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Informed Investments in Clean Energy Technologies

Governments and companies face consequential decisions about allocating resources to the research, development, demonstration and deployment of energy technologies to meet environmental, economic and social goals. Here we discuss how research insights can inform and potentially improve these decisions to make effective use of limited resources and time in shaping the next-generation energy infrastructure. We outline three key research steps: forecasting technological change, relating investments to economic, social and environmental outcomes and informing decision-making processes. We recommend advances to address uncertainty as well as to make methods and results more practicable, emphasizing the importance of model validation, streamlining and interactivity. Progress has been made, yet further work is needed-for example, in the development of reduced-order, testable models and more comprehensive data collection. Overall, this research is beginning to inform decisions but could be adopted more widely by governments and the private sector to help support technological progress for energy affordability, equitable climate change mitigation, health benefits and other objectives.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

Results from the last DD and DT JET campaigns in the framework of the EUROfusion Tokamak Exploitation Work Package activity

JET, the only tokamak capable of operating with deuterium–tritium (D–T) fuel (since TFTR was shutdown in 1999), has provided essential experimental data to support ITER and DEMO design and operation. Within the EUROfusion Tokamak Exploitation Work Package, JET completed its final campaigns (2022–2023), culminating in the third D–T campaign (DTE3). These experiments addressed key challenges in plasma scenarios, exhaust control, and tritium management under reactor-relevant conditions. Significant progress was achieved in demonstrating ITER-like integrated scenarios with impurity seeding, achieving partial divertor detachment and high confinement ($H_{98}(y,2)$ ≈ 0.85) at 3 MA in D–T plasmas. Advanced exhaust regimes such as quasi-continuous exhaust (QCE) and X-point radiator (XPR) were successfully achieved first in D–D and then extended to D–T operation, confirming their relevance for mixed isotope operation. Operational milestones included a new world record of 69 MJ fusion energy in tritium-rich hybrid plasmas and long-pulse H-mode operation up to 60 s, contributing with unique data to the CICLOP database. Physics studies focused on peeling-limited pedestals in support of ITER and improved understanding of edge stability and impurity screening in metallic environments. Extensive usage of the shattered pellet injector (SPI) on JET provided critical information for the design of the ITER disruption mitigation system (DMS). Real-time control systems for D/T ratio control and plasma exhaust were deployed and demonstrated in D–D and D–T, while energetic particle physics investigations unfolded the role of fast ions in turbulence suppression mechanisms. Comprehensive tritium retention studies using gas balance method, post-mortem analysis, and ITER-relevant laser induced desorption spectroscopy (LIDS) diagnostics provided essential input for tritium accountancy strategies. These results are validating the ITER operational concepts, inform DEMO design, and deliver critical experience in nuclear operation and scenario integration.

disruptions↗

Leveraging national laboratories to increase Black representation in STEM: recommendations within the Department of Energy

Increasing diversity in STEM disciplines has been a goal at scientific institutions for many decades. Black representation in STEM, however, has remained critically low at all levels (high school, undergraduate, graduate, and professional) for over 40 years, highlighting the need for innovative strategies that promote and retain Black students and professionals in STEM. We refocus efforts on increasing Black representation in STEM by promoting early exposure and continued engagement while leveraging national laboratories—an underutilized resource with immense potential to centralize diversity and inclusion efforts nationally.

99 GENERAL AND MISCELLANEOUS↗

Towards provision of regularly updated climate data from the Coupled Model Intercomparison Project

