Frequency Response) resource design.

Identification of viscoelastic properties with fluid inertia in a parallel plate with effective mechanical system analyses

Measurement of viscoelastic properties in small amplitude oscillatory shear (SAOS) can be affected by fluid inertia, especially at high frequencies. In this study, we introduce an effective mechanical system approach to address the effects of fluid inertia on the viscoelastic measurement with a SAOS test, employing a parallel plate geometry. In the effective mechanical system approach, viscous, elastic, and inertial properties of a fluid system are modeled systematically by a rotational drag coefficient, a torsional spring constant, and a second moment of inertia, respectively. In this way, we established the analytic solution for the linear viscoelastic behavior of a fluid in the presence of fluid inertia. The shear modulus on the frequency, obtained by the effective mechanical system, reveals that fluid inertia only affects the storage modulus and not the loss modulus. We investigate the behavior of the storage modulus as a function of the gap size, the oscillation frequency, and the disk radius, demonstrating the dependence on the gap size and the frequency. Comparison was made for the shear modulus from the effective mechanical system with viscoelastic flow simulation, employing two viscoelastic (Oldroyd-B and Giesekus) fluid models to validate the accuracy of this approach. The maximum error was found less than 3.3% over the frequency range from 1 to 100 rad/s.

Visualization and characterization of capillary-to-viscous transition in fluid-induced granular deformation

Comprehending pattern transitions during immiscible two-phase flow through granular materials is of paramount scientific and practical importance, as flow conditions are susceptible to variability along transport pathways in natural and engineering systems. The localized fluid displacement frequently mobilizes the hosting grains and triggers diverse morphological deformation. The interplay between such hydrodynamic and mechanical forces renders the deformation transitions inherently complex and hard to predict. Here, we integrate laboratory experiments with numerical simulations to probe the morphodynamics of fluid-driven granular deformation at the fundamental pore scale. Upon systematically varying capillary–viscous flows, we unveil three deformation patterns and propose a new dimensionless number incorporating the overlooked inertial and size effects to capture their transitions from slender channels to circular cavities to ramified fingers. We consistently observe lower residual saturation in the cavity regime attributed to the balanced capillary–viscous forces in this transition zone. Notably, our numerical model accurately mirrors the experimental observations and sheds light on the physics underlying the nucleation of characteristic crossover cavitation based on the microscale quantities of trivial energy leftover and uniform flow resistance.

An experimental investigation into filament formation during drop generation by pseudo-plastic viscoelastic biofluid at T-junction generators

The advancements in droplet microfluidics have made it an eminent technology for high-throughput biomedical applications involving biofluids such as blood, saliva, tear film, and synovial fluid, all characterized by their non-Newtonian/viscoelastic properties. However, most existing models for the design and optimization of droplet microfluidic systems are primarily based on Newtonian fluids. Therefore, studies that systematically explore the dynamics underlying biofluid droplet formation and manipulation are critically important, both fundamentally and practically. This study uses artificial tear films to experimentally investigate the effects of operational parameters such as geometric conditions (width ratio Λ = wdwc and aspect ratio h* = hwc), fluid properties (viscosity ratio η = μdμc), and flow rate ratios (ϕ = QdQc) on filament formation during droplet generation in a T-junction geometry. All the experiments were conducted at a constant capillary number of the continuous phase (Ca = μcQcwchγ). The results indicate that filament growth and rupture characteristics are determined by the predominance of two distinct regions: pre-stretch, governed by the interplay between inertial and capillary forces, and elastocapillarity, regulated by elastic and capillary forces. Specifically, filament rupture is influenced by inertia–capillary effects at low flow rates and viscosity ratios. In contrast, the domination of elastic effects is more pronounced at higher flow rates and viscosity ratios. Additionally, reductions in the width (Λ) and aspect (h*) ratio when Λ≥0.5 and h*≥0.4 increase the elastic effects within the filaments while inertial effects dominate for Λ<0.5 and h*<0.4. The relaxation times (λ) are obtained from the exponential thinning curve, with longer times observed for cases with high elastic effects. Finally, the filament collapses into satellite droplets, and their monodispersity increases with elasticity.

