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DOE OSTI2025

Design and structural basis of selective 1,4-dihydropyridine inhibitors of the calcium-activated potassium channel K Ca 3.1

The 1,4-dihydropyridines, drugs with well-established bioavailability and toxicity profiles, have proven efficacy in treating human hypertension, peripheral vascular disorders, and coronary artery disease. Every 1,4-dihydropyridine in clinical use blocks L-type voltage-gated calcium channels. We now report our development, using selective optimization of a side activity (SOSA), of a class of 1,4-dihydropyridines that selectively and potently inhibit the intermediate-conductance calcium-activated K + channel K Ca 3.1, a validated therapeutic target for diseases affecting many organ systems. One of these 1,4-dihydropyridines, DHP-103, blocked K Ca 3.1 with an IC 50 of 6 nM and exhibited exquisite selectivity over calcium channels and a panel of >100 additional molecular targets. Using high-resolution structure determination by cryogenic electron microscopy together with mutagenesis and electrophysiology, we delineated the drug binding pocket for DHP-103 within the water-filled central cavity of the K Ca 3.1 channel pore, where bound drug directly impedes ion permeation. DHP-103 inhibited gain-of-function mutant K Ca 3.1 channels that cause hereditary xerocytosis, suggesting its potential use as a therapeutic for this hemolytic anemia. In a rat model of acute ischemic stroke, the second leading cause of death worldwide, DHP-103 administered 12 h postischemic insult in proof-of-concept studies reduced infarct volume, improved balance beam performance (measure of proprioception) and decreased numbers of activated microglia in infarcted areas. K Ca 3.1-selective 1,4-dihydropyridines hold promise for the many diseases for which K Ca 3.1 has been experimentally confirmed as a therapeutic target.

Ong, Seow Theng [Lee Kong Chian School of Medicine↗

DOE OSTI2021

Model-based approach to investigate equipment-induced error in pressure-waveform derived hemodynamic measurements

Advanced hemodynamic monitoring systems have provided less invasive methods for estimating pressure-derived measurements such as pressure-derived cardiac output (CO) measurements. These devices apply algorithms to arterial pressure waveforms recorded via pressure recording components that transmit the pressure signal to a pressure monitor. While standards have been developed for pressure monitoring equipment, it is unclear how the equipment-induced error can affect secondary measurements from pressure waveforms. We propose an approach for modelling different components of a pressure monitoring system and use this model-based approach to investigate the effect of different pressure recording configurations on pressure-derived hemodynamic measurements. The proposed model-based approach is a three-step process. (1) Modelling the response of pressure recording components using bench tests; (2) verifying the identified models through nonparametric equivalence tests; and (3) assessing the effects of pressure recording components on pressure-derived measurements. To delineate the application of this approach, we performed a series of model-based analyses to quantify the combined effect of a wide range of tubing configurations with various damping ratios and natural frequencies and monitors with different bandwidths on pressure waveforms and CO measurements by six pulse contour algorithms. Model-based results show the error in pressure-derived CO measurements because of tubing configurations with different natural frequencies and damping ratios. Tubing configurations with low natural frequencies (<23 Hz) altered characteristics of pressure waveforms in a way that affected the CO measurement, some by as much as 20%. Our method can serve as a tool to quantify the performance of pressure recording systems with different dynamic properties. In conclusion, this approach can be applied to investigate the effects of physiologic signal recording configurations on various pressure-derived hemodynamic measurements.

