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NASA NTRS2021

Comparison of Health and Performance Risk for Accelerated Mars Mission Scenarios

This document details the results for a quantitative estimate of the difference in human health and performance risk that crews would face for two hypothetical variations on Mars mission scenarios: an Accelerated Mars Mission (AMM) and a Standard Mars Mission(SMM).NASA goals for Mars mission concepts, duration, and tasks have varied over the years. While neither of the cases considered here are likely to accurately represent the initial mission to Mars, the exercise of evaluating significant differences in mission duration from an astronaut health perspective can provide bounding insight to the level of risk that is likely to be encountered in an eventual Mars mission. Medical Probabilistic Risk Assessment using the Integrated Medical Model (IMM)(1–3)and the NASA Space Radiation Cancer Risk Model (NSCR)(4,5) are used here to help mission planners gain the best insight currently available into the expected magnitude of impacts to astronaut health when undertaking a Mars mission. These impacts occur both in-mission as well as in the long-term health of the astronauts post-mission. These evaluations are currently the best available modeling estimates to characterize and bound the health risks in a proposed mission domain where humans have no experience.

Erik Antonsen↗

NASA NTRSDate not supplied

Identification of Health Events in Astronaut Missions Using Longitudinal Molecular Signature Detection

Individualized health monitoring can now incorporate a precision medicine approach, profiling multiple molecular and physiological measures of health (generalized omics) longitudinally to enable the timely diagnosis and treatment of disease. Such measurements can include blood chemistries, gene expression data, metabolite measurements, and digital device data. We will present our work on extending such an approach to monitoring individual astronaut health for deep space missions. We have developed and implemented novel algorithms to monitor and detect physiolgical state departures from individualized healthy astronaut baselines , utilizing and biologically annotating generalized omics. Our new methods can detect baseline deviations across omics corresponding to potentially adverse medical events. Events pointing to changes in individual health are then compared across individuals to identify common responses and detect changes affecting multiple crewmembers. We show the utility of our methods in detecting temporal health changes across subjects using retrospective Earth and astronaut mission data (metabolite and immune marker data across multiple missions), in order for this technique t o be applicable for future missions.

G I Mias↗

NASA NTRSDate not supplied

Watching Without Seeing a Tool to Surveil Astronaut Health Outcomes While Maintaining Astronaut Medical Privacy

BACKGROUND The Privacy Act of 1974 regulates the use a nd disclosure of personally identifiable information by US Federal agencies. The Act applies to biographical, financial, a nd other identity-linked information, a s well a s personal health information (PHI). As such, the use of astronaut PHI is limited to authorized personnel for preapproved uses, with data reporting often limited to aggregated information about groups. These limitations on the use a nd reporting of astronaut PHI complicates surveillance efforts, wherein epidemiologists a t the National Aeronautics and Space Administration (NASA)monitor the incidence of targeted health conditions in the astronaut population, or to discover emerging trends of aging and disease. Stratification on one or more covariates –particularly time-period, sex, a nd mission participation –can lead to extremely small datasets such that the reporting of results is potentially attributable to individuals. An additional challenge is the small size of the astronaut population, both in terms of numbers of individuals a s well a s in terms of density of exposure time. Such small datasets yield volatile rate estimates that are difficult to interpret. To a id the epidemiological surveillance efforts, a surveillance tool is required that can (a) satisfy the need for rapid computation of condition-specific incidence and mortality rates; (b) improve the statistical estimates of these estimated rates; and (c) maintain astronaut privacy. Here we describe a nd demonstrate such a tool. METHODS We devised a system that models incidence a nd mortality rates rather than calculating them directly. This ha s the advantage of using all the available data to derive the estimates, lea ding to rates that a re not attributable to any one individual, a nd a re a s numerically stable a s they can be given the extremely limited data. The system models disease endpoints using a Poisson regression model with exposure density (measured in person-years) a s a n offset term. By doing so the model is estimating event counts per person-year, equivalent to modeling the rates directly. It uses a standard (pre-specified)set of covariates; the system does not engage in “model-building” as model parsimony is not the goa l. Instead, it is explicitly recognized that if a covariate is not statistically significant a nd not a confounder then it will likely have very little effect on the estimate of the incidence a nd mortality rates. Users are able to specify the disease endpoint of interest and the covariates over which they would like to stratify. The system then uses the resulting model to compute the estimated rates for the user-chosen configuration of variables as visualizes those either over an age range within a specified time-period, or over time for astronauts with a specified age range. RESULTS The first iteration of the tool computes incidence a nd mortality rates for cardiovascular conditions and cancers. Code ha s been developed to retrieve the appropriate data from the IMPALA analysis platform, compute the models for incidence a nd mortality, a nd then use those models to generate the corresponding rate curves. A companion graphical user interface allows the user to specify the curves and visualize the results. CONCLUSIONS It is important to note that the rapid surveillance tool described here is neither meant to be a definitive assessment of the incidence or mortality of any particular disease or condition in the astronaut population, nor is it meant to be used for research purposes. Rather, it is meant as an early indicator that in-depth investigation may be warranted. By automating a repetitive process and leveraging carefully curated astronaut health outcomes, the tool makes possible a rapid “first look” into known areas of concern, and, if used judiciously, may surface new areas of concern for long-term astronaut health. This work is supported in part by the Translational Research Institute for Space Health (TRISH) through NASA Cooperative Agreement NNX16AO69A.

