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At least 217 records · Page 12

Results of a Multi-institutional Phase 2 Clinical Trial for 4DCT-ventilation Functional Avoidance Thoracic Radiation Therapy

Radiation pneumonitis remains a major limitation in the radiation therapy treatment of patients with lung cancer. Functional avoidance radiation therapy uses functional imaging to reduce pulmonary toxic effects by designing radiation therapy plans that reduce doses to functional regions of the lung. Lung functional imaging has been developed that uses 4-dimensional computed tomography (4DCT) imaging to calculate 4DCT-based lung ventilation (4DCT-ventilation). A phase 2 multicenter study was initiated to evaluate 4DCT-ventilation functional avoidance radiation therapy. The study hypothesis was that functional avoidance radiation therapy could reduce the rate of grade ≥2 radiation pneumonitis to 12% compared with a 25% historical rate, with the trial being positive if ≤16.4% of patients experienced grade ≥2 pneumonitis.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Demons in the North Atlantic: Variability of Deep Ocean Ventilation

Abstract Translation of atmospheric forcing variability into the ocean interior via ocean ventilation is an important aspect of transient climate change. On a seasonal timescale in the subtropics, this translation is mediated by a so‐called “Demon” that prevents access to all except late‐winter mixed‐layer water. Here, we use an eddy‐permitting numerical circulation model to investigate a similar process operating on longer (interannual) timescales in the subpolar North Atlantic. We find that variations in atmospheric forcing are mediated in their translation to the ocean interior, with year‐to‐year changes in the late‐winter mixed layer depth being the critical factor. The signature of persistent strong atmospheric forcing driving deep mixed layers is preferentially ventilated to the interior when the forcing is ceased. Susceptibility to this effect depends on the location and density of subduction—with the rate at which newly ventilated water escapes its region of subduction being the crucial factor.

MacGilchrist, G. A.↗

Measured air quality impacts after teaching parents about cooking ventilation with a video: a pilot study

BackgroundCooking-related emissions contribute to air pollutants in the home and may influence children’s health outcomes.ObjectiveIn this pilot study, we investigate the effects of a cooking ventilation intervention in homes with gas stoves, including a video-based educational intervention and range hood replacement (when needed) in children’s homes.MethodsThis was a pilot (n = 14), before-after trial (clinicaltrials.gov #NCT04464720) in homes in the San Francisco Bay Area that had a school-aged child, a gas stove, and either a venting range hood or over-the-range microwave/hood. Cooking events, ventilation use, and indoor air pollution were measured in homes for 2–4 weeks, and children completed respiratory assessments. Midway, families received this intervention: (1) education about the hazards of cooking-related pollutants and benefits of both switching to back burners and using the range hood whenever cooking and (2) ensuring the range hood met airflow and sound performance standards. The educational intervention was delivered via a video developed in conjunction with local youth.ResultsWe found substantially increased use of back burners and slight increases in range hood use during cooking after intervening. Even though there was no change in cooking frequency or duration, these behavior changes resulted in decreases in nitrogen dioxide (NO2), including significant decreases in the total integrated concentration of NO2 over all cooking events from 1230 ppb*min (IQR 336, 7861) to 756 (IQR 84.0, 4210; p < 0.05) and NO2 collected on samplers over the entire pre- and post-intervention intervals from 10.4 ppb (IQR 3.5, 47.5) to 9.4 (IQR 3.0, 36.1; p < 0.005). There were smaller changes in PM2.5, and no changes were seen in respiratory outcomes.ImpactThis pilot before-after trial evaluated the use of a four-minute educational video to improve cooking ventilation in homes with gas stoves and one or more school-aged children. Participant behavior changed after watching the video, and there were decreases in indoor air pollutant concentrations in the home, some of which were significant. This brief video is now publicly available in English and Spanish (wspehsu.ucsf.edu/projects/indoor-air-quality), and this provides suggestive evidence of the utility of this simple intervention, which could be particularly beneficial for households that have children with asthma.

