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Learning robust parameter inference and density reconstruction in flyer plate impact experiments

Estimating physical parameters or material properties from experimental observations is a common objective in many areas of physics and material science. In many experiments, especially in shock physics, radiography is the primary means of observing the system of interest. However, radiography does not provide direct access to key state variables, such as density, which prevents the application of traditional parameter estimation approaches. Here we focus on flyer plate impact experiments on porous materials, and resolving the underlying parameterized equation of state (EoS) and crush porosity model parameters given radiographic observation(s). We use machine learning as a tool to demonstrate with high confidence that using only high impact velocity data does not provide sufficient information to accurately infer both EoS and crush model parameters, even with fully resolved density fields or a dynamic sequence of images. We thus propose an observable data set consisting of low and high impact velocity experiments/simulations that capture different regimes of compaction and shock propagation, and proceed to introduce a generative machine learning approach which produces a posterior distribution of physical parameters directly from radiographs. We demonstrate the effectiveness of the approach in estimating parameters from simulated flyer plate impact experiments, and show that the obtained estimates of EoS and crush model parameters can then be used in hydrodynamic simulations to obtain accurate and physically admissible density reconstructions. Finally, we examine the robustness of the approach to model mismatches, and find that the learned approach can provide useful parameter estimates in the presence of out-of-distribution radiographic noise and previously unseen physics, thereby promoting a potential breakthrough in estimating material properties from experimental radiographic images.

97 MATHEMATICS AND COMPUTING↗

An ideal MHD δW stability analysis that bypasses the Newcomb equation

In the following work, we demonstrate the efficacy of a Riccati δW ideal MHD stability analysis that bypasses the numerically intractable integration of the Newcomb equation. By transforming the linear Newcomb equation into a quadratic Riccati equation, an accurate and equivalent δW analysis is performed that is shown to enjoy some numerical advantages. Additionally, we demonstrate that the Riccati approach is better conditioned than its Newcomb counterpart at the magnetic axis, and we apply dynamical systems insights to examine its behavior at singular points. We further discuss the constraints involved in solving for the extremal admissible perturbations of a δW analysis.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗

Scaling patch analysis of turbulent planar plume

Proper scaling in turbulent planar plumes is investigated in this study using a scaling patch approach. Based on the scaled boundary conditions, a proper velocity scale for the mean axial flow is the plume centerline velocity U ref = U ctr , and a proper temperature scale for the temperature excess is Θ ref = T ctr – T ∞ , where T ctr is the plume centerline temperature and T ∞ is the ambient fluid temperature. By seeking an admissible scaling, a key concept in the scaling patch approach, for the mean continuity, mean momentum, and mean energy equations, respectively, the following is found: (1) a proper scale for the mean transverse flow is V ref = ( d δ / d x ) U ctr , where d δ / d x is the growth rate of the plume width. (2) A proper scale for the Reynolds shear stress is R vu , ref = U ctr V ref = ( d δ / d x ) U ctr 2 , a mix of the scales for the mean axial and transverse flows. (3) A proper scale for the turbulent heat flux is R v θ , ref = V ref Θ ctr , a mix of the scales for the mean transverse flow and mean temperature excess. The mean transverse flow thus plays a critical role in the scaling of turbulent planar plumes. Approximate functions are developed for the scaled mean transverse flow, Reynolds shear stress, and turbulent temperature flux, and are found to agree favorably with experimental and numerical simulation data. The integral analysis of the mean momentum equation yields a Richardson number Ri, which remains invariant in the axial direction. The Richardson number is defined as Ri = def g β Θ ctr δ t / ( U ctr V ref ) ≈ 1 / 2 , where g is the gravitational acceleration, β is the thermal expansion coefficient, and δ t is the plume half-width based on the mean temperature profile. This Richardson number arises directly from the scaling patch analysis of the mean momentum equation, including both the streamwise and transverse velocity scales.

