Length Of Period Research Articles

Undersampling effects on observed periods of coronal oscillations

Context. Recent observations of decayless transverse oscillations have revealed two branches in the relationship between period and loop length. One is a linear relationship, interpreted as a standing mode, while the other shows almost no correlation and has not yet been interpreted conclusively. Aims. We investigated the undersampling effect on observed periods of decayless oscillations. Methods. We considered oscillating coronal loops that closely follow the observed loop length distribution. Assuming that all oscillations are standing waves, we modelled a signal that represents decayless oscillations where the period is proportional to the loop length and the amplitude and phase are randomly drawn. We generated a downsampled signal from the original signal by considering different sample rates that mimic temporal cadences of telescopes, and analysed the periods for sampled signals using the fast Fourier transform. Results. When the sampling cadence approaches the actual oscillation period, there is a greater tendency to overestimate the periods in short loops. We find the same two branches in the relationship between loop length and period of the sampled signals as those seen in the observations. Conclusions. We find that long periods of decayless oscillations occurring in short loops could be the result of undersampling.

ADMNet: An adaptive downsampling multi-frequency multi-channel network for long-term time series forecasting

Long-term time series forecasting finds widespread applications in various domains such as energy, finance, and transportation. Decomposing time series into sub-sequences with distinct temporal relationships (periods) for analysis and modeling is an effective approach for long-term time series prediction. However, conventional decomposition techniques often rely on fixed-size parameter kernels for sliding averages, leading to inaccurate and unreasonable captures of the underlying periodicities in the time series. Additionally, it is essential to acknowledge that time series data often exhibits multi-periodic characteristics. In many time series prediction tasks, the value at a future time point is influenced by multiple periods within the time series. To accurately and flexibly capture the periodicities of time series, we propose an enhanced adaptive cyclic feature recognizer to automatically identify the periodic lengths for sliding average parameter kernel sizing. To fully exploit the multiple periodicities inherent in time series, we merge and smooth the sequences of features corresponding to the identified cycles, obtaining two frequency-blended cyclic feature fusion terms. Furthermore, we extract high-frequency random components to preserve finer details. Finally, we individually model the three cyclic feature fusion terms. In summary, we introduce the Adaptive Multi-Frequency Multi-Channel Network (ADMNet) designed to autonomously capture multi-periodic features. Experimental results show that, compared to the current state-of-the-art seven benchmark models, the proposed model achieves an average reduction in mean squared error (MSE) ranging from 6.19% to 22.75% across eight datasets, including ETT, Traffic, and Weather. This indicates that our model delivers superior predictive performance on multiple real-world datasets.

Cold-induced degradation of core clock proteins implements temperature compensation in the Arabidopsis circadian clock.

The period of circadian clocks is maintained at close to 24 hours over a broad range of physiological temperatures due to temperature compensation of period length. Here, we show that the quantitative control of the core clock proteins TIMING OF CAB EXPRESSION 1 [TOC1; also known as PSEUDO-RESPONSE REGULATOR 1 (PRR1)] and PRR5 is crucial for temperature compensation in Arabidopsis thaliana. The prr5 toc1 double mutant has a shortened period at higher temperatures, resulting in weak temperature compensation. Low ambient temperature reduces amounts of PRR5 and TOC1. In low-temperature conditions, PRR5 and TOC1 interact with LOV KELCH PROTEIN 2 (LKP2), a component of the E3 ubiquitin ligase Skp, Cullin, F-box (SCF) complex. The lkp2 mutations attenuate low temperature-induced decrease of PRR5 and TOC1, and the mutants display longer period only at lower temperatures. Our findings reveal that the circadian clock maintains its period length despite ambient temperature fluctuations through temperature- and LKP2-dependent control of PRR5 and TOC1 abundance.

