This work extends to third-order previously published work on developing the adjoint sensitivity and uncertainty analysis of the numerical model of a <u>p</u>oly<u>e</u>thylene-<u>r</u...This work extends to third-order previously published work on developing the adjoint sensitivity and uncertainty analysis of the numerical model of a <u>p</u>oly<u>e</u>thylene-<u>r</u>eflected <u>p</u>lutonium (acronym: PERP) OECD/NEA reactor physics benchmark. The PERP benchmark comprises 21,976 imprecisely known (uncertain) model parameters. Previous works have used the adjoint sensitivity analysis methodology to compute exactly and efficiently all of the 21,976 first-order and (21,976)<sup>2</sup> second-order sensitivities of the PERP benchmark’s leakage response to all of the benchmark’s uncertain parameters, showing that the largest and most consequential 1<sup>st</sup>- and 2<sup>nd</sup>-order response sensitivities are with respect to the total microscopic cross sections. These results have motivated extending the previous adjoint-based derivations to third-order, leading to the derivation, in this work, of the exact mathematical expressions of the (180)<sup>3</sup> third-order sensitivities of the PERP leakage response with respect to these total microscopic cross sections. The formulas derived in this work are valid not only for the PERP benchmark but can also be used for computing the 3<sup>rd</sup>-order sensitivities of the leakage response of any nuclear system involving fissionable material and internal or external neutron sources. Subsequent works will use the adjoint-based mathematical expressions obtained in this work to compute exactly and efficiently the numerical values of these (180)<sup>3</sup> third-order sensitivities (which turned out to be very large and consequential) and use them for a third-order uncertainty analysis of the PERP benchmark’s leakage response.展开更多
Rationale: In the literature, some risk factors for severity and mortality from COVID-19 have been indicated. However, these factors can change, depending on the characteristics of the population and health services. ...Rationale: In the literature, some risk factors for severity and mortality from COVID-19 have been indicated. However, these factors can change, depending on the characteristics of the population and health services. In this sense, longitudinal studies can be useful for understanding local realities and subsidizing health actions based on these realities. Objective: To analyze the risk factors for severity and death in hospitalized patients with COVID-19. Methods: A retrospective cohort of patients with COVID-19 hospitalized from August 1 to October 16, 2021 (3<sup>rd</sup> wave of the pandemic), notified by the Department of Epidemiological Surveillance of Sao Tome and Principe. We employed measures of strength of associations for the analysis of exposure risk factors. Results: We analyzed 110 hospitalized patients (31.8% severe-critical and 68.2% non-severe). The risk factors for severe forms of COVID-19 were: being aged ≥60 years (RR = 3.3), being male (RR = 2), having comorbidities (RR = 2) and the risk increases to 10-fold for multicomorbidities, with emphasis on obesity, neoplasia, skin-muscle-surgical infection, dementia and to some degree CVD. 62.9% of patients with severe forms of the disease were not vaccinated. Risk factors for death among hospitalized and severe/critical cases, respectively, were having comorbidities (RR = 8 and 2.4) multicomorbidities (RR = 10 and 2.8 for those with 2 comorbidities and RR = 33.3 and 4 for those with 3 or 4 comorbidities), especially diabetes, dementia, neoplasia, cutaneous-muscular infection, and obesity. Although CVD was not associated with risk factors for death, these were the most frequently found among the severely hospitalized and deaths. In addition, important risk factors associated with death were not using corticoids (RR = 3.3, 230-fold risk) and not using anticoagulants-heparin (RR = 1.3, 30% risk) more compared to the severe cases that did use them. Most of the patients who died (63.2%) were not vaccinated. Moreover, having only 1 dose of the vaccine was a risk factor 1.9 times more for death among all hospitalized patients, but in the severe cases, there was no association between the variable vaccination and death. Among those hospitalized with 2 doses, it was a 0.5-fold protective factor among those hospitalized. The Delta variant of Sarscov-2 was the one found among severe cases and deaths investigated by genetic sequencing, with more exuberant clinical features compared to the other 2 previous vaccinations. Conclusion: Being elderly, male and presenting comorbidities, mainly multicomorbidities were the main characteristics