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At least 19 records

Forecasting and modeling of the COVID-19 pandemic in the USA with a timed intervention model

We propose a novel Timed Intervention S, P, E, I, Q, R, D model for projecting the possible futures of the COVID-19 pandemic in the USA. The proposed model introduces a series of timed interventions that can account for the influence of real time changes in government policy and social norms. We consider three separate types of interventions: (i) Protective interventions: Where population moves from susceptible to protected corresponding to mask mandates, stay-at-home orders and/or social distancing. (ii) Release interventions: Where population moves from protected to susceptible corresponding to social distancing mandates and practices being lifted by policy or pandemic fatigue. (iii) Vaccination interventions: Where population moves from susceptible, protected, and exposed to recovered (meaning immune) corresponding to the mass immunization of the U.S. Population. By treating the pandemic with timed interventions, we are able to model the pandemic extremely effectively, as well as directly predicting the course of the pandemic under differing sets of intervention schedules. We show that without prompt effective protective/vaccination interventions the pandemic will be extended significantly and result in many millions of deaths in the U.S.

60 APPLIED LIFE SCIENCES↗

A Design of Activity-Based Mobility Intervention

Human mobility influences our society and vice versa. During the COVID-19 pandemic, non-pharmaceutical intervention that alters activity-based mobility such as work-from-home greatly impacted human mobility patterns. Many studies on developing mitigation strategies have employed or implemented their own mobility intervention within their model assumption. For fair evaluation between intervention strategies across models, it is significant to set up compatible experimental environments. However, it is difficult to apply the identical intervention to different kinds of models and compare their effectiveness because each model might have different assumptions, capabilities, and implementations. Even if one can apply intervention to heterogeneous models, it may produce undesirable artifacts due to difference of models and integration with intervention. Therefore, minimizing undesirable artifacts and facilitating intervention experiments across heterogeneous models are substantial. Taking this into account, this paper investigates a design of activity-based mobility intervention (ABMI). We define ABMI together with related concepts and develop an extensible data model and schema of ABMI based on the 5W1H method that can be used in different models. As a case study, we apply the ABMI model to a micro-simulation to demonstrate the usability of the proposed model. We expect that standardized ABMI and interfaces may help to streamline development and experiments of intervention strategies across heterogeneous models.

Kim, Joon-Seok↗

Building and experimenting with an agent-based model to study the population-level impact of CommunityRx, a clinic-based community resource referral intervention

CommunityRx (CRx), an information technology intervention, provides patients with a personalized list of healthful community resources (HealtheRx). In repeated clinical studies, nearly half of those who received clinical “doses” of the HealtheRx shared their information with others (“social doses”). Clinical trial design cannot fully capture the impact of information diffusion, which can act as a force multiplier for the intervention. Furthermore, experimentation is needed to understand how intervention delivery can optimize social spread under varying circumstances. To study information diffusion from CRx under varying conditions, we built an agent-based model (ABM). This study describes the model building process and illustrates how an ABM provides insight about information diffusion through in silico experimentation. To build the ABM, we constructed a synthetic population (“agents”) using publicly-available data sources. Using clinical trial data, we developed empirically-informed processes simulating agent activities, resource knowledge evolution and information sharing. Using RepastHPC and chiSIM software, we replicated the intervention in silico, simulated information diffusion processes, and generated emergent information diffusion networks. The CRx ABM was calibrated using empirical data to replicate the CRx intervention in silico. We used the ABM to quantify information spread via social versus clinical dosing then conducted information diffusion experiments, comparing the social dosing effect of the intervention when delivered by physicians, nurses or clinical clerks. The synthetic population (N = 802,191) exhibited diverse behavioral characteristics, including activity and knowledge evolution patterns. In silico delivery of the intervention was replicated with high fidelity. Large-scale information diffusion networks emerged among agents exchanging resource information. Varying the propensity for information exchange resulted in networks with different topological characteristics. Community resource information spread via social dosing was nearly 4 fold that from clinical dosing alone and did not vary by delivery mode. This study, using CRx as an example, demonstrates the process of building and experimenting with an ABM to study information diffusion from, and the population-level impact of, a clinical information-based intervention. While the focus of the CRx ABM is to recreate the CRx intervention in silico, the general process of model building, and computational experimentation presented is generalizable to other large-scale ABMs of information diffusion.

