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Purpose: This study is to describe patient demographic characteristics and estimate annual prevalence and incidence rates of Crohn's disease (CD) in Japan and the United States (US). Methods: Two large employment-based healthcare claims databases (Japan Medical Data Center [JMDC] in Japan and Merative MarketScan [Merative] in the US) were used to identify patients with CD from 2010 to 2019. Cases were confirmed using an algorithm based on diagnostic with/without treatment codes. The Merative population was used for sex and age standardization of annual prevalence and incidence rates estimated from the JMDC. Results: Patients with CD were generally younger in Japan than in the US at diagnosis (mean 33.6 vs. 39.4 years) and 71.5% were male versus 45.1% in the US. Annual prevalence per 100,000 population increased substantially in both countries, from 34.2 in 2010 to 54.5 in 2019 in Japan (standardized) and 163.3 to 224.2 in the US. Prevalence rates increased in both males and females in all age groups between 6 and < 65 years. Annual incidence rate per 100,000 person-years was almost fourfold higher in the US than Japan (21.0 vs. 5.5 [standardized] in 2019) but remained stable in both countries over time in both sexes and in all age groups. Conclusion: The epidemiology of CD differs between Japan and the US. Research to understand the basis of these differences could help to identify at-risk groups in each country, and guide implementation of preventive measures. [ABSTRACT FROM AUTHOR]

This paper examines the evolving global digital landscape from an African perspective. To do this, the paper problematises the concept of “digital sovereignty” in the African context by exploring the continent’s unique challenges. While investments by the United States (US) and particularly China in digital infrastructure projects have increased connectivity and improved lives, they raise ongoing concerns about Africa’s over-reliance on external partners and the implications of data exploitation and surveillance for the continent’s digital independence. Growing out of these concerns, the central argument of this paper is the need to delink African nation-states from foreign influence and control of the digital sector and to rearticulate or reframe the latter in terms of digital sovereignty. In this light, the paper contends that mainstream research on the Fourth Industrial Revolution in the African context does not sufficiently look past the power repertoires and dynamics of the US and China – whether blaming or crediting - when theorising digital sovereignty. Instead, the paper argues that to fully understand the African continent’s battle to establish and maintain a coherent framework for digital independence, it is essential to consider the challenges and constraints of digital sovereignty. Drawing on a review of extant literature, the paper springboards off a set of broad themes and case studies to deepen understanding and highlight key hurdles to Africa’s digital independence. The paper suggests that African nations must strive to overcome risks to digital sovereignty if the latter is to genuinely empower nation-states and citizens in the Fourth Industrial Revolution. [ABSTRACT FROM AUTHOR]

Purpose: To estimate and compare annual prevalence and incidence, and demographic characteristics of patients with ulcerative colitis (UC) in Japan and the United States (US). Methods: All patients with UC were identified from large employment-based healthcare claims databases (Japan Medical Data Center [JMDC] in Japan and IBM MarketScan Commercial Claims and Encounters database [CCAE] in the US), from 2010 to 2019. Cases were confirmed using International Classification of Disease-9/10 codes with/without Anatomical Therapeutic Chemical codes. Annual age-standardized prevalence and incidence rates were estimated for the JMDC by direct standardization using the CCAE as the standard population. Results: Patients with UC were younger in Japan than in the US and men were affected more than women, whereas the reverse was true in the US. Annual prevalence per 100,000 population increased significantly from 5 in 2010 to 98 in 2019 in Japan and from 158 to 233 in the US. Prevalence increased in men more than in women and in all age groups in Japan, whereas increases were observed similarly in men and women, and in the 6 to < 65-year age groups in the US. Annual incidence per 100,000 person-years increased significantly over time in both sexes and in all age groups in Japan, with higher increases in women and in ≥ 18 year-olds. UC incidence rates did not change over time in the US. Conclusion: Ten-year trends in epidemiology of UC differ between Japan and the US. The data point to a growing disease burden in both countries that warrants investigation of measures for prevention and treatment. [ABSTRACT FROM AUTHOR]

