Engineering Papers⌕ Search

SEARCH · Engineering Papers

Results for “HOSPITALS”

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.

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

At least 559 records · Page 31
All sourcesNASA NTRSDOE OSTI
DOE OSTI2019

Postoperative weight loss followed by radical cystectomy predicts poor prognosis in patients with muscle-invasive bladder cancer

We aimed to investigate the impact of postoperative weight loss following radical cystectomy (RC) on patients’ prognoses. RC and urinary diversion were performed in 512 consecutive patients with muscle-invasive bladder cancer at our hospitals between May 1996 and July 2018. Demographic clinical information, pre- and postoperative serum albumin, hemoglobin, and weight were evaluated retrospectively at 1 month. We also evaluated the association of weight loss with complications and overall survival (OS) as estimated using the Kaplan–Meier method and compared using the log-rank test. Risk factors for poor OS were determined by Inverse Probability of Treatment Weighted (IPTW)-adjusted Cox regression analysis. In 385 patients who met the study search criteria, median postoperative weight loss from baseline at 1 week and 1 month was 1.1 (− 1.8%) and 3.2 (− 5.4%) kg, respectively. Patients with significant weight loss (defined as ≥ 7.5% at 1 month) had higher-grade complications within 1 month and had significantly shorter OS than those with weight loss of < 7.5%. Type of urinary diversion, loss of serum albumin, and loss of hemoglobin were not significantly associated with weight loss. IPTW-adjusted Cox regression analysis showed that such significant weight loss was an independent risk factor for poor OS. Weight loss followed by radical cystectomy was significantly associated with poor prognosis in patients with muscle-invasive bladder cancer.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

The timing of docetaxel initiation in metastatic castrate-sensitive prostate cancer and the rate of chemotherapy-induced toxicity

Docetaxel pharmacokinetics are affected by androgen deprivation therapy (ADT), which is attributed to changes in liver metabolism induced by castration. In this retrospective analysis, we assessed whether initiating docetaxel treatment in close proximity to the start of ADT therapy for metastatic castrate-sensitive prostate cancer (mCSPC) is associated with more treatment-related toxicity. We identified all patients with mCSPC treated at The Ottawa Hospital that received docetaxel chemotherapy between June 2014 and September 2017. For each patient, we calculated the time to chemotherapy (TTC) interval between the start of ADT and the first cycle of docetaxel. We checked for an association between TTC and febrile neutropenia (FN), toxicity-induced dose reduction, toxicity-induced treatment delay, and toxicity-induced treatment discontinuation. Eighty-three patients were identified. The median TTC was 67 days (range 3–189). Twenty-three patients (27.7%) experienced FN. Docetaxel toxicity resulted in 8 patients (9.6%) having their treatment delayed, 30 patients (36.1%) having their dose reduced and 18 (21.6%) having their treatment discontinued before completing the scheduled 6 cycles. No correlation was found between the TTC and FN (P = 0.99), docetaxel dose reduction (P = 0.95), treatment delay (P = 0.06), and treatment discontinuation (P = 0.88). The timing of docetaxel treatment initiation in relation to ADT initiation in patients with mCSPC did not affect the rate of treatment-related toxicity. Therefore, there is no indication for upfront chemotherapy delay from start of ADT unless clinical factors warrant a delay in starting chemotherapy. A higher than expected FN rate was identified, and primary prophylaxis should be considered.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Multicenter open-label randomized phase II study of second-line panitumumab and irinotecan with or without fluoropyrimidines in patients with KRAS wild-type metastatic colorectal cancer (PACIFIC study)

This phase II clinical trial compared the efficacy and safety of second-line irinotecan and panitumumab treatment (IRI + Pmab) with that of irinotecan, fluoropyrimidines and panitumumab treatment (control) in patients with KRAS wild-type mCRC. The primary endpoint was progression-free survival. In addition, early predictive markers of treatment efficacy were explored. Eighty patients were planned to be recruited. Due to a slow accrual rate, only 48 patients were recruited from 2012 to 2016, of which 23 were allocated to the control group and 25 were allocated to the IRI + Pmab group. The median progression-free survival was 254 days (95% confidence interval, 159–306) for control, and 190 days (95% confidence interval, 159–213) for IRI + Pmab (log-rank test, P = 0.26). The response rate without confirmation was 21.7% (5/23) for control and 40.0% (10/25) for IRI + Pmab. Neutropenia, leukopenia, and anorexia were the most common Grade 3/4 adverse events, and several early drop-outs from the treatment protocol were observed in the control group. As for the biomarkers, carcinoembryonic antigen and lactate dehydrogenase (LDH) smoothly declined immediately after the initial dosing in patients with a partial response or stable disease. After starting treatment, LDH-1 and − 2 increased, while LDH-4 and − 5 decreased, irrespective of tumor response. However, exceptions were frequent. In conclusion, this study failed to prove the safety and efficacy of irinotecan and panitumumab treatment due to insufficient patient accrual. Although LDH and its isozymes changed after initiation of treatment, their ability to predict the tumor response may not surpass that of carcinoembryonic antigen levels. The University Hospital Medical Information Network Clinical Trial Registry: UMIN000007658.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