42 ENGINEERING↗

DOE OSTI2023

Involvement of the Streptococcus mutans PgfE and GalE 4-epimerases in protein glycosylation, carbon metabolism, and cell division

Streptococcus mutans is a key pathogen associated with dental caries and is often implicated in infective endocarditis. This organism forms robust biofilms on tooth surfaces and can use collagen-binding proteins (CBPs) to efficiently colonize collagenous substrates, including dentin and heart valves. One of the best characterized CBPs of S. mutans is Cnm, which contributes to adhesion and invasion of oral epithelial and heart endothelial cells. These virulence properties were subsequently linked to post-translational modification (PTM) of the Cnm threonine-rich repeat region by the Pgf glycosylation machinery, which consists of 4 enzymes: PgfS, PgfM1, PgfE, and PgfM2. Inactivation of the S. mutans pgf genes leads to decreased collagen binding, reduced invasion of human coronary artery endothelial cells, and attenuated virulence in the Galleria mellonella invertebrate model. The present study aimed to better understand Cnm glycosylation and characterize the predicted 4-epimerase, PgfE. Using a truncated Cnm variant containing only 2 threonine-rich repeats, mass spectrometric analysis revealed extensive glycosylation with HexNAc2. Compositional analysis, complemented with lectin blotting, identified the HexNAc2 moieties as GlcNAc and GalNAc. Comparison of PgfE with the other S. mutans 4-epimerase GalE through structural modeling, nuclear magnetic resonance, and capillary electrophoresis demonstrated that GalE is a UDP-Glc-4-epimerase, while PgfE is a GlcNAc-4-epimerase. While PgfE exclusively participates in protein O-glycosylation, we found that GalE affects galactose metabolism and cell division. Furthermore, this study further emphasizes the importance of O-linked protein glycosylation and carbohydrate metabolism in S. mutans and identifies the PTM modifications of the key CBP, Cnm.

4-epimerases↗

DOE OSTI2022

Impact of Surface Chemistry of Ultrasmall Superparamagnetic Iron Oxide Nanoparticles on Protein Corona Formation and Endothelial Cell Uptake, Toxicity, and Barrier Function

Ultrasmall superparamagnetic iron oxide nanoparticles (USPIONs) have been investigated for biomedical applications, including novel contrast agents, magnetic tracers for tumor imaging, targeted drug delivery vehicles, and magneto-mechanical actuators for hyperthermia and thrombolysis. Despite significant progress, recent clinical reports have raised concerns regarding USPION safety related to endothelial cell dysfunction; however, there is limited information on factors contributing to these clinical responses. The influence of USPION surface chemistry on nanoparticle interactions with proteins may impact endothelial cell function leading to adverse responses. Therefore, the goal of this study was to assess the effects of carboxyl-functionalized USPION (CU) or amine-functionalized USPION (AU) (approximately 30 nm diameter) on biological responses in human coronary artery endothelial cells. Increased protein adsorption was observed for AU compared with CU after exposure to serum proteins. Exposure to CU, but not AU, resulted in a concentration-dependent decrease in cell viability and perinuclear accumulation inside cytoplasmic vesicles. Internalization of CU was correlated with endothelial cell functional changes under non-cytotoxic conditions, as evidenced by a marked decreased expression of endothelial-specific adhesion proteins (eg, vascular endothelial-cadherin and platelet endothelial cell adhesion molecule-1) and increased endothelial permeability. Evaluation of downstream signaling indicated endothelial permeability is associated with actin cytoskeleton remodeling, possibly elicited by intracellular events involving reactive oxygen species, calcium ions, and the nanoparticle cellular uptake pathway. This study demonstrated that USPION surface chemistry significantly impacts protein adsorption and endothelial cell uptake, viability, and barrier function. This information will advance the current toxicological profile of USPION and improve development, safety assessment, and clinical outcomes of USPION-enabled medical products.

