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At least 163 records · Page 9

The Prediction Model of Risk Factors for COVID-19 Developing into Severe Illness Based on 1046 Patients with COVID-19

This study analyzed the risk factors for patients with COVID-19 developing severe illnesses and explored the value of applying the logistic model combined with ROC curve analysis to predict the risk of severe illnesses at COVID-19 patients’ admissions. The clinical data of 1046 COVID-19 patients admitted to a designated hospital in a certain city from July to September 2020 were retrospectively analyzed, the clinical characteristics of the patients were collected, and a multivariate unconditional logistic regression analysis was used to determine the risk factors for severe illnesses in COVID-19 patients during hospitalization. Based on the analysis results, a prediction model for severe conditions and the ROC curve were constructed, and the predictive value of the model was assessed. Logistic regression analysis showed that age (OR = 3.257, 95% CI 10.466–18.584), complications with chronic obstructive pulmonary disease (OR = 7.337, 95% CI 0.227–87.021), cough (OR = 5517, 95% CI 0.258–65.024), and venous thrombosis (OR = 7322, 95% CI 0.278–95.020) were risk factors for COVID-19 patients developing severe conditions during hospitalization. When complications were not taken into consideration, COVID-19 patients’ ages, number of diseases, and underlying diseases were risk factors influencing the development of severe illnesses. The ROC curve analysis results showed that the AUC that predicted the severity of COVID-19 patients at admission was 0.943, the optimal threshold was −3.24, and the specificity was 0.824, while the sensitivity was 0.827. The changes in the condition of severe COVID-19 patients are related to many factors such as age, clinical symptoms, and underlying diseases. This study has a certain value in predicting COVID-19 patients that develop from mild to severe conditions, and this prediction model is a useful tool in the quick prediction of the changes in patients’ conditions and providing early intervention for those with risk factors.

Lian, Zhichuang↗

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↗

Risk Factors and Trends for HPV-Associated Subsequent Malignant Neoplasms among Adolescent and Young Adult Cancer Survivors

Subsequent malignant neoplasms (SMN; new cancers that arise after an original diagnosis) contribute to premature mortality among adolescent and young adult (AYA) cancer survivors. Because of the high population prevalence of human papillomavirus (HPV) infection, we identify demographic and clinical risk factors for HPV-associated SMNs (HPV-SMN) among AYA cancer survivors in the SEER-9 registries diagnosed from 1976 to 2015. Outcomes included any HPV-SMN, oropharyngeal-SMN, and cervical-SMN. Follow-up started 2 months after their original diagnosis. Standardized incidence ratios (SIR) compared risk between AYA survivors and general population. Age-period-cohort (APC) models examined trends over time. Fine and Gray's models identified therapy effects controlling for cancer and demographic confounders. Of 374,408 survivors, 1,369 had an HPV-SMN, occurring on average 5 years after first cancer. Compared with the general population, AYA survivors had 70% increased risk for any HPV-SMN [95% confidence interval (CI), 1.61–1.79] and 117% for oropharyngeal-SMN (95% CI, 2.00–2.35); cervical-SMN risk was generally lower in survivors (SIR, 0.85; 95% CI, 0.76–0.95), but Hispanic AYA survivors had a 8.4 significant increase in cervical-SMN (SIR, 1.46; 95% CI, 1.01–2.06). AYAs first diagnosed with Kaposi sarcoma, leukemia, Hodgkin, and non-Hodgkin lymphoma had increased HPV-SMN risks compared with the general population. Oropharyngeal-SMN incidence declined over time in APC models. Chemotherapy and radiation were associated with any HPV-SMN among survivors with first HPV-related cancers, but not associated among survivors whose first cancers were not HPV-related. HPV-SMN in AYA survivors are driven by oropharyngeal cancers despite temporal declines in oropharyngeal-SMN. Hispanic survivors are at risk for cervical-SMN relative to the general population. Encouraging HPV vaccination and cervical and oral cancer screenings may reduce HPV-SMN burden among AYA survivors.