The Coupled Model Intercomparison Project (CMIP) is a flagship of the World Climate Research Programme (WCRP). CMIP has become a recognised ‘brand’ in climate circles evolving over the last thirty years from a targeted research activity by a small number of climate modelling centres intercomparing their Earth System Model (ESM) simulations to a broad international coordinated research effort (Durack et al, 2025). CMIP is organized as a research activity leveraging funded and in-kind contributions from experts within modelling centres and the broader scientific community supported more recently by a fully-funded International Project Office. Within CMIP, Model Intercomparison Projects (MIPs) are community-designed to understand past, present and future climate. CMIP data provides a valuable resource for climate research and is routinely used to assess model representation of climate processes and test scientific hypotheses in the context of model uncertainty and (forced and internal) variability as evident from its prolific use in scientific publications1 . The impact relies on enabling infrastructure (most prominently via the Earth System Grid Federation (ESGF)), which allows sharing of simulation output, provision of the boundary conditions used in each simulation, and definition of the data standards that are essential to facilitating wide use of the data. The impact is supplemented by the wide-ranging scrutiny to which model simulations are subjected. Beyond its use in research, CMIP data is a key resource for communities producing derived climate information from downscaling and impact studies, such as the Coordinated Regional Downscaling Experiment (CORDEX; Gutowski et al., 2016) and the Intersectoral Impacts MIP (ISIMIP; Frieler et al., 2024). Government, academic and commercial entities also increasingly rely on CMIP and its downstream data for climate risk assessments and climate services (for example, Copernicus Climate Change Service and World Bank portal). This means that, although CMIP is a research activity, it increasingly serves a secondary and very relevant role as a provider of climate data – a long-recognised dichotomy (Stevens, 2024). Research and applications have distinct needs, with the former requiring flexibility and generality and the latter consistency. Here we explain how the design of the research activity has been adapted to reduce the burdens imposed by applications and how the research infrastructure might evolve to further enable scientific inquiry. We propose one possible approach to consistently providing model information and projections for applications in the future.

Environmental sciences↗

An evolving Coupled Model Intercomparison Project phase 7 (CMIP7) and Fast Track in support of future climate assessment

The Coupled Model Intercomparison Project (CMIP) coordinates community-based efforts to answer key and timely climate science questions, facilitate delivery of relevant multi-model simulations through shared infrastructure, and support national and international climate assessments. Generations of CMIP have evolved through extensive community engagement from punctuated phasing into more continuous support for the design of experimental protocols, infrastructure for data publication and access, and public delivery of climate information. We identify four fundamental research questions motivating a seventh phase of coupled model intercomparison relating to patterns of sea surface temperature change, changing weather, the water–carbon–climate nexus, and tipping points. Key CMIP7 advances include an expansion of baseline experiments, a focus on CO 2 -emissions-driven experiments, sustained support for community MIPs, periodic updating of historical forcings and diagnostics requests, and a collection of prioritized experiments, or the “Assessment Fast Track”, drawn from community MIPs to support climate research, assessment, and service goals across prediction and projection, characterization, attribution, and process understanding.

Environmental sciences↗

Brick Schema Standardized Plug Load Control Strategies for Load Reduction: Preprint

Plug loads comprise a significant percentage of commercial building energy consumption. Applying intelligent controls to turn off plug loads when unused can provide dynamic load reduction and flexibility, which are key traits of grid-interactive efficient buildings. This capability is important for equitable decarbonization as it can enable disadvantaged communities to electrify buildings without costly upgrades to electrical infrastructure. In this work, we present the effectiveness of various control strategies along with the operational lessons that informed their design. During a three-year period, we operated over 600 smart outlets in 12 university office buildings. The attached plug loads consisted primarily of printers, TVs, water dispensers, and copiers. After recording baseline power measurements for one year, we designed plug load control (PLC) strategies for each plug load type, use, and for different risk tolerance levels because PLC can potentially be disruptive to daily work. We used the Brick Schema to facilitate the management of plug load locations and other metadata. For advanced controls, we integrated the smart plugs with heating, ventilation, and air conditioning (HVAC) systems through the campus building automation system. We found static schedules to be the least disruptive and most predictable for occupants, resulting in 38% and 66% energy savings in two studies. For printers, print server-triggered PLC produced 86% savings, the highest of all strategies with minimal occupant impact. Scheduling of water dispensers and digital signage TVs produced 49% and 70% savings respectively with opportunities to improve performance with the use of HVAC occupancy data.

ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATION↗

The Suisun Summit 2022: Emerging Themes and Open Questions in qEEG and Neurotherapies

The Suisun Summit 2022 was a gathering of 70 clinicians, educators, and researchers in quantitative electroencephalography and neurofeedback. During this 5-day event, several themes emerged in talks or discussion groups: EEG/qEEG Reading Skills; Medication Effects and Pharmaco-EEG; Technological Advancements; Emerging Concerns; and Growing Community Prestige through Research. Participants were asked to summarize what they believed to be the most important messages from the event to share with colleagues who were not in attendance, resulting in this review. A unifying concept for all the themes was a desire for higher quality, standardized EEG/qEEG education that provides depth as well as breadth. Models of clinical care that encourage open communication with prescribers and functional medicine specialists were strongly emphasized. Abstracts from all presentations are attached in Addendum B.

60 APPLIED LIFE SCIENCES↗

Application of Manufacturing Quality Management Principles to PV System Installations

To help SETO/DOE achieve its goals, the IBTS team proposed a project addressing system reliability by improving installation standards and quality management. The proposed approach was designed to help achieve measurable reductions in installation defect density and improvements in the performance of PV systems by optimizing design and installation of residential and commercial PV systems. This approach addressed the soft costs associated with installations and quality management. The project demonstrated improved system reliability and reduced PV system installation costs. The software developed improved operations, decreased risk, and increased the overall value of PV systems across their lifecycle. The project used several data collection methods, including extensive industry surveys, face-to-face high-level interviews at industry conferences, stakeholder teleconferences, and in-depth interviews conducted by IBTS staff. Results from the research found the industry needs a uniform assessment method for national providers to be more efficient; the software should support both code officials and installers; most industry stakeholders would find value in a centralized software system that allows them to collect, report, and review information on in-process and completed solar installations; and mobile solutions that bridge existing knowledge gaps with inspectors and integrate with existing methodologies (such as permitting software) are of great value. The software solution developed is web-based, allowing for national access, and is built on a Google Firebase platform that can handle significant users and data. It can be used onsite or remotely, allowing for code compliance to continue despite ongoing pandemic related delays or shutdowns for local economies. The information provided by the software tool allows users to uniformly assess a system for compliance and use that aggregated data to identify training topics or create internal process designed to improving issues and reducing occurrence. This solution has multiple benefits in managing quality at time of use and promoting an increase in future safety and quality through education. Perhaps most importantly, this software increases public safety by ensuring compliance of installed systems and allows for local AHJs to remotely engage specialized and qualified solar specific expertise for oversite of the installation in their jurisdictions. Data analysis provides the quality feedback loop identifying the root cause of failure and drives installation practices to improve through training and education, resulting in systems with higher performance, greater reliability, and reduced operations and maintenance costs. With the successful completion of this project, the industry can expect reduced soft costs and increased performance and safety and will ultimately benefit from longer performing systems that cost less to operate.

14 SOLAR ENERGY↗

Residential Solar-Adopter Income and Demographic Trends: 2024 Update [Slides]