associated with severity of COVID-19. On the other hand, comorbidities, and even worse, multicomorbidities, hospitalization for respiratory failure, lowered level of consciousness, no use of corticoid and no use of anticoagulation in critically ill patients, and not having at least 2 doses of vaccine for covid-19, were characteristics associated with death by COVID-19. These results will help inform healthcare providers so that the best interventions can be implemented to improve outcomes for patients with COVID-19. Public health interventions must be carefully tailored and implemented in these susceptible groups to reduce the risk of mortality in patients with COVID-19 and then the risk of major complications. Intensive and regular follow-up is needed to detect early occurrences of clinical conditions.展开更多
This work presents the results of the exact computation of (180)<sup>3</sup> = 5,832,000 third-order mixed sensitivities of the leakage response of a polyethylene-reflected plutonium (PERP) experimental be...This work presents the results of the exact computation of (180)<sup>3</sup> = 5,832,000 third-order mixed sensitivities of the leakage response of a polyethylene-reflected plutonium (PERP) experimental benchmark with respect to the benchmark’s 180 microscopic total cross sections. This computation was made possible by applying the Third-Order Adjoint Sensitivity Analysis Methodology developed by Cacuci. The numerical results obtained in this work revealed that many of the 3<sup>rd</sup>-order sensitivities are significantly larger than their corresponding 1<sup>st</sup>- and 2<sup>nd</sup>-order ones, which is contrary to the widely held belief that higher-order sensitivities are all much smaller and hence less important than the first-order ones, for reactor physics systems. In particular, the largest 3<sup>rd</sup>-order relative sensitivity is the mixed sensitivity <img src="Edit_754b8437-dfdf-487d-af68-c78c637e6d4e.png" width="180" height="24" alt="" />of the PERP leakage response with respect to the lowest energy-group (30) total cross sections of <sup>1</sup>H (“isotope 6”) and <sup>239</sup>Pu (“isotope 1”). These two isotopes are shown in this work to be the two most important parameters affecting the PERP benchmark’s leakage response. By comparison, the largest 1<sup>st</sup>-order sensitivity is that of the PERP leakage response with respect to the lowest energy-group total cross section of isotope <sup>1</sup>H, having the value <img src="Edit_a5cfcc11-6a99-41ee-b844-a5ee84b454b3.png" width="100" height="24" alt="" />, while the largest 2<sup>nd</sup>-order sensitivity is <img src="Edit_05166a2b-97f7-43f1-98ff-b21368c00228.png" width="120" height="22" alt="" />. The 3<sup>rd</sup>-order sensitivity analysis presented in this work is the first ever such analysis in the field of reactor physics. The consequences of the results presented in this work on the uncertainty analysis of the PERP benchmark’s leakage response will be presented in a subsequent work.展开更多
文摘This work extends to third-order previously published work on developing the adjoint sensitivity and uncertainty analysis of the numerical model of a <u>p</u>oly<u>e</u>thylene-<u>r</u>eflected <u>p</u>lutonium (acronym: PERP) OECD/NEA reactor physics benchmark. The PERP benchmark comprises 21,976 imprecisely known (uncertain) model parameters. Previous works have used the adjoint sensitivity analysis methodology to compute exactly and efficiently all of the 21,976 first-order and (21,976)<sup>2</sup> second-order sensitivities of the PERP benchmark’s leakage response to all of the benchmark’s uncertain parameters, showing that the largest and most consequential 1<sup>st</sup>- and 2<sup>nd</sup>-order response sensitivities are with respect to the total microscopic cross sections. These results have motivated extending the previous adjoint-based derivations to third-order, leading to the derivation, in this work, of the exact mathematical expressions of the (180)<sup>3</sup> third-order sensitivities of the PERP leakage response with respect to these total microscopic cross sections. The formulas derived in this work are valid not only for the PERP benchmark but can also be used for computing the 3<sup>rd</sup>-order sensitivities of the leakage response of any nuclear system involving fissionable material and internal or external neutron sources. Subsequent works will use the adjoint-based mathematical expressions obtained in this work to compute exactly and efficiently the numerical values of these (180)<sup>3</sup> third-order sensitivities (which turned out to be very large and consequential) and use them for a third-order uncertainty analysis of the PERP benchmark’s leakage response.