Background: Osmotic release oral system methylphenidate (OROS-MPH) is one of the most commonly used medication for attention-deficit hyperactivity disorder (ADHD), however, real-world knowledge on OROS-MPH dose titration has been limited. This study aims to summarize and visualise the OROS-MPH titration patterns in children and adolescents with ADHD in the United States (US) and Japan. Methods: This retrospective cohort study used the US IBM® MarketScan® Commercial Claims and Encounters database from 2000 to 2019 and the Japan Medical Data Centre database from 2008 to 2019. New OROS-MPH users with ADHD were identified and split into child (6 to < 13 years) and adolescent (13 to < 18 years) groups according to age at OROS-MPH initiation/reinitiation. Patient characteristics and OROS-MPH treatment patterns were described. OROS-MPH dose titration pathways were visualised by Sankey diagrams. Results: We included 98,973 children and 62,002 adolescents in the US cohort, and 4595 children and 1508 adolescents in the Japanese cohort. In Japanese cohort, 91.9% of children and 77.9% of adolescents initiated OROS-MPH at the lowest dose (18 mg/day), whereas US patients had a broader distribution of initial doses (e.g., 18–54 mg/day). The US patients had higher daily dose of OROS-MPH than Japanese patients. Overall, a minority (< 40%) of the OROS-MPH users underwent dose titration, and different titration patterns were observed between the US and Japanese patients. Conclusions: Different treatment and titration patterns of OROS-MPH were observed in the two countries. Additional real-world studies about clinical reasoning underlying dose selection are needed to support clinical decision-making. [ABSTRACT FROM AUTHOR]

This study investigates the impact of climatic variability on both agricultural production and total factor productivity (TFP) in the Southern United States (US). It also aims at identifying the drivers of productivity in this region. The analysis is tailored to inform decision makers about effective policy options to increase and sustain productivity in this important agricultural region. We use data from the US Department of Agriculture, National Climatic Data Center, and US Geological Survey to estimate alternative stochastic production frontier models. The estimated parameters are then analyzed and used to compute and decompose TFP into several measures of efficiency. The results show that agricultural production in the Southern US is more responsive to labor and has been increasing at a 1.13 percent rate annually. The findings also suggest that while precipitation, on average, has a positive and significant impact on productivity, intra-annual variation in both temperature and precipitation, which can be considered as anomalies, has a negative and significant impact on production. The impact of climatic effects on productivity across states is mixed and technological progress has been the main driver of TFP growth. Findings indicate that climatic variability is having a negative impact on agricultural productivity in the Southern US, similar in magnitude to the positive impact of irrigation. [ABSTRACT FROM AUTHOR]

To investigate trends in synthetic cannabinoid exposures reported to United States (US) poison control centres, and their association with status of state cannabis legalisation. A retrospective study of National Poison Data System (NPDS) data from 2016 to 2019 identified and associated synthetic poisoning reports with annual state cannabis law and market status. State status was categorised as restrictive (cannabis illegal or limited medical legalisation), medical (allowing THC-containing medical cannabis use) and permissive (allowing non-medical use of THC-containing cannabis by adults). We categorised a subset of states with permissive policies by their implementation of legal adult possession/use and opening retail markets, on a quarterly basis. Mixed-effects Poisson regression models assessed synthetic exposures associated with legal status, first among all states using annual counts, and then among states that implemented permissive law alone using quarterly counts. A total of 7600 exposures were reported during the study period. Overall, reported synthetic exposures declined over time. Most reported exposures (64.8%) required medical attention, and 61 deaths were documented. State implementation of medical cannabis law was associated with 13% fewer reported annual exposures. Adoption of permissive state cannabis policy was independently and significantly associated with 37% lower reported annual synthetic exposures, relative to restrictive policies (IRR: 0.63, 95% CI: 0.50–0.79). Among states with permissive law during the period, implementation of legal adult possession/use was associated with 22% fewer reported quarterly exposures. Opening of retail markets was associated with 36% fewer reported exposures, relative to states with medical cannabis only. Adoption of permissive cannabis law was associated with significant reductions in reported synthetic cannabinoid exposures. More permissive cannabis law may have the unintended benefit of reducing both motivation and harms associated with use of synthetic cannabis products. [ABSTRACT FROM AUTHOR]

Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii and can manifest in an acute or chronic form. Many persons with acute Q fever are asymptomatic, but some develop a febrile illness, pneumonia or hepatitis. Chronic infections are rare and occur in less than 5% of persons exposed. Forms of chronic Q fever include endocarditis, infection of vascular grafts or aneurysms, osteomyelitis and osteoarthritis. Acute and chronic Q fever are nationally notifiable diseases, and presented here are the incidence, demographics and distribution of acute and chronic Q fever in the United States during 2008–2017. We summarized passive surveillance data from the Centers for Disease Control and Prevention's (CDC) National Notifiable Diseases Surveillance System (NNDSS) and supplemental case report forms (CRFs). Health departments reported 1,109 cases of acute Q fever and 272 chronic Q fever cases to NNDSS during this period. The 10‐year average annual incidence for acute Q fever was 0.36 cases per million persons, and the average annual incidence for chronic Q fever was 0.09. Males accounted for nearly 75% of both acute and chronic Q fever cases. Average annual incidence was highest among persons aged 60–69 years for both acute and chronic Q fever (0.70 cases per million persons and 0.25, respectively). As reported through CRFs, many Q fever cases did not have a known exposure to C. burnetii; 60% (n = 380) of acute Q fever cases did not report exposure to animals in the 2 months before symptom onset. Almost 90% (n = 558) did not report exposure to unpasteurized milk. Only 40% (n = 247) of persons with reported Q fever were employed in high‐risk occupations. Even though Q fever is a rare disease in the United States, incidence doubled from 2008 to 2017. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between abortion restrictions and maternal mortality in the United States.Study Design: This was a retrospective study examining maternal mortality in the United States from 1995 to 2017. We used the Global Health Data Exchange and the Centers for Disease Control and Prevention WONDER databases to extract maternal mortality data for all 50 states for each year from 1995 to 2017. We categorized states as restrictive, neutral, or protective of abortion access according to policy information published by the Guttmacher Institute. We assessed associations between abortion restrictions and maternal mortality ratios (maternal deaths per 100,000 live births).Results: In 1995, the mean maternal mortality ratios were similar across all groups of states (Restrictive 12.6, 95% CI 11.4-13.6; Neutral 12.2, 95% CI 10.9-13.4; Protective 10.9, 95% CI 9.6-11.9). Maternal mortality ratios increased for each group of states over time and in 2017, the mean maternal mortality ratio was higher in restrictive states than in protective states (Restrictive 28.5, 95% CI 20.7-35.1; Neutral 22.9, 95% CI 16.1-28.6; Protective 15.7, 95% CI 10.7-19.9). Regressions accounting for policy, state and year showed a statistically significant increase in maternal mortality ratios in restrictive states relative to neutral states (1.06, 95% CI 1.01-1.11) and a non-significant decrease associated with protective states (0.89, 95% CI 0.78-1.01).Conclusions: States that restrict abortion have higher maternal mortality than states that either protect or are neutral towards abortion. Further investigation is needed to determine how abortion restrictions are associated with increased maternal mortality.Implications: The association between abortion restrictions and maternal mortality may reflect the overall legislative priorities of individual states as restrictive states are less likely to pass proactive legislation demonstrated to improve maternal outcomes. [ABSTRACT FROM AUTHOR]

Spatial prediction is commonly achieved under the assumption of a Gaussian random field by obtaining maximum likelihood estimates of parameters, and then using the kriging equations to arrive at predicted values. For massive datasets, fixed rank kriging using the expectation–maximization algorithm for estimation has been proposed as an alternative to the usual but computationally prohibitive kriging method. The method reduces computation cost of estimation by redefining the spatial process as a linear combination of basis functions and spatial random effects. A disadvantage of this method is that it imposes constraints on the relationship between the observed locations and the knots. We develop an alternative method that utilizes the spatial mixed effects model, but allows for additional flexibility by estimating the range of the spatial dependence between the observations and the knots via an alternating expectation conditional maximization algorithm. Experiments show that our methodology improves estimation without sacrificing prediction accuracy while also minimizing the additional computational burden of extra parameter estimation. The methodology is applied to a temperature dataset archived by the United States National Climate Data Center, with improved results over previous methodology. [ABSTRACT FROM AUTHOR]