Comprehensive model for multi-fracture localization based on water hammer signals: Evaluation and field application

Determining fracture locations in hydraulic fracturing is essential for diagnostic purposes. Water hammer waves generated during pump shut-in in hydraulic fracturing create pressure fluctuations as they pass through fractures. The pressure signals collected at the wellhead contain valuable information about subsurface fracture positions. This study, based on the water hammer equation, establishes an internal flow model within pipelines, considering both the pump shut-in process and subsurface fracture boundary conditions (fracture permeability, fracture storage, and fracture inertia effects). The method of characteristics (MOC) is employed for numerical discretization to simulate the wellhead pressure fluctuations during pump shut-in. A novel fracture localization method is proposed, combining comprehensive filtering, cepstral analysis, and velocity conversion. Comprehensive filtering effectively removes various noises present in the collected signals. Subsequently, cepstral analysis identifies negative peaks in the cepstral domain generated by pulse functions at fracture locations. This information is then used to determine the propagation time of pressure waves from fractures to the wellhead, which is converted to depth by wave velocity. Through numerical simulations and field experiments, the method's effectiveness is validated, demonstrating its capability to efficiently filter out signal noise, identify cepstral negative peaks from pulse functions at fractures, and provide precise inversion of fracture locations. This method holds significant guidance for practical field applications.

Ten-moment fluid model for low-temperature magnetized plasmas

In this paper, a one-dimensional 10-moment multi-fluid plasma model is developed and applied to low-temperature magnetized plasmas. The 10-moment model solves for six anisotropic pressure terms, in addition to density and three components of fluid momentum, which allows the model to capture finite kinetic effects. The results are benchmarked against a 5-moment model, which assumes that the gas constituents follow a Maxwellian velocity distribution function (VDF), and a particle-in-cell Monte Carlo collision model that allows for arbitrary non-Maxwellian VDFs. The models are compared in a one-dimensional, low-temperature, partially magnetized plasma test case. The 10-moment results accurately reproduce the anisotropic temperature profile in low-temperature magnetized plasmas, where shear gradients exist due to the E×B drift. We discuss the mechanisms by which the anisotropic pressure can be generated in low-temperature magnetized plasmas. In addition, the importance of a self-consistent heat flux closure to the 10-moment model is studied, showing consistency with other models only when the assumptions of the underlying model are met. The 10-moment model allows for study of electron inertia effects and non-Maxwellian VDFs without the need for kinetic methods that are more computationally expensive.

Undisturbed velocity recovery with transient and weak inertia effects in volume-filtered simulations of particle-laden flows

Undisturbed velocity recovery with transient and weak inertia effects in volume-filtered simulations of particle-laden flows

Quasi-linear homogenization for large-inertia laminar transport across permeable membranes

Porous membranes are thin solid structures that allow the flow to pass through their tiny openings, called pores. Flow inertia may play a significant role in several filtration flows of natural and engineering interest. Here, we develop a predictive macroscopic model to describe solvent and solute flows past thin membranes for non-negligible inertia. We leverage homogenization theory to link the solvent velocity and solute concentration to the jumps of solvent stress and solute flux across the membrane. Within this framework, the membrane acts as a boundary separating two distinct fluid regions. These jump conditions rely on several coefficients, stemming from closure problems at the microscopic pore scale. Two approximations for the advective terms of Navier–Stokes and advection–diffusion equations are introduced to include inertia in the microscopic problem. The approximate inertial terms couple the micro- and macroscopic fields. Here, this coupling is solved numerically using an iterative fixed-point procedure. We compare the resulting models against full-scale simulations, with a good agreement both in terms of averaged values across the membrane and far-field values. Eventually, we develop a strategy based on unsupervised machine learning to improve the computational efficiency of the iterative procedure. The extension of homogenization towards weak-inertia flow configurations as well as the performed data-driven approximation may find application in preliminary analyses as well as optimization procedures towards the design of filtration systems, where inertia effects can be instrumental in broadening the spectrum of permeability and selectivity properties of these filters.

