Search NASA⌕ Search

SEARCH · Search NASA

Results for “HOSPITALS”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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

At least 37 records · Page 2
All sourcesNASA NTRSDOE OSTI
NASA NTRS1972

Acquisition of electroencephalographic data in a large regional hospital - Bringing the brain waves to the computer.

This paper describes a complete electroencephalographic acquisition and transmission system, designed to meet the needs of a large hospital with multiple critical care patient monitoring units. The system provides rapid and prolonged access to a centralized recording and computing area from remote locations within the hospital complex, and from locations in other hospitals and other cities. The system includes quick-on electrode caps, amplifier units and cable transmission for access from within the hospital, and EEG digitization and telephone transmission for access from other hospitals or cities.

Low, M. D.↗
DOE OSTI2015

Targeting 100! Advanced Energy Efficient Building Technologies for High Performance Hospitals: Executive Summary.

This research, Targeting 100!, provides a conceptual framework and decision-making structure at a schematic design level of precision for hospital owners, architects and engineers to radically reduce energy use in hospitals. Following the goals of Architecture 2030 and The 2030 Challenge, it offers access to design strategies and the cost implications of those strategies for new hospitals to utilize 60% less energy. The name, Targeting 100!, comes from the 2030 Challenge energy reduction goal for hospitals; a 60% energy use reduction from typical acute care hospital targets approximately 100 KBtu/SF Year, thus the name “Targeting 100!”. Targeting 100! was developed through funding partnerships with the US Department of Energy and the Northwest Energy Efficiency’s BetterBricks Initiative. The technical team was led by the University of Washington Integrated Design Lab supported by deep collaboration with Solarc Architecture and Engineering, TBD Cost Consultants, and NBBJ Architecture. Through extensive research and design development, Targeting 100! provides a framework for developing high performance healthcare projects today and into the future. An online tool houses a Targeting 100! knowlegebase and roadmap. It can be accessed at: www.idlseattle.com/t100. The webtool is structured from high-level overview materials to detailed library with modeling inputs and outputs, providing a comprehensive report of the background, data, and outcomes from the project.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2017

Comparative effectiveness of coronary CT angiography vs stress cardiac imaging in patients following hospital admission for chest pain work-up: The Prospective First Evaluation in Chest Pain (PERFECT) Trial

Background: Because the frequency of cardiac event rates is low among chest pain patients following either performance of coronary CT angiography (CCTA) or stress testing, there is a need to better assess how these tests influence the central management decisions that follow from cardiac testing. The present study was performed to assess the relative impact of CCTA vs stress testing on medical therapies and downstream resource utilization among patients admitted for the work-up of chest pain. Methods: The admitted patients were randomized in a 1:1 ratio to either cardiac imaging stress test or CCTA. Primary outcomes were time to discharge, change in medication usage, and frequency of downstream testing, cardiac interventions, and cardiovascular re-hospitalizations. We randomized 411 patients, 205 to stress testing, and 206 to CCTA. Results: There were no differences in time to discharge or initiation of new cardiac medications at discharge. At 1 year follow-up, there was no difference in the number of patients who underwent cardiovascular downstream tests in the CCTA vs stress test patients (21% vs 15%, P = .1) or cardiovascular hospitalizations (14% vs 16%, P = .5). However, there was a higher frequency of invasive angiography in the CCTA group (11% vs 2%, P = .001) and percutaneous coronary interventions (6% vs 0%, P < .001). Conclusions: Randomization of hospitalized patients admitted for chest pain work-up to either CCTA or to stress testing resulted in similar discharge times, change in medical therapies at discharge, frequency of downstream noninvasive testing, and repeat hospitalizations. However, a higher frequency of invasive coronary angiography and revascularization procedures were performed in the CCTA arm. (ClinicalTrials.gov number, NCT01604655.)