Low-velocity impact response and damage mechanism of cosine function cell-based lattice core sandwich panels

This study aims to investigate the impact response and damage mechanism of cosine-function cell-based (CFCB) lattice core sandwich panels. Several low-velocity impact tests were conducted to explore their advantages in impact resistance by comparing them with traditional body-centered cubic (BCC) lattice-core sandwich panels. The impact response and deformation patterns of CFCB lattice core sandwich panels with two different faceplate materials (aluminum alloy and carbon fiber reinforced plastic composite) were experimentally investigated. The CFCB lattice core sandwich panels exhibited higher impact resistance and energy absorption capacity than their BCC lattice core counterparts. Furthermore, sandwich panels with aluminum alloy faceplates provided better impact resistance capacity than those with CFRP faceplates. Subsequently, several numerical models were developed to explore the deformation mechanisms and energy absorption characteristics of CFCB lattice core sandwich panels. In addition, the effects of the core structural parameters on mechanical performance were numerically investigated. Results indicated that increasing the cell rod diameter and/or reducing the cosine period length could decrease the indentation depth and enhance crush force efficiency. Finally, based on the principle of minimum potential energy, a theoretical model was developed to predict the initial peak load of CFCB lattice core sandwich panels with isotropic faceplates. This study aimed to explore the impact response and provide design guidance for CFCB lattice core sandwich panels.

Novel drug sampling technique: portal vein catheterization in steers.

To determine the feasibility of catheterizing the portal vein to obtain serial portal vein blood samples in steers. We hypothesized that the portal vein catheterization would be a successful continuous sampling technique with minimal adverse effects in steers. 2 groups of steers were used: a pilot group (n = 2) and experimental group (n = 6). In both groups, steers were sedated with xylazine. The right rib spaces were clipped and aseptically prepped. The portal vein was visualized via ultrasound, and a 14-gauge catheter was placed percutaneously and advanced into the portal vein. A guide wire was passed through the catheter, followed by a tissue dilator and then a vascular balloon catheter. In the pilot group, blood chemistries were performed prior to portal vein catheterization and then again once the catheter was placed (with samples from both the jugular vein and portal catheter). The liver was also examined at necropsy for any gross lesions in both groups. All steers tolerated the portal vein catheters well, with the catheters lasting for the full length of the study period (7 days). The only observed adverse reaction was a superficial abscess at the catheter site (n = 3). On necropsy, 1 liver had gross discoloration, but no other abnormalities were noted. There were no significant changes in biochemistry profiles before or after portal vein catheterization. Portal vein catheterization is a novel and feasible serial sampling technique of the portal vein. This technique can be used in future pharmacokinetic, nutrition, metabolism, or toxicity studies.

Design and fabrication of a sub-3 dB grating coupler on an X-cut thin-film lithium niobate platform.

Thin-film lithium niobate (TFLN) based integrated photonic devices have been intensively investigated due to their promising properties, enabling various on-chip applications. Grating couplers (GCs) are wildly used for their flexibility and high alignment tolerance for fiber-to-chip coupling. However, achieving high coupling efficiency (CE) in TFLN GCs often requires the use of reflectors, hybrid materials, or extremely narrow linewidths of the grating arrays, which significantly increases the fabrication difficulty. Therefore, there is a demand for high-CE GCs on TFLN with simple structure and easy fabrication processes. In this paper, combining process capabilities, we demonstrate a highly efficient apodized GC by linearly optimizing the period length and the fill factor on a 600-nm-thick TFLN platform. Without any reflector or hybrid material, we achieve a remarkable coupling loss of -2.97 dB at 1555 nm on the 600-nm-thick X-cut TFLN platform with only a single lithography and etching step. Our work sets a new benchmark for CE among GCs on the 600-nm-thick TFLN platform.

Automated System to Capture Patient Symptoms From Multitype Japanese Clinical Texts: Retrospective Study.

