Detection and Characterization of Clonal Hematopoiesis.

Clonal hematopoiesis (CH) is the age-related expansion of hematopoietic stem cell clones resulting from the acquisition of somatic point mutations or mosaic chromosomal alterations (mCAs). It is linked to adverse systemic effects, including hematologic malignancies, cardiovascular diseases, metabolic disorders, as well as liver and kidney ailments, ultimately contributing to elevated overall mortality.Given its diverse biological and clinical implications, the identification of clonal hematopoiesis holds significance in various contexts. While traditionally centered on mutations associated with myeloid malignancies, stem/progenitor cell involvement has been documented for various lymphoid malignancies, including T-cell lymphoma, chronic lymphocytic leukemia (CLL), and follicular lymphoma (FL). Lymphoid CH (L-CH) involves a broader spectrum of genes and occurs at a lower prevalence, resulting in reduced mutation prevalences per gene. This characteristic poses challenges for efficient CH detection.The major strategies to identify CH are whole exome sequencing (WES), whole genome sequencing (WGS), or targeted sequencing. Targeted sequencing allows for much higher sequencing depth compared to WES and WGS because of the focus on genes known to be associated with CH and therefore allows detecting potential variants at low frequencies with high precision. Here, we describe an error-corrected targeted sequencing approach for detection of CH in bone marrow (BM) or peripheral blood (PB) samples, which we have successfully established and used in various cohorts. This protocol includes the process of DNA isolation from PB and BM samples, library preparation with molecular tags including quality control steps and computational analysis including variant filtering.

Biofoundry-Assisted Golden Gate Cloning with AssemblyTron.

Golden Gate assembly is a requisite method in synthetic biology that facilitates critical conventions such as genetic part abstraction and rapid prototyping. However, compared to robotic implementation, manual Golden Gate implementation is cumbersome, error-prone, and inconsistent for complex assembly designs. AssemblyTron is an open-source python package that provides an affordable automation solution using open-source OpenTrons OT-2 lab robots. Automating Golden Gate assembly with AssemblyTron can reduce failure-rate, resource consumption, and training requirements for building complex DNA constructs, as well as indexed and combinatorial libraries. Here, we dissect a panel of upgrades to AssemblyTron's Golden Gate assembly capabilities, which include Golden Gate assembly into modular cloning part vectors, error-prone polymerase chain reaction (PCR) combinatorial mutant library assembly, and modular cloning indexed plasmid library assembly. These upgrades enable a broad pool of users with varying levels of experience to readily implement advanced Golden Gate applications using low-cost, open-source lab robotics.

Surface enhanced transmission Raman spectroscopy: Quantitative performances for impurity analysis in complex matrices.

A transmission detection mode was investigated with SERS analyses (SETRS). A comparison between backscattering and transmission detection modes was conducted to demonstrate the feasibility of performing SETRS analyses. The impact of various parameters on the SERS signal intensity such as sample volume, lens collection optic, laser beam size and laser power were then examined. The analytical performances of SETRS were further evaluated through the quantification of an impurity (4-aminophenol) ranging from 3 to 20 µg/mL in a commercial pharmaceutical product using a total error risk-based approach. To account for expected variability of routine analysis, 9 batches of silver nanoparticles suspensions were used and experiments were performed over 5 different days and by 2 operators. Univariate spectral analysis based on a quadratic regression was compared to a multivariate approach using a partial least square regression. The presented results demonstrated that SETRS can be used to determine an impurity in a complex matrix opening new perspectives for quantitative applications.

A tied-weight autoencoder for the linear dimensionality reduction of sample data.

Dimensionality reduction is a method used in machine learning and data science to reduce the dimensions in a dataset. While linear methods are generally less effective at dimensionality reduction than nonlinear methods, they can provide a linear relationship between the original data and the dimensionality-reduced representation, leading to better interpretability. In this research, we present a tied-weight autoencoder as a dimensionality reduction model with the merit of both linear and nonlinear methods. Although the tied-weight autoencoder is a nonlinear dimensionality reduction model, we approximate it to function as a linear model. This is achieved by removing the hidden layer units that are largely inactivated by the input data, while preserving the model's effectiveness. We evaluate the proposed model by comparing its performance with other linear and nonlinear models using benchmark datasets. Our results show that the proposed model performs comparably to the nonlinear model of a similar autoencoder structure to the proposed model. More importantly, we show that the proposed model outperforms the linear models in various metrics, including the mean square error, data reconstruction, and the classification of low-dimensional projections of the input data. Thus, our study provides general recommendations for best practices in dimensionality reduction.