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2021

Genetic and behavioral adaptation of Candida parapsilosis to the microbiome of hospitalized infants revealed by in situ genomics, transcriptomics, and proteomics

Background Candida parapsilosis is a common cause of invasive candidiasis, especially in newborn infants, and infections have been increasing over the past two decades. C. parapsilosis has been primarily studied in pure culture, leaving gaps in understanding of its function in a microbiome context. Results. Here, we compare five unique C. parapsilosis genomes assembled from premature infant fecal samples, three of which are newly reconstructed, and analyze their genome structure, population diversity, and in situ activity relative to reference strains in pure culture. All five genomes contain hotspots of single nucleotide variants, some of which are shared by strains from multiple hospitals. A subset of environmental and hospital-derived genomes share variants within these hotspots suggesting derivation of that region from a common ancestor. Four of the newly reconstructed C. parapsilosis genomes have 4 to 16 copies of the gene RTA3, which encodes a lipid translocase and is implicated in antifungal resistance, potentially indicating adaptation to hospital antifungal use. Time course metatranscriptomics and metaproteomics on fecal samples from a premature infant with a C. parapsilosis blood infection revealed highly variable in situ expression patterns that are distinct from those of similar strains in pure cultures. For example, biofilm formation genes were relatively less expressed in situ, whereas genes linked to oxygen utilization were more highly expressed, indicative of growth in a relatively aerobic environment. In gut microbiome samples, C. parapsilosis co-existed with Enterococcus faecalis that shifted in relative abundance over time, accompanied by changes in bacterial and fungal gene expression and proteome composition. Conclusions The results reveal potentially medically relevant differences in Candida function in gut vs. laboratory environments, and constrain evolutionary processes that could contribute to hospital strain persistence and transfer into premature infant microbiomes.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2018

Second-hand smoke exposure in outdoor hospitality venues: Smoking visibility and assessment of airborne markers

Highlights: • Smoking visibility remains widespread in outdoor hospitality venues in Madrid. • SHS levels are relatively high, especially in closed outdoor terraces. • Outdoor hospitality venues should be considered to become completely smoke-free. • Policymakers should ensure that the existing smoke-free regulations are enforced. After the implementation of smoke-free policies in indoor hospitality venues (including bars, cafeterias, restaurants, and pubs), smokers may have been displaced to their outdoor areas. We aimed to study smoking visibility and second-hand smoke exposure in outdoor hospitality venues.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2022

Six Machine-Learning Methods for Predicting Hospital-Stay Duration for Patients with Sepsis: A Comparative Study

Sepsis is a life-threatening medical condition that, if not treated promptly, can result in tissue damage, organ failure, and death. According to the Centers for Disease Control, about 270,000 individuals die of sepsis in the US each year. Further, sepsis expenditures accounted for 13% of total US hospital costs in 2013, totaling more than $24 billion. Our project objectives were to determine if Machine Learning algorithms could reliably predict hospital stay duration for patients with sepsis. The data set we used has been de-identified and is freely available through the BupaR package. The data includes 1050 cases, 15214 events, and 16 types of actions related to sepsis patient care. First, we used process mining to determine how long each patient was in the hospital. Using BupaR’s functions, we created several process model graphs. These process models depict the movement of patients at a hospital and provide duration data for each patent case. Second, we identified outlier data and created two dataset versions: one with and one without outliers. We then applied the following analysis methods: Linear Regression, Random Forest, K-Nearest Neighbors, Neural Networks, XGBoost, and lightGBM. We compared the model validations for the six machine learning models using the same data-splitting method. We found that the XGBoost model had the best prediction accuracy of 73.9 percent for cases with outliers, and 79 percent for cases without outliers. We also found that the lightGBM model had the lowest mean absolute error between prediction and actual duration in days with 3.66 days for the case with outliers, and 2.4 days for the case without outliers. These two models outperformed the other four models. This work will be enhanced in the future by exploring new prediction algorithms and comparing them with the results of this study.

Chen, Lingtao↗
DOE OSTI2020

Nurses’ Satisfaction with Patient Room Lighting Conditions: A Study of Nurses in Four Hospitals with Differences in the Environment of Care

Lighting systems in patient rooms must balance energy efficiency concerns with the holistic needs of patients, families, and medical caregivers. This paper reports survey responses from 138 individuals working in medical-surgical units in four hospitals, with three of the hospitals having traditional lighting systems and the other hospital having a more contemporary lighting system. The results add to a growing evidence base on the effects of lighting on nurses’ job performance, job satisfaction, and overall perceptions of the environment, and provide evidence that innovative lighting approaches and technologies are worth considering as an investment by hospital administrators looking to improve employees’ and patients’ perceptions of the patient room environment. This knowledge is intended to help facility designers and managers incorporate nurses’ perspectives in their decisions, as well as to inform technologists and engineers developing future generations of lighting systems for patient rooms. These future systems will utilize solid-state lighting technologies, such as LEDs, and will provide new opportunities for adapting the intensity, distribution, and spectrum of light to better satisfy the holistic needs of patients and caregivers at different times of day or night.