Enhanced Q-factor in microcantilevers using stiffened inertial amplifiers

Microcantilevers are widely employed in sensing applications because they are highly sensitive to changes in vibrational frequency. The Q-factor, a measure of the effectiveness of energy storage in resonant systems, is a crucial parameter that directly influences the sensitivity and performance of microcantilevers. Conventional approaches to improving the Q-factor by choosing certain materials or making changes to the shape have notable practical and economic constraints. This study introduces a new method that utilizes reinforced inertial amplifiers to significantly improve the Q-factor of microcantilevers. We introduce three setups: the standard amplifier, the compound amplifier, and the nested amplifier, each specifically engineered to enhance the system’s effective inertia. According to theoretical modeling, all arrangements enhance the Q-factor, with the nested design resulting in an impressive amplification of over 3000. These findings present a scalable technique to improve the sensitivity of microcantilevers, offering a potential approach for future experimental verification and utilization in precision sensing technologies.

Flow of viscoelastic films over grooved surfaces with partial wetting

We consider the steady flow of a viscoelastic film over an inclined plane featuring periodic trenches normal to the main flow direction. The trenches have a square cross-section and side length 5–8 times the capillary length. Owing to the orientation of the substrate, the film fails to coat the topographical feature entirely, forming a second gas–liquid interface inside the trench and two three-phase contact lines at the points where the free surface meets the wall of the trench. The volume of entrapped air depends on material and flow parameters and geometric conditions. We develop a computational model and carry out detailed numerical simulations based on the finite element method to investigate this flow. We solve the two-dimensional mass and momentum conservation equations using the exponential Phan-Thien & Tanner constitutive model to account for the rheology of the viscoelastic material. Due to the strong nonlinearity, multiple steady solutions possibly connected by turning points forming hysteresis loops, transcritical bifurcations and isolated solution branches are revealed by pseudo-arc-length continuation. We perform a thorough parametric analysis to investigate the combined effects of elasticity, inertia, capillarity and viscosity on the characteristics of each steady flow configuration. The results of our simulations indicate that fluid inertia and elasticity may or may not promote wetting, while shear thinning and hydrophilicity always promote the wetting of the substrate. Interestingly, there are conditions under which the transition to the inertial regime is not smooth, but a hysteresis loop arises, signifying an abrupt change in the film hydrodynamics. Additionally, we investigate the effect of the geometrical characteristics of the substrate, and our results indicate that there is a unique combination of the geometry and viscoelastic properties that either maximizes or minimizes the wetting lengths.

Dynamic analysis in polar exploration: Fluid-structure interaction modeling of projectile colliding with floating ice during water entry

In polar resource exploration, the interaction between polar detectors and floating ice, as well as their water entry mechanisms, are crucial for ensuring effective detector operation and data collection. This study developed a fluid-structure interaction (FSI) model to simulate the water entry of the projectile in a multidegree motion state upon collision with the floating ice, and the numerical method was validated through experiments. This study analyzes the mechanisms of cavity evolution and the laws of cavity pinch-off. This analysis further explores the motion states and dynamic characteristics under the interaction between the projectile and the floating ice. Additionally, this study also considers the influence of structural parameters of the floating ice, including thickness (Lt), width (Lw), and collision position (Sd), on the water entry process. The study reveals that increasing the submergence depth of the floating ice enhances the stability between the floating ice and water, and can mitigate flow separation phenomena generated by passive motion under inertial effects. Variations in the floating ice thickness significantly affect the cavity evolution and the projectile's underwater motion state. Conversely, variations in the floating ice width notably affect the liquid level disturbances, the development of splash crowns, and the evolution of passive water entry cavities. In specific multidegree motion states, various collision positions do not alter the evolution form of water entry cavities, yet the variation in collision positions notably affects floating ice displacement. As the collision position shifts from the center to the side edge of the floating ice, both the hydrodynamic forces on the projectile and the stress on the floating ice gradually decrease, with the decrease in hydrodynamic forces being the most significant, reaching up to 58%. This study is important for enhancing multi-body fluid-structure interaction algorithms and advancing polar exploration engineering development.