The report describes income, demographic, and other socio-economic trends among U.S. residential rooftop solar adopters. The report is based on address-level data for roughly 4.1 million residential rooftop solar systems installed through 2023, representing 87% of all U.S. systems. With its unique size, geographic scope, and level of detail, this report is intended to serve as a foundational reference document for policy-makers, industry stakeholders, and researchers. Key findings include the following: -The median income of households that installed solar in 2023 was about $\$$115k/year, compared to a U.S. median of $\$$75k/year for all households and $\$$94k/year for all U.S. owner-occupied households. -Compared to owner-occupied households in the same state, 2023 solar-adopter incomes were 7% higher in the median case, and in 10 states, median solar-adopter incomes were below the corresponding median income for all owner-occupied households. -Roughly 49% of solar adopters in 2023 had incomes below 120% of their area median income (AMI), a threshold sometimes used to define “low-and-moderate income” (or LMI), while 26% were below 80% of AMI, often used to define “low-income”. -Solar adoption continues to shift toward less affluent households over time, with the median present-day income of solar adopters dropping from $\$$141k for households that installed systems in 2010 to $\$$115k in 2023. -PV systems installed in 2023 by households earning less than $\$$50k had a median size of 6.4 kW, 33% were third-party owned, and 6% included battery storage, compared to corresponding values of 8.0 kW, 18%, and 14% for households earning more than $\$$200k. -Compared to all households in their respective state, solar adopters in 2023 were slightly more likely to be college educated and to live in rural areas; had higher home values; and were more likely to live outside a disadvantaged community (DAC), be middle-aged, identify as non-Hispanic white, work in a business or financial occupation, and own a single-family home. In conjunction with the report, Berkeley Lab has published an updated accompanying set of online data visualizations that allow users to further explore the underlying data. Berkeley Lab is also offering related analytical support to states, local agencies, and other organizations on issues related to solar adoption among low-to-moderate income households; requests for analytical support may be submitted through this online form.

14 SOLAR ENERGY↗

Accuracy of self‐reported weight, height and body mass index among older people in Japan

Aim Weight and height are usually self‐reported in population‐based epidemiological surveys. While the accuracy of self‐reports has been extensively studied in younger populations, less is known in older populations. We investigated the accuracy of self‐reported weight, height and body mass (BMI) in an older cohort in Japan, where overweight/obesity and underweight coexist. Methods We used data from older Japanese adults (≥65 years) participating in the Japan Gerontological Evaluation Study in 2016 to 2017 (7357 men and 9271 women). Self‐report data were linked to objective data obtained from clinical examinations. Results The mean ± standard deviation (SD) age was 74.5 ± 5.8 years, mean ± SD weight, height and BMI were 55.7 ± 10.1 kg, 156.0 ± 8.9 cm and 22.8 ± 3.1, respectively. Results showed high intraclass correlation coefficients for self‐reported and measured values (0.97 for weight; 0.96 for height). While weight/height were overestimated among men (weight by 0.096 kg; height by 0.27 cm) and women (weight by 0.18 kg; height by 0.27 cm), BMI tended to be slightly underestimated (−0.034 kg/m 2 for men; −0.037 kg/m 2 for women). However, the absolute differences between self‐reported and measured values were not negligible; people had a higher risk for both under‐ and overestimation of their BMI category with increasing age. Lower education predicted BMI overestimation, whereas lower income predicted BMI underestimation. Conclusions Overall accuracy of self‐reported body habitus was higher in this cohort of older Japanese compared with previous reports. Nevertheless, misclassification of BMI due to the misreporting of their weight/height was more common among the oldest‐old, as well as those with lower education and income. Geriatr Gerontol Int 2020; 20: 803–810 .

Yazawa, Aki↗

A data-driven mobility–energy typology framework for New York State

Exploring multidimensional aspects of differences in technology adoption, travel, and vehicle ownership across settlement types can help inform energy-efficient and affordable mobility system goals. Concurrently, mapping key enablers, barriers, and risks for successfully meeting ambitious goals and targets (e.g. by geography, age, income, education, population density) offer important explanatory power as to context-specific challenges and opportunities. This paper explores how a highly geographically resolved understanding of social, economic, techno-infrastructural, environmental, and governance (SET EG) factors shape variations in technology adoption and associated mobility and energy outcomes in diverse communities of New York State, in terms of electric vehicle adoption rates, alternative commute mode choices, vehicles per household, and vehicle fuel economy. Results indicate the range of two to three times higher adoption rates for electric vehicles by more highly educated, wealthier, “Core Urban” populations relative to the other identified typologies, given the labels “Rural”, “Suburban”, and “Urban” populations. Additionally, commute mode choice is closely linked with population and employment density—more than 89% of Core Urbanites use transit or active modes, compared with just 26% and 18% of Suburban and Rural residents, respectively. Household vehicle ownership varies from approximately 1.9 vehicles per household in Rural areas to only 0.6 in Core Urban settings. Findings on differences among the four settlement types, which go beyond simply rural to urban contexts, suggest an important need to explore how best to manage and anticipate very different types of services that may be supportive in achieving energy-efficient and affordable mobility systems statewide.