Natural language processing (NLP) techniques can be used to analyze large amounts of electronic health record texts, which encompasses various types of patient information such as quality of life, effectiveness of treatments, and adverse drug event (ADE) signals. As different aspects of a patient's status are stored in different types of documents, we propose an NLP system capable of processing 6 types of documents: physician progress notes, discharge summaries, radiology reports, radioisotope reports, nursing records, and pharmacist progress notes. This study aimed to investigate the system's performance in detecting ADEs by evaluating the results from multitype texts. The main objective is to detect adverse events accurately using an NLP system. We used data written in Japanese from 2289 patients with breast cancer, including medication data, physician progress notes, discharge summaries, radiology reports, radioisotope reports, nursing records, and pharmacist progress notes. Our system performs 3 processes: named entity recognition, normalization of symptoms, and aggregation of multiple types of documents from multiple patients. Among all patients with breast cancer, 103 and 112 with peripheral neuropathy (PN) received paclitaxel or docetaxel, respectively. We evaluate the utility of using multiple types of documents by correlation coefficient and regression analysis to compare their performance with each single type of document. All evaluations of detection rates with our system are performed 30 days after drug administration. Our system underestimates by 13.3 percentage points (74.0%-60.7%), as the incidence of paclitaxel-induced PN was 60.7%, compared with 74.0% in the previous research based on manual extraction. The Pearson correlation coefficient between the manual extraction and system results was 0.87 Although the pharmacist progress notes had the highest detection rate among each type of document, the rate did not match the performance using all documents. The estimated median duration of PN with paclitaxel was 92 days, whereas the previously reported median duration of PN with paclitaxel was 727 days. The number of events detected in each document was highest in the physician's progress notes, followed by the pharmacist's and nursing records. Considering the inherent cost that requires constant monitoring of the patient's condition, such as the treatment of PN, our system has a significant advantage in that it can immediately estimate the treatment duration without fine-tuning a new NLP model. Leveraging multitype documents is better than using single-type documents to improve detection performance. Although the onset time estimation was relatively accurate, the duration might have been influenced by the length of the data follow-up period. The results suggest that our method using various types of data can detect more ADEs from clinical documents.

Evaluating potential evapotranspiration methods in a rapidly warming Arctic region, SW Spitsbergen (1983–2023)

Study regionsHornsund, SW Spitsbergen, Svalbard – area representing atlantic sector of High Arctic Study focusSvalbard's warming climate significantly alters its hydrological conditions. Evapotranspiration, a crucial hydrological component, is understudied in this High Arctic environment. In this study, daily potential evapotranspiration (PET) estimates for the period 1983–2023 were calculated using meteorological data from the Polish Polar Station Hornsund (SW Spitsbergen). 11 different PET methods were applied, those include radiation-based, temperature-based, radiation-temperature-based, and combined methods. New hydrological insights for the regionThe results show a large spread in the annual sum of PET ranging from ∼20 mm/y (Kharrufa) through ∼300 mm/y (Penman-Monteith) up to ∼450 mm/y (Abtew). Trends analysis shows different outcomes depending on the length of the averaging period. Using a daily timescale, PET methods tend to show more similar patterns of changes than using monthly timescales. The changes in PET estimates differ between the models, hence classifying PET methods should consider their sensitivity to meteorological changes. PET estimates were compared with pan measurements at a daily time scale in 2022–2023. The Penman method produced the best results in relation to pan measurements. In other cases, despite a relatively high linear correlation, calibration to local conditions is needed to scale the outcomes and limit biases. This study improves understanding of how PET models perform in the rapidly changing High Arctic climate.

The peeling behavior of film/substrate systems with periodic and discontinuous bonding

Discontinuous bonding is a common adhesion state in multilayer structures within the shipbuilding, automotive, and semiconductor industries, as well as in biological adhesion. Based on the cohesive theory and the Euler-Bernoulli beam model, we investigate the peeling behavior of a film from the rigid substrate subjected to periodic and discontinuous bonding. Different from the continuous bonding model, the peeling force during the peeling process exhibits repeated fluctuations. The increase and decrease of peeling force correspond respectively to the initiation of cohesive zones within the non-bonded and bonded segments. Furthermore, the bonding state at the crack tip influences the change pace of the energy release rate. Specifically, when the cohesive zone initiates within a bonded segment, the decrease in the energy release rate accelerates noticeably as the crack tip enters a non-bonded segment. Additionally, the influence of diverse bonding ratios and varying periodic lengths is discussed. This paper provides insights into the peeling behavior under discontinuous bonding effects in nature, and offers potential applications for the optimization and design of multilayer structures.