Analysis of high-frequency errors and linguistic patterns in EFL medical students' English writing: Insights from a learner corpus.

BACKGROUND: The perceived language barrier in English is said to hinder, and in certain instances, impede the global dissemination of knowledge, including medical information, to non-native English speakers within medical institutions. As English for medical purposes instructors, we contend that the issue persists in medical universities across various EFL contexts. Medical students face the challenge of presenting their research findings in English for international journals and conferences. Given this, the present research study aimed to compile a comprehensive catalog of high-frequency errors and examine them in recurring linguistic patterns commonly found in the writing of Iranian medical students. METHODS: In conducting the present study, we developed a learner corpus of 1,040 essays (339,040 words and 18,235 sentences in total). Through using the results obtained from Wordsmith Tools 8 and sifting the leaner corpus, we identified 11 high-frequency errors and five commonly used linguistic patterns. RESULTS: Only five out of 11 high-frequency errors account for 61% of the total number of errors. Results also showed that a majority of errors were of grammatical nature. In this regard, cohesion and cohesive devices (16%) were the most prevalent errors followed by omission/misusing of articles/determiners (14%). Additionally, results showed that discourse markers were extensively used in the corpus (22.07%), followed by hedges (11.42%). CONCLUSIONS: The outcomes of this study are expected to assist English for medical purposes instructors in designing focused lesson plans and classroom activities. Ultimately, these efforts might contribute to enhancing medical education in non-English speaking universities.

The Correlation Between Cervical Proprioception and Scapular Dyskinesis in Patients With Neck Pain: A Case-Control Study.

Introduction Neck pain is common among office workers, and the assessment of cervical proprioception and scapular dyskinesis is key in the management of patients with neck pain. While some studies have shown the relevance of both factors in neck pain patients, the correlation between the two parameters has not yet been investigated. Hence, this study aimed to determine the correlation between cervical proprioception and scapular dyskinesis in workplace computer users without neck pain (control group) versus those with neck pain (case group). Methodology A case-control, correlational study was performed within office settings; based on the selection criteria, 88 participants were included and categorized into two groups consisting of 44 workplace computer users without neck pain in the control group (Group A) and 44 workplace computer users with neck pain in the case group (Group B). Cervical proprioception was evaluated by using the joint position error (JPE) test and scapular dyskinesis was assessed using the modified lateral scapular slide test (MLSST). Results There was a statistically significant difference in cervical proprioception and scapular dyskinesis between the case and control groups (p<0.001). Workplace computer users with neck pain showed greater JPE compared to those without neck pain, and scapular dyskinesis was observed in the case group. Moreover, Spearman's correlation coefficient showed a significant correlation between cervical proprioception and scapular dyskinesis in workplace computer users with neck pain. Conclusions The present study provides guidance on the assessment as well as management of JPE with different positions of scapular dyskinesia. The evaluation of scapular dyskinesis is frequent clinically; given its positive correlation, managing JPE in neck pain patients is feasible.

Methods of Calculating Prediction Error Variance and Prediction Accuracy for Restricted Best Linear Unbiased Prediction of Breeding Values.

Prediction error variance (PEV) and prediction accuracy (PA) of breeding values (BVs) are essential for formulating breeding plans and predicting response to selection. However, restricted best linear unbiased prediction method (RBLUP method) carries many unknowns: in particular, the formulas for calculating PEV and PA are not clear. New findings were obtained using the RBLUP method. The uniqueness of RBLUP of BVs was proven. The formulas of PEV and PA for the RBLUP of BVs were derived from restricted mixed model equations. A method was also devised for easily calculating the PEV and PA for the RBLUP of BVs. Finally, the relationship between the RBLUP and ordinary BLUP of BVs was derived. It has become easier to calculate the PEV and PA for the RBLUP of BVs. This method is particularly effective for calculating the PEV and PA when applying the RBLUP method to achieve relative desired changes in all traits. This has also made it possible to predict the response to selection using the RBLUP method.

Common error traps in anesthesia for neonatal surgical emergencies.

Neonatal surgical emergencies are challenging, often high-risk procedures for the pediatric anesthesiologist. Though each emergency presents different anesthetic challenges, several error traps exist that are common to all procedures in this patient population. These error traps include errors in surgical timing, airway management, maintenance of normothermia and normoglycemia, and recognition of pharmacologic and physiologic differences. In this narrative review, we will discuss each error trap to aid the clinician in recognizing, planning for, and mitigating adverse events.

