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At least 127 records · Page 7
All sourcesNASA NTRSDOE OSTI
DOE OSTI2023

Bullying among children with heart conditions, National Survey of Children’s Health, 2018–2020

Abstract Children with chronic illnesses report being bullied by peers, yet little is known about bullying among children with heart conditions. Using 2018–2020 National Survey of Children’s Health data, the prevalence and frequency of being bullied in the past year (never; annually or monthly; weekly or daily) were compared between children aged 6–17 years with and without heart conditions. Among children with heart conditions, associations between demographic and health characteristics and being bullied, and prevalence of diagnosed anxiety or depression by bullying status were examined. Differences were assessed with chi-square tests and multivariable logistic regression using predicted marginals to produce adjusted prevalence ratios and 95% confidence intervals. Weights yielded national estimates. Of 69,428 children, 2.2% had heart conditions. Children with heart conditions, compared to those without, were more likely to be bullied (56.3% and 43.3% respectively; adjusted prevalence ratio [95% confidence interval] = 1.3 [1.2, 1.4]) and bullied more frequently (weekly or daily = 11.2% and 5.3%; p < 0.001). Among children with heart conditions, characteristics associated with greater odds of weekly or daily bullying included ages 9–11 years compared to 15–17 years (3.4 [2.0, 5.7]), other genetic or inherited condition (1.7 [1.0, 3.0]), ever overweight (1.7 [1.0, 2.8]), and a functional limitation (4.8 [2.7, 8.5]). Children with heart conditions who were bullied, compared to never, more commonly had anxiety (40.1%, 25.9%, and 12.8%, respectively) and depression (18.0%, 9.3%, and 4.7%; p < 0.01 for both). Findings highlight the social and psychological needs of children with heart conditions.

Cardiovascular System & Cardiology↗
DOE OSTI2021

Accelerating phase-field-based microstructure evolution predictions via surrogate models trained by machine learning methods

Abstract The phase-field method is a powerful and versatile computational approach for modeling the evolution of microstructures and associated properties for a wide variety of physical, chemical, and biological systems. However, existing high-fidelity phase-field models are inherently computationally expensive, requiring high-performance computing resources and sophisticated numerical integration schemes to achieve a useful degree of accuracy. In this paper, we present a computationally inexpensive, accurate, data-driven surrogate model that directly learns the microstructural evolution of targeted systems by combining phase-field and history-dependent machine-learning techniques. We integrate a statistically representative, low-dimensional description of the microstructure, obtained directly from phase-field simulations, with either a time-series multivariate adaptive regression splines autoregressive algorithm or a long short-term memory neural network. The neural-network-trained surrogate model shows the best performance and accurately predicts the nonlinear microstructure evolution of a two-phase mixture during spinodal decomposition in seconds, without the need for “on-the-fly” solutions of the phase-field equations of motion. We also show that the predictions from our machine-learned surrogate model can be fed directly as an input into a classical high-fidelity phase-field model in order to accelerate the high-fidelity phase-field simulations by leaping in time. Such machine-learned phase-field framework opens a promising path forward to use accelerated phase-field simulations for discovering, understanding, and predicting processing–microstructure–performance relationships.

36 MATERIALS SCIENCE↗
DOE OSTI2024

Market optimization and technoeconomic analysis of hydrogen-electricity coproduction systems

Decarbonization efforts across North America, Europe, and beyond rely on variable renewable energy sources such as wind and solar, as well as alternative fuels, such as hydrogen, to support the sustainable energy transition. These advancements have prompted a need for more flexibility in the electric grid to complement non-dispatchable energy sources and increased demand from electrification. Integrated energy systems are well suited to provide this flexibility, but conventional technoeconomic modeling paradigms neglect the time-varying dynamic nature of the grid and thus undervalue resource flexibility. In this work, we develop a computational optimization framework for dynamic market-based technoeconomic comparison of integrated energy systems that coproduce low-carbon electricity and hydrogen (e.g., solid oxide fuel cells, solid oxide electrolysis) against technologies that only produce electricity (e.g., natural gas combined cycle with carbon capture) or only produce hydrogen. Our framework starts with rigorous physics-based process models, built in the open-source Institute for the Design of Advanced Energy Systems (IDAES) modeling and optimization platform, for six energy process concepts. Using these rigorous models and a workflow to optimally design each technology, the framework is shown to be capable of evaluating new and emerging technologies in varying energy markets under a plethora of future scenarios (i.e., renewables penetration, carbon tax, etc.). Ultimately, our framework finds that solid oxide fuel cell-based coproduction systems achieve positive profits for 85% of the analyzed market scenarios. From these market optimization results, we use multivariate linear regression (R 2 values up to 0.99) to determine which electricity price statistics are most significant to predict the optimized annual profit of each system. The proposed framework provides a powerful tool for directly comparing flexible, multi-product energy process concepts to help discern optimal technology and integration options.

