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At least 19 records

All sources NASA NTRS DOE OSTI

DOE OSTI2024

Health Care Usage During the COVID-19 Pandemic and the Adoption of Telemedicine: Retrospective Study of Chronic Disease Cohorts

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.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2025

Immigrants’ access to health care: Problems identified in a high-risk tuberculosis population

Not Available

Linhas, R.↗

DOE OSTI2026

VA Community Determinants of Health Data Curation Documentation FY26-Q2

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Community Determinants of Health (EDH) Data project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1 km grid) to another (e.g., U.S. Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, U.S. Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1 km grids. Some economic data may only be available at the ZIP code level. In this context, ‘standardized’ means that all datasets share the same spatial extent (e.g., U.S. Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Community Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2024

VA EDH Data Curation Documentation FY24-Q4

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2025

VA Determinants of Health Data Curation Documentation FY25-Q2

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Determinants of Health (EDH) project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, ‘standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2025

VA Determinants of Health Data Curation Documentation FY25-Q3

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Determinants of Health (EDH) project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, ‘standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2025

VA Community Determinants of Health Data Curation Documentation FY25-Q4

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Determinants of Health (EDH) project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2025

VA Community Determinants of Health Data Curation Documentation FY26-Q1

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Community Determinants of Health (EDH) Data project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, ‘standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Community Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2024

Generalizability of heat-related health risk associations observed in a large healthcare claims database of patients with commercial health insurance

Extreme ambient heat is unambiguously associated with higher risk of illness and death. The Optum Labs Data Warehouse (OLDW), a database of medical claims from US-based patients with commercial or Medicare Advantage health insurance, has been used to quantify heat-related health impacts. Whether results for the insured sub-population are generalizable to the broader population has to our knowledge not been documented. We sought to address this question, for the US population in California from 2012 to 2019. We examined changes in daily rates of emergency department (ED) encounters and in-patient hospitalization encounters for all-causes, heat-related outcomes, renal disease, mental/behavioral disorders, cardiovascular disease, and respiratory disease. OLDW was the source for health data for insured individuals in California, and health data for the broader population were gathered from the California Department of Health Care Access and Information (HCAI). We defined extreme heat exposure as any day in a group of 2 or more days with maximum temperatures exceeding the county-specific 97.5 th percentile and used a space-time-stratified case–crossover design to assess and compare the impacts of heat on health. Average incidence rates of medical encounters differed by dataset. However, rate ratios for ED encounters were similar across datasets for all causes (ratio of incidence rate ratios (rIRR) = 0.989; 95% confidence interval (CI) = 0.973, 1.011), heat-related causes (rIRR = 1.080; 95% CI = 0.999, 1.168), renal disease (rIRR = 0.963; 95% CI = 0.718, 1.292), and mental health disorders (rIRR = 1.098; 95% CI = 1.004, 1.201). Rate ratios for inpatient encounters were also similar. This work presents evidence that OLDW can continue to be a resource for estimating the health impacts of extreme heat.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2026

VA Community Determinants of Health Data Curation Documentation FY26-Q3

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2024

ToF-SIMS evaluation of PEG-related mass peaks and applications in PEG detection in cosmetic products

Polyethylene glycols (PEGs) are used in industrial, medical, health care, and personal care applications. The cycling and disposal of synthetic polymers like PEGs pose significant environmental concerns. Detecting and monitoring PEGs in the real world calls for immediate attention. This study unveils the efficacy of time-of-flight secondary ion mass spectrometry (ToF-SIMS) as a reliable approach for precise analysis and identification of reference PEGs and PEGs used in cosmetic products. By comparing SIMS spectra, we show remarkable sensitivity in pinpointing distinctive ion peaks inherent to various PEG compounds. Moreover, the employment of principal component analysis effectively discriminates compositions among different samples. Notably, the application of SIMS two-dimensional image analysis visually portrays the spatial distribution of various PEGs as reference materials. The same is observed in authentic cosmetic products. The application of ToF-SIMS underscores its potential in distinguishing PEGs within intricate environmental context. ToF-SIMS provides an effective solution to studying emerging environmental challenges, offering straightforward sample preparation and superior detection of synthetic organics in mass spectral analysis. These features show that SIMS can serve as a promising alternative for evaluation and assessment of PEGs in terms of the source, emission, and transport of anthropogenic organics.