42 ENGINEERING↗

Linear complexity

We present factorization and solution phases for a new linear complexity direct solver designed for concurrent batch operations on fine-grained parallel architectures, for matrices amenable to hierarchical representation. We focus on the strong-admissibility-based $\mathscr{H}^{2}$ format, where strong recursive skeletonization factorization compresses remote interactions. We build upon previous implementations of $\mathscr{H}^{2}$ matrix construction for efficient factorization and solution algorithm design, which are illustrated graphically in stepwise detail. The algorithms are ‘blackbox’ in the sense that the only inputs are the matrix and right-hand side, without analytical or geometrical information about the origin of the system. We demonstrate linear complexity scaling in both time and memory on four representative families of dense matrices up to one million in size. Parallel scaling up to 16 threads is enabled by a multi-level matrix graph coloring and avoidance of dynamic memory allocations thanks to prefix-sum memory management. An experimental backward error analysis is included. We break down the timings of different phases, identify phases that are memory-bandwidth limited, and discuss alternatives for phases that may be sensitive to the trend to employ lower precisions for performance.

Boukaram, Wajih↗

Optimization of a Lethal, Combat-Relevant Model of Sterile Inflammation in Mice for Drug Candidate Screening

ABSTRACT Introduction Extensive trauma, commonly seen in wounded military Service Members, often leads to a severe sterile inflammation termed systemic inflammatory response syndrome (SIRS), which can progress to multiple organ dysfunction syndrome (MODS) and death. MODS is a serious threat to wounded Service Members, historically causing 10% of all deaths in trauma admissions at a forward deployed combat hospital. The importance of this problem will be exacerbated in large-scale combat operations, in which evacuation will be delayed and care of complex injuries at lower echelons of care may be prolonged. The main goal of this study was to optimize an existing mouse model of lethal SIRS/MODS as a therapeutic screening platform for the evaluation of immunomodulatory drugs. Materials and Methods Male C57BL/6 mice were euthanized, and the bones and muscles were collected and blended into a paste termed tissue–bone matrix (TBX). The TBX at 12.5%–20% relative to body weight of each recipient mouse was implanted into subcutaneous pouches created on the dorsum of anesthetized animals. Mice were observed for clinical scores for up to 48 hours postimplantation and euthanized at the preset point of moribundity. To test effects of anesthetics on TBX-induced mortality, animals received isoflurane or ketamine/xylazine (K/X). In a separate set of studies, mice received TBX followed by intraperitoneal injection with 20 mg/kg or 40 mg/kg Eritoran or a placebo carrier. All Eritoran studies were performed in a blinded fashion. Results We observed that K/X anesthesia significantly increased the lethality of the implanted TBX in comparison to inhaled anesthetics. Although all the mice anesthetized with isoflurane and implanted with 12.5% TBX survived for 24 hours, 60% of mice anesthetized with K/X were moribund by 24 hours postimplantation. To mimic more closely the timing of lethal SIRS/MODS following polytrauma in human patients, we extended observation to 48 hours. We performed TBX dose–response studies and found that as low as 15%, 17.5%, and 20% TBX caused moribundity/mortality in 50%, 80%, and 100% mice, respectively, over a 48-hour time period. With 17.5% TBX, we tested if moribundity/mortality could be rescued by anti-inflammatory drug Eritoran, a toll-like receptor 4 antagonist. Neither 20 mg/kg nor 40 mg/kg doses of Eritoran were found to be effective in this model. Conclusions We optimized a TBX mouse model of SIRS/MODS for the purpose of evaluating novel therapeutic interventions to prevent trauma-related pathophysiologies in wounded Service Members. Negative effects of K/X on lethality of TBX should be further evaluated, particularly in the light of widespread use of ketamine in treatment of pain. By mimicking muscle crush, bone fracture, and necrosis, the TBX model has pleiotropic effects on physiology and immunology that make it uniquely valuable as a screening tool for the evaluation of novel therapeutics against trauma-induced SIRS/MODS.