R J Reynolds↗

NASA NTRSDate not supplied

The Benefit of NASA's Atmosphere Observing System (AOS) Mission Lidar and Polarimeter Observations for Health and Air Quality Applications

The Atmosphere Observing System (AOS) seeks to explore fundamental questions of how interconnections between aerosols, clouds and precipitation impact our weather and climate, addressing real-world challenges to benefit society. AOS will provide key information to enhance the communities’ ability to improve weather and air quality forecasting today, seasonal to sub-seasonal changes in the near future, and societal challenges resulting from climate change in the decades to come. A fundamental component of the AOS mission is ensuring that health and air quality applications are considered to the greatest extent possible in mission design. As a result, the Applications Impact Team (AIT) was implemented to address this objective. The overarching goal of the AIT is to help improve the capacity for transitioning science to applications to make it possible to more quickly and effectively inform decisions that will directly benefit society. We seek to maximize AOS benefit to impact decisions through early engagement in the mission development phase in order to prepare stakeholders to apply observations as soon as AOS mission data becomes available. To support these efforts, we leverage existing and near future mission applications activities and initiatives, such as the NASA CALIPSO, MAIA, TEMPO, and PACE missions to form a framework to enhance health and air quality applications for AOS. The unique synergy between lidar and polarimeter instruments onboard the AOS constellation, as well as diurnally varying observations of aerosol profiles, will provide new opportunities to engage health and air quality stakeholders for forecasting, monitoring, and warning of hazardous events (e.g., wildfire smoke, volcanic ash) that impact human health. Engaging with existing missions helps identify and understand data needs, gaps and opportunities for current and future stakeholders, determine what aerosol data products are of highest value and use, and helps connect stakeholders with current mission data that can serve as AOS proxy data, among others. In this presentation, we provide an overview of AOS aerosol observations relevant for health and air quality applications, AIT activities and initiatives and how existing aerosol satellite missions and their applications activities can play a critical role in AOS applications development during mission design.

Melanie Follette-Cook↗

NASA NTRSDate not supplied

The Exploration Crew Health and Performance System of the Future - A Shared Mental Model

The challenges involved in vehicle/habitat design and operation for long-duration deep space missions are complex, and the needs of a human crew must be considered in the context of all the system trades required to enable such missions. An exploration Crew Health and Performance (CHP) system complements all the other vehicle/habitat systems to achieve one specific and critical endpoint – ensuring that the astronauts can perform the job that they were sent into space to do. This includes accounting for all aspects of the physiological, psychological, medical, and environmental realities that the human crew must face in deep space. Along with this system complexity comes the additional need for increased autonomy of the crew due to the immense distance from Earth. The design of future systems must respect the real human capabilities and limitations within the context of a mission to the Moon or Mars. The NASA Moon to Mars Objectives document outlines the need for advanced CHP system designs: • Develop systems that monitor and maintain crew health and performance throughout all mission phases, including during communication delays to Earth, and in an environment that does not allow emergency evacuation or terrestrial medical assistance. • Evaluate and validate progressively Earth-independent crew health & performance systems and operations with mission durations representative of Mars-class missions. • Validate readiness of systems and operations to support crew health and performance for the initial human Mars exploration campaign. This presentation will outline the initial work that Exploration Medical Capability is leading on the development of a prototype design for an exploration Crew Health and Performance (CHP) system for future NASA human deep space long-duration missions. This effort will require commitment from all stakeholders to a shared mental model of what a future exploration CHP system should look like, one that will address the needs, goals, and objectives of the Agency and help to ensure mission success in deep space.