59 BASIC BIOLOGICAL SCIENCES↗

The Connected We St@nd programme: A feasibility pilot study of an online self‐management intervention for adults on in‐centre haemodialysis and family caregivers

Abstract Objective The ‘Connected We St@nd’ is an online self‐management intervention programme for people receiving in‐centre haemodialysis and family caregivers that combines an educational and psychosocial support component. This study aimed to evaluate its feasibility and acceptability before proceeding to a large‐scale trial. Design This was a pre‐post single‐arm feasibility pilot study conducted with adults undergoing in‐centre haemodialysis and family caregivers. Methods Feasibility was based on eligibility, consent, retention, completion and intervention adherence rates, while acceptability was assessed in post‐intervention focus group interviews. Results Twenty‐six people (16 adults on haemodialysis and 10 family caregivers) recruited through social networks completed the intervention. Consent, retention and completion rates were excellent (>90%) and eligibility (77.5%) and intervention adherence were satisfactory (69% for the psychosocial support sessions). Qualitative findings revealed that participants shared positive feelings regarding their participation in the programme. The valuable interactions with group peers and health psychologists during the support sessions, the perception of the adequacy and coherence of the programme's contents and materials and the participants' confidence in using the platform developed to deliver the intervention were some of the aspects highlighted as facilitators of intervention acceptability. Additionally, people on haemodialysis and caregivers reported that participation in the programme brought several educational and emotional benefits (e.g., additional disease‐related knowledge, improved communication and coping skills, greater confidence in managing dialysis complications or caregiving demands) that helped increase their self‐management skills and psychosocial adjustment to the demands of kidney failure and renal therapies. Conclusions The results suggested that the ‘Connected We St@nd’ programme is likely to be feasible and acceptable for adults on haemodialysis and family caregivers, thus representing a promising resource for the future of interdisciplinary renal rehabilitation. Suggestions were made to fine‐tune the intervention design to proceed with a large‐scale trial.

Sousa, Helena↗

Screening and Brief Interventions for Alcohol Use During Pregnancy: Practices Among US Primary Care Clinicians, DocStyles 2019

Alcohol use during pregnancy can cause birth defects and developmental disabilities. From 2018 through 2020, 13.5% of pregnant women reported current drinking. The US Preventive Services Task Force recommends evidence-based tools (eg, AUDIT-C and SASQ) for implementing screening and brief interventions to reduce excessive alcohol use among adults, including pregnant people, for whom any alcohol use is considered excessive. We used DocStyles 2019 data to conduct a cross-sectional analysis to examine current screening and brief intervention practices that primary care clinicians conduct among pregnant patients; clinicians’ confidence levels in conducting screening, brief interventions, and referral to treatment; and the documentation of brief interventions in the medical record. A total of 1,500 US adult medicine clinicians completed the entire survey. Among the respondents who conduct screening (N = 1,373) and brief interventions (N = 1,357) in their practice, nearly all reported implementing screening (94.6%) and brief interventions (94.9%) with their pregnant patients for alcohol use, but fewer than half felt confident about conducting their screening practices (46.5%). Two-thirds (64%) reported using a tool that met the criteria recommended by the US Preventive Services Task Force (USPSTF). Over half documented brief interventions in electronic health record notes (51.7%) or designated space (50.7%). Pregnancy presents a unique opportunity for clinicians to incorporate screening into routine obstetric care and encourage behavior change among patients. Most providers reported always screening their pregnant patients for alcohol use, but fewer used evidence-based USPSTF-recommended screening tools. Increased clinician confidence in screening and brief intervention, the use of standardized screening tools tailored to pregnant people, and maximal use of electronic health record technology may enhance the benefits of their application to alcohol use, which ultimately can reduce adverse outcomes associated with alcohol use during pregnancy.

