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All sourcesNASA NTRSDOE OSTI
DOE OSTI2022

Effect of vaccination on the case fatality rate for COVID-19 infections 2020–2021: multivariate modelling of data from the US Department of Veterans Affairs

Objectives: To evaluate the benefits of vaccination on the case fatality rate (CFR) for COVID-19 infections. Design, setting and participants: The US Department of Veterans Affairs has 130 medical centres. We created multivariate models from these data—339 772 patients with COVID-19—as of 30 September 2021. Outcome measures: The primary outcome for all models was death within 60 days of the diagnosis. Logistic regression was used to derive adjusted ORs for vaccination and infection with Delta versus earlier variants. Models were adjusted for confounding factors, including demographics, comorbidity indices and novel parameters representing prior diagnoses, vital signs/baseline laboratory tests and outpatient treatments. Patients with a Delta infection were divided into eight cohorts based on the time from vaccination to diagnosis. A common model was used to estimate the odds of death associated with vaccination for each cohort relative to that of unvaccinated patients. Results: 9.1% of subjects were vaccinated. 21.5% had the Delta variant. 18 120 patients (5.33%) died within 60 days of their diagnoses. The adjusted OR for a Delta infection was 1.87±0.05, which corresponds to a relative risk (RR) of 1.78. The overall adjusted OR for prior vaccination was 0.280±0.011 corresponding to an RR of 0.291. Raw CFR rose steadily after 10–14 weeks. The OR for vaccination remained stable for 10–34 weeks. Conclusions: Our CFR model controls for the severity of confounding factors and priority of vaccination, rather than solely using the presence of comorbidities. Our results confirm that Delta was more lethal than earlier variants and that vaccination is an effective means of preventing death. After adjusting for major selection biases, we found no evidence that the benefits of vaccination on CFR declined over 34 weeks. We suggest that this model can be used to evaluate vaccines designed for emerging variants.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2023

Health outcomes among offspring of US Coast Guard responders to the Deepwater Horizon oil spill, 2010–2011

To evaluate the potential for adverse health outcomes among infants born to US Coast Guard (USCG) responders to the Deepwater Horizon (DWH) oil spill disaster. Department of Defense Birth and Infant Health Research programme data identified a cohort of singleton infants born 2010–2011 to USCG personnel in the DWH Oil Spill Coast Guard Cohort study. Infants were included if their military parent (‘sponsor’) responded to the oil spill during a selected reproductive exposure window (ie, 3 months preconception for male sponsors and periconception through pregnancy for female sponsors), or if their sponsor was a non-responder. χ 2 tests and multivariable log-binomial regression were used to compare the demographic and health characteristics of infants born to spill responders and non-responders. Altogether, 1974 infants with a male sponsor (n=182 responder, n=1792 non-responder) and 628 infants with a female sponsor (n=35 responder, n=593 non-responder) in the DWH Oil Spill Coast Guard Cohort were identified. Health outcomes were similar among the offspring of male responders and non-responders. The frequency of any poor live birth outcome (ie, low birth weight, preterm birth or birth defect) was higher among infants born to female responders (17.1%, n=6) than non-responders (8.9%, n=53); the maternal age-adjusted association was suggestively elevated (risk ratio 1.93, 95% CI 0.89 to 4.16). Infant health outcomes were comparable between the offspring of male USCG oil spill responders and non-responders. Findings were limited by the small number of infants identified, particularly among female responders, and should be interpreted with caution.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

A geo-visual analysis for exploring the socioeconomic benefits of the heating electrification using geothermal energy

In parallel to population growth and climate change, the rapid pace of urbanization worldwide has led to an enormous increase in energy demand and costs in urban areas. The subsequent energy burden has become an increasing concern for many households in the U.S. Previous studies have revealed that geothermal resources can effectively lower the electricity demand and carbon emissions in large cities. In this paper, we focus on the socioeconomic impacts of geothermal energy on urban systems by presenting an interactive visual analytics dashboard. The dashboard allows urban planners to spatially examine geothermal energy's practical benefits on energy affordability, urban livability, and resilience across the U.S. We compiled a list of socioeconomic metrics by integrating the simulation results from multiple geothermal and building models with multi-domain urban datasets (socioeconomic, demographic, and electricity utility). These metrics are created to characterize the benefits of the heating electrification of buildings using Geothermal Heat Pumps (GHP) for lowering the energy burden of middle-and low-income households nationwide. The visual dashboard employs a combination of multivariate, glyph-based, and geospatial visualization to reveal the variability and patterns in our metrics. We present a pilot study to demonstrate the GHPs' potential as a renewable and affordable solution for increasing the economic and energy grid resilience in U.S cities.