Introduction: In the United States, the opioid epidemic claims over 130 lives per day due to overdoses. While the use of opioids in trauma patients has been well-described in the literature, it is unknown whether prescription opioid use is associated with mortality after trauma. We hypothesized that legally obtained prescription opioid consumption would be positively associated with injury-related deaths in the United States.Methods: Cross-sectional time-series data was compiled using state-level mortality data from the Centers for Disease Control and Prevention Multiple Causes of Death database and prescription opioid shipping data to each state using the US Department of Justice Automated Reports and Consolidated Ordering System Retail Drug Summary reports from 2006 to 2017, with opioids shipped used as a proxy for local opioid consumption. Oxycodone and hydrocodone amounts were converted to morphine equivalent doses (MEDs). Our primary outcome was an association between MEDs and injury mortality rates at the state-level. We analyzed total injury-related deaths and subgroups of unintentional deaths, suicides, and homicides. We modeled the data using fixed effects regression to reduce bias from unmeasured differences between states.Results: Data were available for all states and the District of Columbia. Opioid deliveries increased through 2012 and then declined. Total injury-related mortalities have been increasing steadily since 2012. Opioid MEDs did not show a consistent or statistically significant relationship with injury-related mortality, including with any subgroups of unintentional deaths, suicides, and homicides.Conclusion: In every state examined, there was no consistent relationship between the amount of prescription opioids delivered and total injury-related mortality or any subgroups, suggesting that there is not a direct association between prescription opioids and injury-related mortality. This is the first study to combine national mortality and opioid data to investigate the relationship between legally obtained opioids and injury-related mortality. The US opioid epidemic remains a significant challenge that requires ongoing attention from all stakeholders in our medical and public health systems. [ABSTRACT FROM AUTHOR]

Studies from around the world have found that the preferred place of death is at home. Although desired, the ability to die at home requires personal, social, and structural factors to be in place. In the United States, between 2003 and 2017, there were decreased hospital and nursing facility deaths and increased home and hospice facility deaths. This study aims to determine whether a change in the place of death in those greater than 65 years of age in Hawai'i is similar to the overall United States data and if these changes in place of death are similar across islands/counties in the state of Hawai'i. Data from the Centers for Disease Control and Prevention database were analyzed for natural deaths between 2003 and 2018 in Hawai'i. Between 2003 and 2018, there were 120 115 natural deaths in Hawai'i, with a decrease in the overall percentage of deaths in hospitals from 53% in 2003 to 33% in 2018. During the same period, home deaths increased from 23% to 33%, and nursing facility deaths increased from 14% to 16%. This study found that the change in the place of death in those greater than 65 years in Hawai'i is similar to the overall United States data as a whole, but not within individual Hawai'i counties. [ABSTRACT FROM AUTHOR]

Objective: This analysis identified the rate of transfers and averted transfers and their associated costs across multiple emergency department telemedicine (teleED) networks. Methods: This study is a prospective cohort analysis in six teleED networks operating in 65 hospitals in 11 states across the United States. Each submitted uniform data on all teleED encounters for a 26-month period to a data co-ordinating center. Averted transfers were identified if an encounter met specific criteria. Cost savings from averted transfers were estimated from hospital-specific costs of transferred patients. Results: A total of 4,324 teleED encounters were reported. Excluding patients who died, 1,934 (46.2%) were transferred to another inpatient facility. Records of the remaining 2,248 teleED patients were examined and 882 (39.2% of nontransfers; 20.4% of all teleED cases) teleED patients met the criteria for an averted transfer. Of the averted transfer cases, 53.3% were admitted to the local inpatient facility, and 43.5% were discharged. Patients who averted transfer had lower levels of severity and less billed services than those who were transferred. Transport savings for averted transfers were estimated to total $1,074,663 annually across the six teleED networks. Average estimated transport savings were $2,673 for each averted transfer. Conclusions: In a large cohort of teleED cases, 39% of nontransfer cases were averted transfers (20% of all teleED cases). Importantly, 43% of these patients were routinely discharged rather than being transferred. Averted transfers saved on average $2,673 in avoidable transport costs per patient, with 63.6% of these cost savings accruing to public insurance. [ABSTRACT FROM AUTHOR]