General & Internal Medicine↗

Machine Learning in Infectious Disease for Risk Factor Identification and Hypothesis Generation: Proof of Concept Using Invasive Candidiasis

Machine learning (ML) models can handle large data sets without assuming underlying relationships and can be useful for evaluating disease characteristics, yet they are more commonly used for predicting individual disease risk than for identifying factors at the population level. We offer a proof of concept applying random forest (RF) algorithms to Candida-positive hospital encounters in an electronic health record database of patients in the United States. Candida-positive encounters were extracted from the Cerner HealthFacts database; invasive infections were laboratory-positive sterile site Candida infections. Features included demographics, admission source, care setting, physician specialty, diagnostic and procedure codes, and medications received before the first positive Candida culture. We used RF to assess risk factors for 3 outcomes: any invasive candidiasis (IC) vs non-IC, within-species IC vs non-IC (eg, invasive C. glabrata vs noninvasive C. glabrata), and between-species IC (eg, invasive C. glabrata vs all other IC). Fourteen of 169 (8%) variables were consistently identified as important features in the ML models. When evaluating within-species IC, for example, invasive C. glabrata vs non-invasive C. glabrata, we identified known features like central venous catheters, intensive care unit stay, and gastrointestinal operations. In contrast, important variables for invasive C. glabrata vs all other IC included renal disease and medications like diabetes therapeutics, cholesterol medications, and antiarrhythmics. Known and novel risk factors for IC were identified using ML, demonstrating the hypothesis-generating utility of this approach for infectious disease conditions about which less is known, specifically at the species level or for rarer diseases.

60 APPLIED LIFE SCIENCES↗

An Uncertainty Management Framework for Integrated Gas-Electric Energy Systems

In many parts of the world, electric power systems have seen a significant shift toward generation from renewable energy and natural gas. Because of their ability to flexibly adjust power generation in real time, gas-fired power plants are frequently seen as the perfect partner for variable renewable generation. However, this reliance on gas generation increases interdependence and propagates uncertainty between power grids and gas pipelines and brings coordination and uncertainty management challenges. To address these issues, we propose an uncertainty management framework for uncertain, but bounded gas consumption by gas-fired power plants. The admissible ranges are computed based on a joint optimization problem for the combined gas and electricity networks, which involves chance-constrained scheduling for the electric grid and a novel robust optimization formulation for the natural-gas network. This formulation ensures feasibility of the integrated system with a high probability, while providing a tractable numerical formulation. A key advance with respect to existing methods is that our method is based on a physically accurate, validated model for transient gas pipeline flows. Our case study benchmarks our proposed formulation against methods that ignore how reserve activation impacts the fuel use of gas power plants and only consider predetermined gas consumption. Here, the results demonstrate the importance of considering uncertainty to avoid operating constraint violations and curtailment of gas to the generators.

24 POWER TRANSMISSION AND DISTRIBUTION↗

ReVise: A Human-AI Interface for Incremental Algorithmic Recourse

The recent adoption of artificial intelligence in socio-technical systems raises concerns about the black-box nature of the resulting decisions in fields such as hiring, finance, admissions, etc. If data subjects—such as job applicants, loan applicants, and students—receive an unfavorable outcome, they may be interested in algorithmic recourse, which involves updating certain features to yield a more favorable result when re-evaluated by algorithmic decision-making. Unfortunately, when individuals do not fully understand the incremental steps needed to change their circumstances, they risk following misguided paths that can lead to significant, long-term adverse consequences. Existing recourse approaches focus exclusively on the final recourse goal but neglect the possible incremental steps to reach the goal with real-life constraints, user preferences, and model artifacts. To address this gap, we formulate a visual analytic workflow for incremental recourse planning in collaboration with AI/ML experts and contribute an interactive visualization interface that helps data subjects efficiently navigate the recourse alternatives and make an informed decision. We also present one of the many usage scenarios, developed during exploratory feedback sessions with twelve graduate students using a real-world dataset, which demonstrates that our approach can be instrumental for data subjects in choosing a suitable recourse path.

algorithmic recourse↗

Early initiation of prophylactic anticoagulation for prevention of coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort study

Early initiation of prophylactic anticoagulation compared with no anticoagulation among patients admitted to hospital with covid-19 was associated with a decreased risk of 30 day mortality and no increased risk of serious bleeding events. These findings provide strong real world evidence to support guidelines recommending the use of prophylactic anticoagulation as initial treatment for patients with covid-19 on hospital admission.