60 APPLIED LIFE SCIENCES↗

Combined dietary and exercise intervention for control of serum cholesterol in the workplace

PURPOSE: To elucidate a potential combined dietary and exercise intervention affect on cardiovascular risk reduction of the National Aeronautics and Space Administration Headquarters employees. DESIGN: A nonexperimental, longitudinal, clinical-chart review study (1987 to 1996) of an identified intervention group and a reference (not a control) group. SETTING: The study group worked in an office environment and participated in the annual medical examinations. SUBJECTS: An intervention group of 858 people with initially elevated serum cholesterol, and a reference group of 963 people randomly sampled from 10% of the study group. MEASURES: Serum cholesterol data were obtained for both groups, respectively, from pre- and postintervention and annual examinations. The reference group was adjusted by statistical exclusion of potential intervention participants. Regression equations (cholesterol vs. study years) for the unadjusted/adjusted reference groups were tested for statistical significance. INTERVENTION: An 8-week individualized, combined dietary and exercise program was instituted with annual follow-ups and was repeated where warranted. RESULTS: Only the unadjusted (but not the adjusted) reference group with initial mean total serum cholesterol levels above 200 mg/dL shows a significant 9-year decline trend and significant beta coefficient tests. An intervention effect is suggested. Mean high density lipoprotein cholesterol rose slightly in the intervention group but was maintained in the reference group. CONCLUSION: With potential design limitations, the NASA intervention program focusing on a high risk group may be associated to some degree, if not fully, with an overall cardiovascular risk profile improvement.

Occupational Health Services↗

Simulating policy interventions in the interfirm diffusion of low-carbon technologies: An agent-based evolutionary game model

Policy interventions are frequently used by authorities around the world to mitigate carbon emissions. However, economic systems are essentially complex adaptive systems, which often exhibit unexpected responses to exogenous interventions and leave intervenors in a dilemma, even if the interventions are elaborately designed. To explore the behaviors of the diffusion system regarding low-carbon technologies, this study builds an agent-based model (ABM) to simulate enterprises' reactions to multiple policy interventions aimed at spurring low-carbon technology diffusion. The simulated enterprises are in a complex network where they play evolutionary games with their neighbors, which enables the model to possess two critical features of economic systems: adaptiveness and equilibrium. The model reveals a dilemma of policy interventions: intuitively, carbon taxes, asymmetric penalties (only imposed on un-low-carbon enterprises) and subsidies can improve the diffusion, which is consistent with previous research; counter-intuitively, all these policies turn out to be inefficient or even harmful to low-carbon enterprises because of the diffusion system's high adaptiveness. Specifically, when carbon taxes and penalties increase, both the low-carbon and un-low-carbon enterprises end up with the equilibrium of equivalent but lower profits. In contrast, all the enterprises earn equivalent but more profits even though subsidies are only given to the low-carbon enterprises, which implies that the un-low-carbon enterprises (indirectly) grab a portion of the subsidies and accordingly weaken the incentive effect of subsidies. These system behaviors are summarized as "equalizing effect" because the system tends to equalize the impact of both positive and negative interventions among all enterprises even though the policy interventions are asymmetrically imposed on one type of the enterprises. The findings also indicate that policies implemented to enlarge green market sizes can help policymakers bypass the dilemma.

Agent-based modeling↗

Biphasic decay of intact SHIV genomes following initiation of antiretroviral therapy complicates analysis of interventions targeting the reservoir

The latent reservoir for HIV-1 in resting CD4 + T cells persists despite antiretroviral therapy (ART) and precludes cure. Reservoir-targeting interventions are evaluated in ART-treated macaques infected with simian immunodeficiency virus (SIV) or simian-human immunodeficiency virus (SHIV). Efficacy is determined by reservoir measurements before and after the intervention. However, most proviruses persisting in the setting of ART are defective. In addition, intact HIV-1 and SIV genomes undergo complex, multiphasic decay observable when new infection events are blocked by ART. Intervention-induced elimination of latently infected cells must be distinguished from natural decay. Here, we address these issues for SHIV. We describe an intact proviral DNA assay that allows digital counting of SHIV genomes lacking common fatal defects. We show that intact SHIV genomes in circulating CD4 + T cells undergo biphasic decay during the first year of ART, with a rapid first phase (t 1/2 = 30.1 d) and a slower second phase (t 1/2 = 8.1 mo) that is still more rapid that the slow decay observed in people with HIV-1 on long-term ART (t 1/2 = 3.7 y). In SHIV models, most interventions are tested during 2nd phase decay. Natural 2nd phase decay must be considered in evaluating interventions as most infected cells present at this time do not become part of the stable reservoir. In addition, for interventions tested during 2nd phase decay, a caveat is that the intervention may not be equally effective in people with HIV on long-term ART whose reservoirs are dominated by latently infected cells with a slower decay rate.