A study of mechanistic mapping of novel SNPs to male breast cancer

Alterations in BRCA2, PALB2, CHEK2, and p53 genes have been identified for their association with male breast cancer in various studies. The incidence of male breast cancer in India is consistent with its global rate. The present study was carried out with an aim to evaluate the genetic alterations in male breast cancer patients from Malwa region of Punjab, India. Four male breast cancer patients belonging to different families were recruited from Guru Gobind Singh Medical College and Hospital, Faridkot, India. A total of 51 genes reported with implications in the pathogenesis of breast cancer were screened using next generation sequencing. Germline variations were found in BRCA1, BRCA2, PMS2, p53, and PALB2 genes, previously reported to be associated with MBC as well as FBC. In addition to these, 13 novel missense alterations were detected in eight genes including STK11, FZR1, PALB2, BRCA2, NF2, BAP1, BARD1, and CHEK2. Impact of these missense alterations on structure and function of protein was also analyzed through molecular dynamics simulation. Structural analysis of these single nucleotide polymorphisms (SNPs) revealed significant impact on the encoded protein functioning.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2017

Energy savings potential from improved building controls for the US commercial building sector

The U.S. Department of Energy’s (DOE’s) Building Technologies Office (BTO) sponsored a study to determine the potential national savings achievable in the commercial building sector through widespread deployment of best practice controls, elimination of system and component faults, and use of better sensing. Detailed characterization of potential savings was one source of input to set research, development, and deployment (RD&D) goals in the field of building sensors and controls. DOE’s building energy simulation software, EnergyPlus, was employed to estimate the potential savings from 34 measures in 9 building types and across 16 climates representing almost 57% of commercial building sector energy consumption. In addition to estimating savings from individual measures, three packages of measures were created to estimate savings from the packages. These packages represented an 1) efficient building, 2) typical building, and 3) inefficient building. To scale the results from individual measures or a package to the national scale, building weights by building type and climate locations from the Energy Information Administration’s 2012 Commercial Building Energy Consumption Survey (CBECS) were used. The results showed significant potential for energy savings across all building types and climates. The total site potential savings from individual measures by building type and climate location ranged between 0% and 25%. The total site potential savings by building type aggregated across all climates (using the CBECS building weights) for each measure varied between 0% and 16%. The total site potential savings aggregated across all building types and climates for each measure varied between 0% and 11%. Some individual measures had negative savings because correcting underlying operational problems (e.g., inadequate ventilation) resulted in increased energy consumption. When combined into packages, the overall national savings potential is estimated to be 29%; seven of the nine building types were in the range of 23 to 29% and two exceeded 40%. The total potential national site savings in for each building type ranged between 95x106 GJ (0.09 Quadrillion British thermal units [Quads]; Large Hotels) to 222x106 GJ (0.21 Quads; Large Office, Hospital Administrative areas, and College/University), resulting in total site savings of 1,393x106 GJ (1.32 Quads) when the three packages are applied to the U.S. commercial buildings stock. Using the source (or primary) energy conversion factors of 1.05 for natural gas and 3.14 for electricity resulted in an approximate potential primary energy savings of 2,912x106 GJ (2.76 Quads), which would be 15% of the sector’s 2015 use of approximately 18,991x106 GJ (18 Quads). Extrapolating the results for other building types not analyzed as part of this study, the primary energy savings could be in the range of 4,220x106 GJ to 5,275x106 GJ (4 to 5 Quads). If this savings potential is realized, it would be equivalent to not combusting 180 to 230 million tons of coal or reducing the energy impacts, at today’s energy intensities, of the per capita consumption of 12 to 15 million people in the U.S. To realize most of this potential savings, many gaps can be addressed through RD&D, as recommended in this paper.