59 BASIC BIOLOGICAL SCIENCES↗

Building hypotheses to understand the synergistic effects of heat and pollution exposure in a changing climate

The increasing intensity, frequency, and duration of extreme weather events due to climate change poses a broad range of health risks, and the synergistic effects of extreme temperature co-occurring with other hazardous exposures such as air pollution may result in higher risks of all-cause mortality and cardiovascular and respiratory morbidity than exposure to either event alone. There are a number of hypothesized mechanisms for this interaction effect, including increased susceptibility to heat effects on chronic conditions affected by air pollution exposure, exacerbation of pollution effects due to temperature-induced stress, and shared pathophysiological pathways (e.g., systemic inflammation), but specific physiological mechanisms are not well understood. In this editorial, the authors discuss this aspect of a recently published study examining ambient formaldehyde combined with high temperature exposure and respiratory disease admissions among children. Here, the observation that the health effects of pollutants such as formaldehyde are amplified following periods of high temperature can help inform risk warning systems even without knowledge of the underlying physiological mechanisms, but a deeper biological understanding of the interaction effects of heat and ambient air pollution may better inform interventions. This is even more important in view of increases in both extreme temperature and pollution events tied to climate change.

Chambliss, Sarah [University of Texas at Austin, T↗

Butterfly Factorization Via Randomized Matrix-Vector Multiplications

This paper presents an adaptive randomized algorithm for computing the butterfly factorization of an m × n matrix with m ≈ n provided that both the matrix and its transpose can be rapidly applied to arbitrary vectors. The resulting factorization is composed of O(log n) sparse factors, each containing O(n) nonzero entries. The factorization can be attained using O(n 3/2 log n) computation and O(n log n) memory resources. Furthermore, the proposed algorithm can be implemented in parallel and can apply to matrices with strong or weak admissibility conditions arising from surface integral equation solvers as well as multi-frontal-based finite-difference, finite-element, or finite-volume solvers. A distributed-memory parallel implementation of the algorithm demonstrates excellent scaling behavior.

97 MATHEMATICS AND COMPUTING↗

COVID-19 Outcomes by Cancer Status, Site, Treatment, and Vaccination

Background: Studies have shown an increased risk of severe SARS-CoV-2–related (COVID-19) disease outcome and mortality for patients with cancer, but it is not well understood whether associations vary by cancer site, cancer treatment, and vaccination status. Methods: Using electronic health record data from an academic medical center, we identified a retrospective cohort of 260,757 individuals tested for or diagnosed with COVID-19 from March 10, 2020, to August 1, 2022. Of these, 52,019 tested positive for COVID-19 of whom 13,752 had a cancer diagnosis. We conducted Firth-corrected logistic regression to assess the association between cancer status, site, treatment, vaccination, and four COVID-19 outcomes: hospitalization, intensive care unit admission, mortality, and a composite “severe COVID” outcome. Results: Cancer diagnosis was significantly associated with higher rates of severe COVID, hospitalization, and mortality. These associations were driven by patients whose most recent initial cancer diagnosis was within the past 3 years. Chemotherapy receipt, colorectal cancer, hematologic malignancies, kidney cancer, and lung cancer were significantly associated with higher rates of worse COVID-19 outcomes. Vaccinations were significantly associated with lower rates of worse COVID-19 outcomes regardless of cancer status. Conclusions: Patients with colorectal cancer, hematologic malignancies, kidney cancer, or lung cancer or who receive chemotherapy for treatment should be cautious because of their increased risk of worse COVID-19 outcomes, even after vaccination. Impact: Additional COVID-19 precautions are warranted for people with certain cancer types and treatments. Further, significant benefit from vaccination is noted for both cancer and cancer-free patients.

