Engineering topics

Tatara, Eric

Publications and source records attributed to Tatara, Eric.

5 records

DOE OSTI2024

Spatial inequities in access to medications for treatment of opioid use disorder highlight scarcity of methadone providers under counterfactual scenarios

Access to treatment and medication for opioid use disorder (MOUD) is essential in reducing opioid use and associated behavioral risks, such as syringe sharing among persons who inject drugs (PWID). Syringe sharing among PWID carries high risk of transmission of serious infections such as hepatitis C and HIV. MOUD resources, such as methadone provider clinics, however, are often unavailable to PWID due to barriers like long travel distance to the nearest methadone provider and the required frequency of clinic visits. The goal of this study is to examine the uncertainty in the effects of travel distance in initiating and continuing methadone treatment and how these interact with different spatial distributions of methadone providers to impact co-injection (syringe sharing) risks. A baseline scenario of spatial access was established using the existing locations of methadone providers in a geographical area of metropolitan Chicago, Illinois, USA. Next, different counterfactual scenarios redistributed the locations of methadone providers in this geographic area according to the densities of both the general adult population and according to the PWID population per zip code. We define different reasonable methadone access assumptions as the combinations of short, medium, and long travel distance preferences combined with three urban/suburban travel distance preference. Our modeling results show that when there is a low travel distance preference for accessing methadone providers, distributing providers near areas that have the greatest need (defined by density of PWID) is best at reducing syringe sharing behaviors. However, this strategy also decreases access across suburban locales, posing even greater difficulty in regions with fewer transit options and providers. As such, without an adequate number of providers to give equitable coverage across the region, spatial distribution cannot be optimized to provide equitable access to all PWID. Our study has important implications for increasing interest in methadone as a resurgent treatment for MOUD in the United States and for guiding policy toward improving access to MOUD among PWID.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2024

Reducing Sample Size While Improving Equity in Vaccine Clinical Trials: A Machine Learning-Based Recruitment Methodology with Application to Improving Trials of Hepatitis C Virus Vaccines in People Who Inject Drugs

Despite the availability of direct-acting antivirals that cure individuals infected with the hepatitis C virus (HCV), developing a vaccine is critically needed in achieving HCV elimination. HCV vaccine trials have been performed in populations with high incidence of new HCV infection such as people who inject drugs (PWID). Developing strategies of optimal recruitment of PWID for HCV vaccine trials could reduce sample size, follow-up costs and disparities in enrollment. We investigate trial recruitment informed by machine learning and evaluate a strategy for HCV vaccine trials termed PREDICTEE—Predictive Recruitment and Enrichment method balancing Demographics and Incidence for Clinical Trial Equity and Efficiency. PREDICTEE utilizes a survival analysis model applied to trial candidates, considering their demographic and injection characteristics to predict the candidate’s probability of HCV infection during the trial. The decision to recruit considers both the candidate’s predicted incidence and demographic characteristics such as age, sex, and race. We evaluated PREDICTEE using in silico methods, in which we first generated a synthetic candidate pool and their respective HCV infection events using HepCEP, a validated agent-based simulation model of HCV transmission among PWID in metropolitan Chicago. We then compared PREDICTEE to conventional recruitment of high-risk PWID who share drugs or injection equipment in terms of sample size and recruitment equity, with the latter measured by participation-to-prevalence ratio (PPR) across age, sex, and race. Comparing conventional recruitment to PREDICTEE found a reduction in sample size from 802 (95%: 642–1010) to 278 (95%: 264–294) with PREDICTEE, while also reducing screening requirements by 30%. Simultaneously, PPR increased from 0.475 (95%: 0.356–0.568) to 0.754 (95%: 0.685–0.834). Even when targeting a dissimilar maximally balanced population in which achieving recruitment equity would be more difficult, PREDICTEE is able to reduce sample size from 802 (95%: 642–1010) to 304 (95%: 288–322) while improving PPR to 0.807 (95%: 0.792–0.821). PREDICTEE presents a promising strategy for HCV clinical trial recruitment, achieving sample size reduction while improving recruitment equity.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2022

Modeling hepatitis C micro-elimination among people who inject drugs with direct-acting antivirals in metropolitan Chicago