Holm, Stephanie M↗

Computational Fluid Dynamics Simulations to Assess Spatial Variability and Optimal Ventilation Scenarios for Biological Laboratory Exposures

A significant amount of uncertainty exists regarding potential human exposure to laboratory biomaterials and organisms in Biosafety Level 2 (BSL-2) research laboratories. Computational fluid dynamics (CFD) modeling is proposed as a way to better understand potential impacts of different combinations of biomaterials, laboratory manipulations, and exposure routes on risks to laboratory workers. Here, in this study, we use CFD models to simulate airborne concentrations of contaminants in an actual BSL-2 laboratory under different configurations. Results show that ventilation configuration, sampling location, and contaminant source location can significantly impact airborne concentrations and exposures. Depending on the source location and airflow patterns, the transient and time-integrated concentrations varied by several orders of magnitude. Contaminant plumes from sources located near a return vent (or exhaust like a fume hood or ventilated biosafety cabinet) are likely to be more contained than sources that are further from the exhaust. Having a direct flow between the source and the exhaust (through-flow condition) may reduce potential exposures to individuals outside the air flow path. Designing a BSL-2 room with ventilation and airflow patterns that maximize through-flow conditions to the return/exhaust vents and minimize dispersion and mixing throughout the room is, therefore, recommended. CFD simulations can also be used to assist in characterizing the impacts of supply and return vent locations, room layout, and source locations on spatial and temporal contaminant concentrations. In addition, proper placement of particle sensors can also be informed by CFD simulations to provide additional characterization and monitoring of potential exposures in BSL-2 facilities.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗

Exploration of a Potential DOOR Endpoint for Hospital-acquired Bacterial Pneumonia and Ventilator-associated Bacterial Pneumonia Using Six Registrational Trials for Antibacterial Drugs

Abstract Background Desirability of outcome ranking (DOOR) is an innovative approach to clinical trial design and analysis that uses an ordinal ranking system to incorporate the overall risks and benefits of a therapeutic intervention into a single measurement. Here we derived and evaluated a disease-specific DOOR endpoint for registrational trials for hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP). Methods Through comprehensive examination of data from nearly 4000 participants enrolled in six registrational trials for HABP/VABP submitted to the Food and Drug Administration (FDA) between 2005 and 2022, we derived and applied a HABP/VABP specific endpoint. We estimated the probability that a participant assigned to the study treatment arm would have a more favorable overall DOOR or component outcome than a participant assigned to comparator. Results DOOR distributions between treatment arms were similar in all trials. DOOR probability estimates ranged from 48.3% to 52.9% and were not statistically different. There were no significant differences between treatment arms in the component analyses. Although infectious complications and serious adverse events occurred more frequently in ventilated participants compared to non-ventilated participants, the types of events were similar. Conclusions Through a data-driven approach, we constructed and applied a potential DOOR endpoint for HABP/VABP trials. The inclusion of syndrome-specific events may help to better delineate and evaluate participant experiences and outcomes in future HABP/VABP trials and could help inform data collection and trial design.

Immunology↗

Acute Shortage Ventilator

Abstract We have implemented an “Acute Shortage Ventilator” (ASV) motivated by the COVID-19 pandemic and the possibility of severe ventilator shortages in the near future. The unit cost per ventilator is less than $400 US excluding the patient circuit parts. The ASV mechanically compresses a self-inflating bag resuscitator, uses a modified patient circuit, and is commanded by a microcontroller and an optional laptop. It operates in both Volume-Controlled Assist-Control mode and a Pressure-Controlled Assist-Control mode. It has been tested using an artificial lung against the EURS guidelines. The key design goals were to develop a simple device with high performance for short-term use, made primarily from common hospital parts and generally-available non-medical components, and at low cost and ease in manufacturing.