Xu, Haowen↗
DOE OSTI2025

CareWELL: Multimodal Region Representation Learning with Spatial Contexts for Urban Health

Rapid urbanization affects living environments by intensifying exposure to air pollution, heat, noise, and urban dynamics, which together contribute to uneven health outcomes across neighborhoods. For instance, cardiovascular, respiratory, and mental health conditions are each influenced by distinct exposures such as air pollution, extreme temperatures, or limited access to green space. These heterogeneous patterns require understanding the characteristics of geographic regions in order to explain why urban health risks vary across urban areas. Recent work in self-supervised region representation learning provides a promising way to model such characteristics from multimodal geospatial data. However, existing methods face two major limitations: (i) they often depend on non-public datasets, limiting reproducibility and applicability, and (ii) their generic pretraining objectives overlook health-relevant determinants, including temporal variability in environmental exposures and inequalities in social conditions. To address these gaps, we propose Context-Aware Region rEpresentation with Weather, Environment, and Location Learning (CareWELL). CareWELL leverages large language models to encode seasonal variability in weather, employs contrastive learning to align geo-coordinate and weather representations, and introduces a context-aware objective that integrates socio-demographic factors while preserving spatial correlations. We evaluate CareWELL by predicting six urban health outcomes in Manhattan, New York City, and demonstrate that CareWELL consistently outperforms state-of-the-art baselines as well as a traditional spatial computing method. These results suggest the importance of context-aware pretraining objectives for learning health-relevant region representations.

Namgung, Min [ORNL]↗
DOE OSTI2022

Nomogram for Predicting Postoperative Portal Venous Systemic Thrombosis in Patients with Cirrhosis Undergoing Splenectomy and Esophagogastric Devascularization

Objectives. The aim of the study is to develop a nomogram for predicting postoperative portal venous systemic thrombosis (PVST) in patients with cirrhosis undergoing splenectomy and esophagogastric devascularization. Methods. In total, 195 eligible patients were included. Demographic characteristics were collected, and the results of perioperative routine laboratory investigations and ultrasound examinations were also recorded. Blood cell morphological traits, including the red cell volume distribution width (RDW), mean platelet volume, and platelet distribution width, were identified. Univariate and multivariate logistic regressions were implemented for risk factor filtration, and an integrated nomogram was generated and then validated using the bootstrap method. Results. A color Doppler abdominal ultrasound examination on a postoperative day (POD) 7 (38.97%) revealed that 76 patients had PVST. The results of the multivariate logistic regression suggested that a higher RDW on POD3 (RDW3) (odds ratio (OR): 1.188, 95% confidence interval (CI): 1.073–1.326), wider portal vein diameter (OR: 1.387, 95% CI: 1.203–1.642), history of variceal hemorrhage (OR: 3.407, 95% CI: 1.670–7.220), and longer spleen length (OR: 1.015, 95% CI: 1.001–1.029) were independent risk parameters for postoperative PVST. Moreover, the nomogram integrating these four parameters exhibited considerable capability in PVST forecasting. The nomogram’s receiver operating characteristic curve reached 0.83 and achieved a sensitivity and specificity of 0.711 and 0.848, respectively, at its cutoff. The nomogram’s calibration curve demonstrated that it was well calibrated. Conclusion. The nomogram exhibited excellent performance in PVST prediction and might assist surgeons in identifying vulnerable patients and administering timely prophylaxis.

Chen, Miao↗
DOE OSTI2026

Housing Unit Level Social Vulnerability Indices for 2010 and 2020

Housing unit level demographic characteristics for SETX counties. Census years 2010 and 2020. These data are in beta testing stage, designed for use with the SETX-UIFL project. Contact Nathanael Rosenheim (nrosenheim@arch.tamu.edu) for more information. Papers using these data should include Nathanael Rosenheim in the development phase and co-authorship discussions.