60 APPLIED LIFE SCIENCES↗

Low-Level Mesoscale and Cloud-Scale Interactions Promoting Deep Convection Initiation

Data from scanning radars, radiosondes, and vertical profilers deployed during three field campaigns are analyzed to study interactions between cloud-scale updrafts associated with initiating deep moist convection and the surrounding environment. Three cases are analyzed in which the radar networks permitted dual-Doppler wind retrievals in clear air preceding and during the onset of surface precipitation. These observations capture the evolution of (i) the mesoscale and boundary layer flow, and (ii) low-level updrafts associated with deep moist convection initiation (CI) events yielding sustained or short-lived precipitating storms. The elimination of convective inhibition did not distinguish between sustained and unsustained CI events, though the vertical distribution of convective available potential energy may have played a role. The clearest signal differentiating the initiation of sustained versus unsustained precipitating deep convection was the depth of the low-level horizontal wind convergence associated with the mesoscale flow feature triggering CI, a sharp surface wind shift boundary, or orographic upslope flow. The depth of the boundary layer relative to the height of the LFC failed to be a consistent indicator of CI potential. Widths of the earliest detectable low-level updrafts associated with sustained precipitating deep convection were ~3–5 km, larger than updrafts associated with surrounding boundary layer turbulence (~1–3 km wide). It is hypothesized that updrafts of this larger size are important for initiating cells to survive the destructive effects of buoyancy dilution via entrainment.

54 ENVIRONMENTAL SCIENCES↗

Vegetable intake and the risk of bladder cancer in the BLadder Cancer Epidemiology and Nutritional Determinants (BLEND) international study

Although a potential inverse association between vegetable intake and bladder cancer risk has been reported, epidemiological evidence is inconsistent. This research aimed to elucidate the association between vegetable intake and bladder cancer risk by conducting a pooled analysis of data from prospective cohort studies. Vegetable intake in relation to bladder cancer risk was examined by pooling individual-level data from 13 cohort studies, comprising 3203 cases among a total of 555,685 participants. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were estimated using Cox proportional hazards regression models stratified by cohort for intakes of total vegetable, vegetable subtypes (i.e. non-starchy, starchy, green leafy and cruciferous vegetables) and individual vegetable types. In addition, a diet diversity score was used to assess the association of the varied types of vegetable intake on bladder cancer risk. The association between vegetable intake and bladder cancer risk differed by sex ( P -interaction = 0.011) and smoking status ( P -interaction = 0.038); therefore, analyses were stratified by sex and smoking status. With adjustment of age, sex, smoking, energy intake, ethnicity and other potential dietary factors, we found that higher intake of total and non-starchy vegetables were inversely associated with the risk of bladder cancer among women (comparing the highest with lowest intake tertile: HR = 0.79, 95% CI = 0.64–0.98, P = 0.037 for trend, HR per 1 SD increment = 0.89, 95% CI = 0.81–0.99; HR = 0.78, 95% CI = 0.63–0.97, P = 0.034 for trend, HR per 1 SD increment = 0.88, 95% CI = 0.79–0.98, respectively). However, no evidence of association was observed among men, and the intake of vegetable was not found to be associated with bladder cancer when stratified by smoking status. Moreover, we found no evidence of association for diet diversity with bladder cancer risk. Higher intakes of total and non-starchy vegetable are associated with reduced risk of bladder cancer for women. Further studies are needed to clarify whether these results reflect causal processes and potential underlying mechanisms.

59 BASIC BIOLOGICAL SCIENCES↗

Prescribed fires, smoke exposure, and hospital utilization among heart failure patients