Accurate parameterization of water quality routines within stormwater models can improve simulation, prediction of system behavior, and lead to more informed decision making. This work recognizes that factors controlling runoff concentrations and treatment in stormwater best management practices (BMPs) vary with region, assumes region is a proxy for these factors, and seeks to improve tool parameterization by (1) identifying a regionalization scheme that best explains variability in national datasets of runoff water quality and BMP performance, (2) generating region-specific model parameter values, and (3) demonstrating how model output varies when using national vs. regional parameters. Of the four regionalization schemes tested, the National Climatic Data Center's Regions best explained variance in pollutant runoff concentrations from the National Stormwater Quality Database, accounting for more data variability (1.1%) than the watershed's land use (0.4%). For BMP performance extracted from the International Stormwater BMP Database, the United States (U.S.) Environmental Protection Agency's Rain Zones explained the most variance (1.1%), which is one-fifth of the variance explained by BMP type (5.0%). These results were used to generate regional parameter lookup tables for stormwater quality modeling. Test cases from the 100 most populous cites in the U.S. showed national parameters predicted BMP effluent concentrations that were 15% lower than the regional parameters for five pollutants. [ABSTRACT FROM AUTHOR]

Background: Recently, there has been an increase in prescription drug abuse and related fatalities. Although opioid analgesics are commonly implicated, there have been significant increases in the prevalence of benzodiazepine exposures and overdoses. Objective: To describe national trends in pediatric benzodiazepine exposures from 2000 to 2015. Methods: A retrospective database analysis was conducted. Data regarding benzodiazepine exposures in children ages 0 to <18 years reported to participating United States poison centers from January 2000 through December 2015 were obtained from the National Poison Data System. Population data were obtained from the US Census Bureau to determine annual population estimates. Data were analyzed using chi-square tests. Results: A total of 296,838 pediatric benzodiazepine exposures were identified during the study period. The rate of pediatric benzodiazepine exposure increased 54% between 2000 and 2015. The severity of medical outcomes also increased, as did the prevalence of co-ingestion of multiple drugs, especially in children ages 12 to <18 years. Nearly half of all reported exposures in 2015 were documented as intentional abuse, misuse, or attempted suicide, reflecting a change from prior years. The most commonly identified pediatric benzodiazepines of exposures were alprazolam, clonazepam, and lorazepam. Conclusions: The rate and severity of reported pediatric benzodiazepine exposure is increasing over time. Adolescent exposures are of specific concern, as co-ingestion and intentional abuse were found to be more common in this group. Medical providers and caretakers should be cognizant of this growing epidemic to avoid preventable harm to adolescents, young children, and infants. [ABSTRACT FROM AUTHOR]

While society at large recognizes the many benefits of sport, it is important to also recognize and prevent factors that can lead to an abusive environment. This paper seeks to combine the current research on abuse in the sport environment with the work of the U.S. Center for SafeSport. The inclusion of risk factors unique to sport and evidence-informed practices provides framing for the scope and response to sexual abuse in sport organizations in the United States. The paper then explores the creation and mission of the U.S. Center for SafeSport, including the role of education in prevention and of policy, procedures, audit, and compliance as important aspects of a comprehensive safeguarding strategy. This paper provides preliminary data on the reach of the Center, established in 2017. This data captures the scope of education and training and the increase in reports to the Center from within the U.S. Olympic and Paralympic Movement. [ABSTRACT FROM AUTHOR]