Toxicology↗

DOE OSTI2023

A Three-Tier Incremental Approach for Development of Smart Corridor Digital Twins

Development of an arterial smart corridor digital twin requires the integration of real time data streams, data storage, and simulation model execution. This process may be complex, time consuming, and susceptible to errors. To aid in smart corridor digital twin development this paper seeks to provide a framework, best practices, and development guidance. As such, a three-tier incremental approach to smart corridor digital twin development is presented. The paper highlights practical issues in digital twin construction along with key data challenges based on experiences from the development of digital twins for two large Smart Corridor deployments, one in Chattanooga, Tennessee, and the other in Atlanta, Georgia. The presented three-tier incremental approach includes: 1) development of a prepopulated offline simulation, 2) development of a pseudo digital twin that is driven by archived data, and 3) integration of real time data streams to create the online digital twin model. The three-tiered approach facilitates conducting multiple trials and scenarios with increasing complexity, allowing for incremental error processing and updating of the digital twin.

Saroj, Abhilasha↗

DOE OSTI2021

Multilane Automated Driving With Optimal Control and Mixed-Integer Programming

Road vehicle lane changes often initiate traffic disturbances and can therefore impact road networks’ energy and time efficiency. Furthermore, unexpected changes in traffic conditions may also render lane changes counterproductive for the lane-changing vehicle. Vehicle-to-vehicle connectivity combined with anticipative control could address these challenges via improved lane change decisions by automated vehicles. In a move toward this objective, receding horizon control cast as a mixed-integer quadratic program is used to plan lane changing and acceleration in a coupled optimization. A long-term pacing module, based on Pontryagin’s minimum principle from optimal control theory, sets terminal and input references for receding horizon control to target a user’s expected travel time. To remove nonlinear vehicle dynamics from the receding horizon controller, lane change commands are passed to a pure pursuit steering module whose response is approximated by a second-order linear model. Here, comparison against a rule-based reactive algorithm in arterial and highway scenarios shows an 8.9%–13.7% reduction in energy consumption and a 5.2%–10.3% reduction in the travel time, along with navigational improvements.

33 ADVANCED PROPULSION SYSTEMS↗

DOE OSTI2021

Analysis of GPU Data Access Patterns on Complex Geometries for the D3Q19 Lattice Boltzmann Algorithm

GPU performance of the lattice Boltzmann method (LBM) depends heavily on memory access patterns. When implemented with GPUs on complex domains, typically, geometric data is accessed indirectly and lattice data is accessed lexicographically. Although there are a variety of other options, no study has examined the relative efficacy between them. Here, we examine a suite of memory access schemes via empirical testing and performance modeling. We find strong evidence that semi-direct is often better suited than the more common indirect addressing, providing increased computational speed and reducing memory consumption. For the layout, we find that the Collected Structure of Arrays (CSoA) and bundling layouts outperform the common Structure of Array layout; on V100 and P100 devices, CSoA consistently outperforms bundling, however the relationship is more complicated on K40 devices. When compared to state-of-the-art practices, our recommendations lead to speedups of 10–40 percent and reduce memory consumption up to 17 percent. Using performance modeling and computational experimentation, we determine the mechanisms behind the accelerations. We demonstrate that our results hold across multiple GPUs on two leadership class systems, and present the first near-optimal strong results for LBM with arterial geometries run on GPUs.

42 ENGINEERING↗

DOE OSTI2021

A Multirange Vehicle Speed Prediction With Application to Model Predictive Control-Based Integrated Power and Thermal Management of Connected Hybrid Electric Vehicles

Abstract Connectivity and automated driving technologies have opened up new research directions in the energy management of vehicles which exploit look-ahead preview and enhance the situational awareness. Despite this advancement, the vehicle speed preview that can be obtained from vehicle-to-vehicle/infrastructure (V2V/I) communications is often limited to a relatively short time-horizon. The vehicular energy systems, specifically those of the electrified vehicles, consist of multiple interacting power and thermal subsystems that respond over different time-scales. Consequently, their optimal energy management can greatly benefit from long-term speed prediction beyond that available through V2V/I communications. Accurately extending the look-ahead preview, on the other hand, is fundamentally challenging due to the dynamic nature of the traffic environment. To address this challenge, we propose a data-driven multirange vehicle speed prediction strategy for arterial corridors with signalized intersections, providing the vehicle speed preview for three different ranges, i.e., short-, medium-, and long-range. The short-range preview is obtained by V2V/I communications. The medium-range preview is realized using a neural network (NN), while the long-range preview is predicted based on a Bayesian network (BN). The predictions are updated in real-time based on the current state of traffic and incorporated into a multihorizon model predictive control (MH-MPC) for integrated power and thermal management (iPTM) of connected vehicles. The results of design and evaluation of the performance of the proposed data-informed MH-MPC for iPTM of connected hybrid electric vehicles (HEVs) using traffic data for real-world city driving are reported.