K R Lehnhardt↗

NASA NTRSDate not supplied

Long-Term Health Metric Development Effort

INTRODUCTION Probabilistic Risk Assessment (PRA) is a methodology applied when high-stakes decisions need to be made about complex systems. PRA often uses risk minimization to aid decision making, such as when establishing vehicle requirements or resource allocations. The NASA Human System Risk Board (HSRB) maintains the human spaceflight risk postures, many of which have in-mission medical outcomes, but the full risk set also includes performance and Long-Term Health (LTH) outcomes. An effort is underway to determine the dependencies between LTH risk outcomes and mission characteristics and to identify metrics for quantifying LTH outcomes. The LTH metrics will be incorporated into future PRA tools currently under development to support crew health and performance decision making. LONG-TERM HEALTH (LTH) RISK LTH risk encompasses the timeframe from immediately post-flight, through the rest of an astronaut’s career, through retirement, and until death. LTH outcomes include the time and interventions needed for the astronaut to return to preflight physiological states after experiencing spaceflight hazards and recovery from any in-mission medical events that persist into the post-flight timeframe. It includes chronic complications that may arise due to experiencing in-flight medical conditions or injuries and medical conditions that occur later in life with a higher probability of occurrence or with more severity because of their spaceflight exposure. Finally, LTH outcomes can also include a reduction in life expectancy due to spaceflight exposures. Eighteen of the HSRB risks contain an LTH component, each with a unique incidence rate and consequence severity. ON-GOING LTH METRIC DEVELOPMENT EFFORTS Based on guidance from a stakeholder workshop held on June 1, 2023, only LTH outcomes with causes tied to spaceflight experience that are significantly different from normal healthy aging and which can be affected by changes in in-mission resources are targeted for inclusion within the PRA modeling efforts. Current on-going efforts include a sensitivity analysis of potential in-flight medical conditions to determine which conditions may persist into post-flight and how the consequences may be affected by in-mission medical resources. Also underway is determination of differences in the time for a return to preflight physiological baselines when in-flight countermeasures are available versus when they are not. Analyses performed with publicly available astronaut data and collaborations with the Lifetime Surveillance of Astronaut Health team are being designed to understand which LTH outcomes differ significantly from natural healthy aging. Information exchanges are also occurring with LTH risk custodians to understand how they quantify outcomes. FUTURE PLANS Risk characteristics will be determined for each LTH risk that meets our inclusion criteria and the dependencies of their outcomes to in-mission resources and mission characteristics will be established. The individual risks will be integrated together into one or more high level LTH metrics for inclusion in the PRA tool, so that LTH risks can be considered along with in-mission risks during crew health and performance system decision support trade studies.

B. E. Lewandowski↗

DOE OSTI2020

Environmental, Health and Safety Assessment Application of a Heat Integrated, Post-combustion CO2 Capture System Using Monoethanolamine and Hitachi H3-1 Solvent at the E.W. Brown Coal-fired Power Plant

