A Personalized AI Assistant for Intuition-Driven Visual Explorations
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Background: The COVID-19 pandemic accelerated telehealth adoption across disease cohorts of patients. For many patients, routine medical care was no longer an option, and others chose not to visit medical offices in order to minimize COVID-19 exposure. In this study, we take a comprehensive multidisease approach in studying the impact of the COVID-19 pandemic on health care usage and the adoption of telemedicine through the first 12 months of the COVID-19 pandemic. Objective: We studied the impact of the COVID-19 pandemic on in-person health care usage and telehealth adoption across chronic diseases to understand differences in telehealth adoption across disease cohorts and patient demographics (such as the Social Vulnerability Index [SVI]). Methods: We conducted a retrospective cohort study of 6 different disease cohorts (anxiety: n=67,578; depression: n=45,570; diabetes: n=81,885; kidney failure: n=29,284; heart failure: n=21,152; and cancer: n=35,460). We used summary statistics to characterize changes in usage and regression analysis to study how patient characteristics relate to in-person health care and telehealth adoption and usage during the first 12 months of the pandemic. Results: We observed a reduction in in-person health care usage across disease cohorts (ranging from 10% to 24%). For most diseases we study, telehealth appointments offset the reduction in in-person visits. Furthermore, for anxiety and depression, the increase in telehealth usage exceeds the reduction in in-person visits (by up to 5%). We observed that younger patients and men have higher telehealth usage after accounting for other covariates. Patients from higher SVI areas are less likely to use telehealth; however, if they do, they have a higher number of telehealth visits, after accounting for other covariates. Conclusions: The COVID-19 pandemic affected health care usage across diseases, and the role of telehealth in replacing in-person visits varies by disease cohort. Understanding these differences can inform current practices and provides opportunities to further guide modalities of in-person and telehealth visits. Critically, further study is needed to understand barriers to telehealth service usage for patients in higher SVI areas. A better understanding of the role of social determinants of health may lead to more support for patients and help individual health care providers improve access to care for patients with chronic conditions.
Personal micromobility devices like bicycles, e-bikes, and scooters are low- or zero-energy alternatives to single-occupancy vehicles. However, a lack of data has led to a dearth of data-driven research on personally owned e-bike usage. We present longitudinal findings from the CanBikeCO program, focused on e-bike adoption and use across demographics, trip characteristics, and geographies in the state of Colorado. CanBikeCO recorded travel survey data from low-income individuals provided with personal e-bikes by the Colorado Energy Office in six communities across Colorado from July 2021 to December 2022. The data were collected using a custom instance of the National Renewable Energy Laboratory OpenPATH platform, which combines passive data collection with semantic information such as trip mode and purpose labels. To our knowledge, there are no prior travel survey data on personally owned e-bikes with this range and scope. Insights from this unique dataset include: (i) work trips were 17% more likely than average trips to be taken on an e-bike, (ii) e-bikes were most often reported to replace cars (34% of e-bike trips) and other personal micromobility devices (22%), and (iii) participants favored walking for trips less than 1 mile, e-bikes for trips of 1-3 miles, and e-bikes, cars, or shared rides for trips of 3-20 miles. The data used to generate these results have been made available in the Transportation Secure Data Center. We find e-bike use is appealing across age groups and may be related to characteristics of land use, urban form, occupation, income, and car ownership. We conclude for this population that the energy demand added by e-bike use (induced demand and replacing non-motorized modes) is outweighed by the reduction in energy demand from replacement of single-occupancy vehicle trips with e-bike trips. Our findings suggest considerable potential for energy savings from personal e-bike ownership.
