SEARCH · Engineering Papers

Results for “confidence intervals”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2

All sources NASA NTRS DOE OSTI

DOE OSTI2021

Too Good to Be True? Evaluation of Colonoscopy Sensitivity Assumptions Used in Policy Models

Background: Models can help guide colorectal cancer screening policy. Although models are carefully calibrated and validated, there is less scrutiny of assumptions about test performance. Methods: We examined the validity of the CRC-SPIN model and colonoscopy sensitivity assumptions. Standard sensitivity assumptions, consistent with published decision analyses, assume sensitivity equal to 0.75 for diminutive adenomas (<6 mm), 0.85 for small adenomas (6–10 mm), 0.95 for large adenomas (≥10 mm), and 0.95 for preclinical cancer. We also selected adenoma sensitivity that resulted in more accurate predictions. Targets were drawn from the Wheat Bran Fiber study. In the study, we examined how well the model predicted outcomes measured over a three-year follow-up period, including the number of adenomas detected, the size of the largest adenoma detected, and incident colorectal cancer. Results: Using standard sensitivity assumptions, the model predicted adenoma prevalence that was too low (42.5% versus 48.9% observed, with 95% confidence interval 45.3%–50.7%) and detection of too few large adenomas (5.1% versus 14.% observed, with 95% confidence interval 11.8%–17.4%). Predictions were close to targets when we set sensitivities to 0.20 for diminutive adenomas, 0.60 for small adenomas, 0.80 for 10- to 20-mm adenomas, and 0.98 for adenomas 20 mm and larger. Conclusions: Colonoscopy may be less accurate than currently assumed, especially for diminutive adenomas. Alternatively, the CRC-SPIN model may not accurately simulate onset and progression of adenomas in higher-risk populations. Impact: Misspecification of either colonoscopy sensitivity or disease progression in high-risk populations may affect the predicted effectiveness of colorectal cancer screening. When possible, decision analyses used to inform policy should address these uncertainties.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2020

Direct measurement of the contribution of street lighting to satellite observations of nighttime light emissions from urban areas

Nighttime light emissions are increasing in most countries worldwide, but which types of lighting are responsible for the increase remains unknown. Also unknown is what fraction of outdoor light emissions and associated energy use are due to public light sources (i.e. streetlights) or various types of private light sources (e.g. advertising). Here we show that it is possible to measure the contribution of street lighting to nighttime satellite imagery using ‘smart city’ lighting infrastructure. The city of Tucson, USA, intentionally altered its streetlight output over 10 days, and we examined the change in emissions observed by satellite. We find that streetlights operated by the city are responsible for only 13% of the total radiance (in the 500–900 nm band) observed from Tucson from space after midnight (95% confidence interval 10–16%). If Tucson did not dim their streetlights after midnight, the contribution would be 18% (95% confidence interval 15–23%). When streetlights operated by other actors are included, the best estimates rise to 16% and 21%, respectively. Existing energy and lighting policy related to the sustainability of outdoor light use has mainly focused on street lighting. These results suggest an urgent need for consideration of other types of light sources in outdoor lighting policy.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

DOE OSTI2020

Benchmark Dose Analysis of DNA Damage Biomarker Responses Provides Compound Potency and Adverse Outcome Pathway Information for the Topoisomerase II Inhibitor Class of Compounds

Genetic toxicology data have traditionally been utilized for hazard identification to provide a binary call for a compound's risk. Recent advances in the scientific field, especially with the development of high‐throughput methods to quantify DNA damage, have influenced a change of approach in genotoxicity assessment. The in vitro MultiFlow® DNA Damage Assay is one such method which multiplexes γH2AX, p53, phospho‐histone H3 biomarkers into a single‐flow cytometric analysis (Bryce et al., [2016]: Environ Mol Mutagen 57:546–558). This assay was used to study human TK6 cells exposed to each of eight topoisomerase II poisons for 4 and 24 hr. Using PROAST v65.5, the Benchmark Dose approach was applied to the resulting flow cytometric datasets. With “compound” serving as covariate, all eight compounds were combined into a single analysis, per time point and endpoint. The resulting 90% confidence intervals, plotted in Log scale, were considered as the potency rank for the eight compounds. The in vitro MultiFlow data showed a maximum confidence interval span of 1Log, which indicates data of good quality. Patterns observed in the compound potency rank were scrutinized by using the expert rule‐based software program Derek Nexus, developed by Lhasa Limited. Compound sub‐classification and structural alerts were considered contributory to the potencies observed for the topoisomerase II poisons studied herein. The Topo II poison Adverse Outcome Pathway was evaluated with MultiFlow endpoints serving as Key Events. The step‐wise approach described herein can be considered as a foundation for risk assessment of compounds within a specific mode of action of interest. Environ. Mol. Mutagen. 2020. © 2020 Wiley Periodicals, Inc.