Fernandez, Nick↗
DOE OSTI2019

Prognostic study of cardiac events in Japanese patients with chronic kidney disease using ECG-gated myocardial Perfusion imaging: Final 3-year report of the J-ACCESS 3 study

Background: Myocardial perfusion imaging (MPI) is considered useful for risk stratification among patients with chronic kidney disease (CKD), without renal deterioration by contrast media. Methods and Results: The Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS 3) is a multicenter, prospective cohort study investigating the ability of MPI to predict cardiac events in 529 CKD patients without a definitive coronary artery disease. All patients were assessed by stress and rest MPI with {sup 99m}Tc-tetrofosmin and data were analyzed using a defect scoring method and QGS software. Major cardiac events were analyzed for 3 years after registration. The mean eGFR was 29.0 ± 12.8 (mL/minute/1.73 m{sup 2}). The mean summed stress/rest/difference (SSS, SRS, SDS) scores were 1.9 ± 3.8, 1.1 ± 3.0, and 0.8 ± 1.8, respectively. A total of 60 cardiac events (three cardiac deaths, six sudden deaths, five nonfatal myocardial infarctions, 46 hospitalization cases for heart failure) occurred. The event-free survival rate was lower among patients with kidney dysfunction, higher SSS, and higher CRP values. Multivariate Cox regression analysis independently associated SSS ≥8, eGFR <15 (mL/minute/1.73 m{sup 2}), and CRP ≥0.3 (mg/dL) with cardiac events. Conclusions: Together with eGFR and CRP, MPI can predict cardiac events in patients with CKD.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

{sup 18}F-FDG-PET in Finnish patients with clinical suspicion of cardiac sarcoidosis: Female sex and history of atrioventricular block increase the prevalence of positive PET findings

Introduction: Fluorodeoxyglucose positron emission tomography (FDG-PET) is a non-invasive imaging modality that has been shown to be a feasible method to demonstrate myocardial inflammation. The aim of this study was to identify the patients suspected of having cardiac sarcoidosis (CS), who are most likely to benefit from PET imaging. Materials and methods: 137 patients suspected of having CS underwent a dedicated cardiac FDG-PET examination at Tampere University Hospital between August 2012 and September 2015. These examinations were retrospectively analyzed. Results: 33 and 12 of the 137 patients had abnormal left and right ventricular (LV and RV) FDG-uptake, respectively. Abnormal LV-uptake and RV-uptake were significantly associated with female sex and a history of advanced AV-block (P < 0.05). Abnormal RV-uptake was also associated with ventricular tachycardia and atrial fibrillation (P < 0.05). 56% of the 27 female patients with a history of AV-block had a pathological PET finding compared to only 6% of the 49 male patients without a history of AV-block. There were 17 female patients with history of both AV-block and ventricular tachycardia, 71% of them had abnormal PET finding. Conclusions: Abnormal FDG-PET findings were associated with female sex, AV-block, and arrhythmias in this clinical cohort.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2018

Pitfalls in the Diagnosis of Acute Pulmonary Embolism on Computed Tomography: Common Pathologic and Imaging Mimics

Purpose of Review: Acute pulmonary embolism (PE) is the third most-common acute cardiovascular disease in the United States. Nearly 900,000 new diagnoses are made each year, with 250,000 associated hospitalizations and up to 100,000 deaths (Palacio et al. in Semin Roentgenol 50(3):217–225, 2015; Metter et al. in Am J Roentgenol 208(3):489–494, 2017; Jaff et al. in Circulation 123(16):1788–830, 2011). Timely and accurate diagnosis of acute PE is crucial for the prevention of most deaths associated with PE, even more so than optimal medical therapy (Palacio et al. in Semin Roentgenol 50(3):217–225, 2015; Jaff et al. in Circulation 123(16):1788–830, 2011; Raja et al. in Ann Intern Med 163(9):701, 2015). Recent Findings: Computed tomography (CT) has emerged as the primary imaging modality used in the diagnosis of acute PE. Thus, radiologists play a key role in the correct diagnosis of acute PE, and must differentiate this diagnosis from other conditions that mimic the imaging findings of acute PE, as well as from artifacts associated with imaging techniques (Palacio et al. in Semin Roentgenol 50(3):217–225, 2015; Jaff et al. in Circulation 123(16):1788–830, 2011; Raja et al. in Ann Intern Med 163(9):701, 2015). Understanding how these diagnoses present on CT is necessary for improved patient care. Summary: This article will discuss the diagnosis of acute PE with CT, the diagnosis of diseases that may be mistaken for acute PE, and how to identify imaging artifacts that may be mistaken for an acute PE.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2022