Akerib, D. S.↗

Measured performance of filtration and ventilation systems for fine and ultrafine particles and ozone in an unoccupied modern California house

This study evaluated nine ventilation and filtration systems in an unoccupied 2006 house located 250 m downwind of the I-80 freeway in Sacramento, California. Systems were evaluated for reducing indoor concentrations of outdoor particles in summer and fall/winter, ozone in summer, and particles from stir-fry cooking. Air exchange rate was measured continuously. Energy use was estimated for year-round operation in California. Exhaust ventilation without enhanced filtration provided indoor PM 2.5 that was 70% lower than outdoors. Supply ventilation with MERV13 filtration provided slightly less protection, whereas supply MERV16 filtration reduced PM 2.5 by 97-98% relative to outdoors. Supply filtration systems used little energy but provided no benefits for indoor-generated particles. Systems with MERV13-16 fil ter in the recirculating heating and cooling unit (FAU) operating continuously or 20 min/h reduced PM 2.5 by 93-98%. Across all systems, removal percentages were higher for ultrafine particles and lower for black carbon, relative to PM 2.5 . Indoor ozone was 3-4% of outdoors for all systems except an electronic air cleaner that produced ozone. Filtration via the FAU or portable filtration units lowered PM 2.5 by 25-75% when operated over the hour following cooking. The energy for year-round operation of FAU filtration with an efficient blower motor was estimated at 600 kWh/year.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

SU-E-J-86: Functional Conformal Planning for Stereotactic Body Radiation Therapy with CT-Pulmonary Ventilation Imaging

Purpose: To evaluate the functional planning using CT-pulmonary ventilation imaging for conformal SBRT. Methods: The CT-pulmonary ventilation image was generated using the Jacobian metric in the in-house program with the NiftyReg software package. Using the ventilation image, the normal lung was split into three lung regions for functionality (high, moderate and low). The anatomical plan (AP) and functional plan (FP) were made for ten lung SBRT patients. For the AP, the beam angles were optimized with the dose-volume constraints for the normal lung sparing and the PTV coverage. For the FP, the gantry angles were also optimized with the additional constraint for high functional lung. The MLC aperture shapes were adjusted to the PTV with the additional 5 mm margin. The dosimetric parameters for PTV, the functional volumes, spinal cord and so on were compared in both plans. Results: Compared to the AP, the FP showed better dose sparing for high- and moderate-functional lungs with similar PTV coverage while not taking care of the low functional lung (High:−12.9±9.26% Moderate: −2.0±7.09%, Low: +4.1±12.2%). For the other normal organs, the FP and AP showed similar dose sparing in the eight patients. However, the FP showed that the maximum doses for spinal cord were increased with the significant increment of 16.4Gy and 21.0Gy in other two patients, respectively. Because the beam direction optimizer chose the unexpected directions passing through the spinal cord. Conclusion: Even the functional conformal SBRT can selectively reduce high- and moderatefunctional lung while keeping the PTV coverage. However, it would be careful that the optimizer would choose unexpected beam angles and the dose sparing for the other normal organs can be worse. Therefore, the planner needs to control the dose-volume constraints and also limit the beam angles in order to achieve the expected dose sparing and coverage.

60 APPLIED LIFE SCIENCES↗

Seven days of ischemic preconditioning augments hypoxic exercise ventilation and muscle oxygenation in recreationally trained males