Sources of PM2.5 exposure misclassification in three Finnish register-based study populations and the impact on attenuation of health effect estimates

Air pollution is a leading environmental health risk factor. The risk estimates, primarily based on air pollution epidemiology, are sensitive to exposure misclassification, which can result in underestimation. To address some of these challenges, our aim is to investigate how the length of the period over which the exposure is averaged, trends in long-term PM2.5 concentrations, and the seasonal variability are associated with each other. Furthermore, we assess the impact of residential relocation on exposure levels and quantify random exposure misclassification due to modelling and its impact on the attenuation of effects with respect to averaging time.We used nested air quality modelling across Finland, gridded population, and address histories from three study populations: the MATEX pregnancy and preschool children cohorts, as well as the FINPARK study's individuals diagnosed with Parkinson's disease and their controls, to estimate PM2.5 exposures. The prediction error was estimated by comparing modelled concentrations to observations and by using previous estimates for random monitoring instrument error.Due to the decreasing trend in PM2.5 concentrations, exposure levels rose progressively with longer averaging times, increasing by up to 28 % over a 16-year period. The shorter the exposure period, the more pronounced the seasonal effects: pregnant mothers' trimester-specific exposures were 13–22 % higher for trimesters ending in spring and 10–16 % lower for those ending in autumn compared to the average for the entire pregnancy. Residential relocation had a relatively minor impact on the exposure levels of the preschool children and adult FINPARK study population, but this effect was possibly partly masked by the decreasing trend. The results indicated that using predicted concentrations led to random exposure misclassification and potentially attenuated health effects. This effect became more notable when increasing the length of the exposure period from 3 months to 5 years, doubling the underestimation ratio from 1.5 to 3.1.

Electronic Health Record Nudges and Health Care Quality and Outcomes in Primary Care

Nudges have been increasingly studied as a tool for facilitating behavior change and may represent a novel way to modify the electronic health record (EHR) to encourage evidence-based care. To evaluate the association between EHR nudges and health care outcomes in primary care settings and describe implementation facilitators and barriers. On June 9, 2023, an electronic search was performed in PubMed, Embase, PsycINFO, CINAHL, and Web of Science for all articles about clinician-facing EHR nudges. After reviewing titles, abstracts, and full texts, the present review was restricted to articles that used a randomized clinical trial (RCT) design, focused on primary care settings, and evaluated the association between EHR nudges and health care quality and patient outcome measures. Two reviewers abstracted the following elements: country, targeted clinician types, medical conditions studied, length of evaluation period, study design, sample size, intervention conditions, nudge mechanisms, implementation facilitators and barriers encountered, and major findings. The findings were qualitatively reported by type of health care quality and patient outcome and type of primary care condition targeted. The Risk of Bias 2.0 tool was adapted to evaluate the studies based on RCT design (cluster, parallel, crossover). Studies were scored from 0 to 5 points, with higher scores indicating lower risk of bias. Fifty-four studies met the inclusion criteria. Overall, most studies (79.6%) were assessed to have a moderate risk of bias. Most or all descriptive (eg, documentation patterns) (30 of 38) or patient-centeredness measures (4 of 4) had positive associations with EHR nudges. As for other measures of health care quality and patient outcomes, few had positive associations between EHR nudges and patient safety (4 of 12), effectiveness (19 of 48), efficiency (0 of 4), patient-reported outcomes (0 of 3), patient adherence (1 of 2), or clinical outcome measures (1 of 7). This systematic review found low- and moderate-quality evidence that suggested that EHR nudges were associated with improved descriptive measures (eg, documentation patterns). Meanwhile, it was unclear whether EHR nudges were associated with improvements in other areas of health care quality, such as effectiveness and patient safety outcomes. Future research is needed using longer evaluation periods, a broader range of primary care conditions, and in deimplementation contexts.

Short Rest Between Flights Is Associated With Increased Serum Stress Hormone Levels in Airline Pilots: A Cross-Sectional Study.