Automation & Control Systems↗

DOE OSTI2026

Discovery of Probabilistic Dirichlet-to-Neumann Maps on Graphs

Dirichlet-to-Neumann maps enable the coupling of multiphysics simulations across computational subdomains by ensuring continuity of state variables and fluxes at artificial interfaces. We present a novel method for learning Dirichlet-to-Neumann maps on graphs using Gaussian processes, specifically for problems where the data obey a conservation law arising from an underlying partial differential equation. Our approach combines discrete exterior calculus and nonlinear optimal recovery to infer relationships between vertex and edge values. This framework yields data-driven predictions with uncertainty quantification across the entire graph, even when observations are limited to a subset of vertices and edges. By minimizing the reproducing kernel Hilbert space norm while penalizing kernel complexity through maximum likelihood estimation, our method ensures that the resulting surrogate strictly enforces conservation laws without overfitting. We demonstrate our method on two representative applications: subsurface flow in fracture networks and arterial blood flow. Finally, the results demonstrate that the method maintains high accuracy and well-calibrated uncertainty estimates even under severe data scarcity, highlighting its potential for scientific applications where limited data and reliable uncertainty quantification are critical.

Dirichlet-to-Neumann map↗

DOE OSTI2021

Trust-but-Verify in Cyber-Physical Systems

Cyber-physical systems span a wide spectrum, from long-lived legacy systems to more modern installations. Trust is an issue that arises across the spectrum, albeit with different variants of goals and constraints. On the one end of the spectrum, legacy systems are characterized by function-based designs in which trust is an implicitly in-built concept -- the operation is historically designed, implemented, and optimized in a benign stance with respect to intended use. On the other end of the spectrum, modern systems are characterized by offerings from manufacturers, vendors, and system installers -- the devices and deployments use a variety of security features that offer promises of increased trust. All along this spectrum of cyber-physical systems, extending trust beyond the traditional cyber portions to the arteries that connect the physical portions to the cyber portions is a major challenge. Here, we identify a Trust-but-Verify approach that spans this spectrum in addressing trust.

Perumalla, Kalyan↗

DOE OSTI2025

Development of Emergency Vehicle Preemption Strategies on Smart Corridors in a Digital Twin Environment

Emergency Response Vehicles (ERVs), such as firetrucks, ambulances, etc. operate with the purpose of saving lives and mitigating property damage. As such, ERV travel-time reductions may result in significant benefits to the community. A common strategy to improve travel times is Emergency Vehicle Preemption (EVP). EVP seeks to reduce ERV delays by providing the right-of-way to ERVs as they approach an intersection. This study proposes a new Dynamic Preemption strategy that determines the need for preemption prior to the ERV reaching the vicinity of the intersection, utilizing real-time data streams. This paper evaluates the effectiveness of some existing and proposed preempt control strategies using a digital twin testbed consisting of a series of signalized intersections on an urban arterial in Georgia. The best EVP strategy maximizes the improvement in ERV travel time while minimizing the adverse effect of preemption on the traffic in conflicting directions. Therefore, this study evaluates both the positive impact of EVP on the ERV as well as the adverse impact on the cross-street traffic. The study found that the potential exists for significant improvements in ERV travel time with the proposed Dynamic Preemption strategy, with minimal impact to the conflicting traffic. For the simulation corridor there was a 20% reduction in the ERV travel times with the implementation of the Dynamic Preemption strategy, compared to traditional EVP practices.

