Sunday, August 18, 2024

 

Transforming satellite imagery: innovative fusion method for precision agriculture




Journal of Remote Sensing
Flowchart of StarFusion. 

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Flowchart of StarFusion.

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Credit: Journal of Remote Sensing





Researchers have introduced StarFusion, a cutting-edge spatiotemporal fusion method that significantly improves the temporal resolution and fusion accuracy of high-resolution satellite imagery in agriculture. By fusing data from China's Gaofen-1 and Europe's Sentinel-2 satellites, StarFusion addresses the common problem of infrequent imaging due to long revisit periods and cloud cover interference from high-resolution satellites, which often hinders the effectiveness of high-resolution remote sensing in dynamic agricultural environments. By integrating deep learning with traditional regression models, the method enhances both spatial detail and temporal resolution, making it an invaluable tool for more effective crop monitoring and management.

Remote sensing plays a vital role in monitoring agricultural landscapes, yet current satellite sensors often struggle with the trade-off between spatial and temporal resolution. High spatial resolution images, while detailed, are often limited by infrequent captures and cloud interference, reducing their utility in rapidly changing environments. Conversely, images with better temporal resolution lack the necessary spatial detail for precise analysis. These challenges underscore the need for advanced fusion methods that can better serve agricultural applications.

A team from the State Key Laboratory of Remote Sensing Science at Beijing Normal University, in collaboration with other institutions, has developed StarFusion, a new spatiotemporal fusion method. Published (DOI: 10.34133/remotesensing.0159) on July 22, 2024, in the Journal of Remote Sensing, the study combines deep learning and traditional regression techniques to address the limitations of current fusion methods. StarFusion effectively merges high-resolution Gaofen-1 data with medium-resolution Sentinel-2 data, resulting in significantly enhanced imagery for agricultural monitoring.

StarFusion represents an innovative approach to spatiotemporal image fusion, blending the strengths of deep learning and traditional regression models. By integrating a super-resolution generative adversarial network (SRGAN) with a partial least squares regression (PLSR) model, StarFusion achieves high fusion accuracy while preserving fine spatial details. The method effectively manages challenges like spatial heterogeneity and limited cloud-free image availability, making it highly practical for real-world agricultural applications. Extensive testing across various agricultural sites has shown that StarFusion outperforms existing techniques, particularly in maintaining spatial detail and enhancing temporal resolution. Its capability to function with minimal cloud-free data sets it apart, providing a reliable solution for crop monitoring in regions plagued by frequent cloud cover.

"StarFusion represents an valuable attempt in remote sensing technology for agriculture," said Professor Jin Chen, the study's lead author. "Its ability to generate high-quality images with improved temporal resolution will greatly enhance precision agriculture and environmental monitoring."

StarFusion offers significant advantages for digital agriculture, providing high-resolution imagery essential for detailed crop monitoring, yield prediction, and disaster assessment. Its ability to produce accurate images despite cloud cover and limited data availability makes it particularly valuable for agricultural management in regions with challenging weather conditions. As this technology evolves, StarFusion is expected to play a crucial role in advancing agricultural productivity and sustainability.

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References

DOI

10.34133/remotesensing.0159

Original Source URL

https://spj.science.org/doi/10.34133/remotesensing.0159

Funding information

This study was supported by High-Resolution Earth Observation System (09-Y30F01-9001-20/22).

About Journal of Remote Sensing

The Journal of Remote Sensingan online-only Open Access journal published in association with AIR-CAS, promotes the theory, science, and technology of remote sensing, as well as interdisciplinary research within earth and information science.

 

PolyU researchers invent intelligent soft robotic clothing for automatic thermal adaptation in extreme heat



The Hong Kong Polytechnic University
PolyU researchers invent intelligent soft robotic clothing for automatic thermal adaptation in extreme heat 

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PolyU researchers invent intelligent soft robotic clothing for automatic thermal adaptation in extreme heat

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Credit: © 2024 Research and Innovation Office, The Hong Kong Polytechnic University. All Rights Reserved.