60 APPLIED LIFE SCIENCES↗

Association of Serum Triglyceride Levels with Severity in Acute Pancreatitis: Results from an International, Multicenter Cohort Study

Hypertriglyceridemia (HTG) is considered within the top 5 etiologies in acute pancreatitis (AP), but the association of serum triglyceride (TG) levels with the clinical course of AP remains controversial. This study aims to examine the effect of TG levels on severity of AP. Patients were enrolled prospectively through APPRENTICE. High TG levels were defined based on the Endocrine Society Clinical Practice Guidelines. HTG was categorized as mild (serum TG levels 150–199 mg/dL), moderate (200–999 mg/dL), severe (1,000–1,999 mg/dL), and very severe (≥2,000 mg/dL). Severity of AP was based on the revised Atlanta classification criteria. Additionally, early TG levels were measured in 764 subjects and found elevated in 342 (120 with mild; 176, moderate; and 46, severe/very severe HTG). Patients with increased TG levels were younger (age ≥60, 16.7 vs. 30.3%), more likely to be male (66.1 vs. 51.2%), with more frequent alcohol use (62.8 vs. 50.7%), and diabetes mellitus (30.2 vs. 12.3%; all p ≤ 0.005). Severe AP (24.9 vs. 10.0%), ICU admission (32.5 vs. 19.7%), and mortality (5.3 vs. 1.7%; all p ≤ 0.005) were more frequently seen in patients with elevated TG levels. Based on multivariable analysis, elevated TG levels were independently associated with severe AP ( p < 0.05). This large multicenter study confirms that elevated TG levels are associated with severe disease regardless of AP etiology.

60 APPLIED LIFE SCIENCES↗

Circulating SARS-CoV-2 + megakaryocytes are associated with severe viral infection in COVID-19

Several independent lines of evidence suggest that megakaryocytes are dysfunctional in severe COVID-19. Herein, we characterized peripheral circulating megakaryocytes in a large cohort of inpatients with COVID-19 and correlated the subpopulation frequencies with clinical outcomes. Using peripheral blood, we show that megakaryocytes are increased in the systemic circulation in COVID-19, and we identify and validate S100A8/A9 as a defining marker of megakaryocyte dysfunction. We further reveal a subpopulation of S100A8/A9 + megakaryocytes that contain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) protein and RNA. Using flow cytometry of peripheral blood and in vitro studies on SARS-CoV-2–infected primary human megakaryocytes, we demonstrate that megakaryocytes can transfer viral antigens to emerging platelets. Mechanistically, we show that SARS-CoV-2–containing megakaryocytes are nuclear factor κB (NF-κB)-activated, via p65 and p52; express the NF-κB–mediated cytokines interleukin-6 (IL-6) and IL-1β; and display high surface expression of Toll-like receptor 2 (TLR2) and TLR4, canonical drivers of NF-κB. In a cohort of 218 inpatients with COVID-19, we correlate frequencies of megakaryocyte subpopulations with clinical outcomes and show that SARS-CoV-2–containing megakaryocytes are a strong risk factor for mortality and multiorgan injury, including respiratory failure, mechanical ventilation, acute kidney injury, thrombotic events, and intensive care unit admission. Furthermore, we show that SARS-CoV-2 + megakaryocytes are present in lung and brain autopsy tissues from deceased donors who had COVID-19. To our knowledge, this study offers the first evidence implicating SARS-CoV-2 + peripheral megakaryocytes in severe disease and suggests that circulating megakaryocytes warrant investigation in inflammatory disorders beyond COVID-19.