An Environmental Health and Safety (EH&S) Assessment was completed for operation of a pilot scale carbon dioxide (CO2) capture system (CCS) at the Louisville Gas & Electric (LG&E) and Kentucky Utilities (KU) Energy, LLC (LG&E-KU) E. W. Brown Generating Station in Harrodsburg, Mercer County, Kentucky. The pilot system was evaluated using two CO2 capture solvents, monoethanolamine (MEA) and Hitachi’s H3-1 solvent. The purpose of the EH&S Assessment was to determine if there were any unacceptable environmental, health or safety concerns that may prevent operation or environmental permitting of a larger scale pilot scale plant. The assessment included review of process flow diagrams, input and output flow rates for primary materials, literature describing similar processes and chemicals used or created during the process, actual air emission and wastewater test data and air emission calculations. The evaluation included identification of risks related to hazardous chemicals, air emissions, wastewater discharges, solid wastes generated and employee hazards. Most potential EH&S issues that were identified are commonly found and successfully managed at large industrial facilities. No risks were identified that could not be successfully managed or would likely prevent implementation or environmental permitting of the pilot or larger scale plant. Potential exposures and resulting health risks from exposure to low concentrations of nitrosamines generated from degradation of the Hitachi H3-1 and possibly MEA solvents may be a health concern for site workers, but additional investigation is needed to accurately assess this risk. Applying the information gained from operating the pilot plant, performing air emission testing and used solvent testing to a large-scale facility at a commercial coal-fired electric generating plant suggests additional air emission control measures may be necessary to reduce potential site worker health risks and possibly community risks. Depending upon the location and regional air quality, considerable effort may be required to obtain the necessary air permit for construction and operation of a similarly configured large-scale PCCCS facility.

gas separation↗

DOE OSTI2020

Environmental, Health and Safety Assessment Application of a Heat Integrated, Post-combustion CO 2 Capture System Using Monoethanolamine and Hitachi H3-1 Solvent at the E.W. Brown Coal-Fired Power Plant

An Environmental Health and Safety (EH&S) Assessment was completed for operation of a pilot scale carbon dioxide (CO 2 ) capture system (CCS) at the Louisville Gas & Electric (LG&E) and Kentucky Utilities (KU) Energy, LLC (LG&E-KU) E. W. Brown Generating Station in Harrodsburg, Mercer County, Kentucky. The pilot system was evaluated using two CO 2 capture solvents, monoethanolamine (MEA) and Hitachi’s H3-1 solvent. The purpose of the EH&S Assessment was to determine if there were any unacceptable environmental, health or safety concerns that may prevent operation or environmental permitting of a larger scale pilot scale plant. The assessment included review of process flow diagrams, input and output flow rates for primary materials, literature describing similar processes and chemicals used or created during the process, actual air emission and wastewater test data and air emission calculations. The evaluation included identification of risks related to hazardous chemicals, air emissions, wastewater discharges, solid wastes generated and employee hazards. Most potential EH&S issues that were identified are commonly found and successfully managed at large industrial facilities. No risks were identified that could not be successfully managed or would likely prevent implementation or environmental permitting of the pilot or larger scale plant. Potential exposures and resulting health risks from exposure to low concentrations of nitrosamines generated from degradation of the Hitachi H3-1 and possibly MEA solvents may be a health concern for site workers, but additional investigation is needed to accurately assess this risk. Applying the information gained from operating the pilot plant, performing air emission testing and used solvent testing to a large-scale facility at a commercial coal-fired electric generating plant suggests additional air emission control measures may be necessary to reduce potential site worker health risks and possibly community risks. Depending upon the location and regional air quality, considerable effort may be required to obtain the necessary air permit for construction and operation of a similarly configured large-scale PCCCS facility.

gas separation↗

DOE OSTI2020

Quantifying Occupant Health and Productivity for Deep Retrofits: Beyond Traditional IEQ Studies

As energy-efficiency standards for both new construction and existing building renovations become more stringent, further reductions become less tractable and more expensive. With increasing interest and rising investment in healthy built environments, integrating energy efficiency with improved occupant experience (i.e., health, comfort, and work performance) offers a new path to drive deep energy retrofits. However, the difficulty in quantifying and verifying health and productivity gains from building upgrades leads to lower valuation of human benefits in practice. Building codes and standards have progressive energy targets but often give minimum requirements to occupant health for factors such as ventilation and thermal comfort. State and federal laws in the United States that govern the energy service performance contract (ESPC) have no clear and consistent guidance on quantifying non-energy benefits and incorporating them into a formal cost-effectiveness analysis. This paper presents a methodology to measure a building’s potential performance improvement regarding occupant health based on existing evidence correlating IEQ to occupant outcomes. Health improvement measures are integrated with a building energy model to identify and measure the impact of holistic improvement strategies. The net present value of these measures is determined based on the investment costs required to attain those improvements, energy savings, and personnel gains. We will discuss results from one pilot building, which showed nearly $50 per square foot 20-year net present value using the integrated approach.