As global warming intensifies, people increasingly suffer from extreme heat. For those working in a high-temperature environment indoors or outdoors, keeping thermally comfortable becomes particularly crucial. A team led by Dr Dahua SHOU, Limin Endowed Young Scholar in Advanced Textiles Technologies and Associate Professor of the School of Fashion and Textiles of The Hong Kong Polytechnic University (PolyU) has developed first-of-its-kind thermally-insulated and breathable soft robotic clothing that can automatically adapt to changing ambient temperatures, thereby helping to ensure worker safety in hot environments. Their research findings have been published in the international interdisciplinary journal Advanced Science.

Maintaining a constant body temperature is one of the most critical requirements for living and working. High-temperature environments elevate energy consumption, leading to increased heat stress, thus exacerbating chronic conditions such as cardiovascular disease, diabetes, mental health issues and asthma, while also increasing the risk of infectious disease transmission. According to the World Health Organisation, globally, there were approximately 489,000 heat-related deaths annually between 2000 and 2019, with 45% occurring in Asia and 36% in Europe.

Thermal protective clothing is essential to safeguard individuals in extreme high-temperature environments, such as firefighters who need to be present at fires scenes and construction workers who work outdoors for extended periods. However, traditional gear has been limited by statically fixed thermal resistance, which can lead to overheating and discomfort in moderate conditions, while its heat insulation may not offer sufficient protection in extreme fire events and other high-temperature environments. To address this issue, Dr Shou and his team have developed intelligent soft robotic clothing for automatic temperature adaptation and thermal insulation in hot environments, offering superior personal protection and thermal comfort across a range of temperatures.

Their research was inspired by biomimicry in nature, like the adaptive thermal regulation mechanism in pigeons, which is mainly based on structural changes. Pigeons use their feathers to trap a layer of air surrounding their skin to reduce heat loss to the environment. When the temperature drops, they fluff up their feathers to trap a significant amount of still air, thereby increasing thermal resistance and retaining warmth.

The protective clothing developed by the team uses soft robotic textile for dynamic adaptive thermal management. Soft actuators, designed like a human network-patterned exoskeleton and encapsulating a non-toxic, non-flammable, low-boiling-point fluid, were strategically embedded within the clothing. This thermo-stimulated system turns the fluid from a liquid into a gas when the ambient temperature rises, causing expansion of soft actuators and thickening the textile matrix, thereby enhancing the gap of still air and doubling the thermal resistance from 0.23 to 0.48 Km²/W. The protective clothing can also keep the inner surface temperatures at least 10°C cooler than conventional heat-resistant clothing, even when the outer surface reaches 120°C.

This unique soft robotic textile, made by thermoplastic polyurethane, is soft, resilient and durable. Notably, it is far more skin-friendly and conformable than temperature-responsive clothing embedded with shape-memory alloys and is adjustable for a wide range of protective clothing. The soft actuators have exhibited no signs of leakage after undergoing rigorous standard washing tests. The porous, spaced knitting structure of the material can also significantly reduce convective heat transfer while maintaining high moisture breathability. Not relying on thermoelectric chips or circulatory liquid cooling systems for cooling or heat conduction, the light-weighted, soft robotic clothing can effectively regulate temperature itself without any energy consumption.

Dr Shou said, “Wearing heavy firefighting gear can feel extremely stifling. When firefighters exit a fire scene and remove their gear, they are sometimes drained nearly a pound of sweat from their boots. This has motivated me to develop a novel suit capable of adapting to various environmental temperatures while maintaining excellent breathability. Our soft robotic clothing can seamlessly adapt to different seasons and climates, multiple working and living conditions, and transitions between indoor and outdoor environments to help users experience constant thermal comfort under intense heat.”

Looking forward, Dr Shou finds the innovation to have a wide range of potential applications, from activewear, winter jackets, healthcare apparel and outdoor gear, to sustainable textile-based insulation for construction and buildings, contributing to energy-saving efforts. Supported by the Innovation and Technology Commission and the Hong Kong Research Institute of Textiles and Apparel, Dr Shou and his team have also extended the thermo-adaptive concept to develop inflatable, breathable jackets and warm clothing. This soft robotic clothing is suitable for low-temperature environments or sudden temperature drops to aid those who are stranded in the wilderness to maintain normal body temperature.