Numerical Investigation of Effects of Obstacles in Flow Channels and Depth of Flow Channels for PEMFCs

The channel is a crucial component of the polymer electrolyte membrane fuel cell (PEMFC). Since the channel can change the reactant transfer capability, water removal capability, and distribution of the reactant, it affects the performance and durability of PEMFCs. This study investigated the effects of obstacles in the serpentine-type flow channel on the performance of PEMFCs by computational fluid dynamics (CFD). The height of the obstacles was varied to analyze the electrochemical performances of the fuel cells. In addition, the depth of the flow channel was varied to compare the performances of the PEMFCs. To better represent the real-world tendency, the agglomerate model and the Forchheimer inertial effect were used. The results showed that changes in the channel depth caused greater performance improvements compared to the installation of obstacles, due to the enhanced mass transfer and improved water removal. However, the results for the installation of obstacles showed the lower non-uniformity of the current density and a reduced pressure drop compared to the changes in the channel depth, offering advantages in terms of flooding, the fuel cell life, and the operating cost.

Experimental investigation and predictive modeling of dry-out and salt precipitation effects during underground gas storage operations

Formation damage poses the greatest threat to underground gas storage (UGS) operations, with permeability reduction being a key cause of injectivity and productivity losses. To better understand the mechanisms behind dry-out and salt precipitation (DSP) and predict the resulting near-wellbore damage, this study experimentally and quantitatively evaluates key factors affecting rock properties before and after salt precipitation. We conducted long-term gas-brine core flooding experiments, obtained salt-contaminated samples, and supplemented them with core permeability-porosity parameter tests, high-pressure mercury intrusion porosimetry (MIP), and scanning electron microscopy (SEM) experiments to better evaluate the salt clogging behavior of the samples. In addition, we discussed the applicability of the key parameter prediction model in modeling the DSP effects, including the water content of natural gas (WCNG), the porosity-permeability clogging model (PPC), and relative permeability (RP) function, providing usage recommendations. Based on our findings, we introduced a model to predict water saturation, salt saturation, and the salt-induced skin factor near the wellbore, particularly after viscous displacement ends, when liquid becomes immobile and evaporation dominates.The results show that salt precipitation has a significant impact on core porosity and permeability. Notably, lower flow rates subtly promote salt precipitation by enhancing the role of evaporation, resulting in greater salt accumulation. In addition, elevated salinity and higher initial water saturation are key contributors to the precipitation process, further exacerbating salt buildup within the reservoir. MIP experiments further confirm the aforementioned impacts. SEM observations reveal NaCl crystals, either clustered or isolated, extensively distributed within the pores and filling the pore spaces from micro to nanometer scale, highlighting their substantial role in altering pore structure and impacting porosity and permeability due to DSP effects. Our developed model confirms that high temperature, low pressure, high flow rates, low initial porosity and permeability, and strong near-well inertia effects lead to DSP effects manifesting sooner near the wellbore during the post-viscous displacement stage. Model validation with core-scale predictions closely matches experimental data in terms of trend.By laying the groundwork for analyzing the mechanisms of flow-through drying and salt precipitation, our findings can be directly applied to identifying the key controlling factors influencing DSP effects, mitigating formation damage, improving injectivity and productivity, and enhancing the efficiency of UGS operations under various operational conditions.