Wheeldon, Ryan P.↗

DOE OSTI2021

A Primer on Dose-Response Data Modeling in Radiation Therapy

An overview of common approaches used to assess a dose response for radiation therapy–associated endpoints is presented, using lung toxicity data sets analyzed as a part of the High Dose per Fraction, Hypofractionated Treatment Effects in the Clinic effort as an example. Each component presented (eg, data-driven analysis, dose-response analysis, and calculating uncertainties on model prediction) is addressed using established approaches. Specifically, the maximum likelihood method was used to calculate best parameter values of the commonly used logistic model, the profile-likelihood to calculate confidence intervals on model parameters, and the likelihood ratio to determine whether the observed data fit is statistically significant. The bootstrap method was used to calculate confidence intervals for model predictions. Correlated behavior of model parameters and implication for interpreting dose response are discussed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2024

On the uncertainty of long-period return values of extreme daily precipitation

Methods for calculating return values of extreme precipitation and their uncertainty are compared using daily precipitation rates over the Western U.S. and Southwestern Canada from a large ensemble of climate model simulations. The roles of return-value estimation procedures and sample size in uncertainty are evaluated for various return periods. We compare two different generalized extreme value (GEV) parameter estimation techniques, namely L-moments and maximum likelihood (MLE), as well as empirical techniques. Even for very large datasets, confidence intervals calculated using GEV techniques are narrower than those calculated using empirical methods. Furthermore, the more efficient L-moments parameter estimation techniques result in narrower confidence intervals than MLE parameter estimation techniques at small sample sizes, but similar best estimates. It should be noted that we do not claim that either parameter fitting technique is better calibrated than the other to estimate long period return values. While a non-stationary MLE methodology is readily available to estimate GEV parameters, it is not for the L-moments method. Comparison of uncertainty quantification methods are found to yield significantly different estimates for small sample sizes but converge to similar results as sample size increases. Finally, practical recommendations about the length and size of climate model ensemble simulations and the choice of statistical methods to robustly estimate long period return values of extreme daily precipitation statistics and quantify their uncertainty.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2026

Frequentist cosmological constraints from full-shape clustering measurements in DESI DR1

We present a frequentist analysis of clustering measurements from Data Release 1 of the Dark Energy Spectroscopic Instrument (DESI) using the standard profile likelihood method. While Bayesian inferences for effective field theory models of galaxy clustering can be highly sensitive to prior choices for extended cosmological models, frequentist inferences are not susceptible to such effects. We compare frequentist and Bayesian constraints for the parameter set {σ 8 , H 0 , Ω m , w 0 , w a } using the full-shape power spectrum multipoles, post-reconstruction baryon acoustic oscillation (BAO) measurements, and external datasets from the CMB and type Ia supernovae measurements. The frequentist confidence intervals are significantly shifted relative to the Bayesian credible intervals for the w 0 w a CDM model, unless supernovae data are included. When DESI full-shape and BAO data are fit jointly, we obtain the following 1σ frequentist confidence intervals for ΛCDM (w 0 w a CDM): σ 8 = 0.863 +0.048 -0.040 , H 0 = 68.96 +0.81 -0.80 km s -1 Mpc -1 , Ω m = 0.3034 ± 0.0110 (σ 8 = 0.782 +0.060 -0.036 , H 0 = 63.7 +4.2 -2.0 km s -1 Mpc -1 , Ω m = 0.378 +0.024 -0.047 , w 0 = -0.16 +0.10 -0.50 , w a = -3.0 +1.7 ), corresponding to 0.8σ, 0.3σ, 0.7σ (2.1σ, 4.1σ, 6.5σ, 6.3σ, 6.6σ) shifts between the maximum likelihood estimate and the Bayesian posterior mean for ΛCDM (w 0 w a CDM) respectively.