Design concept of thermally adaptive soft robotic textiles. a) Under normal conditions, the SRT's slim profile and reduced thermal resistance facilitate the transfer of heat and moisture away from the skin. b) Upon exposure to a fire environment, the SRT activates to provide enhanced thermal protection maintaining lightness and breathability. Specifically, outside fire events, SRT layers deflate for low thermal resistance; when activated in a fire scenario, the layers separate, creating an insulating air gap that impedes heat transfer. c) Illustration of the SRT featuring a flame-resistant outer layer, a breathable moisture barrier, a knitted thermal liner, and an STA filled with a low boiling point fluid. d) Construction specifics of the knitted thermal liner with embedded STAs. e) Phase transition of a low boiling point fluid within the STA, characterized by significant volume change: in ambient temperatures, the fluid remains in a liquid state; as temperatures rise, the fluid vaporizes, and then reverts into a liquid upon cooling.

Thermoadaptation of STA embedded in a customized knitted fabric. a,b) Illustrations of the knitted thermal liner (240 mm × 340 mm) featuring a connecting clasp (width:15 mm) and a channel (width:60 mm) for STA. c) The STA within the knitted thermal liner depicted in a fully deflated state, exhibiting minimal thickness. d) The STA encapsulated in the knitted thermal liner shown in a fully inflated state, achieving maximal thickness. e) Comparison of thermal and moisture resistance between traditional liners and present SRTs. f) Cross-sectional views of the SRT in the fully deflated and fully inflated states. g) Images of the SRT in its initial, inactive state progressing to the fully activated state. h) Schematic representation of an SRT-based firefighter garment exposed to radiant heat. i) Side view of the garment in its initial state. j) Side view of the garment once thermally activated.

Credit

© 2024 Research and Innovation Office, The Hong Kong Polytechnic University. All Rights Reserved


 

New journal explores therapeutic relationship between food and medicine



Tsinghua University Press
Food & Medicine Homology journal cover 

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Tsinghua University Press has launched a new journal, named Food & Medicine Homology, that will publish its first issue in September. The journal will focus on the close association and interconnection between food and medicine, an idea that originated from the theory of ancient traditional Chinese medicine, and how this relationship can benefit human health.

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Credit: Food & Medicine Homology




A spoonful of honey may make the medicine go down smoother, but could the honey have its own therapeutic benefits, too? That therapeutic relationship between food and medicine is the focus of a new open-access journal called Food & Medicine Homology.

 

“The concept of food and medicine homology originated from the theory of ancient traditional Chinese medicine, which emphasizes the close association and interconnection between food and medicine,” wrote Bin Cong, one of the editors-in-chief, in a perspectives article set to publish in the journal’s first issue, scheduled for September.

 

Cong, who is the dean of the College of Medicine and Forensics at Hebei Medical University in China, explained that food may supplement medicine — and vice versa — to contribute to better health and longer lifespans. This builds on how traditional Chinese medicine promotes the idea of balance when it comes to diet and how various foods can both satisfy hunger and fulfill specific needs.  

 

“The establishment of this theory has been a prolonged process,” Cong wrote. “… accumulation of myriad data has demonstrated that some ‘foods’ can not only satisfy satiety, but also possess various biological functions such as health preservation, wellness promotion, disease preventions and even treatment.”

 

The idea, Cong explained, is not that food can serve as a treatment by itself. Rather, food and medicine can work together to provide a bevy of benefits — from nutritional to therapeutic. For example, leafy greens or whole grains may not cure a cold, but they can provide nutrients that help the human immune system function better. Some foods, such as bread or rice, can help protect the stomach lining from more abrasive medication while also encouraging digestion to metabolize the medicine.

 

The journal will be published by Tsinghua University Press, the publishing arm of Tsinghua University in China.