文摘Rationale: In the literature, some risk factors for severity and mortality from COVID-19 have been indicated. However, these factors can change, depending on the characteristics of the population and health services. In this sense, longitudinal studies can be useful for understanding local realities and subsidizing health actions based on these realities. Objective: To analyze the risk factors for severity and death in hospitalized patients with COVID-19. Methods: A retrospective cohort of patients with COVID-19 hospitalized from August 1 to October 16, 2021 (3<sup>rd</sup> wave of the pandemic), notified by the Department of Epidemiological Surveillance of Sao Tome and Principe. We employed measures of strength of associations for the analysis of exposure risk factors. Results: We analyzed 110 hospitalized patients (31.8% severe-critical and 68.2% non-severe). The risk factors for severe forms of COVID-19 were: being aged ≥60 years (RR = 3.3), being male (RR = 2), having comorbidities (RR = 2) and the risk increases to 10-fold for multicomorbidities, with emphasis on obesity, neoplasia, skin-muscle-surgical infection, dementia and to some degree CVD. 62.9% of patients with severe forms of the disease were not vaccinated. Risk factors for death among hospitalized and severe/critical cases, respectively, were having comorbidities (RR = 8 and 2.4) multicomorbidities (RR = 10 and 2.8 for those with 2 comorbidities and RR = 33.3 and 4 for those with 3 or 4 comorbidities), especially diabetes, dementia, neoplasia, cutaneous-muscular infection, and obesity. Although CVD was not associated with risk factors for death, these were the most frequently found among the severely hospitalized and deaths. In addition, important risk factors associated with death were not using corticoids (RR = 3.3, 230-fold risk) and not using anticoagulants-heparin (RR = 1.3, 30% risk) more compared to the severe cases that did use them. Most of the patients who died (63.2%) were not vaccinated. Moreover, having only 1 dose of the vaccine was a risk factor 1.9 times more for death among all hospitalized patients, but in the severe cases, there was no association between the variable vaccination and death. Among those hospitalized with 2 doses, it was a 0.5-fold protective factor among those hospitalized. The Delta variant of Sarscov-2 was the one found among severe cases and deaths investigated by genetic sequencing, with more exuberant clinical features compared to the other 2 previous vaccinations. Conclusion: Being elderly, male and presenting comorbidities, mainly multicomorbidities were the main characteristics associated with severity of COVID-19. On the other hand, comorbidities, and even worse, multicomorbidities, hospitalization for respiratory failure, lowered level of consciousness, no use of corticoid and no use of anticoagulation in critically ill patients, and not having at least 2 doses of vaccine for covid-19, were characteristics associated with death by COVID-19. These results will help inform healthcare providers so that the best interventions can be implemented to improve outcomes for patients with COVID-19. Public health interventions must be carefully tailored and implemented in these susceptible groups to reduce the risk of mortality in patients with COVID-19 and then the risk of major complications. Intensive and regular follow-up is needed to detect early occurrences of clinical conditions.
文摘This work presents the results of the exact computation of (180)<sup>3</sup> = 5,832,000 third-order mixed sensitivities of the leakage response of a polyethylene-reflected plutonium (PERP) experimental benchmark with respect to the benchmark’s 180 microscopic total cross sections. This computation was made possible by applying the Third-Order Adjoint Sensitivity Analysis Methodology developed by Cacuci. The numerical results obtained in this work revealed that many of the 3<sup>rd</sup>-order sensitivities are significantly larger than their corresponding 1<sup>st</sup>- and 2<sup>nd</sup>-order ones, which is contrary to the widely held belief that higher-order sensitivities are all much smaller and hence less important than the first-order ones, for reactor physics systems. In particular, the largest 3<sup>rd</sup>-order relative sensitivity is the mixed sensitivity <img src="Edit_754b8437-dfdf-487d-af68-c78c637e6d4e.png" width="180" height="24" alt="" />of the PERP leakage response with respect to the lowest energy-group (30) total cross sections of <sup>1</sup>H (“isotope 6”) and <sup>239</sup>Pu (“isotope 1”). These two isotopes are shown in this work to be the two most important parameters affecting the PERP benchmark’s leakage response. By comparison, the largest 1<sup>st</sup>-order sensitivity is that of the PERP leakage response with respect to the lowest energy-group total cross section of isotope <sup>1</sup>H, having the value <img src="Edit_a5cfcc11-6a99-41ee-b844-a5ee84b454b3.png" width="100" height="24" alt="" />, while the largest 2<sup>nd</sup>-order sensitivity is <img src="Edit_05166a2b-97f7-43f1-98ff-b21368c00228.png" width="120" height="22" alt="" />. The 3<sup>rd</sup>-order sensitivity analysis presented in this work is the first ever such analysis in the field of reactor physics. The consequences of the results presented in this work on the uncertainty analysis of the PERP benchmark’s leakage response will be presented in a subsequent work.