Roy, Somdut [Georgia Institute of Technology]↗

DOE OSTI2022

Effect of Electroacupuncture at Wushu Acupoints of the Cardiopulmonary Meridian on the Autophagy in Rats with Acute Myocardial Ischemia

Wushu acupoints are the five acupoints distributed below the human elbow and knee joint. They are all located on the same meridian and divided into five categories: Jing, Ying, Shu, Jing, and He. It has been shown that electroacupuncture (EA) at Shenmen point of heart meridian can improve acute myocardial ischemia (AMI) early. However, it is still unclear if all the Wushu acupoints of the heart meridian can improve AMI. Hence, this study emphasizes Wushu acupoints of heart meridian, compares them with Wushu acupoints of lung meridian, and studies the therapeutic effect of EA at Wushu acupoints on AMI and its possible mechanism. It also discusses the specificity of the heart meridian to heart disease. The AMI model is established by ligation of the left anterior descending coronary artery. The detection methods like the physiological recorder, TTC staining, ELISA, and so forth were used to determine the ECG, myocardial infarct size, serum myocardial enzymes, and myocardial tissue-related protein expression in rats. The heart rate (HR) and ST segment along with creatine kinase (CK), creatine kinase isoenzymes (CK-MB), lactate dehydrogenase (LDH), and myocardial infarctions increased after the induction with AMI. Furthermore, the expressions of PINK1 and Parkin protein also showed an increase. However, EA at Wushu acupoints in the heart meridian can reverse the above changes, whereas EA at the lung meridian exhibits limited effect. It is depicted that the heart meridian has a relatively specific relationship with the heart in a diseased state.

Zhu, Chao↗

DOE OSTI2022

SARS-CoV-2 Infection-Associated Aortic Thrombosis Treated with Oral Factor Xa Inhibition

Coronavirus disease 2019 (COVID-19) is an acute complex systemic disorder caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).While SARS-CoV-2 is known to cause significant pulmonary disease, various extrapulmonary manifestations of COVID-19 have also been reported. Growing evidence suggests that COVID-19 is associated with coagulopathy leading to micro and macrovascular complications. Although in patients with COVID-19, venous thromboembolic events are more frequent, arterial thrombosis also occurs at an increased rate. These often lead to acute life-threatening ischemia, which requires urgent diagnosis and treatment. We present case reports of two patients with an abnormal thrombus formation in the thoracic aorta who recently overcame COVID-19, which led to systemic embolism and splenic infarction. Ambulatory oral factor Xa inhibitor therapy led to aortic thrombosis resolution in both patients.

Strýčková, Alena↗

DOE OSTI2020

Collagen Turnover in Relation to Risk Factors and Hemodynamics in Human Intracranial Aneurysms

Determinants for molecular and structural instability, that is, impending growth or rupture, of intracranial aneurysms (IAs) remain uncertain. To elucidate this, we endeavored to estimate the actual turnover rates of the main molecular constituent in human IA (collagen) on the basis of radiocarbon ( 14 C) birth dating in relation to IA hemodynamics. Collagen turnover rates in excised human IA samples were calculated using mathematical modeling of 14 C birth dating data of collagen in relation to risk factors and histological markers for collagen maturity/turnover in selected IA. Hemodynamics were simulated using image-based computational fluid dynamics. Correlation, logistic regression, and receiver operating characteristic analyses were performed. Collagen turnover rates were estimated in 46 IA (43 patients); computational fluid dynamics could be performed in 20 IA (20 patients). The mean collagen turnover rate (γ) constituted 126% (±1% error) per year. For patients with arterial hypertension, γ was greater than 2600% annually, whereas γ was distinctly lower with 32% (±1% error) per year for patients without risk factors, such as smoking and hypertension. There was a distinct association between histological presence of rather immature collagen in human IA and the presence of modifiable risk factors. Spatial-temporal averaged wall shear stress predicted rapid collagen turnover (odds ratio, 1.6 [95% CI, 1.0–2.7]). Receiver operating characteristic analysis demonstrated a good test accuracy (area under the curve, 0.798 [95% CI, 0.598–0.998]) for average wall shear stress with a threshold ≥4.9 Pa for rapid collagen turnover. Our data indicate that turnover rates and stability of collagen in human IA are strongly associated with the presence of modifiable risk factors and aneurysmal hemodynamics. Finally, these findings underline the importance of strict risk factor modification in patients with unruptured IA. Future should include more detailed risk factor data to establish a more causal understanding of hemodynamics and the rupture risk of individual IA.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2021