Abstract Background Prescribed fires often have ecological benefits, but their environmental health risks have been infrequently studied. We investigated associations between residing near a prescribed fire, wildfire smoke exposure, and heart failure (HF) patients’ hospital utilization. Methods We used electronic health records from January 2014 to December 2016 in a North Carolina hospital-based cohort to determine HF diagnoses, primary residence, and hospital utilization. Using a cross-sectional study design, we associated the prescribed fire occurrences within 1, 2, and 5 km of the patients’ primary residence with the number of hospital visits and 7- and 30-day readmissions. To compare prescribed fire associations with those observed for wildfire smoke, we also associated zip code-level smoke density data designed to capture wildfire smoke emissions with hospital utilization amongst HF patients. Quasi-Poisson regression models were used for the number of hospital visits, while zero-inflated Poisson regression models were used for readmissions. All models were adjusted for age, sex, race, and neighborhood socioeconomic status and included an offset for follow-up time. The results are the percent change and the 95% confidence interval (CI). Results Associations between prescribed fire occurrences and hospital visits were generally null, with the few associations observed being with prescribed fires within 5 and 2 km of the primary residence in the negative direction but not the more restrictive 1 km radius. However, exposure to medium or heavy smoke (primarily from wildfires) at the zip code level was associated with both 7-day (8.5% increase; 95% CI = 1.5%, 16.0%) and 30-day readmissions (5.4%; 95% CI = 2.3%, 8.5%), and to a lesser degree, hospital visits (1.5%; 95% CI: 0.0%, 3.0%) matching previous studies. Conclusions Area-level smoke exposure driven by wildfires is positively associated with hospital utilization but not proximity to prescribed fires.

Raab, Henry↗

Estimating the Effects of Soil Remediation on Children’s Blood Lead near a Former Lead Smelter in Omaha, Nebraska, USA

Lead exposures from legacy sources threaten children’s health. Soil in Omaha, Nebraska, was contaminated by emissions from a lead smelter and refinery. The U.S. Environmental Protection Agency excavated and replaced contaminated soil at the Omaha Lead Superfund Site between 1999 and 2016. The goal of this study was to assess the association of soil lead level (SLL) and soil remediation status with blood lead levels (BLLs) in children living near or on the site. We linked information on SLL at residential properties with children’s BLLs and assigned remediation status to children’s BLL measurements based on whether their measurements occurred during residence at remediated or unremediated properties. We examined the association of SLL and remediation status with elevated BLL (EBLL). We distinguished the roles of temporal trend and the intervention with time-by-intervention-status interaction contrasts. All analyses estimated odds ratios (ORs) with a generalized estimating equations approach to ensure robustness under the complex correlations among BLL measurements. All analyses controlled for relevant covariates including children’s characteristics. EBLL (> 5 μg/dL ) was associated with both residential SLL [e.g., OR=2.00; 95% confidence interval (CI): 1.83, 2.19; > 400–800 vs. ≤ 200 ppm] and neighborhood SLL [e.g., OR=1.85 (95% CI: 1.62, 2.11; > 400–800 vs. ≤ 200 ppm)] before remediation but only with neighborhood SLL after remediation. The odds of EBLL were higher before remediation [OR 1.52 (95% CI: 1.34, 1.72)]. Similarly, EBLL was positively associated with preremediation status in our interaction analysis [interaction OR=1.18 (95%CI: 1.02, 1.37)]. Residential and neighborhood SLLs were important predictors of EBLLs in children residing near or on this Superfund site. Neighborhood SLL remained a strong predictor following remediation. Our data analyses showed the benefit of soil remediation. Results from the interaction analyses should be interpreted cautiously due to imperfect correspondence of remediation times between remediation and comparison groups. https://doi.org/10.1289/EHP8657

54 ENVIRONMENTAL SCIENCES↗

FY20 Proxy App Suite Release: Report for ECP Proxy App Project Milestone ADCD-504-10

Version 4.0 of the ECP Proxy App Suite is practically unchanged from the previous release. The current set of proxies has proven useful for many aspects of benchmarking and co-design and we see little reason to alter the suite. Although there have been few changes to the ECP suite, the team has been hard at work in other areas. In the area of Machine Learning (ML) we have now created a separate proxy suite dedicated to this scientific applications of ML. The suite includes: miniGAN (Generative Adversarial Networks), miniRL (Reinforcement Learning), CRADL (inline inference), Cosmoflow-Benchmark (Convolutional Neural Network), and MLPerf-DeepCam (Climate Segmentation Benchmark). Section 3 contains more information about these proxies as well as the principles that are guiding the development of the suite. We have surveyed available proxies for several application domains including Computational Fluid Dynamics, Quantum Chemistry, Quantum Computing Simulation, Molecular Dynamics, Monte Carlo Transport, and Density Functional Theory to identify gaps in proxy coverage. Several new proxy apps are either already available or will be released soon to fill these gaps. Section 4 provides full details. Finally, section 5 reports on our continued collaboration with the ECP Continuous Integration (CI) effort to use proxy apps to help identify problems and roadblocks to cross-lab CI. We have also assisted the El Capitan Center of Excellence (COE) to stand up a CI system that will be used to test releases of HPE and AMD software stacks. We hope that the COE effort can serve as a model for ECP by showing how the Proxy App Team can work with AD and ST teams identify critical features, kernels, patterns, etc. and incorporate them into a CI system that will help ensure that Frontier and Aurora will provide those needed capabilities.