 

“Food & Medicine Homology aims to integrate traditional Chinese medicine and food science, fill the gap of forward-looking English science, technology and medicine journals on food and medicine, and achieve the inheritance, innovation and breakthrough of traditional Chinese medicine culture,” said Wenyi Kang, the journal’s executive editor-in-chief and a professor at Henan University, where he directs the university’s National Research and Development Center for Edible Fungus Processing Technology. “We chose Tsinghua University Press as the publisher because of the technological empowerment of its international publishing platform SciOpen, which can help us achieve the goal of becoming a world class journal on food and medicine.”

 

Kang, who also directs the Henan Province Food Engineering Technology Research Center and the Joint International Research Laboratory of Food and Medicine Resource Function of Henan Province, explained that SciOpen provides free access to an online collection of journals from across multiple disciplines. The platform completely digitizes the process of submitting manuscripts, facilitating peer review, editing, publishing and more to accelerate the scientific communications.

 

“This aligns with the reason we established the journal,” Cong said. “Food & Medicine Homology aims to promote and lead the development of disciplines with cutting-edge scientific research and to advocate for the profound and comprehensive concept of ‘medicine and food homology’ in China and the world.”

 

The articles in the first issue are listed as below:

[1]Perspectives in Food & Medicine Homology. https://doi.org/10.26599/FMH.2024.9420018

[2]Transformation from traditional medicine-food homology to modern food-medicine homology. https://doi.org/10.26599/FMH.2024.9420014

[3]The chemical composition of the walnut pellicle and its benefits to health Chen-Rui. https://doi.org/10.26599/FMH.2024.9420007

[4]Chemical compositions and health-promoting effects of Cichorium intybus L. (chicory): a narrative review. https://doi.org/10.26599/FMH.2024.9420012

[5]Anti-virulence potential of carvone against Serratia marcescens. https://doi.org/10.26599/FMH.2024.9420001

[6]A bibliometric analysis of lipid peroxidation in alcoholic liver disease from 2001 to 2024. https://doi.org/10.26599/FMH.2024.9420009

[7]Yinshan Zhengyao: exploring the power of food and inheriting healthy thoughts. https://doi.org/10.26599/FMH.2024.9420006

[8]Artemisia argyi polysaccharide alleviates intestinal inflammation and intestinal flora dysbiosis in lipopolysaccharide-treated mice. https://doi.org /10.26599/FMH.2024.9420008

[9]Screening and extraction process optimization for potential Î±-glucosidase inhibitors from quinoa seeds. https://doi.org/10.26599/FMH.2024.9420004

[10]A novel antidiabetic peptide GPAGAP from Andrias davidianus collagen hydrolysates: screening, action mechanism prediction and improving insulin resistance in HepG2 cells. https://doi.org/10.26599/FMH.2024.9420010

[11]Analysis and comparison of staminate flowers components in five Chinese walnut varieties. https://doi.org/10.26599/FMH.2024.9420005

 


About Food & Medicine Homology

Food & Medicine Homology is a peer-reviewed, cross-disciplinary, open access journal dedicated to cutting-edge research integrating findings in food science and medicine. The journal publishes papers dealing with plants, animals and microorganisms, reporting the food resources and base materials with nutritional and medicinal values and health-promoting effects that are discovered and confirmed using modern scientific theories and technologies, and providing insights into their health-promoting functions, underlying molecular mechanisms of action and regulatory modes.

Journal website: https://www.sciopen.com/journal/3006-6867

Submission site: https://mc03.manuscriptcentral.com/fmh

About SciOpen 

SciOpen is an open access resource of scientific and technical content published by Tsinghua University Press and its publishing partners. SciOpen provides end-to-end services across manuscript submission, peer review, content hosting, analytics, identity management, and expert advice to ensure each journal’s development. By digitalizing the publishing process, SciOpen widens the reach, deepens the impact, and accelerates the exchange of ideas.

 

Why do plants wiggle? New study provides answers


University of Colorado at Boulder





In a new study, physicists from the United States and Israel may have gotten to the bottom of a quirky behavior of growing plants—and a mystery that intrigued Charles Darwin himself during the later decades of his life.