Davis, Robert G.↗
NASA NTRS1979

The value of improved telecommunications service to hospitals: A preliminary assessment

In view of the rapid rate of development of domestic telecommunication services and the emphasis on private networks, it was sought to determine if hospitals had major requirements which could be aggregated and served by such networks. The value of the information transfer services judged to be most promising over the next twenty years was evaluated, based on expenditures and activity levels in five hospitals and one management services firm and the judgement of their senior staff. An implicit assumption is that services will become affordable once the hospital industry aggregates its requirements. A methodology to evaluate the value of telecommunication services in a hospital was developed and tested.

Potter, J. G.↗
NASA NTRS2004

Temporal dynamics of emergency department and hospital admissions of pediatric asthmatics

Asthma is a chronic disease that can result in exacerbations leading to urgent care in emergency departments (EDs) and hospitals. We examined seasonal and temporal trends in pediatric asthma ED (1997-1999) and hospital (1986-1999) admission data so as to identify periods of increased risk of urgent care by age group, gender, and race. All pediatric ED and hospital admission data for Maryland residents occurring within the state of Maryland were evaluated. Distinct peaks in pediatric ED and hospital asthma admissions occurred each year during the winter-spring and autumn seasons. Although the number and timing of these peaks were consistent across age and racial groups, the magnitude of the peaks differed by age and race. The same number, timing, and relative magnitude of the major peaks in asthma admissions occurred statewide, implying that the variables affecting these seasonal patterns of acute asthma exacerbations occur statewide. Similar gross seasonal trends are observed worldwide. Although several environmental, infectious, and psychosocial factors have been linked with increases in asthma exacerbations among children, thus far they have not explained these seasonal patterns of admissions. The striking temporal patterns of pediatric asthma admissions within Maryland, as described here, provide valuable information in the search for causes.

Emergency Treatment/utilization↗
DOE OSTI2018

Optimizing Travel Time to Outpatient Interventional Radiology Procedures in a Multi-Site Hospital System Using a Google Maps Application

The purpose of this study is to determine whether a custom Google Maps application can optimize site selection when scheduling outpatient interventional radiology (IR) procedures within a multi-site hospital system. The Google Maps for Business Application Programming Interface (API) was used to develop an internal web application that uses real-time traffic data to determine estimated travel time (ETT; minutes) and estimated travel distance (ETD; miles) from a patient’s home to each a nearby IR facility in our hospital system. Hypothetical patient home addresses based on the 33 cities comprising our institution’s catchment area were used to determine the optimal IR site for hypothetical patients traveling from each city based on real-time traffic conditions. For 10/33 (30%) cities, there was discordance between the optimal IR site based on ETT and the optimal IR site based on ETD at non-rush hour time or rush hour time. By choosing to travel to an IR site based on ETT rather than ETD, patients from discordant cities were predicted to save an average of 7.29 min during non-rush hour (p = 0.03), and 28.80 min during rush hour (p < 0.001). Using a custom Google Maps application to schedule outpatients for IR procedures can effectively reduce patient travel time when more than one location providing IR procedures is available within the same hospital system.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2018

Ambient temperature and added heat wave effects on hospitalizations in California from 1999 to 2009