97 MATHEMATICS AND COMPUTING↗

TRACER-Coastal Urban Boundary-Layer Interactions with Convection (TRACER-CUBIC) Field Campaign Report

To better understand the complicated web of processes governing convective cloud life cycle and aerosol-convection interactions, the U.S. Department of Energy (DOE)’s Atmospheric Radiation Measurement (ARM) user facility supported deployment of a variety of advanced atmospheric measurement systems to the greater Houston, Texas, area from 1 October 2021 to 30 September 2022 as part of the Tracking Aerosol Convection Interactions Experiment (TRACER). Houston was selected as a study area because isolated convection and a variety of aerosol conditions are common in this region. This one-year ARM Mobile Facility (AMF) deployment featured a four-month intensive operational period (IOP) during summer 2022 (1 June–30 September). The ARM instrumentation was deployed at three sites along an east-west transect from La Porte, Texas to an ancillary site in a less-polluted rural region southwest of downtown Houston (Figure 1). At the La Porte Site, which is located near the Houston ship channel in an area that experiences significant pollution, the first ARM Mobile Facility (AMF1) was deployed. During the IOP, the ARM tethered balloon system (TBS) operated at the ancillary site. The second-generation C-Band Scanning ARM Precipitation Radar (CSAPR) operated near Pearland, Texas, roughly halfway between the Laporte and ancillary sites. As part of the TRACER- Coastal Urban Boundary-Layer Interactions with Convection (CUBIC) project, three boundary-layer profiling systems) were deployed along a north-south transect spanning from the University of Houston Coastal Center to the Aldine site north of downtown Houston (also blue dot in Figure 1) during the TRACER IOP. These systems included the National Oceanic and Atmospheric Administration (NOAA) National Severe Storms Laboratory CLAMPS2 (C2), which was deployed at the UHCC, the University of Wisconsin SPARC, which was deployed at the ARM CSAPR site near Pearland (orange diamond in middle of map in Figure 1), and the University of Oklahoma CLAMPS1 (C1), which was deployed at Aldine. These three systems have been successfully operated in various field campaigns, providing data sets that collectively offer new insights into atmospheric-boundary-layer (ABL) processes, sea-breeze (SB) circulations, and convection initiation (CI). For the TRACER IOP window, these systems ran continuously between 1 June and 26 September, 2022. Due to commitments to NOAA projects, the Doppler lidar at the UHCC site was not available until 24 June 2022. The CLAMPS and SPARC profiling systems are self-contained platforms that have benefited from several years of development and deployment. Instruments and data processing were maintained remotely, which made the 4-month deployment for the TRACER-CUBIC IOP period possible. The same basic instrument configuration comprises each system: a scanning Doppler wind lidar for flow characterization and passive profiler(s) for characterizing planetary-boundary-layer (PBL) thermodynamic properties. Each platform includes a Halo Streamline Doppler wind lidar, an Atmospheric Emitted Radiance Interferometer (AERI), and a surface meteorology station. CLAMPS1 and CLAMPS2 each also include a microwave radiometer (MWR, Figure 1d). The TRACER-CUBIC hypotheses included (i) Interactions of SB and urban circulations and how they affect the PBL structure in the Houston environment, causing spatially (horizontally and vertically) and temporally highly variable flow patterns, (ii) heat, moisture, and aerosol transport and mixing depend on these flow dynamics, and (iii) an improved understanding of the flow patterns and PBL structure are critical for investigating the processes leading to CI. To test these hypotheses, the project aimed at (i) characterizing SB circulations and their impacts on the diurnal evolution of the structure of the ABL, (ii) studying the evolution of Houston’s complex urban boundary layer, and (iii) identifying effects of urban-induced circulations on pre-convective environments. TRACER-CUBIC observations generally provide good coverage during the summer IOP. Initial screening of the data indicates a good number of cases with bay-breeze (BB) and/or SB signatures, local CI, and interesting boundary-layer features such as strong nocturnal low-level jets (LLJs, Table 1). The numbers listed in rows 3-5 in this table will be further updated as part of ongoing in-depth analyses and systematic identification of local circulations and CI events. More detailed information about the data availability and quality for each instrument is provided in the “readme” files that were submitted to the ARM Data Center along with each archived data sets. These “readme” files also provide instrument descriptions, information about the data collection and processing procedures, data formats, and any additional information relevant for further data analysis.