For many humans, plants might seem stationary and even a little dull. But green things actually move a lot. If you watch a timelapse video of a sunflower seedling poking up from the soil, for example, it doesn’t just shoot straight up. Instead, as the sunflower grows, its crown spins in circles, twists into corkscrews and, in general, wiggles around—albeit very slowly.

Now, researchers co-led by Orit Peleg at CU Boulder and Yasmine Meroz at Tel Aviv University have discovered one role for these chaotic movements, also known as “circumnutations.” In greenhouse experiments and computer simulations, the group showed that sunflowers take advantage of circumnutations to search the environment around them for patches of sunlight. 

“A lot of people don't really consider the motion of plants because, as humans, we're usually looking at plants at the wrong frame rate,” said Peleg, a co-author of the study and an associate professor in the BioFrontiers Institute and Department of Computer Science.

The team published its findings Aug. 15 in the journal Physical Review X.

The findings could one day help farmers to come up with new strategies for growing an array of crops in more efficient arrangements.

“Our team does a lot of work on social interactions in insect swarms and other groups of animals,” said Chantal Nguyen, lead author and a postdoctoral researcher at BioFrontiers.

“But this research is particularly exciting because we’re seeing similar dynamics in plants. They’re rooted to the ground.”

Darwin’s cucumbers

Nguyen added that plants don’t usually shift around like animals but, instead, move by growing in different directions over time. This phenomenon enchanted Darwin long after he returned from his voyage on the HMS Beagle, according to historical accounts.

In the 1860s, Darwin, who was then suffering from a range of ailments that limited his own mobility, spent days observing plants at his home. He planted seeds from cucumbers and other species, then traced how their crowns moved around from day to day—the resulting maps look wild and haphazard.

“I am getting very much amused by my tendrils—it is just the sort of niggling work which suits me,” he wrote a friend in 1863.

Amused or not, Darwin couldn’t explain why some of his tendrils twisted.

It’s a mystery that has also perplexed Meroz, a physicist by training. One 2017 study pointed her in the right direction. In it, scientists led by the University of Buenos Aires grew lines of sunflowers under cramped conditions. They discovered that the plants naturally and consistently arranged themselves into a zig-zag pattern, almost like the teeth of a zipper. The arrangement likely helps the plants maximize their access to sunlight as a group.

Meroz wondered if plant wiggles could be the engine that drives such patterns in plant growth.

“For climbing plants, it’s obvious that it’s about searching for supports to twine on," said Meroz, a professor of plant sciences and food security. "But for other plants, it’s not clear why it’s worth it.”

Here comes the sun

To find out, she and her colleagues grew five, one-week-old sunflowers in rows. Then, like Darwin before them, they mapped out how the plants moved over the course of a week. 

Next, Nguyen and Peleg developed a computer program to analyze the patterns behind the sunflower growth. The researchers could also use their computer simulations to see what would happen if the sunflowers moved more or less—in other words, if they wiggled haphazardly or in a slow and steady pattern. 

If the digital plants didn’t wiggle at all, the group discovered, they would all wind up all leaning away from each other in a straight line. If they wiggled too much, in contrast, they would grow in a random pattern. If they moved with just the right amount of randomness, however, the sunflowers formed that tell-tale zig-zag, which, in real life plants, provides a lot of access to sunlight. Nguyen explained that plants seem to circumnutate to find where the best light is coming from, then grow in that direction.

“When you add a little bit of noise into the system, it allows the plant to explore its surroundings and settle into those configurations that allow each plant to find maximum light exposure,” she said. “That happens to lead to this nice zig-zag pattern that we see.”

In future experiments, the researchers will test out how sunflowers grow in more complicated arrangements. Meroz, for her part, is glad to see plants get some credit for the movers and shakers they really are.

“If we all lived at the same time scales as plants, you could walk down the street and see them moving,” she said. “Maybe we’d all have plants as pets.”

 

A new advanced framework to assess the impact of invasive plants on ecosystems

Peer-Reviewed Publication

Pensoft Publishers

Mechanisms determine plant invasion impact. 