Work-related stress is a critical area of research in civil aviation, given the potential for severe consequences when airline pilots (APs) are overwhelmed or unable to perform optimally. While pilots are traditionally considered to be exposed to various stressors, the impact of specific occupational characteristics on stress in the aviation industry remains inadequately understood. Considering that biomarkers are increasingly being utilized as objective measures of stress in human research, this cross-sectional study investigated the association between occupational variables and serum levels of cortisol and dehydroepiandrosterone sulfate (DHEAS) as stress biomarkers in commercial APs. A total of 120 male APs completed a survey assessing the following work-related characteristics: position (captain vs. first officer), years of experience, total flight hours, flight hours in the preceding year, inter-flight rest duration, and flight route length. Serum cortisol and DHEAS concentrations were determined from venous blood samples obtained between 08:00 and 09:00 a.m., following a minimum eight-hour fasting period. The biomarker data were analyzed in relation to the aforementioned occupational characteristics. The mean serum cortisol and DHEAS concentrations in the entire cohort were 8.5±2.1 µg/dL and 214.6±96.4 µg/dL, respectively. There were no significant differences in the levels of the two stress hormones in relation to position, years of experience, total flight hours, flight hours in the preceding year, or flight route length. However, an inter-flight rest period of less than one hour was significantly associated with elevated serum cortisol (P<0.01) and reduced DHEAS levels (P<0.001) compared to longer rest durations. Notably, a stepwise decrease in DHEAS concentrations was observed for rest periods of <1 hour, 1-4 hours, 4-24 hours, and >24 hours. After adjustment for potential confounders in multivariable analyses, a rest period of <1 hour remained independently associated with both serum cortisol (odds ratio [OR]=1.09, 95% confidence interval [CI]=1.04-1.13, P<0.01) and DHEAS (OR=0.94, 95% CI=0.92-0.97, P<0.001). Serum stress hormones in APs are associated with short inter-flight rest periods. Optimization of rest durations may contribute to improved pilot well-being and performance. Further research is warranted to determine ideal rest period lengths and develop interventions to mitigate the potential adverse effects of abbreviated rest periods between flights.

Definition and Behavior of Langton's Ant in Three Dimensions

The "virtual ant" automaton was invented by C. Langton [1]. It has an interesting behavior that has been studied in several researches. A definition of generalized ants in three dimensions, as an extension to Langton's ant, is given here. The phenomenon of periodic motion with drift, the so-called "highway," is also observed in three dimensions but occurs in very different forms. Two classification systems of three-dimensional ants according to the period length of their highways and the resources they need before building a highway are presented.

Circadian clock period length is not consistently linked to chronotype in a wild songbird.

Circadian clock properties vary between individuals and relate to variation in entrained timing in captivity. How this variation translates into behavioural differences in natural settings, however, is poorly understood. Here, we tested in great tits whether variation in the free-running period length (tau) under constant dim light (LL) was linked to the phase angle of the entrained rhythm ("chronotype") in captivity and in the wild, as recently indicated in our study species. We also assessed links between tau and the timing of first activity onset and offset under LL relative to the last experienced light-dark (LD) cycle. We kept 66 great tits, caught in two winters, in LL for 14 days and subsequently released them with a radio transmitter back to the wild, where their activity and body temperature rhythms were tracked for 1 to 22 days. For a subset of birds, chronotype was also recorded in the lab before release. Neither wild nor lab chronotypes were related to tau. We also found no correlation between lab and wild chronotypes. However, the first onset in LL had a positive relationship with tau, but only in males. Our results demonstrate that links between tau and phase of entrainment, postulated on theoretical grounds, may not consistently hold under natural conditions, possibly due to strong masking. This calls for more holistic research on how the many components of the circadian system interact with the environment to shape timing in the wild. Wild birds showed chronotypes in the field that were unlinked to their circadian period length tau measured in captivity. In males only, the first onset of activity after exposure to constant dim light did correlate with tau. Our study emphasises the need to investigate clocks in the real world, including a need to better understand masking.

Long-term methylome changes after experimental seed demethylation and their interaction with recurrent water stress in Erodium cicutarium (Geraniaceae).