Highlights: • We examined temperature and heat wave links to hospitalizations in California. • Heat waves set as minimum 2 days above climate zone- and month-specific threshold. • Temperature linked with many hospital visit types (e.g. diabetes, ischemic stroke). • Added heat wave associations observed (e.g. acute renal failure), but less often. • Associations sometimes differed by demographic and region. Investigators have examined how heat waves or incremental changes in temperature affect health outcomes, but few have examined both simultaneously. We utilized distributed lag nonlinear models (DLNM) to explore temperature associations and evaluate possible added heat wave effects on hospitalizations in 16 climate zones throughout California from May through October 1999–2009. We define heat waves as a period when daily mean temperatures were above the zone- and month-specific 95th percentile for at least two consecutive days. DLNMs were used to estimate climate zone-specific non-linear temperature and heat wave effects, which were then combined using random effects meta-analysis to produce an overall estimate for each. With higher temperatures, admissions for acute renal failure, appendicitis, dehydration, ischemic stroke, mental health, non-infectious enteritis, and primary diabetes were significantly increased, with added effects from heat waves observed for acute renal failure and dehydration. Higher temperatures also predicted statistically significant decreases in hypertension admissions, respiratory admissions, and respiratory diseases with secondary diagnoses of diabetes, though heat waves independently predicted an added increase in risk for both respiratory types. Our findings provide evidence that both heat wave and temperature exposures can exert effects independently.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2015

SU-E-T-241: Design and Implement of An Information Management System for Radiation Workers in a Hospital

Purpose: To meet the special needs of Medical Administration Division, an information management system for radiation workers in a hospital(IMSRWH) has been developed. Methods: There are about 200 radiation workers in 20 departments, such as department of radiology, department of radiation oncology, department of nuclear medicine, and so on. An IMSRWH server was used to run a database and web service of Apache+PHP+MySQL. The IMSRWH web service could be accessed with Internet Explorer(IE) to input, search, count, and print the radiation workers’ data. Every worker’s data information includes the following tables: registration, personal dose monitoring records, personnel certificate, training certificate, personnel license, medical examination, etc, and each table includes more optional detail information. Results: In the past year, the IMSRWH has been successfully developed and implemented in the hospital. According to the needs, the user rights are divided into: the system administrator, office manager, department manager and radiation worker. The different users have the different interfaces, and the appropriate authority permissions mean corresponding operations. The administrator and office manager could manage all personnel information, department manager could manage the staff information of his department, and the workers could view or modify their own information. Because information updates, involving hundreds of each entry and modification are complicated, each table information of all workers can be batch import from or export to a Microsoft Excel CSV format file, to update all together. However, it has only Chinese version now. Conclusion: It was demonstrated to be user-friendly and was proven to significantly improve the efficiency of the hospital management. Since it is an in-house developed system, more functions can be added or modified to further enhance its potentials in research and clinical practice.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2019

Minimally Invasive Treatment for Benign Prostatic Hyperplasia: Economic Evaluation from a Standardized Hospital Case Costing System

Purpose: Minimally invasive alternatives to transurethral resection of the prostate (TURP) such as prostate arterial embolization (PAE) and photoselective vaporization of the prostate (PVP) are being explored as adjuncts in the care of patients with benign prostatic hyperplasia. However, there are conflicting reports of the costs of these procedures. The purpose of this study was to compare the direct and indirect hospital costs of TURP, PAE and PVP. Materials and Methods: A chart review was performed in patients who underwent TURP, PVP and PAE from April 2015 to March 2017. All hospital costs were collected in accordance with the Ontario Case Costing Initiative, a standardized medical case costing system. Costs were characterized as direct or indirect and fixed or variable. Probabilistic sensitivity analysis was conducted to study cost uncertainty. Results: During the study period, a total of 209 men underwent TURP, 28 PVP and 21 PAE. Mean age (years) was as follows: TURP 71.43; PVP 73.66; PAE 70.77 (p = 0.366). Mean length of stay (days) was as follows: TURP 1.63; PVP 1.55; PAE 1 (p = 0.076). Total costs of the PAE group ($3829, SD $1582) were less than both PVP ($5719, SD $1515) and TURP groups ($5034, SD $1997, p < 0.001). There was no significant difference in direct costs between the groups. Monte Carlo simulation demonstrated that PAE was the least costly alternative majority of the time. Conclusions: The total hospital costs of PAE at our institution are significantly lower than those of PVP and TURP.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Spectrum of chronic kidney disease in China: A national study based on hospitalized patients from 2010 to 2015