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Mechanisms determine plant invasion impact. Examples of important factors for each category are given in the boxes.

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Credit: Werner et al.

Researchers from the University of Freiburg and Justus Liebig University Giessen have developed a framework to better assess the impact of invasive plant species on ecosystems.

Outlined in a study published in the open-access journal NeoBiota, the framework combines new technologies and techniques to learn and predict how invasive plants alter ecosystems over time and in different environments.

Invasive plant species threaten biodiversity and ecosystem health worldwide. However, predicting the exact impact of these invasions is challenging due to the complexity of interactions between invading species, native communities, and impacted ecosystems.

The new framework addresses this challenge by integrating several advancements:

Environmental mapping: Progress in remote sensing and ecological monitoring allow researchers to capture detailed information about the environmental conditions of invaded areas. Drones, satellites, and advanced sensory networks can be used to create detailed ecosystem maps, which show how invasive species interact with their environment.

Functional tracers: These are specific indicators that reflect changes in ecosystem functions caused by invasive species. For example, nitrogen isotopes can be used to track the impact of nitrogen-fixing invasive plants on ecosystems.

Spatio-temporal modelling: By combining environmental data with new modelling techniques, such as AI, researchers can create detailed models showing the spread and impact of invasive species on ecosystems over time. Such models can predict how changes in environmental conditions, such as climate change, might influence an invasive species’ success.

Beyond scientific analysis, novel technologies also facilitate communication of ecological impacts, as the authors demonstrate in an animated 3D-video visualisation.

"The framework we've introduced offers researchers deeper insights into how invasive plant species interact with their environments, enabling more targeted management to lessen their ecological impact. We advocate for stronger collaboration between ecologists and technical experts to refine and expand these methods,” the authors emphasise.

“Going forward, further research and integration of the wide range of recent methods and tools are needed to enhance the framework's effectiveness,” they conclude.

Original source

Werner C, Hellmann C, Große-Stoltenberg A (2024) An integrative framework to assess the spatio-temporal impact of plant invasion on ecosystem functioning. NeoBiota 94: 225-242. https://doi.org/10.3897/neobiota.94.126714 \

Researcher profiles

Prof. Dr. Christiane Werner: https://www.cep.uni-freiburg.de/mitarbeiter/christiane-werner/cwerner_main

Dr. André Große-Stoltenberg: https://www.uni-giessen.de/en/faculties/f09/institutes/landscape/ecology/team/grosse_stoltenberg_andre?set_language=en


Animated Model visualisation o [VIDEO] |

Modelled isoscapes centred around a N2-fixing invasive plant species using the functional tracer δ15N and information on the environmental matrix in a nutrient poor ecosystem based on Hellmann et al. (2017). Reddish colours indicate high-levels of atmospheric fixed nitrogen inputs (e.g., dense invader patches and flushes of N into native vegetation); yellow colours indicate lower levels of impact, while whitish colours indicate no impact and are representative for the original status before invasion. The local functional changes do not occur uniformly. Isoscapes are plotted onto high-resolution airborne LiDAR data fused with true colour imagery to illustrate the effect of LiDAR-derived vegetation structure of the recipient community and topography on invader impact in this heterogeneous ecosystem. The 3D map was created using QGIS version 3.30.



Model visualisation of spatio-temporal dynamics of invader impacts based on the suggested framework.

Framework for integrating fine-scale environmental heterogeneity and functional changes into spatial models of invader-ecosystem interactions.

Credit

Werner et al.

 

Over half of iron deficiency cases in large health system still unresolved at three years



Study underscores the need for improvements in the proper recognition and timely treatment of more of iron deficiency, especially among female and Black patients


American Society of Hematology





(WASHINGTON, August 15, 2024) – Over half of people with iron deficiency were found to still have low iron levels three years after diagnosis, and among patients whose condition was effectively treated within that timeframe, they faced longer-than-expected delays, pointing to substantial gaps in appropriate recognition and efficient treatment of the condition, according to a study published today in Blood Advances.