This investigation sought to assess whether single or repeated bouts of ischemic preconditioning (IPC) could improve oxyhemoglobin saturation ([Formula: see text]) and/or attenuate reductions in muscle tissue saturation index (TSI) during submaximal hypoxic exercise. Fifteen healthy young men completed submaximal graded exercise under four experimental conditions: 1) normoxia (NORM), 2) hypoxia (HYP) [oxygen fraction of inspired air ([Formula: see text]) = 0.14, ∼3,200 m], 3) hypoxia preceded by a single session of IPC (IPC1-HYP), and 4) hypoxia preceded by seven sessions of IPC, one a day for 7 consecutive days (IPC7-HYP). IPC7-HYP heightened minute ventilation (V̇e) at 80% HYP peak cycling power output ( W peak ) (+10.47 ± 3.35 L·min −1 , P = 0.006), compared with HYP, as a function of increased breathing frequency. Both IPC1-HYP (+0.17 ± 0.04 L·min −1 , P < 0.001) and IPC7-HYP (+0.16 ± 0.04 L·min −1 , P < 0.001) elicited greater oxygen consumption (V̇o 2 ) across exercise intensities compared with NORM, whereas V̇o 2 was unchanged with HYP alone. [Formula: see text] was unchanged by either IPC condition at any exercise intensity, yet the reduction of muscle TSI during resting hypoxic exposure was attenuated by IPC7-HYP (+9.9 ± 3.6%, P = 0.040) compared with HYP, likely as a function of reduced local oxygen extraction. Considering all exercise intensities, IPC7-HYP attenuated reductions of TSI with HYP (+6.4 ± 1.8%, P = 0.001). Seven days of IPC heightens ventilation, posing a threat to ventilatory efficiency, during high-intensity submaximal hypoxic exercise and attenuates reductions in hypoxic resting and exercise muscle oxygenation in healthy young men. A single session of IPC may be capable of modulating hypoxic ventilation; however, our present population was unable to demonstrate this with certainty.

Physiology↗

Mine Ventilation Rate Monitoring Annual Report

The Waste Isolation Pilot Plant (WIPP) Hazardous Waste Facility Permit (Permit) Part 4 requires the WIPP facility Permittees to implement the WIPP Mine Ventilation Flow Rate Monitoring Plan (MVRMP) in Attachment O of the Permit. The MVRMP describes how compliance with the ventilation requirements described in Permit Part 4.5.3.2 and Attachment A2, Section A2-2a(3) for airflow rates for the total underground repository and the active disposal room are obtained and documented. The MVRMP requires ventilation flow rate measurements for the total underground repository and each active disposal room to ensure that the airflows meet Permit conditions.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Developing evidence-based prescriptive ventilation rate standards for commercial buildings in California: a proposed framework

Background - The goal of this project, with a focus on commercial buildings in California, was to develop a new framework for evidence-based minimum ventilation rate (MVR) standards that protect occupants in buildings while also considering energy use and cost. This was motivated by research findings suggesting that current prescriptive MVRs in commercial buildings do not provide occupants with fully safe and satisfactory indoor environments. Methods - The project began with a broad review in several areas ? the diverse strategies now used for standards or guidelines for MVRs or for environmental contaminant exposures, current knowledge about adverse human effects associated with VRs, and current knowledge about contaminants in commercial buildings, including their their presence, their adverse human effects, and their relationships with VRs. Based on a synthesis of the reviewed information, new principles and approaches are proposed for setting evidence-based VRs standards for commercial buildings, considering a range of human effects including health, performance, and acceptability of air. Results ? A review and evaluation is first presented of current approaches to setting prescriptive building ventilation standards and setting acceptable limits for human contaminant exposures in outdoor air and occupational settings. Recent research on approaches to setting acceptable levels of environmental exposures in evidence-based MVR standards is also described. From a synthesis and critique of these materials, a set of principles for setting MVRs is presented, along with an example approach based on these principles. The approach combines two sequential strategies. In a first step, an acceptable threshold is set for each adverse outcome that has a demonstrated relationship to VRs, as an increase from a (low) outcome level at a high reference ventilation rate (RVR, the VR needed to attain the best achievable levels of the adverse outcome); MVRs required to meet each specific outcome threshold are estimated; and the highest of these MVRs, which would then meet all outcome thresholds, is selected as the target MVR. In a second step, implemented only if the target MVR from step 1 is judged impractically high, costs and benefits are estimated and this information is used in a risk management process. Four human outcomes with substantial quantitative evidence of relationships to VRs are identified for initial consideration in setting MVR standards. These are: building-related symptoms (sometimes called sick building syndrome symptoms), poor perceived indoor air quality, and diminished work performance, all with data relating them directly to VRs; and cancer and non-cancer chronic outcomes, related indirectly to VRs through specific VR-influenced indoor contaminants. In an application of step 1 for offices using a set of example outcome thresholds, a target MVR of 9 L/s (19 cfm) per person was needed. Because this target MVR was close to MVRs in current standards, use of a cost/benefit process seemed unnecessary. Selection of more stringent thresholds for one or more human outcomes, however, could raise the target MVR to 14 L/s (30 cfm) per person or higher, triggering the step 2 risk management process. Consideration of outdoor air pollutant effects would add further complexity to the framework. For balancing the objective and subjective factors involved in setting MVRs in a cost-benefit process, it is suggested that a diverse group of stakeholders make the determination after assembling as much quantitative data as possible.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