36 MATERIALS SCIENCE↗

DOE OSTI2024

Electrochemical Amyloid β Immunosensor Based on Ti 3 C 2 T x MXene Nanosheets

Alzheimer’s disease (AD) is the most common neurodegenerative disease and a major health-care problem. More than 55 million people in the world, including 6.7 million Americans, are living with AD. As AD is characterized by production and deposition of β-amyloid peptide (Aβ) in the brain, Aβ is considered as a potential biomarker for diagnosing and monitoring the progression of AD. Nanomaterials-based electrochemical immunosensor is one of the most promising methods for early diagnosis and therapeutic of AD, due to its highly selective, sensitive, and label-free advantages. The graphene-like two-dimensional (2D) MXene nanosheets have shown large surface area, good conductivity, biocompatibility, high ion transport, and low diffusion barrier, attracting attention in recent years to use it as the nanomaterial substrate for biosensor fabrication. In this paper, we presented a Ti 3 C 2 T x MXene nanosheets-based electrochemical immunosensor to detect trace Aβ for early diagnosis of AD.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2025

Reducing the Energy Consumption of Magnetic Resonance Imaging and Computed Tomography Scanners: Integrating Ecodesign and Sustainable Operations

This review aims to provide valuable insights into how energy consumption in magnetic resonance imaging (MRI) and computed tomography (CT) scanners can be effectively monitored, managed, and reduced, thereby contributing to more sustainable medical imaging practices. Demand for advanced imaging technologies such as MRI and CT scanners continues to increase, and understanding the resultant impact on greenhouse gas emissions requires a thorough evaluation of their energy consumption. Here, this review examines the energy monitoring and consumption characteristics of MRI and CT scanners, highlighting potential approaches for energy savings. An overview of MRI and CT principles, hardware components, and their associated energy consumption is provided. After addressing the technical aspects, the hardware and software requirements essential for accurate energy metering are detailed. Baseline measurements of energy consumption data are then provided as a foundation to understand current usage patterns and identify areas for improvement. Ongoing efforts to reduce energy consumption are categorized into 3 main strategies: operations, scanner design enhancements, and active scanning techniques, including accelerated MRI protocols. Ultimately, we emphasize that achieving sustainability in medical imaging requires collaboration across disciplines. By incorporating eco-friendly design in new imaging equipment, we can reduce the environmental impact, promote sustainability, and set a health care industry standard for a healthier planet.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2025

Cognitive IoT and Edge Computing for Intrusion Detection with Federated TinyML

Internet of Things (IoT) and Edge Computing (EC) are rapidly becoming an integral part of the modern society. By 2030, there is estimated to be over 40 billion active and connected IoT devices [1]. This rapid progress also comes with a significant implication on cybersecurity. Back-end infrastructure and systems have a much broader attack than they did previously due to vulnerable IoT/EC devices being connected to wireless networks. This expanding attack surface is a growing concern because IoT/EC are increasingly being used in critical systems such as power grids, health care, and smart homes. To effectively address a problem of this scale, cognitive cyber methods—which can autonomously detect and react to cyber attacks as they develop—are needed. To address this, we bring Artificial Intelligence (AI) and Machine Learning (ML) to IoT/EC devices, using tinyML to monitor voluminous IoT data against cyber threats, and using Federated Learning (FL) to share local detection knowledge across the system while preserving privacy. We propose a novel three-layer architecture: (1) an IoT layer for tinyML-based inference, (2) an edge layer for ML model training, and (3) a cloud layer for FL operations. Using the publicly available 11-class N-BaIoT dataset [2], we demonstrate that this architecture mitigates resource constraints at the IoT layer while improving detection accuracy over standard two-layer designs. An outlier-resistant scaler, feature reduction, and quantization enable the tinyML model to maintain detection accuracy with a reduced model size. Additionally, federated learning that only utilizes the intersection (across heterogenous devices) of the reduced feature set achieves superior detection accuracy compared to locally trained models.

Li, Mingyan [ORNL] (ORCID:0009000569532640)↗

DOE OSTI2024

OASIS: Offsetting Active Reconstruction Attacks in Federated Learning

Federated Learning (FL) has garnered significant attention for its potential to protect user privacy while enhancing model training efficiency. For that reason, FL has found its use in various domains, from health care to industrial engineering, especially where data cannot be easily exchanged due to sensitive information or privacy laws. However, recent research has demonstrated that FL protocols can be easily compromised by active reconstruction attacks executed by dishonest servers. These attacks involve the malicious modification of global model parameters, allowing the server to obtain a verbatim copy of users' private data by inverting their gradient updates. Tackling this class of attack remains a crucial challenge due to the strong threat model. In this paper, we propose a defense mechanism, namely OASIS, based on image augmentation that effectively counteracts active reconstruction attacks while preserving model performance. We first uncover the core principle of gradient inversion that enables these attacks and theoretically identify the main conditions by which the defense can be robust regardless of the attack strategies. We then construct our defense with image augmentation showing that it can undermine the attack principle. Comprehensive evaluations demonstrate the efficacy of the defense mechanism highlighting its feasibility as a solution.