Dynamically Collected Local Density using Low-Cost Lidar and its Application to Traffic Models

This article demonstrates the use of traffic density observations collected dynamically in the vicinity of probe vehicles. Fixed position sensors cannot capture the longitudinal evolution of local traffic density in the corridor. In this research, dynamic traffic density observations were collected in a naturalistic driving setting that was free of any controlled experiment biases. Speed from global positioning system and space headway from a light detection and ranging module was collected on one arterial and one freeway segment, 2 and 4mi long, respectively. The combined data frequency was approximately 3Hz. Space headway was used to estimate the local density and consequently to identify the density of a specific location in a corridor. Besides, driver behavior was characterized using the relationship between instantaneous speed and local density under different regimes of the Wiedemann car-following model. Macroscopic traffic stream models were used to investigate the relationship between dynamically collected instantaneous speed and local density. Using the longitudinal evolution of density, precise local density across the corridor can be obtained along with the leader and follower trajectories. A method to identify driver behavior across density ranges was developed for different facility types using a microscopic relationship between instantaneous speed and local density. Overall driving behavior on the freeway segment can be represented by translating the instantaneous speed and local density relationship to macroscopic stream models.

Engineering↗

DOE OSTI2021

Multi-objective Eco-Routing Model Development and Evaluation for Battery Electric Vehicles

This paper develops a multi-objective eco-routing algorithm (eco- and travel time-optimum routing) for battery electric vehicles (BEVs) and internal combustion engine vehicles (ICEVs) and investigates the network-wide impacts of the proposed multi-objective Nash optimum (user equilibrium) traffic assignment on a large-scale network. Unlike ICEVs, BEVs are more energy efficient on low-speed arterial trips compared with highway trips. Different energy consumption patterns require different eco-routing strategies for ICEVs and BEVs. This study found that single-objective eco-routing could significantly reduce the energy consumption of BEVs but also significantly increase their average travel time. Consequently, the study developed a multi-objective routing model (eco- and travel time-routing) to improve both energy and travel time measures. The model introduced a link cost function that uses the specification of the value of time and the cost of fuel/energy. The simulation study found that multi-objective routing could reduce BEV energy consumption by 13.5%, 14.2%, 12.9%, and 10.7%, as well as ICEV fuel consumption by 0.1%, 4.3%, 3.4%, and 10.6% for “not congested, “slightly congested,”“moderately congested,” and “highly congested” conditions, respectively. The study also found that multi-objective user equilibrium routing reduced the average vehicle travel time by up to 10.1% compared with the standard user equilibrium traffic assignment for highly congested conditions, producing a solution closer to the system optimum traffic assignment. The results indicate that the proposed multi-objective eco-routing strategy can reduce vehicle fuel/energy consumption effectively with minimum impacts on travel times for both BEVs and ICEVs.