Our current favored cosmological theories allow for the striking and controversial possibility that the observable universe is just a small part of a much larger universe in which parameters that describe the effective, low-energy laws of physics vary from one region to another. The controversy is largely driven by the fact that such a “very large universe” is mostly observationally inaccessible to us, so the issue arises of how we can reasonably assess a theory that describes such a universe. In this paper, we propose a Bayesian method for theory assessment based on theory-generated probability distributions for our observations. We focus on the principles that define this method, leaving aside concerns about how, in practice, one would carry out the required calculations. (One important issue that we set aside is the measure problem.) We argue that cosmological theories can be tested by the standard method of Bayesian updating, but we need to use theoretical predictions for “first-person” probabilities—that is, probabilities that we should use for our observations, taking into account all relevant selection effects. These selection effects can vary from one observer to another and can vary with time, so, in principle, first-person probabilities are defined for each observer instant—an observer at a specific instant of time. Calculations of first-person probabilities should take into account everything that the observer believes about herself and her surroundings, which we refer to as her subjective state. If the universe is very large, a theory might predict that there are many observer instants in the same subjective state; we argue that first-person probabilities should be calculated using a principle of self-locating indifference (PSLI), the assumption that any real observer should make predictions for her future as if she were chosen randomly and uniformly from the theoretically predicted observer instants that share her subjective state. We believe the PSLI is intuitively very reasonable, but we also argue that, if the theory is correct, the use of this principle maximizes the expected fraction of observers who will make correct predictions. A further complication is that cosmological theories are not expected to fully predict the detailed properties of the universe, but rather will predict a set of possible universes, each with a probability. Different possible universes will generically have different numbers of observers. We argue that, in the calculation of first-person probabilities, the probability for each possible universe should be weighted by the number of observer instants in the specified subjective state that it contains. These issues have been controversial in the literature, so we also provide a rebuttal to the claim that principles like the PSLI involve a “selection fallacy”; a rebuttal to what we dub the principle of required certainty; an argument rejecting theories that predict a preponderance of Boltzmann brains; a rebuttal to a parable about humans and Jovians used by Hartle and Srednicki to argue that assumptions of typicality can lead to absurd consequences; and, finally, a discussion about how the use of “old evidence” can be fit into a Bayesian mold.
This report presents the environmental dose assessment methods and the estimated potential doses to the public from 2023 Savannah River Site (SRS) air and liquid radioactive releases. Also documented are potential doses from special-case exposure scenarios, such as the consumption of wildlife or goat milk. Dose to the Offsite Representative Person The 2023 dose to the offsite representative person from SRS liquid releases was 0.14 mrem and from SRS air releases it was 0.016 mrem. To show compliance with the U. S. Department of Energy (DOE) all pathway dose standard of 100 mrem/yr, SRS conservatively adds these two doses for a total representative person dose of 0.16 mrem which is 0.16% of the DOE standard. Sportsman Doses Onsite Hunter: SRS conducts annual hunts to control onsite deer and feral hog populations. The estimated dose from consuming harvested deer or hog meat is determined for every onsite hunter. During 2023, the maximum potential dose an onsite hunter received was 9.42 mrem, or 9.42% of DOE’s 100 mrem/yr all pathway dose standard. Creek Mouth Fisherman: SRS estimated the maximum potential dose from fish consumption at 0.17 mrem from bass collected at the mouth of Lower Three Runs. This dose is 0.17% of the DOE standard. SRS bases this hypothetical dose on the low probability scenario that, during 2023, a fisherman consumed 24 kg (53 lbs) of bass caught exclusively from the mouth of Lower Three Runs. Release of Material Containing Residual Radioactivity SRS did not release any real property (land or buildings) in 2023. SRS unconditionally released a total of 13,324 items of personal property (such as tools) from radiological areas in 2023. Most of these items did not leave the Site. However, all of these items required no additional radiological controls post-survey as they met DOE Order 458.1 release criteria. Radiation Dose to Aquatic and Terrestrial Biota SRS conducts screening evaluations of plant and animal doses for aquatic and terrestrial ecosystems. For 2023, all SRS aquatic system locations passed the initial (Level 1) screenings and no further assessments were required at those locations. For the land-based systems evaluation, SRS performed initial screenings using concentration data from the five onsite radiological soil sampling locations. Typically, SRS collects and analyzes only one soil sample per year from each location. For 2023, all land-based locations passed their initial (Level 1) pathway screenings.