A Human Factors and Systems-Thinking approach to Veterinary Patient Safety Education: Why, What, and How?

Preparing graduates to practice safely in today's increasingly complex veterinary workplaces is a key aim for veterinary educators. This requires embedding veterinary patient safety concepts into already full curricula. This teaching tip explores the benefits of incorporating human factors and systems-thinking principles into the design and delivery of veterinary patient safety education, showing how these can inform both what is taught and how. We explore what taking a human factors approach to veterinary patient safety education means, inviting educators to rethink not just curricular content but the whole approach to delivery. Advocating for the adoption of a systems-thinking-informed approach to curriculum design, we present a two-stage curriculum mapping process to support educators to embed core human factors principles as a way of thinking and doing for learners and faculty alike. Learning theories and educational design that align with human factors principles promote participatory methods and encourage collaborative experiential learning, critical thinking, and authentic application of knowledge and skills. Educators should explore opportunities presented by interprofessional education and workplace-based learning for practical application of these principles. Barriers to an integrated human factors-based patient safety curriculum include inconsistent terminology and understanding, significant faculty development requirements, and assessment challenges associated with existing regulatory and licensing requirements. Practical approaches to addressing these barriers are discussed. The recommendations outlined for the design and delivery of veterinary patient safety curricula will help ensure that institutions develop graduates that are effectively prepared for the complexity they will meet in the veterinary workplace, leading to improved patient safety and overall workplace well-being.

The Veterinary Student Survey on Patient Safety Culture (VSSPSC): A Quantitative and Qualitative Exploration of American Veterinary Students' Perceptions of Patient Safety Culture.

Patient safety culture (PSC) is a multidimensional construct that reflects the way healthcare organizations promote safe patient care. Veterinary students are explicitly and implicitly indoctrinated into organizational cultures and will carry these attitudes and behaviors into their future work. In this study, we evaluated the psychometric properties of a PSC survey among veterinary students in the United States and investigated their attitudes toward PSC. Exploratory factor analysis identified factors that explained portions of the variance in responses. Importantly, the measures derived from those factors predicted the likelihood of a student mentioning a negative experience/opinion regarding error reporting. Most students reported receiving explicit training in communication, but coursework in other areas, such as human factors and safety culture, was uncommon. Veterinary students generally reported high levels of agreement with the tenets of patient safety science, though some items demonstrated wide variation in responses, underscoring the need for more uniform incorporation of education in veterinary PSC.

Sensitivity analysis of an inertial calibration method: Influence of leg position on 3D knee kinematics.

BACKGROUND: Inertial systems are increasingly used to analyze human motion, especially for gait analyses and in clinical settings. Calibration methods for these systems are designed for ease of implementation, and previous studies have shown that they can provide accurate knee kinematics in the sagittal plane. However, the reason of their lack of accuracy in the other planes (i.e., transverse and frontal) remain unknown. RESEARCH QUESTION: This study aimed to evaluate the sensitivity of one posture of a double-pose calibration method to analyse 3D knee kinematics during gait with two magnetic inertial measurement units (MIMU). This method consists of a standing posture and a posture with the leg stretched forward in the sagittal plane, which together define the sagittal plane. Our hypothesis was that a change in the definition of the sagittal plane during the calibration process was likely to affect the assessment of knee kinematics in the frontal and transverse planes. METHODS: Ten healthy participants wearing the KneeKG system and two MIMU completed the calibration process in five different leg positions (0°, 3°, 5°, 10° or 15° from the sagittal plane) for the second calibration posture. After static calibration, the participants walked on an instrumented treadmill at a speed of 1.1 m/s and 3D knee kinematics were calculated using the five different calibration conditions. RESULTS: Mean absolute difference (MAD) between the swing-phase peak value of the curve corresponding to the leg in the sagittal plane (0° shift from this plane) when performing the second calibration posture and each of the other curves was 0.20-0.46° for knee flexion, 1.67-2.90° for adduction, and 0.72-1.46° for external rotation. MAD of the swing-phase peak value in the frontal plane was correlated (R2=0.81) with the angulation of the femur in the sagittal plane during calibration. SIGNIFICANCE: An angular shift from the sagittal plane when performing a double-pose calibration method induces a minimal influence on the knee flexion/extension but larger influences on secondary knee motions.

An oriented self-assembly biosensor with built-in error-checking for precise midkine detection in cancer diagnosis and prognosis evaluation.