Keene, Kevin M.↗

DOE OSTI2024

Self-reported health impacts of do-it-yourself air cleaner use in a smoke-impacted community

Smoke exposure from wildfires or residential wood burning for heat is a public health problem for many communities. Do-It-Yourself (DIY) portable air cleaners (PACs) are promoted as affordable alternatives to commercial PACs, but evidence of their effect on health outcomes is limited. Pilot test an evaluation of the effect of DIY PAC usage on self-reported symptoms, and investigate barriers and facilitators of PAC use, among members of a tribal community that routinely experiences elevated concentrations of fine particulate matter (PM 2.5 ) from smoke. We conducted studies in Fall 2021 (“wildfire study”; N = 10) and Winter 2022 (“wood stove study”; N = 17). Each study included four sequential one-to-two-week phases: 1) initial, 2) DIY PAC usage ≥8 h/day, 3) commercial PAC usage ≥8 h/day, and 4) air sensor with visual display and optional PAC use. We continuously monitored PAC usage and indoor/outdoor PM 2.5 concentrations in homes. Concluding each phase, we conducted phone surveys about participants’ symptoms, perceptions, and behaviors. We analyzed symptoms associated with PAC usage and conducted an analysis of indoor PM 2.5 concentrations as a mediating pathway using mixed effects multivariate linear regression. We categorized perceptions related to PACs into barriers and facilitators of use. No association was observed between PAC usage and symptoms, and the mediation analysis did not indicate that small observed trends were attributable to changes in indoor PM 2.5 concentrations. Small sample sizes hindered the ability to draw conclusions regarding the presence or absence of causal associations. DIY PAC usage was low; loud operating noise was a barrier to use. This research is novel in studying health effects of DIY PACs during wildfire and wood smoke exposures. Such research is needed to inform public health guidance. Recommendations for future studies on PAC use during smoke exposure include building flexibility of intervention timing into the study design.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2025

Diagnostic-free onboard battery health assessment

Diverse usage patterns induce complex and variable aging behaviors in lithiumion batteries, complicating accurate health diagnosis and prognosis. Separate diagnostic cycles are often used to untangle the battery’s current state of health from prior complex aging patterns. However, these same diagnostic cycles alter the battery’s degradation trajectory, are time-intensive, and cannot be practically performed in onboard applications. Here, in this work, we leverage portions of operational measurements in combination with an interpretable machine learning model to enable rapid, onboard battery health diagnostics and prognostics without offline diagnostic testing and the requirement of historical data. We integrate mechanistic constraints within an encoder-decoder architecture to extract electrode states in a physically interpretable latent space and enable improved reconstruction of the degradation path. The health diagnosis model framework can be flexibly applied across diverse application interests with slight fine-tuning.

battery aging reconstruction↗

DOE OSTI2020

Assessing health and environmental impacts of solvents for producing perovskite solar cells

Halide perovskites are poised as a game-changing semiconductor system with diverse applications in optoelectronics. Industrial entities aim to commercialize perovskite technologies because of high performance but also because this type of semiconductor can be processed from solution, a feature enabling low cost and fast production. In this work, we analyse the health and environmental impacts of eight solvents commonly used in perovskite processing. We consider first- and higher-order ramifications of each solvent on an industrial scale such as solvent production, use/removal, emissions and potential end-of-life treatments. Further, we consider the energy of evaporation for each solvent, air emission, condensation and subsequent incineration, reuse or distillation for solvent recycling, and apply a full end-of-life analysis. For human health impact, we use the ‘USEtox’ method but also consider toxicity data beyond carcinogenic classifications. We find that dimethyl sulfoxide has the lowest total impact, by being the most environmentally friendly and least deleterious to human health of the solvents considered. The analysis of the effects of these solvents on human health and the environment provides guidance for sustainable development of this new technology.