54 ENVIRONMENTAL SCIENCES↗

Nonsynonymous amino acid changes in the α-chain of complement component 5 influence longitudinal susceptibility to Plasmodium falciparum infections and severe malarial anemia in kenyan children

Background: Severe malarial anemia (SMA; Hb < 5.0 g/dl) is a leading cause of childhood morbidity and mortality in holoendemic Plasmodium falciparum transmission regions such as western Kenya. Methods: We investigated the relationship between two novel complement component 5 (C5) missense mutations [rs17216529:C>T, p(Val145Ile) and rs17610:C>T, p(Ser1310Asn)] and longitudinal outcomes of malaria in a cohort of Kenyan children (under 60 mos, n = 1,546). Molecular modeling was used to investigate the impact of the amino acid transitions on the C5 protein structure. Results: Prediction of the wild-type and mutant C5 protein structures did not reveal major changes to the overall structure. However, based on the position of the variants, subtle differences could impact on the stability of C5b. The influence of the C5 genotypes/haplotypes on the number of malaria and SMA episodes over 36 months was determined by Poisson regression modeling. Genotypic analyses revealed that inheritance of the homozygous mutant (TT) for rs17216529:C>T enhanced the risk for both malaria (incidence rate ratio, IRR = 1.144, 95%CI: 1.059–1.236, p = 0.001) and SMA (IRR = 1.627, 95%CI: 1.201–2.204, p = 0.002). In the haplotypic model, carriers of TC had increased risk of malaria (IRR = 1.068, 95%CI: 1.017–1.122, p = 0.009), while carriers of both wild-type alleles (CC) were protected against SMA (IRR = 0.679, 95%CI: 0.542–0.850, p = 0.001). Conclusion: Collectively, these findings show that the selected C5 missense mutations influence the longitudinal risk of malaria and SMA in immune-naïve children exposed to holoendemic P. falciparum transmission through a mechanism that remains to be defined.

60 APPLIED LIFE SCIENCES↗

How long were older people expected to live with or without sarcopenia? Multistate modeling of a national cohort study

Objectives Sarcopenia is well known to be associated with mortality, but there is a lack of evidence on the estimates of life expectancy (LE) for sarcopenia in China. This study aims to estimate total life expectancy (TLE) and sarcopenia-specific LE in community-dwelling older Chinese adults with and without sarcopenia. Methods This study included participants aged 60 years and older who enrolled in the cohort in 2011 and 2013 and at least completed one follow-up until 2015 as part of the China Health and Retirement Longitudinal Study (CHARLS). The criteria for defining sarcopenia were based on the guidelines established by the Asian Working Group on Sarcopenia in 2019. TLE and sarcopenia-specific LE were estimated for the total population and subgroups using continuous-time multistate modeling. Results A total of 6,029 participants (49.2% women) with an average age of 68.4 (SD: 6.56) years were included in the study. The baseline prevalence of sarcopenia and possible sarcopenia was 19.5 and 44.9%, respectively. We observed that sarcopenia stages naturally deteriorated to worse stages (including death, by 24.4%) and returned to better stages (17.1%) during a median follow-up of 3.92 years (IQR: 2.00 ~ 4.00). The average TLE at the age of 60 was 20.9 [95% CI: 20.2–21.5] years (22.1 [95% CI: 19.6–24.6] for non-sarcopenic older adults, 20.9 [95% CI: 19.5–22.3] for possible sarcopenic, and 18.7 [95% CI: 16.4–21.1] for sarcopenic). Men, former and current smokers, and those living in northwest China had less TLE. Sarcopenic older adults, those with lower education, those who are unmarried, those with agriculture hukou, and those living in rural and northwest China were expected to live fewer years with non-sarcopenia. Sarcopenic older people, men, those with agriculture hukou, and those living in rural and southwest China were expected to live more years with sarcopenia. Discussion The results improved our understanding of the relationship between sarcopenia and life expectancy. We suggested that targeted strategies should be considered in high-risk populations and underdeveloped regions to prevent sarcopenia and improve non-sarcopenic life years for the older population.