Midkine (MDK) is a neurotrophic growth factor highly expressed during embryogenesis, currently recognized as a multifaceted factor in cancer progression and drug resistance. MDK has demonstrated greater accuracy than existing biomarkers. Serum MDK is a valuable indicator for the non-invasive early detection of tumors. It dynamically changes following surgical tumor excision and prior to recurrence, facilitating prognosis and treatment response evaluation. However, existing methods struggle to achieve the sensitivity required for clinical applications. Herein, we developed a triple-mode biosensor with oriented self-construction and built-in error-checking for rapid, sensitive, and convenient MDK detection. The sensor construction adhered to the principle of achieving oriented and strong covalent connections to ensure high sensitivity. Biosynthesized quantum dots (BQDs) were introduced to orient antibodies, enhancing the exploration of active binding sites and significantly increasing antibody-capturing ability. To further enhance sensitivity and signal amplification, Au@Pt nanorods-Ab2 (MF-Probe) were used as multifunctional probes, incorporating an error-checking mechanism to minimize false results. Detection was feasible using an electrochemical workstation, a microplate reader, and even a mobile phone. The sensor exhibited a wide linear range from 5 fg/mL to 100 ng/mL and a low limit of detection (LOD) of 1.620 fg/mL. It accurately distinguished MDK levels in the serum of healthy donors and cancer patients. Compared to existing ELISA kits, it exhibited a lower LOD and a more sensitive response to trace MDK, suggesting it is a promising tool for cancer diagnosis and prognostic evaluation.

A non-parametric framework for evaluating total analytical error in in vitro diagnostic medical devices in transfusion medicine.

The performance assessment of quantitative measurements is predominantly based on evaluating Total Analytical Error (TAE). This evaluation encompasses several key objectives critical to ensuring accurate, reliable, and clinically relevant test results. Traditional parametric methods often fall short due to data normality assumptions in the performance assessment of in vitro diagnostic medical devices (IVD-MDs). This study presents a non-parametric approach to estimating and evaluating the TAE in transfusion medicine, aiming to enhance the reliability and patient safety of IVD-MDs. A protocol to estimate TAE over diverse data distributions is suggested, employing a robust statistical definition and comparative measurement procedures. Results from 200 samples indicate that non-parametric methods provided a more accurate reflection of TAE. The findings assert that non-parametric TAE estimation is vital for ensuring the 'fitness for purpose' of clinical tests in transfusion medicine, directly impacting post-transfusion outcomes and patient care. The study concludes that adopting non-parametric methods in transfusion services can significantly improve test accuracy, aligning with the highest laboratory practice standards.

Comparison of the effects of medication error encouragement training and problem-based scenario on the medication safety competence and knowledge of nursing students: A quasi-experimental study.

BACKGROUND: Medication errors among nursing students pose a threat to medication safety. Medication Error Encouragement Training and Problem Based Scenario are two innovative educational methods used in medication education. AIM: Compare the effects of Medication Error Encouragement Training and Problem Based Scenario on the knowledge and competency of medication safety among nursing students. DESIGN: Quasi -experimental, double-blind, two-group pretest-posttest study. METHOD: This study was conducted in 2023. Participants were randomly assigned to two groups: one group received the Medication Error Encouragement Training method, while the other group was taught using the Problem-Based Scenario method. Data collection was performed using the Medication Safety Critical Element Checklist and Medication Safety Knowledge Assessment before and four weeks after the intervention. Data analysis was conducted using SPSS version 16. RESULTS: The Pair t-test demonstrated that the change in competency and knowledge scores of medication safety before and after the intervention was significant in both groups (P< 0.05). The results of the Mancova test indicated a significant increase in medication safety competency scores in the Medication Error Encouragement Training group compared with the Problem Based Scenario group after the intervention (P< 0.05), while there was no significant difference in medication safety knowledge scores between the two groups after the intervention (P> 0.05). CONCLUSION: The Medication Error Encouragement and Problem Based Scenario methods were effective in increasing the knowledge and competency of medication safety among students, but the effectiveness of the Medication Error Encouragement method was more pronounced in achieving safe medication administration.

Variability of relative treatment effect among populations with low, moderate and high control group event rates: a meta-epidemiological study.