Collapse of microbubbles over an elastoplastic wall

The collapse of a vapour bubble over a material surface has been widely studied over the past few decades, but a comprehensive and quantitative analysis of the cavitation dynamics and its effects on solid materials at the mesoscale (nanometre up to micrometre), which would be of particular interest in applications exploiting cavitation power, is still lacking. In this work, we adopt a diffuse interface model to describe the microbubble dynamics, and a dynamic plasticity model for the solid. The former is particularly suited to studying the rich phenomenology characterising bubble collapse at the mesoscale, which comprises transitions to supercritical conditions, emission and propagation of shock waves, generation of liquid microjets and topological transitions, whereas the latter is used to characterise the permanent plastic deformation caused by the bubble collapse, and has been augmented to consider inertial effects, to assess whether or not an interaction between elastic and plastic waves may influence the resulting deformation. Results concerning the collapse of a microbubble at different liquid overpressures and initial standoff ratios are discussed, and the elastoplastic wave propagation in the solid, together with plastic deformation, is studied for different cases, depending on elastic and plastic material parameters.

Impact of Therapeutic Inertia on Patient-Reported Outcomes in Moderate-to-Severe Atopic Dermatitis: A 12-Month Longitudinal Study from the TARGET-DERM AD Registry

Background: Therapeutic inertia, the delay or reluctance to modify treatment when goals are unmet, is a significant challenge in managing chronic diseases, including atopic dermatitis (AD). This inertia can lead to suboptimal disease control and affect patient outcomes. Objectives: This study evaluates the effect of therapeutic inertia on patient-reported outcomes (PROs) in moderate-to-severe AD patients undergoing systemic treatment over 3 to 12 months. Methods: We analyzed longitudinal data from the TARGET-DERM AD registry, which includes 3,457 patients with moderate-to-severe AD from 39 centers across the U.S. and Canada. Eligible patients had documented patient-reported outcomes (PROs) at the initiation of systemic therapy and at subsequent 3-month intervals up to 12 months of follow-up. We assessed the proportion of patients not meeting treatment targets based on expert consensus. Patients had a validated Investigator Global Assessment (vIGA-AD) score of 3 or more at initiation of either an advanced systemic therapy (AST) such as biologics or JAK inhibitors or a conventional systemic therapy (CST) such as cyclosporine, methotrexate, or prednisone. PROs were evaluated at 3-month intervals up to 12 months, assessing achievement against the predefined treatment targets. PRO measures included Worst-Itch (PROMIS Itch-Severity), POEM, PO-SCORAD, NRS-sleep, and NRS-pain with specific moderate and optimal target levels established for each. Itch-Severity (range: 0–10; moderate target: ≥4-point reduction, optimal target: score ≤1), POEM (range: 0-28; moderate target: ≥4-point reduction, optimal target: score ≤2), PO-SCORAD (range: 0-103; moderate target: score ≤24; optimal target: score ≤10), NRS-sleep and NRS-pain (range: 0-10; moderate target: reduction ≥3-points; optimal target: score ≤1). Results: Out of 2107 patients with moderate-to-severe AD, 445 qualifying participants were included (63.8% adult, 62.0% female, 45.4% Non-Hispanic White, mean age of 31 years). Most patients (88.8%) initiated AST, with dupilumab being the most common (86.5%). At 6 months, significant proportions of AST-treated patients failed to reach moderate and optimal targets for itch (67% and 79%, respectively), POEM (46% and 69%), and NRS-sleep (59% and 47%). By 12 months, these figures were similar, with 66% and 88% failing to meet itch targets, 53% and 73% failing to meet POEM targets, and 62% and 45% failing to meet NRS-sleep targets, respectively. A similar pattern was observed for other PROs. CST-treated patients exhibited similar trends. Conclusions: The study highlights the profound impact of therapeutic inertia on the quality of life of patients with moderate-to-severe AD. Despite systemic therapy, a considerable proportion failed to meet treatment targets over a 12-month period, underscoring the need for more proactive and responsive treatment strategies in AD management.