Engineering↗

DOE OSTI2023

Opposing Hysteresis Patterns in Flow and Outflow Macroscopic Fundamental Diagrams and Their Implications

Two key aggregated traffic models are the relationship between average network flow and density (known as the network or flow macroscopic fundamental diagram [flow-MFD]) and the relationship between trip completion and density (known as network exit function or the outflow-MFD [o-FMD]). The flow- and o-MFDs have been shown to be related by average network length and average trip distance under steady-state conditions. However, recent studies have demonstrated that these two relationships might have different patterns when traffic conditions are allowed to vary: the flow-MFD exhibits a clockwise hysteresis loop, while the o-MFD exhibits a counter-clockwise loop. One recent study attributes this behavior to the presence of bottlenecks within the network. The present paper demonstrates that this phenomenon may arise even without bottlenecks present and offers an alternative, but more general, explanation for these findings: a vehicle’s entire trip contributes to a network’s average flow, while only its end contributes to the trip completion rate. This lag can also be exaggerated by trips with different lengths, and it can lead to other patterns in the o-MFD such as figure-eight patterns. A simple arterial example is used to demonstrate this explanation and reveal the expected patterns, and they are also identified in real networks using empirical data. Then, simulations of a congestible ring network are used to unveil features that might increase or diminish the differences between the flow- and o-MFDs. Finally, more realistic simulations are used to confirm that these behaviors arise in real networks.

42 ENGINEERING↗

DOE OSTI2022

Design and execution of a verification, validation, and uncertainty quantification plan for a numerical model of left ventricular flow after LVAD implantation

Left ventricular assist devices (LVADs) are implantable pumps that act as a life support therapy for patients with severe heart failure. Despite improving the survival rate, LVAD therapy can carry major complications. Particularly, the flow distortion introduced by the LVAD in the left ventricle (LV) may induce thrombus formation. While previous works have used numerical models to study the impact of multiple variables in the intra-LV stagnation regions, a comprehensive validation analysis has never been executed. The main goal of this work is to present a model of the LV-LVAD system and to design and follow a verification, validation and uncertainty quantification (VVUQ) plan based on the ASME V&V40 and V&V20 standards to ensure credible predictions. The experiment used to validate the simulation is the SDSU cardiac simulator, a bench mock-up of the cardiovascular system that allows mimicking multiple operation conditions for the heart-LVAD system. The numerical model is based on Alya, the BSC’s in-house platform for numerical modelling. Alya solves the Navier-Stokes equation with an Arbitrary Lagrangian-Eulerian (ALE) formulation in a deformable ventricle and includes pressure-driven valves, a 0D Windkessel model for the arterial output and a LVAD boundary condition modeled through a dynamic pressure-flow performance curve. The designed VVUQ plan involves: (a) a risk analysis and the associated credibility goals; (b) a verification stage to ensure correctness in the numerical solution procedure; (c) a sensitivity analysis to quantify the impact of the inputs on the four quantities of interest (QoIs) (average aortic root flow $Q^{avg}_{Ao}$, maximum aortic root flow $Q^{max}_{Ao}$, average LVAD flow $Q^{avg}_{VAD}$, and maximum LVAD flow $Q^{max}_{VAD}$; (d) an uncertainty quantification using six validation experiments that include extreme operating conditions. Numerical code verification tests ensured correctness of the solution procedure and numerical calculation verification showed a grid convergence index (GCI)95% <3.3%. The total Sobol indices obtained during the sensitivity analysis demonstrated that the ejection fraction, the heart rate, and the pump performance curve coefficients are the most impactful inputs for the analysed QoIs. The Minkowski norm is used as validation metric for the uncertainty quantification. It shows that the midpoint cases have more accurate results when compared to the extreme cases. The total computational cost of the simulations was above 100 [core-years] executed in around three weeks time span in Marenostrum IV supercomputer. This work details a novel numerical model for the LV-LVAD system, that is supported by the design and execution of a VVUQ plan created following recognised international standards. We present a methodology demonstrating that stringent VVUQ according to ASME standards is feasible but computationally expensive.

59 BASIC BIOLOGICAL SCIENCES↗