Ye, Bo↗

An evaluation of prognostic factors, oncologic outcomes, and management for primary and recurrent squamous cell carcinoma of the vulva

Objective: To evaluate prognostic factors, outcomes, and management patterns of patients treated for squamous cell carcinoma of the vulva. Methods: One hundred sixty-four women were retrospectively identified with primary squamous cell carcinoma of the vulva treated at our institution between 1/1996–12/2018. Descriptive statistics were performed on patient, tumor, and treatment characteristics. The χ 2 tests and t-tests were used to compare categorical variables and continuous variables, respectively. Recurrence free survival (RFS), overall survival (OS), and disease-specific survival (DSS) were analyzed with Kaplan-Meier estimates, the log-rank test, and Cox proportional hazards. Results: Median follow-up was 52.5 months. Five-year RFS was 67.9%, 60.0%, 42.1%, and 20.0% for stage I–IV, respectively. Five-year DSS was 86.2%, 81.6%, 65.0%, and 42.9% for stage I–IV, respectively. On multivariate analysis, positive margins predicted overall RFS (hazard ratio [HR]=3.55; 95% confidence interval [CI]=1.18–10.73; p=0.025), while presence of lichen sclerosus on pathology (HR=2.78; 95% CI=1.30–5.91; p=0.008) predicted local RFS. OS was predicted by nodal involvement (HR=2.51; 95% CI=1.02–6.13; p=0.043) and positive margins (HR=5.19; 95% CI=2.03–13.26; p=0.001). Adjuvant radiotherapy significantly improved RFS (p=0.016) and DSS (p=0.012) in node-positive patients. Median survival after treatment of local, groin, and pelvic/distant recurrence was 52, 8, and 5 months, respectively. Conclusion: For primary treatment, more conservative surgical approaches can be considered with escalation of treatment in patients with concurrent precursor lesions, positive margins, and/or nodal involvement. Further studies are warranted to improve risk stratification in order to optimize treatment paradigms for vulvar cancer patients.

60 APPLIED LIFE SCIENCES↗

INVESTIGATION OF TURBULENT JETS, SPRAYS, AND SUPERCRITICAL MIXING BY TIME RESOLVED RAINBOW SCHLIEREN DEFLECTOMETRY

As technological advancements have enabled higher efficiency compression ignition (CI) engines (diesel engines) by operating at higher pressures and temperatures, the mechanisms of fuel-air mixing are postulated to change. Thus, there is a greater need for experimental data to develop and verify new phenomena. However, the fast time scales and harsh environments associated with CI engines present many experimental difficulties and requires high quality non-intrusive diagnostics to obtain useful data. The diagnostics itself must be validated prior to its implementation in an engine environment. The purpose of this research is to advance rainbow schlieren deflectometry (RSD) to study turbulent fuel sprays including the effects of supercritical mixing in CI engine environments. This objective is met by developing and applying quantitative RSD, for the first time, to three separate aspects of fuel sprays: 1) turbulent mixing, 2) phase boundaries, and 3) non-ideal gas mixing. First, quantitative RSD is demonstrated for turbulent mixing in a canonical helium jet. Rayleigh scattering data in the literature is used to validate the concentration measurements obtained by RSD. The results also provide explanations for phenomena occurring in the helium jet and provide data not yet present in the literature. Second, RSD is applied to high pressure multi-phase fuel sprays and new methodologies are developed to distinguish the liquid region from the vapor region and to quantify the in-between region on a probabilistic basis. Isolating liquid and vapor regions generally requires two separate diagnostics, e.g., Mie scattering (liquid region) and Rayleigh scattering (vapor region). However, the results of this study demonstrate that RSD can be used as a single diagnostic to measure both liquid and vapor boundaries. Third, the optical-to-thermodynamic relations associated with refrac-tometry are investigated under non-ideal gas mixing conditions to develop a generalized relationship valid for both ideal or non-ideal gas mixing. The last part of this research develops the theoretical tools to understand and experimentally realize supercritical mixing at diesel conditions. Guided by the theoretical analysis, RSD is applied to compare supercritical versus transcritical mixing at CI conditions using a constant pressure test rig. It is found that while fully supercritical mixing ers benefits in diesel engines, i.e, faster mixing times (50% higher velocities), the absence of droplets which cause high levels of particulate emissions, etc., it would be difficult to achieve in practice because of the requirements of fuels with low critical temperature and/or substantial fuel preheating.