54 ENVIRONMENTAL SCIENCES↗

Residential Solar-Adopter Income and Demographic Trends: 2023 Update [Slides]

The report describes income, demographic, and other socio-economic trends among U.S. residential rooftop solar adopters. The report is based on address-level data for roughly 3.4 million residential rooftop solar systems installed through 2022, representing 86% of all U.S. systems. With its unique size, geographic scope, and level of detail, this report is intended to serve as a foundational reference document for policy-makers, industry stakeholders, and researchers. Key findings include the following: (1) Median solar adopter income was about $\$117$k/year in 2022, compared to a U.S. median of about $\$69$k/year for all households and $\$86$k/year for all owner-occupied households; (2) The degree of income skew varies significantly across all states, but all exhibit some positive income skew relative to all households in the state, with median solar-adopter incomes ranging from 108-180% of the respective state-median income for all households; (3) Roughly 45% of solar adopters in 2022 had incomes below 120% of their area median income (AMI), a threshold sometimes used to define “low-and-moderate income” (or LMI), while 23% were below 80% of AMI, often used to define “low-income”; (4) Solar adoption continues to shift toward less affluent households, with the median current income of solar adopters dropping from $\$140$k for households that installed systems in 2010 to $\$117$k in 2022; (5) PV systems installed in 2022 by households earning less than $50k had a median size of 6.1 kW, 34% were third-party owned, and 5% included battery storage, compared to corresponding values of 7.6%, 17%, and 15% for households earning more than 200 dollars k; and (6) Compared to all households in their respective state, solar adopters tend to be negligibly more rural; have higher home values; and are more likely to be college educated, identify as non-Hispanic white, live outside a disadvantaged community (DAC), be middle-aged, work in a business or financial occupation, and own a single-family home In conjunction with the report, Berkeley Lab has published an updated accompanying set of online data visualizations that allow users to further explore the underlying data. Berkeley Lab is also offering related analytical support to states, local agencies, and other organizations on issues related to solar adoption among low-to-moderate income households.

14 SOLAR ENERGY↗

Using Robotic Manipulators for Radioactive Waste Inspection - 20090

The global nuclear industry has a growing volume of nuclear waste which needs to be scanned, sorted according to its activity and material type, then processed into the correct waste packages for long term storage and disposal. It is vital that there is a detailed understanding of the waste inventory stored in long term waste containers, as knowledge of their contents could predict or prevent any adverse effects in storage. The numerous 'scan and sort' tables which are currently used at many different facilities around the world to sort waste into their correct containers are human operated and require very slow gamma scanning procedures combined with educated guesswork to manually sort the waste. This often leads to excessive conservatisms, with placement of lower activity wastes in higher activity containers, which in turn costs significantly more to store. In the United Kingdom it costs UK Pounds 46 k per cubic meter to store intermediate level waste compared to just UK Pound 2.9 k per cubic meter to store low level waste according to a 2008 Department of Energy and Climate Change report in the UK. A proposed solution to this problem, is the use of a robotic manipulator to automatically inspect the 'scan and sort table' in order to produce an accurate 3D model of the table's waste contents and attach an overlaid radiation map. The radiation map contains spectrometry data and can in consequence be used to distinguish and locate specific radioisotopes. The 3D model should be as accurate as possible in order to allow for a second robot arm with an attached gripper to grasp the objects and place them into their designated long-term storage container. Various scanning procedures are explored in this study including basic raster scanning, adaptive raster scanning and point sampling. The optimal solution will in practice be defined by the required application and activity level of the wastes being inspected. The results presented in this study indicate that it is possible to produce a centimeter accurate 3D model of a mixed assortment of components on a nuclear waste 'scan and sort' table. In addition, it was shown that the waste objects emitting radiation could be accurately identified and located, with an overlaid radiation map. This study is applicable across the nuclear waste management sector. Many of the ideas and concepts developed in this study are applicable in other decommissioning settings for example, dismantling of legacy gloveboxes or routine inspection of nuclear waste packages in storage. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Opportunities to Expand Building Efficiency Programming at Community Colleges