Objective: To determine social factors associated with advanced stone disease (defined as unilateral stone burden >2 cm) at time of presentation to a regional stone referral center. Little is known about social determinants of urolithiasis. We hypothesize that socioeconomic factors impact kidney stone severity at intake to referral centers.Methods: A retrospective review of the prospectively collected data from the Registry for Stones of the Kidney and Ureter from 2015 to 2018 was conducted to evaluate patient characteristics predictive of having a large (>2 cm) unilateral kidney stone. Data on patient age, gender, body mass index, diabetes, race, language, education level, infection, distance, income, referring regional urologist density, American Society of Anesthesiologists score, and stone analysis were evaluated.Results: Complete imaging and patient variable data was present in 650 of 1142 patients including 197 patients with unilateral stone burden >2 cm. On multivariate analysis, obesity, lower education level, increased distance from the referral center, and symptoms of infection predicted for unilateral stone burden greater than 2 cm. Among 191 patients with stone analysis data present, stone type, income, and urologist density predicted for unilateral stone burden greater than 2 cm.Conclusion: In addition to known biological risk factors, patients with lower education levels and from regions of lower mean income were found to be more likely to present to our tertiary care center with stone burden greater than 2 cm. More research is needed to elucidate the social and societal determinants of advanced stone disease and the impact this has on population costs for stone treatment. [ABSTRACT FROM AUTHOR]

The data center industry is one of the fastest growing energy users in the USA. While the industry has improved its energy efficiency over the past decade, engineering analyses suggest that ample opportunities remain to reduce energy use that would save firms money. This study explores whether and why data centers might limit investment in energy efficiency. Given the scarcity of empirical data in this context, we conducted focus groups and interviews with data center managers to elicit information about factors affecting their investments and used content analysis to qualitatively evaluate the results. Split incentives between departments within companies and between colocation data centers and their tenants, imperfect information about the performance of new technologies, and tradeoffs with data center reliability were the most pervasive factors discussed by participants. While we find some evidence that market failure explanations such as split incentives and imperfect information had a limited role in slowing adoption for participants, rival explanations such as the cost of acquiring context-specific information, and opportunity costs associated with alternate uses of funds or highly valued attributes played a larger role in slowing investment in energy efficiency. [ABSTRACT FROM AUTHOR]

The Multi-angle Imaging SpectroRadiometer (MISR) is one of the five instruments hosted on-board the NASA Terra platform, launched on 18 December 1999. This instrument has been operational since 24 February 2000 and is still acquiring Earth Observation data as of this writing. The primary missions of MISR are to document the state and properties of the atmosphere, and in particular the clouds and aerosols it contains, as well as the planetary surface, on the basis of 36 data channels gathered by each of its nine cameras (pointing in different directions along the orbital track) in four spectral bands (blue, green, red and near-infrared). The Radiometric Camera-by-Camera Cloud Mask (RCCM) is derived from the calibrated measurements at the nominal top of the atmosphere, and is provided separately for each of the nine cameras. This RCCM data product is permanently archived at the NASA Atmospheric Science Data Center (ASDC) in Langley, VA, USA and is openly accessible (Diner et al., 1999 and https://doi.org/10.5067/Terra/MISR/MIRCCM_L2.004). For various technical reasons described in this paper, this RCCM product exhibits missing data, even though an estimate of the clear or cloudy status of the environment at each individual observed location can be deduced from the available measurements. The aims of this paper are (1) to describe how to replace most missing values by estimates and (2) to briefly describe the software to process MISR RCCM data products, which is openly available to the community from the GitHub web site (https://github.com/mmverstraete or https://doi.org/10.5281/zenodo.3240018). Limited amounts of updated MISR RCCM data products are also archived in South Africa and can be made available upon request. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the feasibility of international clinical trials in rare ovarian cancers by first studying the incidence and trends of the rare histologic subtypes in the United States (US) and Asia. Methods: Data were obtained from the United States Cancer Statistics (USCS) Public Use Databases and Taiwan Cancer Registry of Taiwan Health and Welfare Data Center (HWDC) for a diagnosis of ovarian clear cell carcinoma, endometrioid carcinoma, mucinous carcinoma, or carcinosarcoma between 2001 to 2017. SEER*Stat 8.3.9, Joinpoint regression program 4.8.0.1, and Excel were used to calculate the incidence and trends. Results: In 2017, the incidence of ovarian clear cell carcinoma, endometrioid carcinoma, mucinous carcinoma, or carcinosarcoma was 0.81, 0.51, 0.47, or 0.25 per 100,000 in the US, and 1.58, 1.17, 1.08, or 0.15 per 100,000 in Asia, respectively. Over the last 18 years, the average annual percent change (AAPC) in clear cell carcinoma did not change in the US and increased by 6.2% in Asia. The AAPC for ovarian endometrioid carcinoma decreased by 2.7% in the US and increased by 2.9% in Asia. Although the rate of carcinosarcoma is increasing in both the US and Asia, it is 16-fold higher in Asia compared with the US, with an AAPC for ovarian carcinosarcoma of 6.4% in Asia versus 0.4% in the US. The rate of ovarian mucinous carcinoma decreased in both the US and Asia with an AAPC of 2.0% versus 0.9%, respectively. Conclusions: The AAPC of ovarian clear cell carcinoma, endometrioid carcinoma, and carcinosarcoma is increasing at higher rates in Asia than in the US, providing justification to utilize global recruitment strategies for clinical trial investigational treatments and interventions in rare ovarian cancers. [ABSTRACT FROM AUTHOR]