59 BASIC BIOLOGICAL SCIENCES↗

Personal Interventions for Reducing Exposure and Risk for Outdoor Air Pollution: An Official American Thoracic Society Workshop Report

Poor air quality affects the health and wellbeing of large populations around the globe. Although source controls are the most effective approaches for improving air quality and reducing health risks, individuals can also take actions to reduce their personal exposure by staying indoors, reducing physical activity, altering modes of transportation, filtering indoor air, and using respirators and other types of face masks. A synthesis of available evidence on the efficacy, effectiveness, and potential adverse effects or unintended consequences of personal interventions for air pollution is needed by clinicians to assist patients and the public in making informed decisions about use of these interventions. To address this need, the American Thoracic Society convened a workshop in May of 2018 to bring together a multidisciplinary group of international experts to review the current state of knowledge about personal interventions for air pollution and important considerations when helping patients and the general public to make decisions about how best to protect themselves. From these discussions, recommendations were made regarding when, where, how, and for whom to consider personal interventions. In addition to the efficacy and safety of the various interventions, the committee considered evidence regarding the identification of patients at greatest risk, the reliability of air quality indices, the communication challenges, and the ethical and equity considerations that arise when discussing personal interventions to reduce exposure and risk from outdoor air pollution.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗

Climate Interventions Risk Framework White Paper

This work describes a structured, risk-based approach for analyzing questions related to the potential deployment of a climate intervention in any user-established future scenario, and further provides a structured means for considering what the potential consequences of such interventions may be. Because the climatological, technological, and geopolitical conditions are currently not believed to be supportive of climate intervention use, the framework establishes a three-pronged approach to frame key analytical questions predicated on future scenarios of interest to the user. These three pieces are: (1) Building a scenario. (2) Assessing the likelihood of that scenario based on assumptions about an actor and their motivations for deploying a climate intervention. (3) Analyzing the potential consequences of that climate intervention. Finally, results from this consequence analysis are compared against projected consequences of unabated climate change as a complete risk analysis of deploying a climate intervention.

54 ENVIRONMENTAL SCIENCES↗

Defining the Relationship Between Human Error Classes and Technology Intervention Strategies

The modus operandi in addressing human error in aviation systems is predominantly that of technological interventions or fixes. Such interventions exhibit considerable variability both in terms of sophistication and application. Some technological interventions address human error directly while others do so only indirectly. Some attempt to eliminate the occurrence of errors altogether whereas others look to reduce the negative consequences of these errors. In any case, technological interventions add to the complexity of the systems and may interact with other system components in unforeseeable ways and often create opportunities for novel human errors. Consequently, there is a need to develop standards for evaluating the potential safety benefit of each of these intervention products so that resources can be effectively invested to produce the biggest benefit to flight safety as well as to mitigate any adverse ramifications. The purpose of this project was to help define the relationship between human error and technological interventions, with the ultimate goal of developing a set of standards for evaluating or measuring the potential benefits of new human error fixes.

Wiegmann, Douglas A.↗

The First Intervention Study in Elder Self-Neglect: A Randomized Clinical Trial to Improve Vitamin D Levels

Despite high mortality rates, elder self-neglect is characterized by refusal of medical and social interventions. To date there have been no tested clinical interventions in elders who self-neglect. Previous research from the TEAM Institute has shown significantly low vitamin D levels in this population. This study aimed to determine the feasibility of a clinical intervention. Replacement of vitamin D was chosen because of its ease of administration and favorable safety profile. Methods: A randomized clinical trial using directly observed therapy of vitamin D was conducted using 50 elders, >65 years of age, with Adult Protective Services (APS) validated self-neglect. A staggered intervention with waiting controls was used to maximize statistical power. One-third (n=17) of the group was administered 50,000 IU vitamin D2 (ergocalciferol) monthly and the remainder (n=33) were administered 400 IU monthly. Serum 25-OH vitamin D was assessed at baseline and 5-months. Results: 69% agreed to participate in the study and of those n=40 (80%) remained at 5-months. At baseline, 12% (n=7) were deficient in vitamin D (<30nmol/L) and approximately 38% (n=22) had inadequate vitamin D levels (<50nmol/L). The baseline 25-OH vitamin D level was 59 nmol/L +25 (mean SD), and increased significantly to 72nmol/L +21 nmol/L at 5-months. Conclusion: These data are the first to provide evidence that clinical interventions are feasible in elders who self-neglect. The increase in vitamin D levels confirmed that the study personnel were able to successfully intervene community-dwelling elders with self-neglect. This study sets the precedent for future intervention and prevention studies