According to the most recent U.S. Energy and Employment Report, more than 2.3 million workers in the United States are involved in activities that reduce energy usage in buildings. This workforce supports energy efficiency from the design of buildings and their systems through the manufacturing and trade of components and supplies involved in these systems to the installation, repair, and maintenance of these systems. Less than 10% of the workers in key building efficiency occupations have a bachelor’s or higher degree, compared to ~40% of the general workforce. Thus, the community college system is a key stakeholder in training and educating a large portion of the building efficiency workforce. Despite this, the literature review conducted for this report found almost no research focused on better understanding and supporting the role of community colleges as they train this workforce at scale. This report seeks to understand how and to what extent building efficiency and advanced building technology concepts are being addressed in community colleges as well as potential pathways for schools to consider to better prepare students to enter the building efficiency industry. The first section presents information from a literature review and data analysis to provide background on the building efficiency workforce, the types of building efficiency training and education available from community colleges, and the barriers and challenges that exist in the workforce. The second section offers a series of case studies that illustrate the various ways that building efficiency content can be addressed at community colleges. The final section provides an overview of the opportunities available to community colleges as well as considerations for schools that want to increase building efficiency programming.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

Commuter preferences for a first-mile/last-mile microtransit service in the United States

Transportation system models rely heavily upon value of time (VOT) estimates to predict customer behavior. Accurate VOT estimates are particularly vital for planning new services such as on-demand ride hailing or microtransit because customers’ sensitivity to wait time, walk time, and route detour time affects their likelihood of selecting these modes. If an incorrect VOT is assumed during service planning, then ridership will be depressed because of a mismatch between their preferences and how the system is designed. In this paper, we report on the measurement of VOT for microtransit, a shared first-mile/last-mile mobility service, obtained using stated preference microdata from four U.S. cities. Here, we found a median in-vehicle VOT for microtransit of $\$$18.63 (95% CI: $\$$13.39–$\$$24.46) and an access VOT of $\$$75.38 (95% CI: $\$$59.22–$\$$94.96). The former is practically equal to the VOT we found for respondents’ current modes ($\$$20.24, 95% CI: $\$$13.71–$\$$26.94). We also found that men, younger riders, the highly educated, and transit riders are more likely to be interested in microtransit. Since the disutility of time spent on microtransit is not higher than that of other modes, we believe this new service has the potential to attract riders, and particularly if the system is designed with low waiting and walking times.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

Prevalence of Self-Reported Bothersome Tinnitus in U.S. Army Soldiers From January 1, 2015, Through September 30, 2019

Purpose: Tinnitus is a symptom of auditory dysfunction or injury and can be a precursor to permanent hearing loss. Tinnitus can interfere with communication, sleep, concentration, and mood; when this occurs, it is referred to as bothersome tinnitus. Annual hearing surveillance in the U.S. Army includes screening for bothersome tinnitus. Estimating the prevalence of self-reported bothersome tinnitus can facilitate prioritization of prevention and education efforts. The objective of this study was to examine Army hearing conservation data to estimate the prevalence of self-reported bothersome tinnitus as a function of age, hearing, sex, service component, and pay grade. Method: The study employed a cross-sectional, retrospective design. Records from 1,485,059 U.S. Army Soldiers retrieved from the Defense Occupational and Environmental Health Readiness System–Hearing Conservation were analyzed. Descriptive statistics and multinomial logistic regression analysis were used to estimate the prevalence of bothersome tinnitus and its associations with Soldiers' demographic characteristics. Results: The estimated prevalence of self-reported bothersome tinnitus was 17.1% between January 1, 2015, and September 30, 2019; 13.6% of the Soldiers reported “bothered a little” and 3.5% reported “bothered a lot.” Proportionally, the prevalence of self-reported bothersome tinnitus was higher for males, older Soldiers, and Reserve Component Soldiers. For every 1-year increase in age, the odds of self-reporting “bothered a little” tinnitus relative to “bothered not at all tinnitus” would be expected to increase by 2.2% (2.1%, 2.3%), and the odds of self-reporting “bothered a lot” tinnitus relative to “bothered not at all” tinnitus would be expected to increase by 3.6% (3.5%, 3.7%). Conclusions: The self-reported prevalence of bothersome tinnitus in the U.S. Army (17.1%) is substantially higher than that of the general population, where prevalence of bothersome tinnitus is estimated at 6.6%. Examination of bothersome tinnitus among Soldiers is an important step toward optimizing prevention, education, and intervention efforts.