02 PETROLEUM↗

Operational Intelligence in the ATLAS Continuous Integration System

Describes the role of the ATLAS Continuous Integration (CI) System in the ATLAS offline software development infrastructure • Outlines the CI system components and processes • Details Operational Intelligence techniques to accelerate CI jobs and lower operating costs • Explains the Directed Acyclic Graph (DAG) approach in CI pipelines • Reports achieved improvements

97 MATHEMATICS AND COMPUTING↗

Historical Savannah River Site Tritium Releases, Pathways, and Transport

† Releases of tritium from the production reactors were due almost entirely to releases of moderator, either as liquid or vapor from the reactor systems and from the heavy water rework facility. Small amounts could have been released from the reactor blanket gas system and from irradiated lithium-bearing control rods and targets stored underwater in the disassembly basins (Longtin et al. 1973; Jacober et al. 1973). ‡Only a part of the tritium released to the seepage and retention basins leave the site. Of the 3,015,000 Ci of tritium released to the basins, 27% (0.81M Ci) evaporated from the basin surfaces, 40% (1.2M Ci) migrated to outcrops and entered surface streams, and 33% (0.99M Ci) remains under the basins.

Chiswell, Steven R.↗

Configuration–Interaction Perturbation Theory Calculations of Pu II

Configuration–interaction perturbation theory (CI–PT) is applied to calculations of low-energy states of Pu II. This ion is quite challenging due to a large number of possible determinants arising from seven valence electrons and strong relativistic effects. The CI–PT calculations agree with experiments for the energies and g-factors for many low-energy states that allowed positive identification of the theoretical levels. Isotope shifts were also used to aid in identification, and, in case of the odd states, fitting with three independent parameters was used to match theoretical isotope shifts to the experimental values with good accuracy. The CI–PT approach tested here on the Pu II ion can be generally used to calculate properties of many complex atoms, including U I that can find application in fundamental and applied science.

74 ATOMIC AND MOLECULAR PHYSICS↗

Accuracy of Tau Positron Emission Tomography as a Prognostic Marker in Preclinical and Prodromal Alzheimer Disease: A Head-to-Head Comparison Against Amyloid Positron Emission Tomography and Magnetic Resonance Imaging