14 SOLAR ENERGY↗

DOE OSTI2024

Probabilistic machine learning for battery health diagnostics and prognostics—review and perspectives

Abstract Diagnosing lithium-ion battery health and predicting future degradation is essential for driving design improvements in the laboratory and ensuring safe and reliable operation over a product’s expected lifetime. However, accurate battery health diagnostics and prognostics is challenging due to the unavoidable influence of cell-to-cell manufacturing variability and time-varying operating circumstances experienced in the field. Machine learning approaches informed by simulation, experiment, and field data show enormous promise to predict the evolution of battery health with use; however, until recently, the research community has focused on deterministic modeling methods, largely ignoring the cell-to-cell performance and aging variability inherent to all batteries. To truly make informed decisions regarding battery design in the lab or control strategies for the field, it is critical to characterize the uncertainty in a model’s predictions. After providing an overview of lithium-ion battery degradation, this paper reviews the current state-of-the-art probabilistic machine learning models for health diagnostics and prognostics. Details of the various methods, their advantages, and limitations are discussed in detail with a primary focus on probabilistic machine learning and uncertainty quantification. Last, future trends and opportunities for research and development are discussed.

25 ENERGY STORAGE↗

DOE OSTI2025

Including frameworks of public health ethics in computational modelling of infectious disease interventions

Decisions on public health interventions to control infectious diseases are often informed by computational models. Interpreting the predicted outcomes of a public health decision requires not only high-quality modelling but also an ethical framework for assessing the benefits and harms associated with different options. The design and specification of ethical frameworks matured independently of computational modelling, so many values recognized as important for ethical decision-making are missing from computational models. We demonstrate a proof-of-concept approach to incorporate multiple public health values into the evaluation of a simple computational model for vaccination against a pathogen such as SARS-CoV-2. By examining a bounded space of alternative prioritizations of three values relevant to public health ethics (aggregate clinical burden, equity in clinical burden, equity in adverse effects from vaccination), we identify value trade-offs, where the outcomes of optimal strategies differ depending on the ethical framework. This work demonstrates an approach to incorporating diverse values into decision criteria used to evaluate outcomes of models of infectious disease interventions.

"Mathematical Biology"↗

DOE OSTI2021

The use of teledentistry in facilitating oral health for older adults: A scoping review

Teledentistry is used in many countries to provide oral health care services. However, using teledentistry to provide oral health care services for older adults is not well documented. This knowledge gap needs to be addressed, especially when accessing a dental clinic is not possible and teledentistry might be the only way for many older adults to receive oral health care services. Nine databases were searched and 3,396 studies were screened using established eligibility criteria. Included studies were original research or review articles in which the intervention of interest was delivered to an older adult population (≥ 60 years) via teledentistry. The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review criteria. Nineteen studies were identified that met the criteria for inclusion. Only 1 study was from the United States. Seven studies had results focusing on older adult participants only, with most of those conducted in elder care facilities. The remainder consisted of studies with mixed-age populations reporting distinct results or information for older adults. The included studies used teledentistry, in both synchronous and asynchronous modes, to provide services such as diagnosis, oral hygiene promotion, assessment and referral of oral emergencies, and postintervention follow-up. Teledentistry comprises a variety of promising apps. Lastly, the authors identified and described uses, promising possibilities, and limitations of teledentistry to improve the oral health of older adults.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2025

The health and indoor environmental quality impacts of residential building envelope retrofits: A literature review

Retrofitting existing buildings to improve energy efficiency is an important strategy to meet increasingly stringent energy efficiency targets. While the primary objective of energy efficiency retrofits is to reduce energy consumption and greenhouse gas emissions, retrofits can also result in non-energy impacts (NEIs), which contribute to decision-making processes and overall value of the retrofit. NEIs have been studied extensively in retrofitted residential buildings; however, these studies have historically grouped passive (i.e., building envelope) and active (i.e., heating, ventilation, and air conditioning (HVAC) and energy system) upgrades, making it difficult to identify the underlying mechanism(s) of action for each NEI and developing effective retrofit strategies, based on occupant need. The purpose of this study was to better account for NEIs, based on a literature review, summarizing the current state of knowledge on NEIs associated with residential building envelope retrofits. We limited our search to health- and indoor environmental quality-related NEIs. The review identified strong evidence that building envelope retrofits improve acoustic comfort, wintertime thermal comfort, and respiratory and cardiovascular health outcomes. IAQ outcomes were mixed, with studies reporting both increases and decreases to indoor contaminant concentrations following retrofits. The strength of the effect was generally governed by pre-retrofit contaminant concentrations and whether indoor concentrations were dominated by indoor or outdoor sources. Most studies evaluating summertime thermal comfort identified increased incidence of summertime overheating; however, none of these studies linked the change in thermal conditions to health outcomes. Recommendations for future work include expanding studies to include more market rate housing and the health impacts of summertime overheating in retrofitted buildings.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