BACKGROUND: The current practice in guideline development is to use the control group event rate (CR) as a surrogate of baseline risk and to assume portability of the relative treatment effect across populations with low, moderate and high baseline risk. We sought to emulate this practice in a very large sample of meta-analyses. METHODS: We retrieved data from all meta-analyses published in the Cochrane Database of Systematic Reviews (2003-2020) that evaluated a binary outcome, reported 2 × 2 data for each individual study and included at least 4 studies. We excluded studies with no events. We conducted meta-analyses with odds ratios and relative risks and performed subgroup analyses based on tertiles of CR. In sensitivity analyses, we evaluated the use of total event rate (TR) instead of CR and using quartiles instead of tertiles. RESULTS: The analysis included 2,531 systematic reviews (27,692 meta-analyses, 226,975 studies, 25,669,783 patients).The percentages of meta-analyses with statistically significant interaction (P < 0.05) based on CR tertile or quartile ranged 12-18% across various sensitivity analyses. This percentage increased as the number of studies or range of CR per meta-analysis increased, reflecting increased power of the subgroup test. The percentages of meta-analyses with statistically significant interaction (P < 0.05) with TR quantiles were lower than those with CR but remained higher than expected by chance. CONCLUSION: This analysis suggests that when CR or TR are used as surrogates for baseline risk, relative treatment effects may not be portable across populations with varying baseline risks in many meta-analyses. Categroization of the continuous CR variable and not addressing measurement error limit inferences from such analyses and imply that CR is an undesirable source for baseline risk. Guideline developers and decision-makers should be provided with relative and absolute treatment effects that are conditioned on the baseline risk or derived from studies with similar baseline risk to their target populations.

Inadvertent Intrauterine Instillation of Trichloroacetic Acid During Sonohysterography.

Trichloroacetic acid (TCAA) solution is used to treat vulvar condyloma and cervical intraepithelial neoplasia. Saline infusion sonohysterography (SIS) detects intrauterine pathology and fallopian tube patency in infertile patients. A 33-year-old Caucasian nulliparous fertility patient presented to the emergency department with extensive burns following accidental intrauterine instillation of TCAA during SIS with tubal perfusion. On presentation, the patient was hemodynamically stable. There was extensive erythema and tenderness in a spill/burn pattern on both thighs as well as the groin, perineum, and labia. Speculum exam revealed white, leathery mucosa with the absence of normal vaginal rugae. The abdominal exam was notable for generalized tenderness without guarding or rebound. Complete blood count (CBC), serum electrolytes, and CT scan were unremarkable. The patient was admitted for observation and pain management. She received serial abdominal exams, topical aquaphor, vaginal estrogen, and serial labs and pelvic imaging. The patient remained stable and was discharged on hospital day two. At three months, the patient reported improvement in pain and gradual skin healing. She resumed fertility treatment at a different fertility center, and a frozen embryo transfer resulted in a live birth. This case demonstrates severe vaginal and perineal injury after intrauterine instillation of TCAA. At three months, vaginal and external genitalia required ongoing burn care. Notably, endometrial recovery is evidenced by the delivery of a live birth after embryo transfer. The case underscores a preventable medical accident and highlights the regenerative ability of endometrial stem cells to respond to hormonal cues and restore endometrial receptivity after chemical trauma.

Accuracy Standards of Wearable Technologies for Assessment of Soccer Kicking: Protocol for a Systematic Literature Review.

BACKGROUND: Wearable technology is widely applied in performance monitoring, an integral part of sports and exercise sciences. The kick movement in soccer exemplifies a sports technique that could benefit from appropriate biomechanics assessment methodologies. However, the accuracy of wearables in quantifying soccer kick mechanics, particularly under field conditions, remains unclear. OBJECTIVE: This study aims to present a protocol for a systematic review to discuss the measurement properties (validity, reliability, and/or accuracy aspects) of wearable technology systems explicitly used to measure ball-kicking features in soccer. METHODS: This review protocol was preregistered in the Open Science Framework. A total of 2 authors will perform searches in major electronic databases using specific keyword combinations in PubMed, Physical Therapy and Sports Medicine, Web of Science, ProQuest, IEEE Xplore, EBSCOHost, and Scopus. Following a specific population, intervention, comparison, outcome framework (population: soccer players and/or collected human data in a football-related environment; intervention: at least 1 wearable used; comparator: criterion measures, repeated testing sessions and/or actual values; outcome: ball kicking data), studies will be screened based on predetermined inclusion and exclusion criteria. The methodological quality of the included studies will be assessed using the "consensus-based standards for the selection of health measurement instruments" checklist (in studies concerning validity or reliability) or the "quality assessment of diagnostic accuracy studies" tool (in studies concerning accuracy). Data extraction will be conducted to determine the level of evidence according to the "best evidence synthesis method," and an evidence gap map will be constructed. The Cohen κ coefficient will be used to estimate the interevaluator agreement. RESULTS: This ongoing systematic review has completed database searches and is currently in the screening phase. Depending on the number and consistency of studies, results may be presented by meta-analysis or qualitative synthesis, with subgroup analyses considering factors such as gender, age, and playing level. The final results are expected by July 2024, with manuscript submission anticipated by November 2024. CONCLUSIONS: Our study will provide a comprehensive summary of the highest level of evidence available on the use of wearables for the assessment of soccer kick mechanics, providing practical guidance for athletes and sports sciences professionals regarding the validity and reliability aspects of using wearable technology to measure ball-kicking features in soccer. TRIAL REGISTRATION: OSF registries https://osf.io/zm3j6. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/57433.