Rosenheim, Nathanael↗
DOE OSTI2021

Budget Constrained Machine Learning for Early Prediction of Adverse Outcomes for COVID-19 Patients

Background: Machine learning (ML) based risk stratification models of Electronic Health records (EHR) data may help to optimize treatment of COVID-19 patients, but are often limited by their lack of clinical interpretability and cost of laboratory tests. We develop a ML based tool for predicting adverse outcomes based on EHR data to optimize clinical utility under a given cost structure. This cohort study was performed using deidentified EHR data from COVID-19 patients from ProMedica Healthcare in northwest Ohio and southeastern Michigan. Methods: We tested performance of various ML approaches for predicting either increasing ventilatory support or mortality and the set of model features under a budget constraint was optimized via exhaustive search across all combinations of features. Results: The optimal sets of features for predicting ventilation under any budget constraint included demographics and comorbidities (DCM), basic metabolic panel (BMP), D-dimer, lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), CRP, brain natriuretic peptide (BNP), and procalcitonin and for mortality included DCM, BMP, complete blood count, D-dimer, LDH, CRP, BNP, procalcitonin and ferritin. Conclusions: This study presents a quick, accurate and cost-effective method to evaluate risk of deterioration for patients with SARS-CoV-2 infection at the time of clinical evaluation.

Cadena Pico, JoseE.↗
DOE OSTI2023

Justice 40 Tool (J40 Tool) v1.0

The Justice 40 tool provides a quantitative framework to support decision-making around equitable energy interventions at the community level. The tool calculates the optimal portfolio of policy interventions that explicitly mitigates energy insecurity of an eligible population, by reducing its disproportionate energy burden. The place-based analysis assumes a spatial census tract-level resolution and distinguishes different sociodemographic groups within each tract. Instead of focusing on a specific technology, the underlying J40 model captures the combined effect of a set of policy interventions, currently including weatherization, rooftop solar, community solar and community wind. For each tract, the model chooses the optimal (least cost) combination of interventions to address the disproportionate burden, considering the specific population demographics and techno-economic potentials of technologies. Mathematically, this problem is formalized as an optimization model and formulated as a linear program.

Heleno, Miguel↗
DOE OSTI2024

Automobile and Technology Lifecycle-Based Assignment (ATLAS) v2.0.12

ATLAS is a comprehensive vehicle transaction and technology adoption microsimulator. ATLAS evolves the fleet mix of individual households by simulating the transaction (vehicle addition, disposal, and replacement) and choice (vehicle type, vintage, powertrain, and tenure) decisions in response to the co-evolving demographics, land use, and vehicle technology simulations. Different from the existing vehicle models that are either static or aggregated (e.g. stock model), ATLAS is fully disaggregated and dynamic following a sequential and circumstantial decision-making trajectory. This fine-grained approach not only enhances the realism of the simulation but also provides a nuanced understanding of the dynamics inherent in vehicle fleet evolution. ATLAS outputs are fully compatible with subsequent agent-based transportation modeling system and can enable distributional effect analysis regarding the fleet turnover among heterogeneous populations. ATLAS expands the typical new sale focused vehicle choice modeling to including used vehicle transactions that are of increasing interests to understanding the vehicle adoption behavior among lower income households.

Jin, Ling↗
DOE OSTI2023

QuESt Equity v.1

SAND2024-08793O QuESt Equity cross-references several public databases for power plant pollution and demographics to assess energy equity and environmental justice for energy storage projects. It also calculates the impacts of power plant pollution in disadvantaged communities. Sandia National Laboratories is a multimission laboratory managed and operated by National Technology & Engineering Solutions of Sandia, LLC, a wholly owned subsidiary of Honeywell International Inc., for the U.S. Department of Energy’s National Nuclear Security Administration under contract DE-NA0003525.