Bayesian reasoning↗

DOE OSTI2025

Comparison of removal and spatial mark‐resight models for estimating wild pig density

Density estimation is critical to effectively manage invasive species and elucidate areas of highest concern. For wild pigs (Sus scrofa), the ability to estimate density is complicated because of their variable home range sizes and social structure. Common methods for estimating density (e.g., mark-recapture) may be unsuitable in management applications because additional data needs to be collected before and after management. Removal models offer a suitable alternative to estimate density changes following management and can be applied broadly across areas where management of wild pigs is ongoing. We collected wild pig removal and camera trap data from 25 private properties ranging in size from approximately 0.5 km 2 to 95 km 2 across 3 ecoregions in South Carolina, USA, from 2020–2023. We compared factors affecting consistency and precision of property-level density estimates between removal and spatial mark-resight (SMR) models. In general, excluding 1 large outlier, density estimates from removal models were between 0.60 and 15.85 wild pigs/km 2 (median = 5.34) with a median coefficient of variation (CV) of 0.76 and 95% confidence intervals for the CV between 0.70 and 0.94. Similarly, excluding 1 large outlier, density estimates from SMR were between 0.22 and 30.97 wild pigs/km 2 (median = 5.48) with a median CV of 0.39 and 95% confidence intervals for the CV between 0.38 and 1.20. We found the precision of removal models was affected primarily by the number of wild pigs dispatched in the removal period (3 months) and the ecoregion in which they were removed. None of the covariates, including the number of recaptures (a corresponding measure of sample size), influenced precision of the SMR models, although recaptures did influence the density estimates. At the individual property level, density estimates from our 2 estimators were dissimilar from each other in approximately 80% of instances, although none of the covariates we examined influenced dissimilarity. Our results provide unique insight into how sample size affects density estimates using 2 common methods and into novel SMR models that incorporate both marked and unmarked detections. In addition, the density estimates in this study can be used as a reference for wild pig densities in common land cover types throughout the southeastern United States.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2023

Bullying among children with heart conditions, National Survey of Children’s Health, 2018–2020

Abstract Children with chronic illnesses report being bullied by peers, yet little is known about bullying among children with heart conditions. Using 2018–2020 National Survey of Children’s Health data, the prevalence and frequency of being bullied in the past year (never; annually or monthly; weekly or daily) were compared between children aged 6–17 years with and without heart conditions. Among children with heart conditions, associations between demographic and health characteristics and being bullied, and prevalence of diagnosed anxiety or depression by bullying status were examined. Differences were assessed with chi-square tests and multivariable logistic regression using predicted marginals to produce adjusted prevalence ratios and 95% confidence intervals. Weights yielded national estimates. Of 69,428 children, 2.2% had heart conditions. Children with heart conditions, compared to those without, were more likely to be bullied (56.3% and 43.3% respectively; adjusted prevalence ratio [95% confidence interval] = 1.3 [1.2, 1.4]) and bullied more frequently (weekly or daily = 11.2% and 5.3%; p < 0.001). Among children with heart conditions, characteristics associated with greater odds of weekly or daily bullying included ages 9–11 years compared to 15–17 years (3.4 [2.0, 5.7]), other genetic or inherited condition (1.7 [1.0, 3.0]), ever overweight (1.7 [1.0, 2.8]), and a functional limitation (4.8 [2.7, 8.5]). Children with heart conditions who were bullied, compared to never, more commonly had anxiety (40.1%, 25.9%, and 12.8%, respectively) and depression (18.0%, 9.3%, and 4.7%; p < 0.01 for both). Findings highlight the social and psychological needs of children with heart conditions.