This dataset contains sample input 100m resolution raster files for running the CERF-DC python package (see https://github.com/IMMM-SFA/cerf_data_centers) at the state level across the CONUS. Due to data availability constraints, some of the items included in this dataset are proxies or assumptions for siting factors used in the model. These are individually noted in the item descriptions and can be exchanged with more detailed information upon availability. Data Descriptions The following raster files are included in the data download: state_siting_region.tif — State areas identified by state FIPS code composite_siting_suitability.tif — Value of 1 indicates suitable siting location, 0 otherwise. The following areas are excluded from siting: Areas within 300m of a federal airport runway Waterbodies Areas with slope >16% Areas susceptible to sinkholes High coastal or inland flood risk areas Local, state, and federal parks, leisure areas, and cemeteries Areas >2 km away from electric substations Areas >5 km away from a municipal water supplier service area Areas >2 km away from high-speed fiber provider service territory Protected Areas Database of the United States (PAD-US) areas Railroads, major roadways, and minor roadways Military areas and training grounds Developed lands Areas >0.8 km (0.5 miles) from developed lands land_value_dollar_per_sqft.tif — USD per square foot (sqft) derived from USDA $/acre land cost personal_property_tax_rate.tif — Personal property tax rate by state. Uses an assumed 0.0125 personal property tax rate for states with personal property tax, 0 for states without personal property tax. real_property_tax_rate.tif — Real property tax rate. Based on county level residential real estate property tax rates. sales_tax_rate.tif — Sales tax rate by state. mechanical_cooling_fraction.tif — Fraction of year (values between 0 and 1, inclusive) that the data center would be cooled through mechanical processes based on local water stress and humidity levels. water_cooling_fraction.tif — Fraction of year (values between 0 and 1, inclusive) that the data center would be cooled through evaporative (water cooled) processes based on local water stress and humidity levels. distance_to_substation.tif — Distance to nearest substation in hundreds of meters (i.e., value of 1 equals a distance of 100m). Offshore areas have a value of 0. industrial_electricity_rates_dollar_per_kwh.tif — USD/kWh industrial electricity rates. Represents the average industrial rate across all utilities that operate within a given county. Values are derived from the US Utility Rate Database. commercial_electricity_rates_dollar_per_kwh.tif — USD/kWh commercial electricity rates. Represents the average commercial rate across all utilities that operate within a given county. Values are derived from the US Utility Rate Database. data_center_market_locations.tif — Grid cells with positive values represent the centroid of existing data center market clusters. The value of non-zero grid cells represents the number of data centers in the market cluster. All other grid cells have a value of 0. Geospatial Metadata CRS: Albers Equal Area Conic (ESRI:102003) Extent: -2415585.0000000023283064,-1441981.2605773280374706 : 2384414.9999999976716936,1708018.7394226719625294 Dimensions: X: 48000 Y: 31500 Bands: 1 Origin: -2415585.0000000023283064,1708018.7394226719625294 Pixel Size: 100,-100 Acknowledgment IM3 is a multi-institutional effort led by Pacific Northwest National Laboratory and supported by the U.S. Department of Energy's Office of Science as part of research in MultiSector Dynamics, Earth and Environmental Systems Modeling Program. License This data is made available under a CCBY4.0 License Disclaimer This material was prepared as an account of work sponsored by an agency of the United States Government. Neither the United States Government nor the United States Department of Energy, nor the Contractor, nor any or their employees, nor any jurisdiction or organization that has cooperated in the development of these materials, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness or any information, apparatus, product, software, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof, or Battelle Memorial Institute. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof. PACIFIC NORTHWEST NATIONAL LABORATORYoperated byBATTELLEfor theUNITED STATES DEPARTMENT OF ENERGYunder Contract DE-AC05-76RL01830
This dataset contains sample input 100m resolution raster files for running the CERF-DC python package (see https://github.com/IMMM-SFA/cerf_data_centers) at the state level across the CONUS. Due to data availability constraints, some of the items included in this dataset are proxies or assumptions for siting factors used in the model. These are individually noted in the item descriptions and can be exchanged with more detailed information upon availability. Data Descriptions The following raster files are included in the data download: state_siting_region.tif — State areas identified by state FIPS code composite_siting_suitability.tif — Value of 1 indicates suitable siting location, 0 otherwise. The following areas are excluded from siting: Areas within 300 m of a federal airport runway or within an airport area boundary Waterbodies Areas with slope >16% Areas susceptible to sinkholes High coastal or inland flood risk areas Local, state, and federal parks, leisure