Prioritizing vaccination based on analysis of community networks

Abstract Many countries that had early access to COVID-19 vaccines implemented vaccination strategies that prioritized health care workers and the elderly. As barriers to access eased, vaccine prioritization strategies have been relaxed. However, these strategies are still an important tool for decision makers to manage new variants, plan for future booster shots, or stage mass vaccinations. This paper explores the impact of vaccine prioritization strategies using networks that represent communities with different demographics and connectivity. The impact of vaccination is compared to non-medical intervention to reduce transmission. Several sources of uncertainty are considered, including vaccine willingness and mask effectiveness. This paper finds that while prioritization strategies can have a large impact on reducing deaths and peak hospitalization, selecting the best strategy depends on community characteristics and the desired objective. Additionally, in some cases random vaccination performs as well as more targeted prioritization strategies. Understanding these trade-offs is important when planning vaccine distribution.

Klise, Katherine↗
DOE OSTI2017

Large-scale atomistic simulations of low-energy helium implantation into tungsten single crystals

Large-scale molecular dynamics simulations of post-implantation helium behavior in plasma-facing tungsten single crystals reveal orientation-dependent depth profiles, surface evolution patterns, and other crystallographic and diffusion-related characteristics of helium behavior in tungsten during the first microsecond. Here, the flux of implanted helium atoms studied, Γ ≈ 4 × 10 25 m -2 s -1 , is about one order of magnitude larger than that expected in ITER, the experimental fusion reactor currently being constructed in France. With simulation times on the order of 1 μs, these results serve to discover the mechanisms involved in surface evolution as well as to serve as benchmarks for coarse-grained simulations such as kinetic Monte Carlo and continuum-scale drift–reaction–diffusion cluster dynamics simulations. The findings of our large-scale simulations are significant due to diminished finite-size effects and the longer times reached (corresponding to higher fluences). Specifically, our findings are drastically different from findings published previously in the literature for (001) surfaces under a helium flux of Γ ~ 10 28 m -2 s -1 , which is typical of smaller size and shorter time atomistic simulations. In particular, this study highlights the atomic-scale materials processes relevant to helium entrapment and transport in metals, which have implications not only for nuclear fusion–relevant processes, but also helium-induced embrittlement in irradiated materials such as hospital equipment and fission reactor materials.

36 MATERIALS SCIENCE↗
DOE OSTI2021

Sequence Analysis of 20,453 Severe Acute Respiratory Syndrome Coronavirus 2 Genomes from the Houston Metropolitan Area Identifies the Emergence and Widespread Distribution of Multiple Isolates of All Major Variants of Concern

Since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, there has been international concern about the emergence of virus variants with mutations that increase transmissibility, enhance escape from the human immune response, or otherwise alter biologically important phenotypes. In late 2020, several variants of concern emerged globally, including the UK variant (B.1.1.7), the South Africa variant (B.1.351), Brazil variants (P.1 and P.2), and two related California variants of interest (B.1.429 and B.1.427). These variants are believed to have enhanced transmissibility. For the South Africa and Brazil variants, there is evidence that mutations in spike protein permit it to escape from some vaccines and therapeutic monoclonal antibodies. On the basis of our extensive genome sequencing program involving 20,453 coronavirus disease 2019 patient samples collected from March 2020 to February 2021, we report identification of all six of these SARS-CoV-2 variants among Houston Methodist Hospital (Houston, TX) patients residing in the greater metropolitan area. Although these variants are currently at relatively low frequency (aggregate of 1.1%) in the population, they are geographically widespread. Houston is the first city in the United States in which active circulation of all six current variants of concern has been documented by genome sequencing. Finally, as vaccine deployment accelerates, increased genomic surveillance of SARS-CoV-2 is essential to understanding the presence, frequency, and medical impact of consequential variants and their patterns and trajectory of dissemination.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2017