The frequencies and lengths of drought periods are increasing in subtropical and temperate regions worldwide. Epigenetic responses to water stress could be key for plant resilience to these largely unpredictable challenges. Experimental DNA demethylation, together with application of a stress factor is an appropriate strategy to reveal the contribution of epigenetics to plant responses to stress. We analysed leaf cytosine methylation changes in adult plants of the annual Mediterranean herb, Erodium cicutarium, in a greenhouse, after seed demethylation with 5-Azacytidine and/or recurrent water stress. We used bisulfite RADseq (BsRADseq) and a newly reported reference genome for E. cicutarium to characterize methylation changes in a 2 × 2 factorial design, controlling for plant relatedness. In the long term, 5-Azacytidine treatment alone caused both hypo- and hyper-methylation at individual cytosines, with substantial hypomethylation in CG contexts. In control conditions, drought resulted in a decrease in methylation in all but CHH contexts. In contrast, the genome of plants that experienced recurrent water stress and had been treated with 5-Azacytidine increased DNA methylation level by ca. 5%. Seed demethylation and recurrent drought produced a highly significant interaction in terms of global and context-specific cytosine methylation. Most methylation changes occurred around genic regions and within Transposable Elements. The annotation of these Differentially Methylated Regions associated with genes included several with a potential role in stress responses (e.g., PAL, CDKC, and ABCF), confirming an epigenetic contribution in response to stress at the molecular level.

Energetics and Structural Transitions of Nonequivalent Polytypes for FCC and HCP Metals

AbstractAlthough metal nanomaterials with unconventional phases have attracted extensive attention, the lack of information on the characteristics of metal polytypes hinders the development of related research. In this work, the energetics of nonequivalent polytypes for bulk face‐centered cubic (Li, Al, Ca, Cu, Sr, Rh, Pd, Ag, Ir, Pt, Au, and Pb) and hexagonal close‐packed metals (Be, Na, Mg, Sc, Ti, Zn, Cd, Y, Zr, Tc, Ru, Hf, Re, Os, and Tl) is systematically reported. For each metal, the structural properties and energies for its polytypes with up to the periodic stacking length of L = 10 is obtained by DFT calculation. The variation tendency of the energy differences between 3C and 2H polytypes is summarized in the Periodic Table of Elements. Generally, the ratio c/(La) increases when metal crystals except Ir, Rh, Zn, and Cd leave away from their ground‐state structure. It is found that the energy difference between polytypes originates from various interactions between the two types of atomic layers: the k layer and the h layer. The work is helpful to understand not only the structural transitions in bulk metals, such as Li, Na, Sr, Ti, Al, Pb, Y, Re, and Tl, but also the evolutions of Au nanomaterials.

Cover crop grazing length impacts on soil health and crop productivity in US Coastal Plain soils

AbstractIntroducing integrated crop‐livestock systems into row crop production promotes income diversification and potential soil health benefits through cover crop grazing on degraded soils of the southeastern United States, but effects of these practices on crop yields and soil health in Coastal Plain soils are not well established. A 4‐year study was performed to evaluate the effects of grazing a multi‐species winter cover crop on soil health and crop yields under mid‐February, mid‐March, and mid‐April cattle removal dates and a non‐grazed control within an annual cotton (Gossypium hirsutum L.) and peanut crop rotation (Arachis hypogaea L.). Chemical soil health indicators (soil organic carbon and permanganate oxidizable carbon), physical soil health indicators (water‐stable aggregates and penetration resistance), biological soil health indicators (microbial biomass carbon, soil respiration, and arbuscular mycorrhizal fungi colonization), crop yield, and cover crop biomass were evaluated. Cover crop biomass at termination was reduced by 3660, 5250, and 5610 kg ha−1 for the mid‐February, mid‐March, and mid‐April cattle removal treatments compared to the non‐grazed control. No grazing treatment effects were observed for biological soil properties. Soil organic carbon was higher in the non‐grazed treatment than the mid‐April grazing treatment across 0‐ to 30‐cm depth. Penetration resistance across 0‐ to 50‐cm depth and water‐stable aggregates at the 0‐ to 30‐cm depth were both negatively impacted by increased grazing period lengths. Results from this study suggest that longer cover crop grazing periods have little effect on biological and chemical soil health indicators in the short term but can negatively impact some physical soil health indicators.