areas, and cemeteries Areas >2 km away from electric substations Areas >5 km away from a municipal water supplier service area Areas >2 km away from high-speed fiber provider service territory USGS Protected Areas Database of the United States (PAD-US) GAP status 1, 2, or 3 areas US National Parks Wetlands USFWS critical habitats BIA land areas Railroads, major roadways, and minor roadways Military areas and training grounds NLCD developed lands Areas >0.8 km (0.5 miles) from NLCD developed lands land_value_dollar_per_sqft.tif — USD per square foot (sqft) derived from USDA $/acre land cost personal_property_tax_rate.tif — Personal property tax rate by state. Uses an assumed 0.0125 personal property tax rate for states with personal property tax, 0 for states without personal property tax. real_property_tax_rate.tif — Real property tax rate. Based on county level residential real estate property tax rates. sales_tax_rate.tif — Sales tax rate by state. mechanical_cooling_fraction.tif — Fraction of year (values between 0 and 1, inclusive) that the data center would be cooled through mechanical processes based on local water stress and humidity levels. water_cooling_fraction.tif — Fraction of year (values between 0 and 1, inclusive) that the data center would be cooled through evaporative (water cooled) processes based on local water stress and humidity levels. distance_to_substation.tif — Distance to nearest substation in hundreds of meters (i.e., value of 1 equals a distance of 100m). Offshore areas have a value of 0. industrial_electricity_rates_dollar_per_kwh.tif — USD/kWh industrial electricity rates. Represents the average industrial rate across all utilities that operate within a given county. Values are derived from the US Utility Rate Database. commercial_electricity_rates_dollar_per_kwh.tif — USD/kWh commercial electricity rates. Represents the average commercial rate across all utilities that operate within a given county. Values are derived from the US Utility Rate Database. data_center_market_locations.tif — Grid cells with positive values represent the centroid of existing data center market clusters. The value of non-zero grid cells represents the number of data centers in the market cluster. All other grid cells have a value of 0. Geospatial Metadata CRS: Albers Equal Area Conic (ESRI:102003) Extent: -2415585.0000000023283064,-1441981.2605773280374706 : 2384414.9999999976716936,1708018.7394226719625294 Dimensions: X: 48000 Y: 31500 Bands: 1 Origin: -2415585.0000000023283064,1708018.7394226719625294 Pixel Size: 100,-100 Acknowledgment IM3 is a multi-institutional effort led by Pacific Northwest National Laboratory and supported by the U.S. Department of Energy's Office of Science as part of research in MultiSector Dynamics, Earth and Environmental Systems Modeling Program. License This data is made available under a CCBY4.0 License Disclaimer This material was prepared as an account of work sponsored by an agency of the United States Government. Neither the United States Government nor the United States Department of Energy, nor the Contractor, nor any or their employees, nor any jurisdiction or organization that has cooperated in the development of these materials, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness or any information, apparatus, product, software, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof, or Battelle Memorial Institute. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof. PACIFIC NORTHWEST NATIONAL LABORATORYoperated byBATTELLEfor theUNITED STATES DEPARTMENT OF ENERGYunder Contract DE-AC05-76RL01830
A nuclear criticality results in the emission of both neutron and gamma radiation and can produce doses to personnel near the event that exceed 0.1 Gy (10 rad). The primary purpose of nuclear accident dosimetry is to rapidly identify affected personnel in need of prompt medical treatment and to reassure personnel who have been only minimally exposed. While accurate dosimetry is desired, it must be recognized that dose determinations made from whole-body dosimeters or simple triage methods are very rough estimates and contain significant uncertainties. Even when accounting for factors like varying neutron energy spectra, mean photon energies, body orientation within the radiation field, and transient effects on dosimeter response, etc., the end value is a dosimetric quantity defined for very specific radiological conditions and determined within a simple phantom usually at a single depth. Of more importance is the biological response to the radiation, which will vary by person and can be affected by the individual’s radiation sensitivity, age, gender, mass, and underlying health conditions. The overall biological, person-specific response to a given dose cannot be precisely determined except by patient symptom observation and individual biological dosimetry (e.g. chromosome analysis, lymphocyte ratios, etc.). This work describes and discusses the criticality accident dosimetry program at the Y-12 National Security Complex, a United States Department of Energy National Nuclear Security Administration facility. In conclusion, the primary goals of the Y-12 accident dosimetry program are, among others, the rapid identification of significantly exposed persons, prompt routing of exposed workers for medical evaluation and treatment, and the ultimate processing of dosimeters to assign doses to personnel.