Rosewater, David↗
DOE OSTI2023

Commitment to Active Allyship Is Required to Address the Lack of Hispanic and Latinx Representation in the Earth and Atmospheric Sciences

In 2021, people of Hispanic and Latinx origin made up 6% of the atmospheric and Earth sciences workforce of the United States, yet they represent 20% of the population. Motivated by this disparity in Hispanic and Latinx representation in the atmospheric and Earth science workforce, this manuscript documents the lack of representation through existing limited demographic data. The analysis presents a clear gap in participation by Hispanic and Latinx people in academic settings, with a widening gap through each education and career stage. Several factors and challenges impacting the representation disparity include the lack of funding for and collaboration with Hispanic-serving institutions, limited opportunities due to immigration status, and limited support for international research collaborations. We highlight the need for actionable steps to address the lack of representation and provide targeted recommendations to federal funding agencies, educational institutions, faculty, and potential employers. While we wait for systemic cultural change from our scientific institutions, grassroots initiatives like those proudly led by the AMS Committee for Hispanic and Latinx Advancement will emerge to address the needs of the Hispanic and Latinx scientific and broader community. We briefly highlight some of those achievements. Lasting cultural change can only happen if our leaders are active allies in the creation of a more diverse, equitable, and inclusive future. Alongside our active allies we will continue to champion for change in our weather, water, and climate enterprise.

99 GENERAL AND MISCELLANEOUS↗
DOE OSTI2026

The UCAR Africa Initiative: Recent insights, challenges, and opportunities to foster collaborative research for environmental sustainability

Africa is increasingly being exposed to the negative impacts of climate and environmental change, while having less capacity to respond compared to other continents. The vulnerability partially results from unprecedented demographic growth, urbanization, and industrialization. However, the continent has still largely been underserved by the broader Earth System Science (ESS) community, as evidenced by the limited amount of ESS data and research that cover Africa compared to other areas of the world. Here we present the recent University Corporation for Atmospheric Research (UCAR) Africa Initiative that aims to enhance environmental sustainability in Africa by fostering international collaborative research partnerships co-led by African scientists. Specifically, we outline urgent challenges and opportunities identified through an international workshop in six areas of ESS namely (1) air quality and health, (2) weather, (3) climate, (4) land and water, (5) social science perspectives, and (6) developing equitable collaboration and sustainable infrastructure. We highlight examples of successful partnerships and conclude with recommendations to advance collaborative, actionable ESS research that addresses Africa’s critical environmental challenges.

African weather and land variability↗
DOE OSTI2021

Household Transportation Energy Affordability by Region and Socioeconomic Factors

Transportation fuel is an important component of household budgets, as 3.3% of total household expenditures are for vehicle fuel nationwide and over 50% of annual household expenditures on energy are for transportation. These average values vary geographically, and higher energy cost burdens are faced by households with lower incomes. Defining transportation energy affordability burden as the percentage of annual household income spent on vehicle fuel, this study aims to quantify affordability as a function of household characteristics and geography. Here, through analysis at the census tract level, this study (i) projects annual household vehicle miles traveled (VMT) based on demographic factors using machine-learning techniques, (ii) estimates local differences in vehicle fuel economy and fuel price, and (iii) quantifies resulting transportation energy affordability by census tract. This study found that the average burden by tract varies from 0.15% to 8%. The variation in affordability can be largely explained by income level and vehicle fuel efficiency. Suburban and rural households spend more on transportation energy compared with urban households because of the usage of less fuel-efficient vehicle technologies and higher annual VMT. Lower-income groups have a wide distribution of the percentage of income spent on transportation energy, 1.2% to 8%, whereas the range for the highest income group ($125,000+) is from 0.15% to 3.9%. This detailed transportation energy affordability analysis provides a better understanding of regional variations in household travel behavior, helps to determine where fuel-efficient vehicle technologies are more likely to be used, and improves estimates of vehicle ownership costs.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2026