Breastfeeding and Breast Cancer Risk Reduction: Implications for Black Mothers

Breast cancer is the most commonly diagnosed cancer and a leading cause of death from cancer among U.S. women. Studies have suggested that breastfeeding reduces breast cancer risk among parous women, and there is mounting evidence that this association may differ by subtype such that breastfeeding may be more protective of some invasive breast cancer types. The purpose of this review is to discuss breast cancer disparities in the context of breastfeeding and the implications for black mothers. Black women in the U.S. have lower rates of breastfeeding and nearly twice the rates of triple-negative breast cancer (an aggressive subtype) compared with white women. In addition to individual challenges to breastfeeding, black women may also differentially face contextual barriers such as a lack of social and cultural acceptance in their communities, inadequate support from the healthcare community, and unsupportive work environments. More work is needed to improve the social factors and policies that influence breastfeeding rates at a population level. Such efforts should give special consideration to the needs of black mothers to adequately address disparities in breastfeeding among this group and possibly help reduce breast cancer risk. Interventions such as peer counseling, hospital policy changes, breastfeeding-specific clinic appointments, group prenatal education, and enhanced breastfeeding programs have been shown to be effective in communities of color. A comprehensive approach that integrates interventions across multiple levels and settings may be most successful in helping mothers reach their breastfeeding goals and reducing disparities in breastfeeding and potentially breast cancer incidence.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2020

Reliability of emergency and standby diesel generators: Impact on energy resiliency solutions

Emergency diesel generators are the most common form of backup power for critical loads when the grid fails and are most often deployed as stand-alone generators (<2000 kW) tied to individual buildings for hospitals, emergency services, military bases, ports, airports, industries, and commercial facilities. Understanding the finite reliability of emergency diesel generators during continuous operation is critical for energy planners, managers, and end-users. A new analysis of two large non-public emergency diesel generator operational data sets shows that commonly used reliability metrics are inadequate to predict the performance during a grid outage. Additional metrics addressing the likelihood of an emergency diesel generator to be available at the time an outage starts, successfully start and carry load, and constantly run for the duration of the outage are needed to predict the continuous run-time reliability of emergency diesel generators during a grid outage. This is the first analysis of the reliability of modern generators that follow standard maintenance protocols commonly used for backup power and these new metrics are shown to be dependent on the level of emergency diesel generator maintenance with values that can vary by more than an order of magnitude. Even using the new metrics for well-maintained emergency diesel generators, the analysis shows that the single emergency diesel generators configurations are only 80% likely to provide power for the duration of a two-week grid outage.

ENERGY PLANNING, POLICY, AND ECONOMY,POWER TRANSMI↗
DOE OSTI2021

Optimizing design and dispatch of a renewable energy system

Renewable energy technologies are becoming increasingly important due to their cost-competitiveness, and because of enhanced climate concerns. We demonstrate the capabilities of an integer-programming optimization model that minimizes capital (investment) and operational costs, and utility charges, while adhering to system sizing constraints, demand requirements, and interoperability characteristics of the systems chosen. Furthermore, the model recommends an optimally sized mix of renewable energy, conventional generation, and energy storage technologies, while simultaneously optimizing the corresponding dispatch strategy. Our case studies explore several venues, i.e., a small campus and a local hospital, with complex utility rate tariffs, multi-technology integration opportunities, and incentives for renewable power production. Using an optimization model, versus applying rules of thumb, can produce millions of dollars in savings over a 25-year time horizon and result in thousands of kilowatts of installed renewable energy.

25 ENERGY STORAGE↗
DOE OSTI2026

Multi-facility analysis using metered power data to quantify MRI energy use and utility bill costs across scanner operating modes

This study quantifies the energy consumption of magnetic resonance imaging (MRI) scanners across discrete operating modes during routine clinical workflows, based solely on electrical power measurements. Although previous studies have investigated MRI energy consumption within single hospitals or specific clinical settings, this research provides a broader and more systematic analysis. Researchers analyzed electrical power data and applied a previously developed semi-automatic method for identifying MRI operating modes using load duration curves for 20 MRI scanners across four different U.S. healthcare facilities, encompassing outpatient, inpatient, and mixed-use clinical settings. A key innovation is the inclusion of localized hourly utility rates to estimate costs, a parameter absent in prior literature. Key findings indicate significant variability in energy and cost profiles between weekdays and weekends. Scanner characteristics, including magnet strength, manufacturer, vintage, location, and clinical setting, influenced average daily energy consumption and power thresholds for operating modes. Notably, the clinical setting of a scanner predominantly determines its energy use. For example, the scanners in outpatient facilities consumed more energy. The breakdown of energy usage and costs by operating modes showed scanners spend between 61% and 93% of their time in nonproductive modes, with one outlier spending 34%. Average daily energy use for the scanners in the study ranged from 160 to 1069 kWh, with energy costs ranging from $\$$9 to $\$$149. This study uses an existing framework to quantify MRI energy behavior, leading to insights that can enable improved performance and cost savings across different healthcare environments.