Background: Blood-based biomarker tests can potentially change the landscape of colorectal cancer (CRC) screening. We characterize the conditions under which blood test screening would be as effective and cost-effective as annual fecal immunochemical testing or decennial colonoscopy. Methods: We used the 3 Cancer Information and Surveillance Modeling Network–Colon models to compare scenarios of no screening, annual fecal immunochemical testing, decennial colonoscopy, and a blood test meeting Centers for Medicare & Medicaid (CMS) coverage criteria (74% CRC sensitivity and 90% specificity). We varied the sensitivity to detect CRC (74%-92%), advanced adenomas (10%-50%), screening interval (1-3 years), and test cost ($25-$500). Primary outcomes included quality-adjusted life-years (QALY) gained from screening and costs for a US average-risk cohort of individuals aged 45 years. Results: Annual fecal immunochemical testing yielded 125-163 QALY gained per 1000 at a cost of 3811-5384 dollars per person, whereas colonoscopy yielded 132-177 QALY gained at a cost of 5375-7031 dollars per person. A blood test with 92% CRC sensitivity and 50% advanced adenoma sensitivity yielded 117-162 QALY gained if used every 3 years and 133-173 QALY gained if used every year but would not be cost-effective if priced above $$125 per test. If used every 3 years, a $500 blood test only meeting CMS coverage criteria yielded 83-116 QALY gained at a cost of $8559-$9413 per person. Conclusion: Blood tests that only meet CMS coverage requirements should not be recommended to patients who would otherwise undergo screening by colonoscopy or fecal immunochemical testing because of lower benefit. Blood tests need higher advanced adenoma sensitivity (above 40%) and lower costs (below $125) to be cost-effective.
Crowdsource platforms have been used to study a range of perceptual stimuli such as the graphical perception of scatterplots and various aspects of human color perception. Given the lack of control over a crowdsourced participant’s experimental setup, there are valid concerns on the use of crowdsourcing for color studies as the perception of the stimuli is highly dependent on the stimulus presentation. Here, we propose that the error due to a crowdsourced experimental design can be effectively averaged out because the crowdsourced experiment can be accommodated by the Thurstonian model as the convolution of two normal distributions, one that is perceptual in nature and one that captures the error due to variability in stimulus presentation. Based on this, we provide a mathematical estimate for the sample size needed to produce a crowdsourced experiment with the same power as the corresponding in-person study. We tested this claim by replicating a large-scale, crowdsourced study of human lightness perception with a diverse sample with a highly controlled, in-person study with a sample taken from psychology undergraduates. Our claim was supported by the replication of the results from the latter. These findings suggest that, with sufficient sample size, color vision studies may be completed online, giving access to a larger and more representative sample. With this framework at hand, experimentalists have the validation that choosing either many online participants or few in person participants will not sacrifice the impact of their results.
Dataset 2: A National Dataset on Human Choices in Pooled Rideshare, 2022. Dataset Description: Pooled Rideshare Acceptance Survey - Phase 2 (2022, N = 2,884). This dataset captures responses from a nationally representative sample of 2,884 adults across the United States to understand choice behaviors between personal and pooled rideshare services. The primary objective of this research is to investigate choice behaviors in rideshare services and provide insights that inform service design, policymaking, and transportation planning, with the aim of encouraging pooled rideshare adoption and enhancing transportation network energy efficiency. Data was collected via an online survey administered through a national panel provider. Participants ranged in age from 18 to 94 years, and representation from all U.S. regions. The survey was designed with a focus on investigating the stated-preference between personal and pooled rideshare services. Each participant responded to 20 stated-preference questions, where they were presented with a hypothesized situation to choose between a personal rideshare option and a pooled rideshare option to complete a trip. The sociodemographic information and attitudes towards factors of pooled rideshare acceptance were also collected to support the comprehensive investigation of participants’ rideshare choice behaviors. - Phase_2_Final - Each row represents an individual respondent, and each column corresponds to a variable such as stated-preference scenario attributes, stated-preference scenario responses, attitudes toward specific service features, and sociodemographic data. The data is available in both .CSV and .SAV formats. - Phase_2_Final_MapFile - The accompanying data dictionary explains all variable labels, response scales, and codes. An .XLSX format of the full survey instrument is included to support interpretation and reuse of the dataset.