60 APPLIED LIFE SCIENCES↗

Assessing the reliability of medical resource demand models in the context of COVID-19

Abstract Background Numerous medical resource demand models have been created as tools for governments or hospitals, aiming to predict the need for crucial resources like ventilators, hospital beds, personal protective equipment (PPE), and diagnostic kits during crises such as the COVID-19 pandemic. However, the reliability of these demand models remains uncertain. Methods Demand models typically consist of two main components: hospital use epidemiological models that predict hospitalizations or daily admissions, and a demand calculator that translates the outputs of the epidemiological model into predictions for resource usage. We conducted separate analyses to evaluate each of these components. In the first analysis, we validated various hospital use epidemiological models using a recent validation framework designed for epidemiological models. This allowed us to quantify the accuracy of the models in predicting critical aspects such as the date and magnitude of local COVID-19 peaks, among other factors. In the second analysis, we evaluated a range of demand calculators for ventilators, medical gowns, and COVID-19 test kits. To achieve this, we decoupled these demand calculators from the underlying epidemiological models and provided ground truth data for their inputs. This approach enabled a direct comparison of the demand calculators, comparing them against each other and actual usage data when available. The code is available athttps://doi.org/10.5281/zenodo.13712387. Results Performance varied greatly across the epidemiological models, with greater variability in COVID-19 hospital use predictions than for COVID-19 deaths as analyzed previously. Some models did not have any peaks. Among those that did, the models under-estimated date of peak approximately as often as they over-estimated, but were more likely to under-estimate magnitude of peak, with typical relative errors around 50%. Regarding demand calculator predictions, there was significant variability, including five-fold differences in predictions for gown models. Validation against actual or surrogate usage data illustrated the potential value of demand models while demonstrating their limitations. Conclusions The emerging field of demand modeling holds promise in averting medical resource shortages during future public health emergencies. However, achieving this potential necessitates focused efforts on standardization, transparency, and rigorous model validation before placing reliance on demand models in critical public health decision-making.

Medical Informatics↗

NSAID use and clinical outcomes in COVID-19 patients: a 38-center retrospective cohort study

Abstract Background Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce pain, fever, and inflammation but have been associated with complications in community-acquired pneumonia. Observations shortly after the start of the COVID-19 pandemic in 2020 suggested that ibuprofen was associated with an increased risk of adverse events in COVID-19 patients, but subsequent observational studies failed to demonstrate increased risk and in one case showed reduced risk associated with NSAID use. Methods A 38-center retrospective cohort study was performed that leveraged the harmonized, high-granularity electronic health record data of the National COVID Cohort Collaborative. A propensity-matched cohort of 19,746 COVID-19 inpatients was constructed by matching cases (treated with NSAIDs at the time of admission) and 19,746 controls (not treated) from 857,061 patients with COVID-19 available for analysis. The primary outcome of interest was COVID-19 severity in hospitalized patients, which was classified as: moderate, severe, or mortality/hospice. Secondary outcomes were acute kidney injury (AKI), extracorporeal membrane oxygenation (ECMO), invasive ventilation, and all-cause mortality at any time following COVID-19 diagnosis. Results Logistic regression showed that NSAID use was not associated with increased COVID-19 severity (OR: 0.57 95% CI: 0.53–0.61). Analysis of secondary outcomes using logistic regression showed that NSAID use was not associated with increased risk of all-cause mortality (OR 0.51 95% CI: 0.47–0.56), invasive ventilation (OR: 0.59 95% CI: 0.55–0.64), AKI (OR: 0.67 95% CI: 0.63–0.72), or ECMO (OR: 0.51 95% CI: 0.36–0.7). In contrast, the odds ratios indicate reduced risk of these outcomes, but our quantitative bias analysis showed E-values of between 1.9 and 3.3 for these associations, indicating that comparatively weak or moderate confounder associations could explain away the observed associations. Conclusions Study interpretation is limited by the observational design. Recording of NSAID use may have been incomplete. Our study demonstrates that NSAID use is not associated with increased COVID-19 severity, all-cause mortality, invasive ventilation, AKI, or ECMO in COVID-19 inpatients. A conservative interpretation in light of the quantitative bias analysis is that there is no evidence that NSAID use is associated with risk of increased severity or the other measured outcomes. Our results confirm and extend analogous findings in previous observational studies using a large cohort of patients drawn from 38 centers in a nationally representative multicenter database.