Cardiovascular System & Cardiology↗

DOE OSTI2023

Gut microbiome dynamics and associations with mortality in critically ill patients

Abstract Background Critical illness and care within the intensive care unit (ICU) leads to profound changes in the composition of the gut microbiome. The impact of such changes on the patients and their subsequent disease course remains uncertain. We hypothesized that specific changes in the gut microbiome would be more harmful than others, leading to increased mortality in critically ill patients. Methods This was a prospective cohort study of critically ill adults in the ICU. We obtained rectal swabs from 52 patients and assessed the composition the gut microbiome using 16 S rRNA gene sequencing. We followed patients throughout their ICU course and evaluated their mortality rate at 28 days following admission to the ICU. We used selbal, a machine learning method, to identify the balance of microbial taxa most closely associated with 28-day mortality. Results We found that a proportional ratio of four taxa could be used to distinguish patients with a higher risk of mortality from patients with a lower risk of mortality (p = .02). We named this binarized ratio our microbiome mortality index (MMI). Patients with a high MMI had a higher 28-day mortality compared to those with a low MMI (hazard ratio, 2.2, 95% confidence interval 1.1–4.3), and remained significant after adjustment for other ICU mortality predictors, including the presence of the acute respiratory distress syndrome (ARDS) and the Acute Physiology and Chronic Health Evaluation (APACHE II) score (hazard ratio, 2.5, 95% confidence interval 1.4–4.7). High mortality was driven by taxa from theAnaerococcus(genus) andEnterobacteriaceae(family), while lower mortality was driven byParasutterellaandCampylobacter(genera). Conclusions Dysbiosis in the gut of critically ill patients is an independent risk factor for increased mortality at 28 days after adjustment for clinically significant confounders. Gut dysbiosis may represent a potential therapeutic target for future ICU interventions.

Gastroenterology & Hepatology↗

DOE OSTI2021

Radiation effects on atherosclerosis in atomic bomb survivors: a cross-sectional study using structural equation modeling

Past reports indicated that total-body irradiation at low to moderate doses could be responsible for cardiovascular disease risks, but the mechanism remains unclear. The purpose of this study was to investigate the association between radiation exposure and atherosclerosis, an underlying pathology of cardiovascular diseases, in the Japanese atomic bomb survivors. We performed a cross-sectional study measuring 14 clinical-physiological atherosclerosis indicators during clinical exams from 2010 to 2014 in 3274 participants of the Adult Health Study cohort. Multivariable analyses were performed by using a structural equation model with latent factors representing underlying atherosclerotic pathologies: (1) arterial stiffness, (2) calcification, and (3) plaque as measured with indicators chosen a priori on the basis of clinical-physiological knowledge. Radiation was linearly associated with calcification (standardized coefficient per Gy 0.15, 95 % confidence interval: CI [0.070, 0.23]) and plaque (0.11, 95 % CI [0.029, 0.20]), small associations that were comparable to about 2 years of aging per Gy of radiation exposure, but not with arterial stiffness (0.036, 95 % CI [-0.025, 0.095]). The model fitted better and had narrower confidence intervals than separate ordinary regression models explaining individual indicators independently. The associations were less evident when the dose range was restricted to a maximum of 2 or 1 Gy. By combining individual clinical-physiological indicators that are correlated because of common, underlying atherosclerotic pathologies, we found a small, but significant association of radiation with atherosclerosis.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2021

Association of human T-cell leukemia virus type 1 with prevalent rheumatoid arthritis among atomic bomb survivors: A cross-sectional study

Previous studies have suggested that human T-cell leukemia virus type 1 (HTLV-1) might act as a pathogen in rheumatoid arthritis (RA), but epidemiological evidence of an association is scarce. We measured anti-HTLV-1 antibodies among Nagasaki atomic bomb survivors to determine whether HTLV-1 is related to RA and whether radiation exposure is associated with HTLV-1 and RA prevalence. This is a cross-sectional study among atomic bomb survivors who participated in biennial health examinations from 2006 to 2010. Serum levels of anti-HTLV-1 antibodies were measured using a chemiluminescent enzyme immunoassay and confirmed by Western blotting. Association between HTLV-1 and RA was analyzed by a logistic regression model. Of 2091 participants (women 61.5%; median age, 73 years), 215 (10.3%) had anti-HTLV-1 antibodies. HTLV-1 prevalence was higher among women (13.1% vs 5.8%; P<.001). Twenty-two participants (1.1%) were diagnosed with RA. HTLV-1 prevalence among RA participants was significantly higher than that among non-RA participants (27.3% vs 10.1%; P=.020). After adjustment for age, sex, and hepatitis C virus infection, HTLV-1 was significantly associated with prevalent RA (odds ratio, 2.89; 95% confidence interval, 1.06, 7.03). There was no association between radiation dose and either the prevalence of HTLV-1 or RA. This study, among a well-defined group of atomic bomb survivors, suggests that HTLV-1 is associated with RA. Abbreviations: AHS = Adult Health Study, ATL/ATLL = adult T cell leukemia/lymphoma, bioDMARDs = biological disease modifying antirheumatic drugs, CCP = cyclic citrullinated peptide, CI = confidence interval, CLEIA = chemiluminescent enzyme immunoassay, CRP = C-reactive protein, csDMARDs = conventional synthetic disease modifying antirheumatic drugs, Gy = gray, HCV = hepatitis C virus, HTLV-1 = human T-cell leukemia virus type 1, IF = immunofluorescent, RA = rheumatoid arthritis, RERF = Radiation Effects Research Foundation, RF = rheumatoid factor, SS = Sjogren syndrome.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2021