Importance: Tau positron emission tomography (PET) tracers have proven useful for the differential diagnosis of dementia, but their utility for predicting cognitive change is unclear. Objective: To examine the prognostic accuracy of baseline fluorine 18 ( 18 F)-flortaucipir and [18F]RO948 (tau) PET in individuals across the Alzheimer disease (AD) clinical spectrum and to perform a head-to-head comparison against established magnetic resonance imaging (MRI) and amyloid PET markers. Design, setting, and participants: This prognostic study collected data from 8 cohorts in South Korea, Sweden, and the US from June 1, 2014, to February 28, 2021, with a mean (SD) follow-up of 1.9 (0.8) years. A total of 1431 participants were recruited from memory clinics, clinical trials, or cohort studies; 673 were cognitively unimpaired (CU group; 253 [37.6%] positive for amyloid-β [Aβ]), 443 had mild cognitive impairment (MCI group; 271 [61.2%] positive for Aβ), and 315 had a clinical diagnosis of AD dementia (315 [100%] positive for Aβ). Exposures: [ 18 F]Flortaucipir PET in the discovery cohort (n = 1135) or [ 18 F]RO948 PET in the replication cohort (n = 296), T1-weighted MRI (n = 1431), and amyloid PET (n = 1329) at baseline and repeated Mini-Mental State Examination (MMSE) evaluation. Main outcomes and measures: Baseline [ 18 F]flortaucipir/[ 18 F]RO948 PET retention within a temporal region of interest, MRI-based AD-signature cortical thickness, and amyloid PET Centiloids were used to predict changes in MMSE using linear mixed-effects models adjusted for age, sex, education, and cohort. Mediation/interaction analyses tested whether associations between baseline tau PET and cognitive change were mediated by baseline MRI measures and whether age, sex, and APOE genotype modified these associations. Results: Among 1431 participants, the mean (SD) age was 71.2 (8.8) years; 751 (52.5%) were male. Findings for [ 18 F]flortaucipir PET predicted longitudinal changes in MMSE, and effect sizes were stronger than for AD-signature cortical thickness and amyloid PET across all participants (R 2 , 0.35 [tau PET] vs 0.24 [MRI] vs 0.17 [amyloid PET]; P < .001, bootstrapped for difference) in the Aβ-positive MCI group (R2, 0.25 [tau PET] vs 0.15 [MRI] vs 0.07 [amyloid PET]; P < .001, bootstrapped for difference) and in the Aβ-positive CU group (R 2 , 0.16 [tau PET] vs 0.08 [MRI] vs 0.08 [amyloid PET]; P < .001, bootstrapped for difference). These findings were replicated in the [ 18 F]RO948 PET cohort. MRI mediated the association between [ 18 F]flortaucipir PET and MMSE in the groups with AD dementia (33.4% [95% CI, 15.5%-60.0%] of the total effect) and Aβ-positive MCI (13.6% [95% CI, 0.0%-28.0%] of the total effect), but not the Aβ-positive CU group (3.7% [95% CI, -17.5% to 39.0%]; P = .71). Age (t = -2.28; P = .02), but not sex (t = 0.92; P = .36) or APOE genotype (t = 1.06; P = .29) modified the association between baseline [ 18 F]flortaucipir PET and cognitive change, such that older individuals showed faster cognitive decline at similar tau PET levels. Conclusions and relevance: The findings of this prognostic study suggest that tau PET is a promising tool for predicting cognitive change that is superior to amyloid PET and MRI and may support the prognostic process in preclinical and prodromal stages of AD.

59 BASIC BIOLOGICAL SCIENCES↗

Iron Heterogeneity in Early Active Multiple Sclerosis Lesions

Objective: Multiple sclerosis (MS) is a heterogeneous inflammatory demyelinating disease. Iron distribution is altered in MS patients' brains, suggesting iron liberation within active lesions amplifies demyelination and neurodegeneration. Whether the amount and distribution of iron are similar or different among different MS immunopatterns is currently unknown. Methods: We used synchrotron X-ray fluorescence imaging, histology, and immunohistochemistry to compare the iron quantity and distribution between immunopattern II and III early active MS lesions. We analyzed archival autopsy and biopsy tissue from 21 MS patients. Results: Immunopattern II early active lesions contain 64% more iron (95% confidence interval [CI] = 17-127, p = 0.004) than immunopattern III lesions, and 30% more iron than the surrounding periplaque white matter (95% CI = 3–64%, p = 0.03). Iron in immunopattern III lesions is 28% lower than in the periplaque white matter (95% CI = -40 to -14%, p < 0.001). When normalizing the iron content of early active lesions to that of surrounding periplaque white matter, the ratio is significantly higher in immunopattern II (p < 0.001). Microfocused X-ray fluorescence imaging shows that iron in immunopattern II lesions localizes to macrophages, whereas macrophages in immunopattern III lesions contain little iron. Interpretation: Iron distribution and content are heterogeneous in early active MS lesions. Iron accumulates in macrophages in immunopattern II, but not immunopattern III lesions. This heterogeneity in the two most common MS immunopatterns may be explained by different macrophage polarization, origin, or different demyelination mechanisms, and paves the way for developing new or using existing iron-sensitive magnetic resonance imaging techniques to differentiate among immunopatterns in the general nonbiopsied MS patient population.

60 APPLIED LIFE SCIENCES↗