Burnett, Jason↗

Evaluating efficacy of indoor non-pharmaceutical interventions against COVID-19 outbreaks with a coupled spatial-SIR agent-based simulation framework

Contagious respiratory diseases, such as COVID-19, depend on sufficiently prolonged exposures for the successful transmission of the underlying pathogen. It is important that organizations evaluate the efficacy of non-pharmaceutical interventions aimed at mitigating viral transmission among their personnel. We have developed a operational risk assessment simulation framework that couples a spatial agent-based model of movement with an agent-based SIR model to assess the relative risks of different intervention strategies. By applying our model on MIT’s Stata center, we assess the impacts of three possible dimensions of intervention: one-way vs unrestricted movement, population size allowed onsite, and frequency of leaving designated work location for breaks. We find that there is no significant impact made by one-way movement restrictions over unrestricted movement. Instead, we find that reducing the frequency at which individuals leave their workstations combined with lowering the number of individuals admitted below the current recommendations lowers the likelihood of highly connected individuals within the contact networks that emerge, which in turn lowers the overall risk of infection. We discover three classes of possible interventions based on their epidemiological effects. By assuming a direct relationship between data on secondary attack rates and transmissibility in the agent-based SIR model, we compare relative infection risk of four respiratory illnesses, MERS, SARS, COVID-19, and Measles, within the simulated area, and recommend appropriate intervention guidelines.

60 APPLIED LIFE SCIENCES↗

Unraveling the impact of initial choices and in-loop interventions on learning dynamics in autonomous scanning probe microscopy

The current focus in Autonomous Experimentation (AE) is on developing robust workflows to conduct the AE effectively. This entails the need for well-defined approaches to guide the AE process, including strategies for hyperparameter tuning and high-level human interventions within the workflow loop. This paper presents a comprehensive analysis of the influence of initial experimental conditions and in-loop interventions on the learning dynamics of Deep Kernel Learning (DKL) within the realm of AE in scanning probe microscopy. We explore the concept of the “seed effect,” where the initial experiment setup has a substantial impact on the subsequent learning trajectory. Additionally, we introduce an approach of the seed point interventions in AE allowing the operator to influence the exploration process. Using a dataset from Piezoresponse Force Microscopy on PbTiO 3 thin films, we illustrate the impact of the “seed effect” and in-loop seed interventions on the effectiveness of DKL in predicting material properties. The study highlights the importance of initial choices and adaptive interventions in optimizing learning rates and enhancing the efficiency of automated material characterization. This work offers valuable insights into designing more robust and effective AE workflows in microscopy with potential applications across various characterization techniques.

47 OTHER INSTRUMENTATION↗

The impact of interventions in the global land and agri-food sectors on Nature’s Contributions to People and the UN Sustainable Development Goals

Interlocked challenges of climate change, biodiversity loss and land degradation require transformative interventions in the land management and food production sectors to reduce carbon emissions, strengthen adaptive capacity, and maintain or increase food production to 2050. However, deciding which interventions to pursue and understanding their relative synergies with and trade-offs against different social and environmental goals has been difficult without direct comparisons across a range of possible actions. This study examined a series of 40 different options, implemented through land, value chain or risk management, for their relative impacts across 18 Nature’s Contributions to People (also known as ecosystem services) and the 17 Sustainable Development Goals. We find that a relatively small number of interventions show significant positive synergies with both SDGs and NCPs; these include improved cropland management, improved grazing land management, improved livestock management, agroforestry, agricultural diversification, increased soil organic carbon content, reduced soil erosion, salinization and compaction, fire management, reduced landslides and hazards, reduced pollution, management of invasive species, sustainable source, and reduced post-harvest losses. Several interventions show strong negative impacts on either SDGs, NCPs or in some cases, both; these include bioenergy and BECCS, afforestation, and some risk sharing measures, like commercial crop insurance. Our results demonstrate that a better understanding of benefits and trade-offs of comparative policy approaches can help decision-makers choose the most effective, or at the very minimum, benign interventions for implementation in specific contexts.