Attribution of the role of climate change in the forest fires in Sweden 2018

In this study, we analyse the role of climate change in the forestfires that raged through large parts of Sweden in the summer of 2018 from ameteorological perspective. This is done by studying the Canadian FireWeather Index (FWI) based on sub-daily data, both in reanalysis data sets(ERA-Interim, ERA5, the Japanese 55 year Reanalysis, JRA-55, and Modern-Era Retrospective analysis for Research and Applications version 2, MERRA-2) and three large-ensemble climatemodels (EC-Earth, weather@home, W@H, and Community Earth System Model, CESM) simulations. The FWI, based on reanalysis, correlates well with the observed burnt area in summer (r=0.6 to 0.8). We find that the maximum FWI in July 2018 had return times of ~24 years (90 % CI, confidence interval, > 10 years) for southern and northern Sweden. Furthermore, we find a negative trend of the FWI for southern Sweden over the 1979 to 2017 time period in the reanalyses, yielding a non-significant reduced probability of such an event. However, the short observational record, large uncertainty between the reanalysis products and large natural variability of the FWI give a large confidence interval around this number that easily includes no change, so we cannot draw robust conclusions from reanalysis data. The three large-ensembles with climate models point to a roughly 1.1 (0.9 to 1.4) times increased probability (non-significant) for such events in the current climate relative to preindustrial climate. For a future climate (2 °C warming), we find a roughly 2 (1.5 to 3) times increased probability for such events relative to the preindustrial climate. The increased fire weather risk is mainly attributed to the increase intemperature. The other main factor, i.e. precipitation during summer months, isprojected to increase for northern Sweden and decrease for southern Sweden. We, however, do not find a clear change in prolonged dry periods in summer months that could explain the increased fire weather risk in the climate models. In summary, we find a (non-significant) reduced probability of such eventsbased on reanalyses, a small (non-significant) increased probability due to global warming up to now and a more robust (significant) increase in the risk for such events in the future based on the climate models.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2021

Expected individual benefit of prophylactic platelet transfusions in hemato‐oncology patients based on bleeding risks

Abstract Background Prophylactic platelet transfusions prevent bleeding in hemato‐oncology patients, but it is unclear how any benefit varies between patients. Our aim was to assess if patients with different baseline risks for bleeding benefit differently from a prophylactic platelet transfusion strategy. Study design and methods Using the data from the randomized controlled TOPPS trial (Trial of Platelet Prophylaxis), we developed a prediction model for World Health Organization grades 2, 3, and 4 bleeding risk (defined as at least one bleeding episode in a 30 days period) and grouped patients in four risk‐quartiles based on this predicted baseline risk. Predictors in the model were baseline platelet count, age, diagnosis, disease modifying treatment, disease status, previous stem cell transplantation, and the randomization arm. Results The model had a c‐statistic of 0.58 (95% confidence interval [CI] 0.54–0.64). There was little variation in predicted risks (quartiles 46%, 47%, and 51%), but prophylactic platelet transfusions gave a risk reduction in all risk quartiles. The absolute risk difference (ARD) was 3.4% (CI −12.2 to 18.9) in the lowest risk quartile (quartile 1), 7.4% (95% CI −8.4 to 23.3) in quartile 2, 6.8% (95% CI −9.1 to 22.9) in quartile 3, and 12.8% (CI −3.1 to 28.7) in the highest risk quartile (quartile 4). Conclusion In our study, generally accepted bleeding risk predictors had limited predictive power (expressed by the low c‐statistic), and, given the wide confidence intervals of predicted ARD, could not aid in identifying subgroups of patients who might benefit more (or less) from prophylactic platelet transfusion.