Conventional ways of cooling a room or an entire house for occupant thermal comfort during summer consume a significant amount of energy and are vulnerable to overheating risk during power outages that lead to loss of cooling system operations. This study investigates a low-power cooling blanket, as a Personal Cooling System (PCS), that covers the upper human body for direct cooling during a five-day heat wave in a single-family house. A modeling framework is developed for evaluating the thermal and energy performance of the cooling blanket, which builds upon the co-simulation of three models: a house energy model, a personal thermal comfort model, and a cooling blanket model. Simulation results show that under the power outage scenario, the cooling blanket can greatly reduce the occupant heat stress with a reduction of daily hours of exceedance (discomfort hours defined as TSV>2) by up to 17.2 h (a 95.3 % improvement from the baseline power outage without the blanket). The cooling blanket, equipped with an innovative electrocaloric heat pump (COP as high as 10.1) consumes 6.31 W and can be operated by a portable battery for several days. The cooling blanket consumes only 0.28 % of the electricity of a central air-conditioning system running to provide cooling for the whole house during the five-day heatwave period. The findings justify further research of electrocaloric wearable PCS as low-power effective cooling to ensure thermal survivability of occupants during extreme indoor environments.
The American radium dial worker (RDW) cohort of over 3200 persons is being revisited as part of the Million Person Study (MPS) to include a modern approach to RDW dosimetry. An exceptional source of data and contextualization in this project is an extensive collection of electronic records (digitized from existing microfilm and microfiche) housed at the United States Transuranium and Uranium Registries (USTUR). Although the type, extent, and quality (e.g. legibility) of record(s) varies between individuals, the remarkable occupational, medical and demographic data include in vivo radiation measurements (e.g. radon breath, whole body counts), autopsy results, medical records (including copies of radiographs), interviews over the years, and correspondence. Of particular dosimetric interest are the details of radiation measurements. For example, there are some instances where hand-written and transcribed values are both available, along with notes providing context for why a particular measurement in a series of measurements was chosen to assign an intake, or if there were concerns about a particular measurement. Born prior to 1935, RDW have nearly all passed away. Thus, the updated dosimetry, especially for the skeletal tissues, will allow the correlation of lifetime cumulative dose with radiation risk. Here we review typical information available in this collection of historical records and highlight some interesting finds. Additionally, we discuss the relevance to current and ongoing work related to updating the dosimetry of the RDW in the MPS, including providing an example of the usefulness of information contained in these records. The RDW cohort provides a unique historical perspective on occupational exposure to radium, making it a valuable dataset for understanding long-term health effects and improving current radiation protection standards.
Importance Opioid-related overdose accounts for almost 80 000 deaths annually across the US. People who use drugs leaving jails are at particularly high risk for opioid-related overdose and may benefit from take-home naloxone (THN) distribution. Objective To estimate the population impact of THN distribution at jail release to reverse opioid-related overdose among people with opioid use disorders. Design, Setting, and Participants This study developed the agent-based Justice-Community Circulation Model (JCCM) to model a synthetic population of individuals with and without a history of opioid use. Epidemiological data from 2014 to 2020 for Cook County, Illinois, were used to identify parameters pertinent to the synthetic population. Twenty-seven experimental scenarios were examined to capture diverse strategies of THN distribution and use. Sensitivity analysis was performed to identify critical mediating and moderating variables associated with population impact and a proxy metric for cost-effectiveness (ie, the direct costs of THN kits distributed per death averted). Data were analyzed between February 2022 and March 2024. Intervention Modeled interventions included 3 THN distribution channels: community facilities and practitioners; jail, at release; and social network or peers of persons released from jail. Main Outcomes and Measures The primary outcome was the percentage of opioid-related overdose deaths averted with THN in the modeled population relative to a baseline scenario with no intervention. Results Take-home naloxone distribution at jail release had the highest median (IQR) percentage of averted deaths at 11.70% (6.57%-15.75%). The probability of bystander presence at an opioid overdose showed the greatest proportional contribution (27.15%) to the variance in deaths averted in persons released from jail. The estimated costs of distributed THN kits were less than $\$$15 000 per averted death in all 27 scenarios. Conclusions and Relevance This study found that THN distribution at jail release is an economical and feasible approach to substantially reducing opioid-related overdose mortality. Training and preparation of proficient and willing bystanders are central factors in reaching the full potential of this intervention.