[Root Cause Analysis for Incident Reporting Cases of Radiological Technologists Based on Years of Experience].

PURPOSE: Root Cause Analysis (RCA) of reported incident reports can lead to measures to prevent the recurrence of accidents. The purpose of this study is to clarify the relationship between the occurrence of cases, causal factors, contributing factors, and the experience years of the reporters classified into three groups: less than 2 years, 3 to less than 5 years, and more than 5 years, for incident reports subject to RCA. METHODS: From April 2018 to March 2023, a chi-square test was conducted between each item extracted from 239 cases subject to RCA and the experience years of the reporters, with a significance level of less than 5% considered significant. RESULTS: Regarding the occurrence cases, radiological technologists with longer experience had more misidentified a patient and fewer errors in imaging conditions and range, while radiological technologists with 3 to less than 5 years of experience had more errors in imaging conditions (p<0.001). In terms of occurrence factors, radiological technologists with 3 to less than 5 years of experience had more cases of insufficient confirmation (p<0.05). For contributing factors, there was no significant difference between the experience year groups (p=0.19), with "Impatience" being the most common factor. CONCLUSION: This survey suggested that in incident reports of radiological technologists, "Impatience" is a contributing factor that can occur regardless of years of experience.

Lived experience and lessons learned from the support of two secondary eye care units to improve cataract surgery and refractive services in two regions of Ethiopia: health system-strengthening support.

BACKGROUND: Blindness and poor eyesight are significant public health issues globally and specifically in Ethiopia. In Ethiopia, there is limited access to cataract surgery and refractive error treatment centers. Therefore, this study aimed to evaluate the role of health system support in improving access to eye care services, particularly cataract surgery and refractive error treatment services in two secondary eye care units (SECUs). METHODS: A parallel mixed-lived experience study was conducted in two SECUs. A desk review of relevant project documents and health facility activity reports was performed for quantitative data. The study was conducted from 12 December 2022 to 30 January 2023. A total of 21 in-depth interview participants were included. RESULTS: Overall, 14 106 cataract surgeries were performed during the pilot project implementation period. Assela Teaching and Referral Hospital Eye Care Unit performed cataract surgery 20-30 times per week. Similarly, Debre Tabor Comprehensive Hospital performed cataract surgery 18-24 times per week. The refractive service of the two SECUs was planned to range from 15-30 to 60 per week, and the refractive services were increased from 50-60 per week in both eye care units. CONCLUSIONS: This project has significantly helped the existing health system achieve the 2030 global target and has improved access to eye care services in selected SECUs. The use of cataract surgery and refractive error performance markedly increased from 0 to 100%.

Variance estimation using memory type estimators based on EWMA statistic for time scaled surveys in stratified sampling.

In this article, we have proposed memory-type exponential and non-exponential estimators for population variance based on exponentially weighted moving average (EWMA) statistic in stratified sampling. We drive mathematical expressions for mean square errors of the proposed estimators using Taylor and exponential expansions. Our analysis demonstrates that the proposed memory-type estimators outperform the conventional estimators under stratification, particularly, when the information of previous sample is utilized. The performances of the proposed estimators are evaluated mathematically by deriving the conditions in which the memory-type estimators would perform better than their corresponding conventional estimators under stratification. Through an extensive simulation, we evaluated the performance of the proposed estimators across various population parameters, revealing their enhanced efficiency in time-scaled survey. Additionally, a real data application is also used to support the mathematical findings, confirming the practical utility of the proposed estimators. The results of numerical study underscore the importance of the use of previous sampled information which significantly improves the accuracy and reliability of the proposed estimator for variance estimation for time-scaled surveys.