• A novel concept of supply and return approach temperatures is introduced • The method captures non-uniform airflow and temperature distribution in data centers. • The approach temperatures are presimulated by CFD and input into EnergyPlus. • Prototype data center energy models are developed using OpenStudio and EnergyPlus. • A case study was conducted to demonstrate the use of the data center models. Data centers in the United States consume about two percent of the nation's electricity. Because heat gains from IT equipment drive cooling demand, data centers offer unique opportunities for energy savings. However, no prototype energy model for data centers is available in the suite of existing U.S. Department of Energy's Commercial Prototype Building Models. This study presented the development of two new data center prototype models and their implementation in OpenStudio and EnergyPlus. The small-size data center model represents a computer room in a building served by computer room air conditioners (CRACs); while the large-sized model represents stand-alone data centers served by computer room air handlers (CRAHs) with a central chiller plant. For each data center model, two levels of IT equipment (ITE) load density were considered, to cover the wide range of IT power density of data centers: 40 and 100 W/ft2 (430 and 1076 W/m2) for the computer room, and 100 and 500 W/ft2 (1076 and 5382 W/m2) for the stand-alone data center. All other assumptions, such as building envelope, lighting, HVAC efficiencies and schedules, were based on the minimal requirements of ASHRAE Standard 90.1 at various vintages. We introduced a novel concept of supply and return air approach temperatures to capture the essential effects of non-uniform airflow and temperature distribution in data centers. The approach temperatures were pre-computed by computational fluid dynamics (CFD) simulations for various configurations of ITE loads and airflow containment management in data centers. A new feature was developed in EnergyPlus to implement the approach temperature method. A case study was conducted to demonstrate the use of the data center models. The two data center models cover all U.S. climate zones and can be used to evaluate energy saving measures for data centers, as well as to support development of data center energy efficiency codes and standards. [ABSTRACT FROM AUTHOR]

• A framework for data center to bid into electricity market and follow regulation signal in real-time. • A risk-constrained bidding strategy is developed to determine the optimal energy and frequency regulation bids. • Dummy load is introduced to increase the amount of regulation service provision of data center. • Bi-linear server power consumption model and rule-based control enable data center to follow regulation signal accurately. • The proposed regulation service provision framework reduces electricity bill by 12%. The rapid adoption of cloud storage and computing services led to unprecedented growth of data centers in the world. As bulk energy consumers, large-scale data centers in the U.S. rack up billions in electricity costs annually. Fortunately, the operational flexibility of data centers can be leveraged to provide valuable frequency regulation services in smart grids to mitigate the indeterminacy of the renewable generation resources. Specifically, this paper aims to leverage computational flexibility provided by servers, such as dynamic voltage frequency scaling and dummy loads. This paper develops a comprehensive framework for data center's frequency regulation service provision in both hour-ahead market and real-time operations. A risk constrained hour-ahead bidding strategy along with a real-time data center power consumption control algorithm are developed to minimize electricity bills and the total response time of the requests. The introduction of dummy load, realistic bi-linear server power consumption model, and probabilistic forecast of electricity and frequency regulation service prices enable the data center to accurately follow frequency regulation signals, while reducing the financial risks associated with electricity market participation. The simulation results show that the proposed frequency regulation provision framework results not only in significant cost reduction for data centers, but also limits degradation in quality of service. Meanwhile, the stability and reliability of a power grid will be improved by the frequency regulation service provision. [ABSTRACT FROM AUTHOR]