ABSTRACT Aim To investigate the spectrum of chronic kidney disease (CKD) in China. Methods We used a large national in‐patient database covering 878 class three hospitals and involving 64.7 million adult patients in China from 2010 to 2015. The class 3 hospital in China is ranked as the top tier of medical system in China with at least 500 beds and the accreditation from health authorities. The specific causes of CKD were extracted from the International Classification of Diseases‐10 codes of discharge diagnoses. Results A total of 4.5% of hospitalized patients (1.8 million) were identified as CKD, with an increased percentage from 2010 (3.7%) to 2015 (4.7%). Increasing trends of diabetic kidney disease and hypertensive nephropathy were observed from 2010 to 2015 (19.5% vs 24.3% and 11.5% vs 15.9%, respectively), especially for urban residents from north China. The proportion of obstructive nephropathy also increased gradually (10.3% in 2010 vs 15.6% in 2015) and constituted another important cause of CKD for patients, especially for those from south China and rural residents. Conclusion The spectrum of CKD is changing in China, with variations over time and geographic regions, which has implication regarding developing the prevention strategy of CKD.

Huang, Yu‐Ming↗
DOE OSTI2021

COVID-19 Evidence Accelerator: A parallel analysis to describe the use of Hydroxychloroquine with or without Azithromycin among hospitalized COVID-19 patients

Background: The COVID-19 pandemic remains a significant global threat. However, despite urgent need, there remains uncertainty surrounding best practices for pharmaceutical interventions to treat COVID-19. In particular, conflicting evidence has emerged surrounding the use of hydroxychloroquine and azithromycin, alone or in combination, for COVID-19. The COVID-19 Evidence Accelerator convened by the Reagan-Udall Foundation for the FDA, in collaboration with Friends of Cancer Research, assembled experts from the health systems research, regulatory science, data science, and epidemiology to participate in a large parallel analysis of different data sets to further explore the effectiveness of these treatments. Methods: Electronic health record (EHR) and claims data were extracted from seven separate databases. Parallel analyses were undertaken on data extracted from each source. Each analysis examined time to mortality in hospitalized patients treated with hydroxychloroquine, azithromycin, and the two in combination as compared to patients not treated with either drug. Cox proportional hazards models were used, and propensity score methods were undertaken to adjust for confounding. Frequencies of adverse events in each treatment group were also examined. Results: Neither hydroxychloroquine nor azithromycin, alone or in combination, were significantly associated with time to mortality among hospitalized COVID-19 patients. No treatment groups appeared to have an elevated risk of adverse events. Conclusion: Administration of hydroxychloroquine, azithromycin, and their combination appeared to have no effect on time to mortality in hospitalized COVID-19 patients. Continued research is needed to clarify best practices surrounding treatment of COVID-19.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2024

Sequential Inference of Hospitalization Electronic Health Records Using Probabilistic Models

In the dynamic hospital setting, decision support can be a valuable tool for improving patient outcomes. Data-driven inference of future outcomes is challenging in this dynamic setting, where long sequences such as laboratory tests and medications are updated frequently. This is due in part to heterogeneity of data types and mixed-sequence types contained in variable length sequences. In this work we design a probabilistic unsupervised model for multiple arbitrary-length sequences contained in hospitalization Electronic Health Record (EHR) data. The model uses a latent variable structure and captures complex relationships between medications, diagnoses, laboratory tests, neurological assessments, and medications. It can be trained on original data, without requiring any lossy transformations or time binning. Inference algorithms are derived that use partial data to infer properties of the complete sequences, including their length and presence of specific values. We train this model on data from subjects receiving medical care in the Kaiser Permanente Northern California integrated healthcare delivery system. The results are evaluated against held-out data for predicting the length of sequences and presence of Intensive Care Unit (ICU) in hospitalization bed sequences. Our method outperforms a baseline approach, showing that in these experiments the trained model captures information in the sequences that is informative of their future values.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2018

Acute Hospital Encounters in Cancer Patients Treated With Definitive Radiation Therapy

Acute hospital encounters in patients undergoing curative-intent radiation therapy (RT) have not previously been well characterized. Understanding acute visit patterns among RT patients yields insights for risk assessments and cancer urgent care clinics that could decrease hospitalization rates and reduce health care costs. This study aims to identify patient, disease-site, and treatment characteristics associated with emergency department visits and inpatient admissions in cancer patients treated with definitive RT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