60 APPLIED LIFE SCIENCES↗

Gut microbiome dynamics and associations with mortality in critically ill patients

Abstract Background Critical illness and care within the intensive care unit (ICU) leads to profound changes in the composition of the gut microbiome. The impact of such changes on the patients and their subsequent disease course remains uncertain. We hypothesized that specific changes in the gut microbiome would be more harmful than others, leading to increased mortality in critically ill patients. Methods This was a prospective cohort study of critically ill adults in the ICU. We obtained rectal swabs from 52 patients and assessed the composition the gut microbiome using 16 S rRNA gene sequencing. We followed patients throughout their ICU course and evaluated their mortality rate at 28 days following admission to the ICU. We used selbal, a machine learning method, to identify the balance of microbial taxa most closely associated with 28-day mortality. Results We found that a proportional ratio of four taxa could be used to distinguish patients with a higher risk of mortality from patients with a lower risk of mortality (p = .02). We named this binarized ratio our microbiome mortality index (MMI). Patients with a high MMI had a higher 28-day mortality compared to those with a low MMI (hazard ratio, 2.2, 95% confidence interval 1.1–4.3), and remained significant after adjustment for other ICU mortality predictors, including the presence of the acute respiratory distress syndrome (ARDS) and the Acute Physiology and Chronic Health Evaluation (APACHE II) score (hazard ratio, 2.5, 95% confidence interval 1.4–4.7). High mortality was driven by taxa from theAnaerococcus(genus) andEnterobacteriaceae(family), while lower mortality was driven byParasutterellaandCampylobacter(genera). Conclusions Dysbiosis in the gut of critically ill patients is an independent risk factor for increased mortality at 28 days after adjustment for clinically significant confounders. Gut dysbiosis may represent a potential therapeutic target for future ICU interventions.

Gastroenterology & Hepatology↗

Air quality and health impacts of the 2020 wildfires in California

Abstract Background Wildfires in 2020 ravaged California to set the annual record of area burned to date. Clusters of wildfires in Northern California surrounded the Bay Area covering the skies with smoke and raising the air pollutant concentrations to hazardous levels. This study uses the Fire Inventory from the National Center for Atmospheric Research database and the Community Multiscale Air Quality model to estimate the effects of wildfire emissions on air quality during the period from August 16 to October 28 of 2020. In addition, low-cost sensor data for fine particulate matter (PM 2.5 ) from the PurpleAir network is used to enhance modeled PM 2.5 concentrations. The resulting impacts on ozone and PM 2.5 are used to quantify the health impacts caused by wildfires using the Benefits Mapping and Analysis Program – Community Edition. Results Wildfire activity significantly increased direct PM 2.5 emissions and emissions of PM 2.5 and ozone precursors. Direct PM 2.5 emissions surged up to 38 times compared to an average day. Modeling results indicated that wildfires alone led to a rise in ozone daily maximum 8-h average by up to 10 ppb and exceeded PM 2.5 air quality standards in numerous locations by up to 10 times. While modeled PM 2.5 concentrations were lower than measurements, correcting these with PurpleAir data improved the accuracy. The correction using PurpleAir data increased estimates of wildfire-induced mortality due to PM 2.5 exposure by up to 16%. Conclusions The increased hospital admissions and premature mortality attributed to wildfires were found to be comparable to the health impacts avoided by strategies aimed at meeting ozone and PM2.5 air quality standards. This suggests that widespread wildfire emissions can negate years of efforts dedicated to controlling air pollution. The integration of low-cost sensor data proved invaluable in refining the estimates of health impacts from PM2.5 resulting from wildfires.

54 ENVIRONMENTAL SCIENCES↗