Transportation is currently the largest source of U.S. anthropogenic CO 2 emissions, at about a third of the total. Achieving net-zero emissions by mid-century will require substantial reductions in transportation emissions across passenger and freight travel. Here we leverage a model intercomparison study to explore the role of transportation in scenarios achieving net-zero economy-wide CO 2 emissions by 2050. We find the transport sector is poised to play the most significant role in reducing demand-side emissions, mostly driven by technology substitution, as modeling results suggest a limited role for mode shifting and for reduced use of personal car travel in the U.S. Among various technology solutions, models show agreement that passenger on-road vehicles will largely transition to electric vehicles (EVs), while solutions to decarbonize heavier travel modes are more diverse and include greater use of liquid biofuels and hydrogen. Research should continue to investigate the evolution of on-road electrification, the role of biofuels and hydrogen across heavier travel modes, and the role of mode shifting and travel behavior change to support personal transportation decarbonization at national and regional scales to temper the rapid growth in clean fuel and electricity demand.
To facilitate the provision of electric vehicle charging stations (EVCS) in urban areas, this study investigates the benefits of co-locating fleet-owned chargers with public charging stations to enable construction incentives and cord-sharing cost savings. Shared EVCS can serve charging demand from both user types: private (household) EV owners and those managing fleet vehicles – like shared and fully automated EV (SAEV) fleets. Using POLARIS to simulate all person-travel across the 6-county Austin, Texas region, new EVCS were sited and sized with DC fast-charging (DCFC) plugs to lower operating and construction costs while providing public + private (PP) service across an 81-square-mile core geofence (where 200 SAEVs were active) over 24-hour days. When co-location is permitted, 115 DCFC cords were added to the 23 existing (publicly available) stations to enable SAEVs and household EVs (HHEVs) charging access, within the geofence. Each 250-mile-range SAEV was simulated to travel an average of 330 miles per day, serve over 92 person-trips, and recharge 2.7 times a day (for 2.4 h per session). The new DCFC plugs were primarily added to public EVCS at shopping centers and schools, and in residential settings along freeways. The average plug served 4.8 EVs per day. Most co-located PP EVCS permitted immediate (no-wait) charging, except for 2 stations along freeways that averaged 8 min of wait time to begin charging. In conclusion, the co-location strategy lowered fleet owners’ initial EVCS construction costs by 12 % (thanks to cord-sharing to avoid cord duplication), while reducing SAEV wait times to just 3.1 min (versus 10.7 min if SAEV managers had to build and operate their own EVCS).
The evaluation of aerosol exposure relies on generic mathematical models that assume uniform particle deposition profiles over the human respiratory tract and do not account for subject-specific characteristics. Here we introduce a hybrid-automated computational workflow that generates personalized particle deposition profiles in 3D reconstructed human airways from computed tomography scans using Computational Fluid and Particle Dynamics simulations. This is the first large-scale study to consider realistic airways variability, where 380 lower and 40 upper human respiratory tract 3D geometries are reconstructed and parameterized. The data is clustered into nine groups using random forest regression. Computational fluid and particle dynamics simulations are conducted on these representative geometries using a realistic heavy-breathing respiratory cycle and radioactive iodine-131 as a source term. Monte Carlo radiation transport simulations are performed to obtain detailed energy deposition maps. Our findings emphasize the importance of personalized studies, as minor respiratory tract variations notably influence deposition patterns rather than global parameters of the lower airways, observing more than 30% variance in the mass deposition fraction.