Iron deficiency, or when the body’s iron stores are too low, is common, and may affect up to 40% of adolescents and young women. Iron is important in maintaining many body functions, including the production of hemoglobin, the molecule in the blood that carries oxygen, and is essential to maintaining healthy cells, skin, hair, and nails. If untreated, low iron stores can lead to mood changes, fatigue, hair loss, exercise intolerance, and eventually anemia. The condition is generally first treated with oral iron supplementation, and if low iron levels persist after a few months or the patient reports side effects, intravenous (IV) iron is started. According to a previous report, up to 70% of cases go undiagnosed in high-risk populations, such as those with bleeding disorders, issues with malabsorption, or women who menstruate.

“Iron deficiency is probably a bigger problem than we realize. I’ve seen a lot of cases where people don’t have anemia, but they are walking around with very little to no iron in their body and it can have a big impact on how people feel in their day-to-day life,” said Jacob Cogan, MD, assistant professor of medicine at the University of Minnesota and the study’s lead author. “Iron deficiency can be challenging to diagnose, but it’s easy to treat. Our findings underscore the need for a more coordinated effort to recognize and treat iron deficiency to help improve quality of life.”

For this study – the first to look at whether iron deficiency is being recognized and treated efficiently in clinical practice – Dr. Cogan and his team retrospectively analyzed electronic medical record (EMR) data from one of Minnesota’s largest health systems and identified 13,084 adults with a laboratory diagnosis of iron deficiency (with and without anemia) between 2010 and 2020 who had available follow-up data for three years.

In the study, iron deficiency was defined as a ferritin value of 25 ng/mL or less. Patients had to have at least two ferritin values – one initial value and at least one more within the three-year study period. Adequate treatment and resolution was defined as a subsequent ferritin value of at least 50 ng/mL. Most patients received some form of treatment, consistent across sex.

Of the 13,084 patients included in the study, 5,485 (42%) patients had normal iron levels within three years of diagnosis, while 7,599 (58%) had persisting iron deficiency based on low ferritin levels. Only 7% of patients had their iron levels return back to normal within the first year of diagnosis.

Factors associated with a higher likelihood of getting iron levels back to normal included older age (age 60 and up), male sex, Medicare insurance, and treatment with IV iron alone. Additionally, compared with patients who were still iron deficient, those whose condition was resolved had more follow-up blood work to check ferritin values (six vs four ferritin tests). Of note, younger patients, females, and Black individuals were most likely to remain iron deficient or experience longer lags in getting their iron stores back to a healthy level.

Even among patients whose iron levels were restored to normal during the study duration, it took nearly two years (the median time to resolution was 1.9 years), which researchers say is longer than expected and signals missed opportunities to more effectively manage the condition. While there was no data to look at whether anemia iron deficiency was more apt to be treated, Dr. Cogan says it’s reasonable to think this might be the case as iron deficiency without anemia is harder to recognize.

“Two years is too long and well beyond the timeframe within which iron deficiency should be able to be sufficiently treated and resolved [with oral or IV treatments],” said Dr. Cogan. “The numbers are pretty striking and suggest a need to put systems in place to better identify patients and treat them more efficiently.”

As with trends showing persisting iron deficiency, Dr. Cogan attributes the delays in resolution to the diagnosis either being missed or not treated to resolution. He added that there is a clear need for education about non-anemic iron deficiency and who is at high risk, more universal agreement on the best ferritin cut off for diagnosis, and efforts to create an iron deficiency clinic or pathway to “assess and treat patients more efficiently and get people feeling better faster.”

The study was limited by its reliance on EMR data and retrospective nature, which prevented researchers from determining why ferritin tests were ordered for patients or the cause of their iron deficiency.

# # #

Blood Advances (bloodadvances.org) is an online, open-access journal publishing more peer-reviewed hematology research than any other academic journal worldwide. Blood Advances is part of the Blood Journals portfolio (bloodjournals.org) from the American Society of Hematology (ASH) (hematology.org). 

Claire Whetzel, 202-629-5085
cwhetzel@hematology.org

 

Disclaimer: AAAS and Eurek