deep neural networks↗

DOE OSTI2025

Neighborhood sociome factors and pediatric asthma exacerbations: Protective role of tree crown density and importance of pharmacy access in Chicago's south side

Abstract Background Pediatric asthma exacerbations remain a critical public health concern, particularly in historically underserved urban settings. Objective This study investigates sociome factors—the social context of disease—associated with asthma exacerbations among children living in Chicago's South Side, leveraging clinical and publicly available generalizable census tract‐level datasets from agencies including ChiVes, the City of Chicago Data Portal, EPA, Census Bureau, HUD, NOAA, and more. The aim is to uncover novel hypotheses for potential new interventions. Methods A generalized linear model assessed associations with the outcome of asthma exacerbations while accounting for clustering at the patient level. Predictors included all variables from the Sociome Data Commons, including social, environmental, behavioral, economic, housing, and school variables. Results Predictors of decreased risk included patient age (+4.8 years, −22%), tree crown density (+6% coverage, −17%), parks per acre (+0.41, −8%), and labor market engagement (+0.8 points, −9%). Conversely, predictors of increased risk included increased distance to the nearest pharmacy (+0.28 miles, +12%), limited English skills (+2.3%, +10%), higher inequality (+0.08 points, +8%), and visits in the Spring (+11%) and Fall (+20%). Conclusion The results suggest that tree crown density, a novel finding in the context of asthma exacerbations, may play a protective role. Limited access to health care facilities such as pharmacies continues to complicate care. Clinical Implications These findings provide hypotheses for future interventions for long‐standing asthma disparities.

Allergy↗

DOE OSTI2024

Tracking surface charge dynamics on single nanoparticles

Surface charges play a fundamental role in physics and chemistry, in particular in shaping the catalytic properties of nanomaterials. However, tracking nanoscale surface charge dynamics remains challenging due to the involved length and time scales. Here, we demonstrate time-resolved access to the nanoscale charge dynamics on dielectric nanoparticles using reaction nanoscopy. We present a four-dimensional visualization of the spatiotemporal evolution of the charge density on individual SiO 2 nanoparticles under strong-field irradiation with femtosecond-nanometer resolution. The initially localized surface charges exhibit a biexponential redistribution over time. Our findings reveal the influence of surface charges on surface molecular bonding through quantum dynamical simulations. We performed semi-classical simulations to uncover the roles of diffusion and charge loss in the surface charge redistribution process. Understanding nanoscale surface charge dynamics and its influence on chemical bonding on a single-nanoparticle level unlocks an increased ability to address global needs in renewable energy and advanced health care.

74 ATOMIC AND MOLECULAR PHYSICS↗

DOE OSTI2026

The Next Stage for Smart Cities: Metrics to Spur an Evolution from Technology for Efficiency to Technology for People's Needs

The Smart Cities movement is about a decade old, energized by the USDOT Smart Cities grant that sparked cities to dream big. Now, 10 years later, and multitudes of conferences and papers later, the biggest question regarding Smart Cities is whether any progress has been made? Smart Cities forums are typically led by the technology sector, either telecommunications, internet access, or most recently artificial intelligence (AI) concerns. Each of these areas have grown and found new applications in the context of Smart Cities, however, these technology applications are just tools toward ends. Do digital communications and assistance enable or foster improved access to real, tactile, non-virtual goods and services such as transportation, food, housing, trash removal, health care, education, social interaction? These and other topics are not 'big tech', but are each critical to quality of life outcomes and are day-to-day necessities, comprising many of the touch points through which citizens interact with municipal agencies. Regarding Smart Cities, relationships have not been fully refined as to how best to merge the emerging generation of technology and related trends with more mundane but essential requirements of tactile services. How should municipal managers and operators bring the range of new technology tools (e.g. on-demand transit, automated vehicles, digital connectivity) to bear to improve functions serving real- physical- non-virtual needs? How do we make cities more efficient in providing access to services and opportunities for improved quality of life? This paper examines the current Smart City movement, emerging trends, and the need to put metrics with respect to the delivery, access, and provision of real-life needs. Using a few case studies of past, present, and projected future scenarios, this paper attempts to bring Smart Cities into the real cities domain, perhaps pushing the moniker away from 'Smart' to 'Efficient' - something that can be measured, counted, and assessed. Through the consideration of the next stage of the evolution of cities from 'Smart' to 'Efficient', the combined efforts and experience of multiple researchers at the NREL and their network of collaborators highlights the need for updates metrics that can be used to start guiding efforts toward productive initiatives to improve quality of life.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