Risk Assessment and Ventilation Modeling for Hydrogen Release in Vehicle Repair Garages

The availability of repair garage infrastructure for hydrogen fuel cell vehicles is becoming increasingly important for future industry growth. Ventilation requirements for hydrogen fuel cell vehicles can affect both retrofitted and purpose-built repair garages and the costs associated with these requirements can be significant. A hazard and operability study (HAZOP) was performed to identify key risk-significant scenarios related to hydrogen vehicles in a repair garage. Detailed simulations and modeling were performed using appropriate computational tools to estimate the location, behavior, and severity of hydrogen release based on key HAZOP scenarios. This work compares current fire code requirements to an alternate ventilation strategy to further reduce potentially hazardous conditions. Overall, the amount of flammable mass of hydrogen at any one time in the simulation is low compared to the total mass of hydrogen released, due to the low flow rate of a low pressure release. It is shown that position, direction, and velocity of ventilation have a significant impact on the amount of instantaneous flammable mass in the domain.

33 ADVANCED PROPULSION SYSTEMS↗

A Historic Context and Mitigation Documentation for a Portion of the U12n Tunnel Ventilation and Containment Systems, Area 12, Nevada National Security Site, Nye County, Nevada

The National Nuclear Security Administration Nevada Field Office (NNSA/NFO) has proposed repurposing the U12n Vent Hole #2 (SHPO Resource S2488) and the U12n.10 Vent Hole (S2489) for water sampling in the U12n Tunnel. The vent holes are part of the historic ventilation system for the tunnel and are contributing elements to the U12n Tunnel Historic District (D84). In consultation with the SHPO, NNSA/NFO determined the undertaking will have an adverse effect on the vent holes. The NNSA/NFO and the SHPO negotiated a memorandum of (MOA) with stipulations to mitigate adverse effects. This submission is to comply with the stipulations in the executed Memorandum of Agreement Between the National Nuclear Security Administration Nevada Field Office, Environmental Management Nevada Program Office, and the Nevada State Historic Preservation Officer Regarding Repurposing of Portions of the Ventilation System of the U12n Tunnel Complex Located in Area 12 at the Nevada National Security Site. In accordance with the MOA, the manuscript provides a historic context that describes the development and functioning of the historic U12n Tunnel ventilation system for underground nuclear tests (Stipulation III.C). High resolution digital color images of the vent hole containment doors, nearby elements, and overviews were obtained and keyed to a map and a photo index (Stipulation III.A) (Appendix A). Lastly, Architectural Resource Assessment (ARA) forms were completed for each of the vent holes and Historic District D84 (Stipulation III.B) (Appendix B). The documentation including the historic context report, photographs, image files, and resource forms produced to fulfill the terms of the MOA will be archived with the Nuclear Testing Archive in Las Vegas (Stipulation III.D).