Cornelissen, Loes L.↗

DOE OSTI2022

Assessments of epistemic uncertainty using Gaussian stochastic weight averaging for fluid-flow regression

Here, we use Gaussian stochastic weight averaging (SWAG) to assess the epistemic uncertainty associated with neural-network-based function approximation relevant to fluid flows. SWAG approximates a posterior Gaussian distribution of each weight, given training data, and a constant learning rate. Having access to this distribution, it is able to create multiple models with various combinations of sampled weights, which can be used to obtain ensemble predictions. The average of such an ensemble can be regarded as the 'mean estimation', whereas its standard deviation can be used to construct 'confidence intervals', which enable us to perform uncertainty quantification (UQ) with regard to the training process of neural networks. We utilize representative neural-network-based function approximation tasks for the following cases: (i) a two-dimensional circular-cylinder wake; (ii) the DayMET dataset (maximum daily temperature in North America); (iii) a three-dimensional square-cylinder wake; and (iv) urban flow, to assess the generalizability of the present idea for a wide range of complex datasets. SWAG-based UQ can be applied regardless of the network architecture, and therefore, we demonstrate the applicability of the method for two types of neural networks: (i) global field reconstruction from sparse sensors by combining convolutional neural network (CNN) and multi-layer perceptron (MLP); and (ii) far-field state estimation from sectional data with two-dimensional CNN. We find that SWAG can obtain physically-interpretable confidence-interval estimates from the perspective of epistemic uncertainty. This capability supports its use for a wide range of problems in science and engineering.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2022

Improving Traditional Registrational Trial End Points: Development and Application of a Desirability of Outcome Ranking End Point for Complicated Urinary Tract Infection Clinical Trials

Abstract Background Traditional end points used in registrational randomized, controlled trials (RCTs) often do not allow for complete interpretation of the full range of potential clinical outcomes. Desirability of outcome ranking (DOOR) is an approach to the design and analysis of clinical trials that incorporates benefits and risks of novel treatment strategies and provides a global assessment of patient experience. Methods Through a multidisciplinary committee of experts in infectious diseases, clinical trial design, drug regulation, and patient experience, we developed a DOOR end point for infectious disease syndromes and demonstrated how this could be applied to 3 registrational drug trials (ZEUS, APEKS-cUTI, and DORI-05) for complicated urinary tract infections (cUTIs). ZEUS compared fosfomycin to piperacillin/tazobactam, APEKS-cUTI compared cefiderocol to imipenem, and DORI-05 compared doripenem to levofloxacin. Using DOOR, we estimated the probability of a more desirable outcome with each investigational antibacterial drug. Results In each RCT, the DOOR distribution was similar and the probability that a patient in the investigational arm would have a more desirable outcome than a patient in the control arm had a 95% confidence interval containing 50%, indicating no significant difference between treatment arms. DOOR facilitated improved understanding of potential trade-offs between clinical efficacy and safety. Partial credit and subgroup analyses also highlight unique attributes of DOOR. Conclusions DOOR can effectively be used in registrational cUTI trials. The DOOR end point presented here can be adapted for other infectious disease syndromes and prospectively incorporated into future clinical trials.

Immunology↗

DOE OSTI2023

Moving Beyond Mortality: Development and Application of a Desirability of Outcome Ranking (DOOR) Endpoint for Hospital-Acquired Bacterial Pneumonia and Ventilator-Associated Bacterial Pneumonia