DOE OSTI2024

EHR-BERT: A BERT-based model for effective anomaly detection in electronic health records

Objective: Physicians and clinicians rely on data contained in electronic health records (EHRs), as recorded by health information technology (HIT), to make informed decisions about their patients. The reliability of HIT systems in this regard is critical to patient safety. Consequently, better tools are needed to monitor the performance of HIT systems for potential hazards that could compromise the collected EHRs, which in turn could affect patient safety. In this paper, we propose a new framework for detecting anomalies in EHRs using sequence of clinical events. This new framework, EHR-Bidirectional Encoder Representations from Transformers (BERT), is motivated by the gaps in the existing deep-learning related methods, including high false negatives, sub-optimal accuracy, higher computational cost, and the risk of information loss. EHR-BERT is an innovative framework rooted in the BERT architecture, meticulously tailored to navigate the hurdles in the contemporary BERT method; thus, enhancing anomaly detection in EHRs for healthcare applications.Methods: The EHR-BERT framework was designed using the Sequential Masked Token Prediction (SMTP) method. This approach treats EHRs as natural language sentences and iteratively masks input tokens during both training and prediction stages. This method facilitates the learning of EHR sequence patterns in both directions for each event and identifies anomalies based on deviations from the normal execution models trained on EHR sequences.Results: Extensive experiments on large EHR datasets across various medical domains demonstrate that EHR-BERT markedly improves upon existing models. It significantly reduces the number of false positives and enhances the detection rate, thus bolstering the reliability of anomaly detection in electronic health records. This improvement is attributed to the model’s ability to minimize information loss and maximize data utilization effectively.Conclusion: EHR-BERT showcases immense potential in decreasing medical errors related to anomalous clinical events, positioning itself as an indispensable asset for enhancing patient safety and the overall standard of healthcare services. The framework effectively overcomes the drawbacks of earlier models, making it a promising solution for healthcare professionals to ensure the reliability and quality of health data.

96 KNOWLEDGE MANAGEMENT AND PRESERVATION↗

DOE OSTI2025

Long‐Term Impacts of Global Solid Biofuel Emissions on Ambient Air Quality and Human Health for 2000–2019

Globally, solid biofuels (SB) have been widely used for household cooking and energy production for decades due to electricity shortages and socio-economic barriers to adopting renewable energy alternatives. This has detrimental effects on air quality, human health, and climate through trace gas and aerosol emissions. Despite numerous studies, the long-term consequences of SB emissions remain poorly understood. Here, we use the Community Earth System Model and the Community Emissions Data System emission inventory to investigate the SB emission impacts on air quality and human health for 2000–2019. Global SB emission increased the ambient PM 2.5 (particulate matter with aerodynamic diameters ≤2.5 μm) and ozone (O 3 ) concentrations up to 23.61 μg/m 3 and 13.69 ppbv, with significant effects found in India, China, and the Rest of Asia (ROA). Our study estimates total annual premature deaths (APDs) associated with global SB-attributable PM 2.5 and O 3 exposure as 1.11 million [95% confidence interval (95% CI): 1.00–1.22 million] in 2000 up to 1.43 million (95% CI: 1.30–1.56 million) in 2019. China's SB emissions and associated APDs have reduced substantially, whereas India and ROA had a major leap in both estimates in 2019 compared to 2000. China's progress in cutting residential SB emissions accounts for its improvements. Our study urges the reduction of SB usage and emissions to potentially improve overall air quality and human health conditions, especially in highly populated, low- and middle-income countries, where the poor air quality and associated health burden attributable to SB emissions are estimated to be higher.

O 3↗