54 ENVIRONMENTAL SCIENCES↗

Studies of Alternative Ventilation Configurations to Mitigate Airborne Exposure Risks in Office Spaces

The objective of this study was to evaluate the impact of alternative ventilation configurations on airflow patterns and potential exposure risks in office spaces. Two existing conference rooms at Sandia NM were modeled using Computational Fluid Dynamics (CFD) simulations to characterize airflow patterns and potential airborne exposure risks in well-mixed and once-through (through-flow) ventilation conditions. Multiple scenarios were studied to evaluate the impact of occupancy, Plexiglass barriers, and a modified-return airflow configuration. Experimental and visualization tests were also conducted to validate the well-mixed and through-flow models and findings. The simulations demonstrated that the modified-return airflow configuration that promoted through-flow conditions reduced pathogen concentrations within the space compared to the well-mixed airflow configuration; occupancy reduction only reduced the number of exposed individuals, and Plexiglass barriers had almost no effect. The experimentally measured air speeds at nine anemometer locations generally matched the simulated airflow velocities, and a fog-purge visualization test was also consistent with simulated results of plume movement and dissipation. The visualization tests demonstrated improvements in air change rate with the modified return, which promoted through-flow conditions, versus the original well-mixed ventilation configuration. The results of this study demonstrate that minor modifications to a space that promote through-flow conditions can improve air quality and reduce pathogen concentrations. Additional airflow modeling and testing of alternative occupied space configurations are recommended to further inform room designs that mitigate airborne exposure risks for occupants.

42 ENGINEERING↗

Ventilation: Fume Hoods Self-Study Course # 48002

This course presents an overview of the requirements and safe work practices for the use of engineered ventilation controls (EVCs) at Los Alamos National Laboratory (LANL). EVCs addressed in this manual include fume hoods, local exhaust ventilation (LEV) systems other than fume hoods, portable and in-place high-efficiency particulate air (HEPA) filtration systems. Requirements from LANL Procedure P101-16, Industrial Ventilation (non-HVACR) that address EVC certification and use, along with responsibilities of workers who use EVCs and the responsible line managers (RLMs) of such workers, are also presented. Per 101-16, 6.1, workers who use, maintain, or certify (i.e., inspect and test) fume hoods, or Persons in Charge (PICs) who oversee others in those tasks, must complete this course.

42 ENGINEERING↗

The effect of gas diffusion on the flow coefficient for a ventilated cavity

The results of an experimental investigation into the effect of gas diffusion on the volume flow-rate of gas needed to sustain a ventilated cavity are presented. Gas diffusion was found to have a significant effect on the ventilated flow rate required to sustain a cavity of a given size. An analysis for the gas diffusion effect was conducted based on a mathematical model of diffusion proposed by Brennen. The results compare favorably with experimental data. Also, an empirical scaling relationship is proposed for ventilated cavity flows.

Billet, M. L.↗

Protective garment ventilation system

A method and apparatus for ventilating a protective garment, space suit system, and/or pressure suits to maintain a comfortable and nontoxic atmosphere within is described. The direction of flow of a ventilating and purging gas in portions of the garment may be reversed in order to compensate for changes in environment and activity of the wearer. The entire flow of the ventilating gas can also be directed first to the helmet associated with the garment.

Lang, R.↗

Distribution of pulmonary ventilation and perfusion during short periods of weightlessness

Airborne experiments were conducted on four trained normal male subjects (28-40 yr) to study pulmonary function during short periods (22-27 sec) of zero gravity obtained by flying a jet aircraft through appropriate parabolic trajectories. The cabin was always pressurized to a sea-level altitude. The discussion is limited to pulmonary ventilation and perfusion. The results clearly demonstrate that gravity is the major factor causing nonuniformity in the topographical distribution of pulmonary ventilation. More importantly, the results suggest that virtually all the topographical nonuniformity of ventilation, blood flow, and lung volume observed under 1-G conditions are eliminated during short periods of zero gravity.

Michels, D. B.↗