Audiology & Speech-Language Pathology↗

Willingness to Receive mHealth Services Among Patients with Diabetes on Chronic Follow-up in Public Hospitals in Eastern Ethiopia: Multicenter Mixed-Method Study

Background: Management of diabetes requires a long-term care strategy, including support for adherence to a healthy lifestyle and treatment. Exploring the willingness of patients with diabetes to receive mHealth services is essential for designing efficient and effective services. This study aimedto determine willingness to receive mHealth services and associated factors, as well as explore the barriers to receive mHealth services among patients with diabetes. Methods: A multicenter mixed-method study was employed from September 1 to November 30, 2022. For the quantitative part, a total of 365 patients with diabetes receiving chronic follow-up at three public hospitals were enrolled. Data were gathered using structured questionnaires administered by interviewers, entered into Epi-data version 4.6, and analyzed using Stata version 17. A binary and multivariable logistic regression model was computed to identify the associated factors. For qualitative, eight key informants and seven in-depth interviews were conducted. After verbatim transcription and translation, the data were thematically analyzed using ATLAS.ti V. 7.5. Results: Overall, 77.3% had access to a mobile phone, and 74.5% of them were willing to receive mHealth services. Higher odds of willingness to receive mHealth services were reported among patients with an age below 35 years [AOR = 4.11 (1.15– 14.71)], attended formal education [AOR = 2.63 (1.19– 5.77)], without comorbidity [AOR = 3.6 (1.54– 8.41)], < 1-hour travel to reach a health facility [AOR = 3.57 (1.03– 12.36)], answered unknown calls [AOR = 2.3 (1.04– 5.13)], and were satisfied with health-care provider service [AOR = 2.44 (1.04– 5.72)]. In the qualitative part, infrastructure, health facilities, socioeconomic factors, and patients’ behavioral factors were major identified barriers to receiving mHealth services. Conclusion: In this study, the willingness to receive mHealth services for those who have access to mobile phones increased. Additionally, the study highlighted common barriers to receiving mHealth services.

60 APPLIED LIFE SCIENCES↗

A National Secure-by-Design Strategy

The US National Cybersecurity Strategy published March 2, 2023 uses plain language to communicate that the US is calling for a major change in how we prioritize the security of software systems used in critical infrastructure. It acknowledges that our current approach, which is essentially, “let the buyer beware,” leaves entities who are least able to assess or defend vulnerable software responsible for the impacts of designed-in weaknesses while the makers of the technology bear no liability. The strategy recommends a security-by-design approach, recommending that software vendors be held liable to uphold a “duty of care” to consumers and for systems to be designed to “fail safely and recover quickly” . For energy infrastructure, the strategy calls out the need to implement the National Cyber-Informed Engineering Strategy to achieve higher confidence security for energy infrastructures. The Idaho National Laboratory, a pioneer in cyber-informed engineering concepts, is at the forefront of organizations educating others in industry, academia, and government on how to apply these concepts to real-world challenges. In this brief, we'll outline some of the basic principles of security-by-design and offer examples of how, in a water sector context, they're being put into successful practice.

42 ENGINEERING↗