Abstract Background Hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP) are frequently caused by multidrug-resistant organisms. Patient-centered endpoints in clinical trials are needed to develop new antibiotics for HABP/VABP. Desirability of outcome ranking (DOOR) is a paradigm for the design, analysis, and interpretation of clinical trials based on a patient-centered, benefit-risk evaluation. Methods A multidisciplinary committee created an infectious diseases DOOR endpoint customized for HABP/VABP, incorporating infectious complications, serious adverse events, and mortality. We applied this to 2 previously completed, large randomized controlled trials for HABP/VABP. ZEPHyR compared vancomycin to linezolid and VITAL compared linezolid to tedizolid. For each trial, we evaluated the DOOR distribution and probability, including DOOR component and partial credit analyses. We also applied DOOR in subgroup analyses. Results In both trials, the HABP/VABP DOOR demonstrated similar overall clinical outcomes between treatment groups. In ZEPHyR, the probability that a participant treated with linezolid would have a more desirable outcome than a participant treated with vancomycin was 50.2% (95% confidence interval [CI], 45.1%−55.3%). In VITAL, the probability that a participant treated with tedizolid would have a more desirable outcome than a participant treated with linezolid was 48.7% (95% CI, 44.8%–52.6%). The DOOR component analysis revealed that participants treated with tedizolid had a less desirable outcome than those treated with linezolid when considering clinical response alone. However, participants with decreased renal function had improved overall outcomes with tedizolid. Conclusions The HABP/VABP DOOR provided more granular information about clinical outcomes than is typically presented in clinical trials. HABP/VABP trials would benefit from prospectively using DOOR.

Immunology↗

DOE OSTI2026

Electrochemical behavior of SnCl 2 and influence of Cu and Ni ions in molten LiCl−KCl−CaCl 2 eutectic

Reliable transport and thermodynamic data for multivalent ions in complex molten salts are scarce, limiting model fidelity for electrorefining and impurity control. Here, we report a comprehensive electrochemical characterization of SnCl₂ in LiCl–KCl–CaCl₂ (50.5–44.2–5.3 mol%) at 685 K, including the effects of Ni 2+ and Cu + impurities. Using cyclic voltammetry (CV), chronoamperometry (CA), and chronopotentiometry (CP), we quantified Sn 2+ and Ni 2+ diffusion with exceptional agreement across methods: Sn 2+ averaged (1.03 ± 0.10) × 10 −5 cm 2 s −1 , and Ni 2+ averaged (0.75 ± 0.19) × 10 −5 cm 2 s −1 . The tight confidence-interval overlap across CV, CA, and CP strengthens confidence in these values and is uncommon in molten chloride studies. Open-circuit-potential measurements provided standard apparent reduction potentials that closely match LiCl–KCl literature, indicating minimal shift with CaCl₂ present. The Sn 2+ /Sn couple behaves as a reversible two-electron soluble–insoluble process at 685 K; the Sn 4+ /Sn 2+ couple transitions to soluble–soluble behavior near 788 K, which may correlate with the decomposition of surface bound chlorostannates, though direct characterization remains to be established. In mixed systems, Cu+/Cu overlaps Sn 2+ /Sn, limiting Cusingle bondSn electroseparation, whereas the larger potential gap between Ni 2+ /Ni and Sn 2+ /Sn supports selective Ni removal. These internally consistent transport and thermodynamic data establish a validated basis for process modeling and optimization of Sn electrorefining and impurity management in LiCl–KCl–CaCl₂.

Berzins-Delahay↗

DOE OSTI2023

A Multi-Fidelity Gaussian Process Regression Method for Probabilistic Wind Farm Power Curve Estimation

Accurate estimation of the power curve for wind turbines or wind farms is crucial to ensure their efficient operation and management. However, conventional methods for power curve estimation rely either on expensive and infrequent measurements or on low-quality numerical simulations. Moreover, the majority of previous studies on power curve estimation for wind turbines or wind farms focused on deterministic estimation, which provides a point estimate of the relationship between wind speed and power generation. Nevertheless, the deterministic approach fails to consider the inherent uncertainty associated with wind energy production resulting from varying turbine characteristics. This can lead to inaccurate power generation estimation and suboptimal decisions regarding energy management. In this paper, a kernel density estimation (KDE) based Multi-Fidelity Gaussian Process Regression (MFGPR) model is proposed to fuse theoretical power curve data and the ground true measurements to create a mapping of wind speed and wind power. By conducting a case study on an actual wind farm in China, the efficacy of the proposed MFGPR model was demonstrated in characterizing the variability of wind power. The probabilistic MFGPR model was also able to generate confidence intervals that encompassed the measured power, thereby improving the accuracy and confidence in wind power estimation or wind resource assessment. Overall, the proposed MFGPR model offers a reliable approach to integrate high-fidelity ground measurements and theoretical power curve data, resulting in precise wind resource assessment and power estimation.

Gaussian process regression↗