24 POWER TRANSMISSION AND DISTRIBUTION↗
DOE OSTI2025

Deformable phrase level attention: A flexible approach for improving AI based medical coding

Objective: Improving the AI-driven automated medical encoding of clinical text plays a vital role in gathering information on the occurrence of diseases to improve population-level health. This work presents a novel attention mechanism designed to enhance text classification models and ensure appropriate classification of medical concepts in unstructured electronic health records. Materials and Methods: We developed a deformable, phrase-level attention mechanism to identify important lexical word-level and contextual phrase-level information from clinical text documents. We evaluated conventional and transformer-based deep learning models that we extended with our attention mechanism on the extraction of critical cancer information (e.g., site, subsite, laterality, histology, behavior) from 629,908 electronic pathology reports and on the automated medical encoding of 52,722 hospital discharge summaries. Results: Transformer-based models with the deformable, phrase-level attention mechanism achieved the best performance on the extraction of critical cancer information from pathology reports. Conventional- and transformer-based models show similar or better performance than their baseline counterparts on the automated medical encoding of clinical documents. Discussion: The addition of phrase-level information allowed models extended with our proposed method to outperform standard word-level attention. Our method showed favorable properties for the real-world application in terms of model robustness and phenotyping. These results indicate that our method is promising for automated data harmonization for common data models. Conclusion: This work proposes a novel deformable, phrase-level attention mechanism that enhances text classification models in the extraction of medical concepts from clinical text documents. We demonstrate strong performances on two clinical text datasets and showcase real-world deployability of our method.

Automated medical encoding↗
DOE OSTI2018

Dual effect of hemin on renal ischemia-reperfusion injury

Acute kidney injury (AKI) is a major public health concern, which is contributing to serious hospital complications, chronic kidney disease (CKD) and even death. Renal ischemia-reperfusion injury (IRI) remains a leading cause of AKI. The stress-responsive enzyme, heme oxygenase-1 (HO-1) mediates protection against renal IRI and may be preventively induced using hemin prior to renal insult. This HO-1 induction pathway called hemin preconditioning is largely known to be effective. Therefore, HO-1 might be an interesting therapeutic target in case of predictable AKI (e.g. partial nephrectomy or renal transplantation). However, the use of hemin to mitigate established AKI remains poorly characterized. }Mice underwent bilateral renal IRI for 26 min or sham surgery. After surgical procedure, animals were injected either with hemin (5 mg/kg) or vehicle. Twenty-four hours later, mice were sacrificed. Despite strong HO-1 induction, hemin-treated mice exhibited significant renal damage and oxidative stress as compared to vehicle-treated mice. Interestingly, higher dose of hemin is associated with more severe IRI-induced AKI in a dose-dependent relation. To determine whether hemin preconditioning remains efficient to dampen postoperative hemin-amplified IRI-induced AKI, we pretreated mice either with hemin (5 mg/kg) or vehicle 24 h prior to surgical procedure. Then, all mice (hemin- and vehicle-pretreated) received postoperative injection of hemin (5 mg/kg) to amplify IRI-induced AKI. In comparison to vehicle, prior administration of hemin to renal IRI mitigated hemin-amplified IRI-induced AKI as attested by fewer renal damage, inflammation and oxidative stress. In conclusion, hemin may have a dual effect on renal IRI, protective or deleterious, depending on the timing of its administration.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

Bayesian inference of heterogeneous epidemic models: Application to COVID-19 spread accounting for long-term care facilities

Here we propose a high dimensional Bayesian inference framework for learning heterogeneous dynamics of a COVID-19 model, with a specific application to the dynamics and severity of COVID-19 inside and outside long-term care (LTC) facilities. We develop a heterogeneous compartmental model that accounts for the heterogeneity of the time-varying spread and severity of COVID-19 inside and outside LTC facilities, which is characterized by time-dependent stochastic processes and time-independent parameters in ~ 1500 dimensions after discretization. To infer these parameters, we use reported data on the number of confirmed, hospitalized, and deceased cases with suitable post-processing in both a deterministic inversion approach with appropriate regularization as a first step, followed by Bayesian inversion with proper prior distributions. To address the curse of dimensionality and the ill-posedness of the high-dimensional inference problem, we propose use of a dimension-independent projected Stein variational gradient descent method, and demonstrate the intrinsic low-dimensionality of the inverse problem. We present inference results with quantified uncertainties for both New Jersey and Texas, which experienced different epidemic phases and patterns. Moreover, we also present forecasting and validation results based on the empirical posterior samples of our inference for the future trajectory of COVID-19.

42 ENGINEERING↗