Mcelwee, Pam↗

Reduction of Maintenance Error Through Focused Interventions

It is well known that a significant proportion of aviation accidents and incidents are tied to human error. In flight operations, research of operational errors has shown that so-called "pilot error" often involves a variety of human factors issues and not a simple lack of individual technical skills. In aircraft maintenance operations, there is similar concern that maintenance errors which may lead to incidents and accidents are related to a large variety of human factors issues. Although maintenance error data and research are limited, industry initiatives involving human factors training in maintenance have become increasingly accepted as one type of maintenance error intervention. Conscientious efforts have been made in re-inventing the "team" concept for maintenance operations and in tailoring programs to fit the needs of technical operations. Nevertheless, there remains a dual challenge: to develop human factors interventions which are directly supported by reliable human error data, and to integrate human factors concepts into the procedures and practices of everyday technical tasks. In this paper, we describe several varieties of human factors interventions and focus on two specific alternatives which target problems related to procedures and practices; namely, 1) structured on-the-job training and 2) procedure re-design. We hope to demonstrate that the key to leveraging the impact of these solutions comes from focused interventions; that is, interventions which are derived from a clear understanding of specific maintenance errors, their operational context and human factors components.

Kanki, Barbara G.↗

Operational Interventions to Maintenance Error

A significant proportion of aviation accidents and incidents are known to be tied to human error. However, research of flight operational errors has shown that so-called pilot error often involves a variety of human factors issues and not a simple lack of individual technical skills. In aircraft maintenance operations, there is similar concern that maintenance errors which may lead to incidents and accidents are related to a large variety of human factors issues. Although maintenance error data and research are limited, industry initiatives involving human factors training in maintenance have become increasingly accepted as one type of maintenance error intervention. Conscientious efforts have been made in re-inventing the team7 concept for maintenance operations and in tailoring programs to fit the needs of technical opeRAtions. Nevertheless, there remains a dual challenge: 1) to develop human factors interventions which are directly supported by reliable human error data, and 2) to integrate human factors concepts into the procedures and practices of everyday technical tasks. In this paper, we describe several varieties of human factors interventions and focus on two specific alternatives which target problems related to procedures and practices; namely, 1) structured on-the-job training and 2) procedure re-design. We hope to demonstrate that the key to leveraging the impact of these solutions comes from focused interventions; that is, interventions which are derived from a clear understanding of specific maintenance errors, their operational context and human factors components.

Kanki, Barbara G.↗

Performance assessment for climate intervention (PACI): preliminary application to a stratospheric aerosol injection scenario

As the prospect of exceeding global temperature targets set forth in the Paris Agreement becomes more likely, methods of climate intervention are increasingly being explored. With this increased interest there is a need for an assessment process to understand the range of impacts across different scenarios against a set of performance goals in order to support policy decisions. The methodology and tools developed for Performance Assessment (PA) for nuclear waste repositories shares many similarities with the needs and requirements for a framework for climate intervention. Using PA, we outline and test an evaluation framework for climate intervention, called Performance Assessment for Climate Intervention (PACI) with a focus on Stratospheric Aerosol Injection (SAI). We define a set of key technical components for the example PACI framework which include identifying performance goals, the extent of the system, and identifying which features, events, and processes are relevant and impactful to calculating model output for the system given the performance goals. Having identified a set of performance goals, the performance of the system, including uncertainty, can then be evaluated against these goals. Using the Geoengineering Large Ensemble (GLENS) scenario, we develop a set of performance goals for monthly temperature, precipitation, drought index, soil water, solar flux, and surface runoff. The assessment assumes that targets may be framed in the context of risk-risk via a risk ratio, or the ratio of the risk of exceeding the performance goal for the SAI scenario against the risk of exceeding the performance goal for the emissions scenario. From regional responses, across multiple climate variables, it is then possible to assess which pathway carries lower risk relative to the goals. The assessment is not comprehensive but rather a demonstration of the evaluation of an SAI scenario. Future work is needed to develop a more complete assessment that would provide additional simulations to cover parametric and aleatory uncertainty and enable a deeper understanding of impacts, informed scenario selection, and allow further refinements to the approach.

climate intervention↗