Hepatitis C virus (HCV) infection is a leading cause of chronic liver disease and mortality worldwide. Direct-acting antiviral (DAA) therapy leads to high cure rates. However, persons who inject drugs (PWID) are at risk for reinfection after cure and may require multiple DAA treatments to reach the World Health Organization’s (WHO) goal of HCV elimination by 2030. Using an agent-based model (ABM) that accounts for the complex interplay of demographic factors, risk behaviors, social networks, and geographic location for HCV transmission among PWID, we examined the combination(s) of DAA enrollment (2.5%, 5%, 7.5%, 10%), adherence (60%, 70%, 80%, 90%) and frequency of DAA treatment courses needed to achieve the WHO’s goal of reducing incident chronic infections by 90% by 2030 among a large population of PWID from Chicago, IL and surrounding suburbs. We also estimated the economic DAA costs associated with each scenario. Our results indicate that a DAA treatment rate of >7.5% per year with 90% adherence results in 75% of enrolled PWID requiring only a single DAA course; however 19% would require 2 courses, 5%, 3 courses and <2%, 4 courses, with an overall DAA cost of $325 million to achieve the WHO goal in metropolitan Chicago. We estimate a 28% increase in the overall DAA cost under low adherence (70%) compared to high adherence (90%). Our modeling results have important public health implications for HCV elimination among U.S. PWID. Using a range of feasible treatment enrollment and adherence rates, we report robust findings supporting the need to address re-exposure and reinfection among PWID to reduce HCV incidence.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2020

Agent-based modeling of supply disruptions in the global rare earths market

Several independent assessments have identified rare earth elements (REEs) as critical materials, notably neodymium (Nd), praseodymium (Pr), and dysprosium (Dy) used in permanent magnets. Factors affecting their criticality include expected growth in demand arising from their unique performance-enhancing properties in consumer, energy, and military applications and the supply risk associated with China's dominance in their production. We demonstrate the use of Argonne's Global Critical Materials (GCMat) agent-based model to explore the possible consequences to REE market dynamics of different types of regional supply disruptions including a temporary loss of production, shutdown of capacity, and diversion of supply. Results suggest that supply disruptions may foster earlier and more REE mine starts outside of China, although some of these mines may not be able to sustain operations post disruption. Further, price and associated market responses such as production, capacity, and demand tended to extend beyond the disruption period. Such market impacts in the magnet supply chain could affect the costs and availability of a number of emerging clean energy technology applications such as electric vehicles and wind turbines. In the future, GCMat could be used to evaluate the effectiveness of mitigation strategies - including recycling, conservation, product substitution, and diversification of supplies - on reducing the severity of disruptions in REE markets.

36 MATERIALS SCIENCE↗

DOE OSTI2020

Argonne’s global critical materials agent-based model (GCMat)

Several studies have identified rare earths as critical materials. Although reasonably abundant in the Earth’s crust, rare earths typically occur in low concentrations of mined ores. Processes for recovering rare earth concentrates from these ores are complex and capital intensive. Further, lead times for deposit development, licensing, and construction are long, with reports of 10- 15 years. China is a major player in the rare earths supply chain, both in production capacity and technology innovation. In 2017, China supplied more than 80% of global rare earth oxide demand. Rare earth elements (REEs) have unique magnetic, catalytic, and phosphorescent properties that significantly improve performance of a wide range of technologies. These technologies span aerospace, energy, telecommunications, electronics, transportation, defense, and other diverse applications. Consequently, disruptions in rare earth supply can have a significant societal impact. Estimating that impact requires understanding of the dynamics across the supply chain, from rare earth oxide extraction to end use application. This report documents Argonne’s Global Critical Materials model (GCMat), first described by Riddle et al. 2015. GCMat provides capabilities to explore supply chain dynamics and uncertainty under scenarios of demand growth or shrinkage, technology adoption, supply disruptions, and trade policies and mitigation strategies of new supply sources, product substitution, consumer thrifting, and stockpiling. Supply chain participants from rare earth mining through final demand are modeled as interacting agents who make market decisions independently as time progresses. Since the version documented in Riddle et al. 2015, GCMat has been expanded to cover additional REEs, derived products and supply chains that use these REEs, and includes new agent behaviors and modeling capabilities. Section 2 provides a summary of the GCMat model design, including the structure of the model and key assumptions, section 3 summarizes methods used for model calibration and sensitivity analysis, and section 4 provides examples of model results.

36 MATERIALS SCIENCE↗