An On-Demand Electric Transit Case Study of New Rochelle, New York

Here, this article characterizes the performance and ridership patterns of an on-demand transit (ODT) service utilizing lightweight electric vehicles (EVs) in New Rochelle, New York. Ridership sociodemographics, travel patterns (both temporal and spatiotemporal), and energy use from the service were explored using travel and survey data from September 2019 through December 2023. The ODT service was found to be used more by women (nearly 60%) and younger demographics (>65% under the age of 42), with peak use in the middle of the day and a grocery store as a top origin and destination. The service was utilized primarily for short trips (86% under 2 mi), with approximately one-third of riders using the ODT service to connect to a train or bus. The costs associated with fueling/charging were compared for different types of fleet vehicles, and the small, right-sized EVs were found to have annual charging costs that were roughly half of the refueling costs for conventional hybrid vans, and 24 times lower than a fleet of diesel buses. Evaluating the vehicle fleet and mapping current socio-spatial travel demand can inform system performance, guide service area development, and support future planning such as expansion to nearby communities and transit hubs. The findings in this case study suggest that on-demand electric transit may be a significant and growing space for advancing highly valued public mobility services. Public transport interventions that consider right-sized, electric, on-demand vehicles can help improve mobility access and reduce energy use and refueling costs.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2022

The 6-minute walk test predicts mortality in a pulmonary nontuberculous mycobacteria-predominant bronchiectasis cohort

Background: Bronchiectasis is a chronic lung condition frequently associated with nontuberculous mycobacteria pulmonary (NTM) disease. Persons with these conditions are at increased risk of mortality. Patient reported outcome (PRO) instruments and the 6-minute walk test (6MWT) have been shown to predict mortality for several lung conditions, but these measures have not been fully evaluated for bronchiectasis and NTM. Methods: We conducted a retrospective cohort study among adult patients enrolled in a natural history study of bronchiectasis at the National Heart, Lung, and Blood Institute. Electronic medical records were queried for demographic, clinical, microbiologic, radiographic, and PRO instrument data: St. George’s Respiratory Questionnaire (SGRQ), Medical Research Council Dyspnea Scale, and the Pulmonary Symptom Severity Score (PSSS). The study baseline date was defined as the patient’s first visit after January 1st, 2015 with a SGRQ or 6MWT completed. Follow-up was defined as the interval between the study baseline visit and date of death or December 31st, 2019. Sex-stratified Cox proportional-hazards regression was conducted to identify predictors of mortality. Separate models were run for each PRO and 6MWT measure, controlling for age, body mass index (BMI), fibrocavitary disease status, and M. abscessus infection. Results: In multivariable Cox proportional-hazards regression models, the PSSS-severity (aHR 1.29, 95% CI 1.04–1.59), the 6MWT total distance walked (aHR 0.938, 95% CI 0.896–0.981) and distance saturation product (aHR 0.930, 95% CI 0.887–0.974) independently predicted mortality. In addition, BMI was significantly predictive of mortality in all models. Conclusions: The 6MWT and a PRO instrument capturing symptom severity are independently predictive of mortality in our cohort of bronchiectasis patients.

6-minute walk test↗
DOE OSTI2024

Multi-modal characterisation of early-stage, subclinical cardiac deterioration in patients with type 2 diabetes

Abstract Background Type 2 diabetes mellitus (T2DM) is a major risk factor for heart failure with preserved ejection fraction and cardiac arrhythmias. Precursors of these complications, such as diabetic cardiomyopathy, remain incompletely understood and underdiagnosed. Detection of early signs of cardiac deterioration in T2DM patients is critical for prevention. Our goal is to quantify T2DM-driven abnormalities in ECG and cardiac imaging biomarkers leading to cardiovascular disease. Methods We quantified ECG and cardiac magnetic resonance imaging biomarkers in two matched cohorts of 1781 UK Biobank participants, with and without T2DM, and no diagnosed cardiovascular disease at the time of assessment. We performed a pair-matched cross-sectional study to compare cardiac biomarkers in both cohorts, and examined the association between T2DM and these biomarkers. We built multivariate multiple linear regression models sequentially adjusted for socio-demographic, lifestyle, and clinical covariates. Results Participants with T2DM had a higher resting heart rate (66 vs. 61 beats per minute,p < 0.001), longer QTc interval (424 vs. 420ms,p < 0.001), reduced T wave amplitude (0.33 vs. 0.37mV,p < 0.001), lower stroke volume (72 vs. 78ml,p < 0.001) and thicker left ventricular wall (6.1 vs. 5.9mm,p < 0.001) despite a decreased Sokolow-Lyon index (19.1 vs. 20.2mm,p < 0.001). T2DM was independently associated with higher heart rate (beta = 3.11, 95% CI = [2.11,4.10],p < 0.001), lower stroke volume (beta = −4.11, 95% CI = [−6.03, −2.19],p < 0.001) and higher left ventricular wall thickness (beta = 0.133, 95% CI = [0.081,0.186],p < 0.001). Trends were consistent in subgroups of different sex, age and body mass index. Fewer significant differences were observed in participants of non-white ethnic background. QRS duration and Sokolow-Lyon index showed a positive association with the development of cardiovascular disease in cohorts with and without T2DM, respectively. A higher left ventricular mass and wall thickness were associated with cardiovascular outcomes in both groups. Conclusion T2DM prior to cardiovascular disease was linked with a higher heart rate, QTc prolongation, T wave amplitude reduction, as well as lower stroke volume and increased left ventricular wall thickness. Increased QRS duration and left ventricular wall thickness and mass were most strongly associated with future cardiovascular disease. Although subclinical, these changes may indicate the presence of autonomic dysfunction and diabetic cardiomyopathy. Graphical Abstract