The Analysis of Factors Related to Anemia Levels in Adolescent Girls

The impact on teenagers, if they experience anemia, is that it disrupts their ability to learn, reduces their physical exercise ability and body fitness, reduces individual work capacity, reduces the body's immune function, and reduces the ability to regulate body temperature. This research aimed to analyze factors related to anemia in adolescent girls. The research method used quantitative with a cross-sectional approach. The population in the study were all 50 Adolescents who were checked for Hb in March and had moderate anemia. The sample was 44 respondents taken by purposive sampling technique. The instrument used a questionnaire to determine the length of the menstrual period, nutritional status, knowledge, and iron intake. The research used an ordinal distribution used an ordinal regression test. The research results showed that the variable length of menstruation was 0.879 with p=0.348 (&gt; 0.05), the nutritional status variable was 0.231 with p=0.631 (&gt;0.05), the knowledge level variable was 4.407 with p=0.021 (&gt;0.05) and the nutritional intake variable was 11.575 with p=0.001 (&lt;0.05). This meant that the level of knowledge and nutritional intake was related to the level of anemia. Meanwhile, the length of menstruation and nutritional status were not related to the level of anemia. For future researchers, it is expected to provide interventions related to knowledge including individual or group counseling as well as providing a healthy lunch menu program to increase iron intake in adolescents.

Addressing immortal time bias in precision medicine: Practical guidance and methods development.

To compare theoretical strengths and limitations of common immortal time adjustment methods, propose a new approach using multiple imputation (MI), and provide practical guidance for using MI in precision medicine evaluations centered on a real-world case study. Methods comparison, guidance, and real-world case study based on previous literature. We compared landmark analysis, time-distribution matching, time-dependent analysis, and our proposed MI application. Guidance for MI spanned (1) selecting the imputation method; (2) specifying and applying the imputation model; and (3) conducting comparative analysis and pooling estimates. Our case study used a matched cohort design to evaluate overall survival benefits of whole-genome and transcriptome analysis, a precision medicine technology, compared to usual care for advanced cancers, and applied both time-distribution matching and MI. Bootstrap simulation characterized imputation sensitivity to varying data missingness and sample sizes. Case study used population-based administrative data and single-arm precision medicine program data from British Columbia, Canada for the study period 2012 to 2015. While each method described can reduce immortal time bias, MI offers theoretical advantages. Compared to alternative approaches, MI minimizes information loss and better characterizes statistical uncertainty about the true length of the immortal time period, avoiding false precision. Additionally, MI explicitly considers the impacts of patient characteristics on immortal time distributions, with inclusion criteria and follow-up period definitions that do not inadvertently risk biasing evaluations. In the real-world case study, survival analysis results did not substantively differ across MI and time distribution matching, but standard errors based on MI were higher for all point estimates. Mean imputed immortal time was stable across simulations. Precision medicine evaluations must employ immortal time adjustment methods for unbiased, decision-grade real-world evidence generation. MI is a promising solution to the challenge of immortal time bias.

Acceptance and willingness of patients with chronic facial nerve palsy for an implantable device that assists with eye closure

Patients with facial nerve palsy often experience lagophthalmos (incomplete eye closure), which can lead to exposure keratitis. The Bionic Lid Implant for Natural Eye Closure (BLINC) is a medical device designed to mimic the morenatural blink kinetics than traditional lid loading techniques. This study aimed to evaluate potential factors that might influence the design of the BLINC device and willingness of participant to undergo the implant placement surgery. Patients attending a multidisciplinary facial nerve clinic were invited to complete a survey addressing patient acceptance of the BLINC device implantation. Seventy-two patients were mailed the survey, of which 50 returned completed surveys (69%). The most important factor identified by participants was the device function (81% ranked as very important) and the least important factor was cost (16% ranked as very important). Median acceptable device function time was 5 years (range 1-10 years). Ten participants (20%) indicated willingness to be the first to trial BLINC. Women were more likely to rate visual appearance as important (OR 3.32, CI 1.14-9.62, p=0.028), and less likely to rate user friendliness as important (OR 0.16, CI 0.04-0.52, p=0.0021). Older participants were more likely to rate the length of recovery period as important (OR 1.04, CI 1.01-1.08, p=0.006). Participants with complete eye closure were less likely to be willing to trial the implant (OR 0.08, CI 0.00-0.53, p = 0.006, whilst patients with eye irritation were more willing to trial the implant (OR 7.20, CI 1.12-142, p = 0.036). Certain patient demographics impact patient aesthetic and functional preferences and the willingness to trial the BLINC device.