Cardiovascular System & Cardiology↗
DOE OSTI2025

The examination of the spatial and contextual disparities of determinant factors of adult obesity among communities in Chicago

The issue of adult obesity has multiple complexes contributing factors and is becoming a significant public health concern worldwide, including in the neighborhoods of Chicago. This study utilized data on nineteen demographic, environmental, socioeconomic, and behavioral characteristics of community neighborhoods in Chicago to analyze the interplay and impact of these complex factors, which is essential for understanding and addressing the issue. The analysis revealed significant geographic variations in the prevalence of adult obesity across Chicago neighborhoods, with associations of these patterns found significant in 17 out of 19 determinant factors studied. Notably, strong associations were found between obesity and the percentage of the White population, the quality of sidewalks and walkability, the economic hardship index, and the unemployment rate. Identifying high-risk adult obesity communities and understanding the multifaceted contributing factors is crucial for developing evidence-based interventions and policy initiatives to reduce obesity and create healthier, more equitable urban neighborhoods for a city such as Chicago and beyond.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2023

Evaluation of an open forecasting challenge to assess skill of West Nile virus neuroinvasive disease prediction

Abstract Background West Nile virus (WNV) is the leading cause of mosquito-borne illness in the continental USA. WNV occurrence has high spatiotemporal variation, and current approaches to targeted control of the virus are limited, making forecasting a public health priority. However, little research has been done to compare strengths and weaknesses of WNV disease forecasting approaches on the national scale. We used forecasts submitted to the 2020 WNV Forecasting Challenge, an open challenge organized by the Centers for Disease Control and Prevention, to assess the status of WNV neuroinvasive disease (WNND) prediction and identify avenues for improvement. Methods We performed a multi-model comparative assessment of probabilistic forecasts submitted by 15 teams for annual WNND cases in US counties for 2020 and assessed forecast accuracy, calibration, and discriminatory power. In the evaluation, we included forecasts produced by comparison models of varying complexity as benchmarks of forecast performance. We also used regression analysis to identify modeling approaches and contextual factors that were associated with forecast skill. Results Simple models based on historical WNND cases generally scored better than more complex models and combined higher discriminatory power with better calibration of uncertainty. Forecast skill improved across updated forecast submissions submitted during the 2020 season. Among models using additional data, inclusion of climate or human demographic data was associated with higher skill, while inclusion of mosquito or land use data was associated with lower skill. We also identified population size, extreme minimum winter temperature, and interannual variation in WNND cases as county-level characteristics associated with variation in forecast skill. Conclusions Historical WNND cases were strong predictors of future cases with minimal increase in skill achieved by models that included other factors. Although opportunities might exist to specifically improve predictions for areas with large populations and low or high winter temperatures, areas with high case-count variability are intrinsically more difficult to predict. Also, the prediction of outbreaks, which are outliers relative to typical case numbers, remains difficult. Further improvements to prediction could be obtained with improved calibration of forecast uncertainty and access to real-time data streams (e.g. current weather and preliminary human cases). Graphical Abstract

54 ENVIRONMENTAL SCIENCES↗