08 HYDROGEN↗
DOE OSTI2021

Dynamic Transcriptomic and Phosphoproteomic Analysis During Cell Wall Stress in Aspergillus nidulans

The fungal cell-wall integrity signaling (CWIS) pathway regulates cellular response to environmental stress to enable wall repair and resumption of normal growth. This complex, interconnected, pathway has been only partially characterized in filamentous fungi. To better understand the dynamic cellular response to wall perturbation, a β-glucan synthase inhibitor (micafungin) was added to a growing A. nidulans shake-flask culture. From this flask, transcriptomic and phosphoproteomic data were acquired over 10 and 120 min, respectively. To differentiate statistically-significant dynamic behavior from noise, a multivariate adaptive regression splines (MARS) model was applied to both data sets. Over 1800 genes were dynamically expressed and over 700 phosphorylation sites had changing phosphorylation levels upon micafungin exposure. Twelve kinases had altered phosphorylation and phenotypic profiling of all non-essential kinase deletion mutants revealed putative connections between PrkA, Hk-8–4, and Stk19 and the CWIS pathway. Our collective data implicate actin regulation, endocytosis, and septum formation as critical cellular processes responding to activation of the CWIS pathway, and connections between CWIS and calcium, HOG, and SIN signaling pathways.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2022

Analysis of implant loss risk factors after simultaneous guided bone regeneration: A retrospective study of 5404 dental implants

Abstract Purpose The purpose was to analyze the risk factors for implant loss after simultaneous guided bone regeneration (GBR). Materials and Methods Patients who underwent implant placement with simultaneous GBR between January 2011 and December 2018 were screened for this study. The cumulative survival rate (CSR) was calculated using the life table method. Log‐rank test and Kaplan–Meier survival estimates were used to identify potential risk factors for implant loss. The association between the investigated variables and implant loss was determined using hazard ratios (HRs) obtained from a multivariate Cox regression analysis. Results A total of 3973 patients with 5404 implants were included in this study. The CSRs of the implants at 1, 5, and 10 years were 99.6%, 98.9%, and 98.7%, respectively. Male patient (HR = 2.94, 95% CI: 1.41–6.14), periodontitis (HR = 4.26, 95% CI: 2.05–9.86), tissue‐level implants (HR = 3.02, 95% CI: 1.30–6.98), narrow implants (HR = 2.71, 95% CI: 1.12–6.57), and implant length ≤10 mm (HR = 2.91, 95% CI: 1.41–6.02) significantly increased the risk of implant loss ( p < 0.05). The risk of implant loss was significantly higher in the maxillary posterior region (HR = 2.26, 95% CI: 1.04–4.90) than in the maxillary anterior region ( p < 0.05). Compared to Straumann, Nobel (HR = 4.07, 95% CI: 1.75–9.44) and other implant systems (HR = 14.23, 95% CI: 4.32–46.85) showed a significantly higher risk of implant loss ( p < 0.05). Conclusion Male patient, periodontitis, maxillary posterior region, Nobel implant system, other implant systems, tissue‐level implants, narrow implants, and implant length ≤10 mm were considered risk factors for implant loss after simultaneous GBR.

Shen, Xiaoting↗
DOE OSTI2020

Clusters of COVID ‐19 in long‐term care hospitals and facilities in Japan from 16 January to 9 May 2020

Aim To clarify the association of cluster number and size of coronavirus disease 2019 (COVID‐19) in long‐term care (LTC) hospitals/facilities, general medical/welfare facilities and non‐medical/welfare facilities with morbidity and mortality in 47 prefectures during 16 January to 9 May 2020 in Japan. Methods Information on COVID‐19 clusters ( n ≥2), and morbidity and mortality of COVID‐19 was collected. Results A total of 381 clusters with 3786 infected cases were collected, accounting for 23.9% of 15 852 cumulated cases on 9 May 2020. Although the cluster number (/10 7 subjects) in LTC hospitals/facilities was significantly smaller compared with those in the other two groups, the cluster size in LTC hospitals/facilities was significantly larger than that in non‐medical/welfare facilities. Cluster numbers in general medical/welfare facilities and in non‐medical/welfare facilities were significantly positively correlated with morbidity (/10 5 ), indicating relatively early identification of clusters in these facilities. Unlike in these facilities, cluster size in LTC hospitals/facilities was significantly positively correlated with morbidity, indicating that clusters in LTC hospitals/facilities were finally identified after already having grown to a large size in areas where infection was prevalent. Multivariate logistic regression analysis showed that both cluster number and cluster size only in LTC hospitals/facilities were independently associated with higher mortality (≥median 0.64/10 5 subjects) after adjustment. Conclusions Preventive efforts against COVID‐19 outbreaks even at the early phase of the epidemic are critically important in LTC hospitals/facilities, as both the larger number and size of clusters only in LTC hospitals/facilities were independently linked to higher mortality in prefectures in Japan. Geriatr Gerontol Int 2020; 20: 715–719 .

Iritani, Osamu↗
DOE OSTI2022

Learning the Temporal Effect in Infrared Thermal Videos With Long Short-Term Memory for Quality Prediction in Resistance Spot Welding

With the advances of sensing technology, in-situ infrared thermal videos can be collected from Resistance Spot Welding (RSW) processes. Each video records the formulation process of a weld nugget. The nugget evolution creates a “temporal effect” across the frames, which can be leveraged for real-time, nondestructive evaluation (NDE) of the weld quality. Currently, quality prediction with imaging data mainly focuses on optical feature extraction with Convolutional Neural Network (CNN) but does not make the most of such temporal effect. In this study, pixels corresponding to critical locations on the weld nugget surface are extracted from a video to form multivariate time series (MTS). Multivariate Adaptive Regression Splines (MARS) is used in MTS processing to remove noisy signals related to uninformative frames. A Stacked Long Short-Term Memory (LSTM) model is developed to learn from the processed MTS and then predicts weld nugget size and thickness in real-time NDE. Results from a case study on RSW of Boron steel demonstrates the improvement in prediction accuracy and computational time with the proposed method, as compared to CNN-based weld quality prediction.

Guo, Shenghan↗
DOE OSTI2022

Landmark-Warped Emulators for Models with Misaligned Functional Response

Many computer models output functional data, and in some cases, these functional data have similar, but misaligned, shape characteristics. In this paper, we introduce a general approach for building emulators for computer models that output misaligned functional data when key values in the functional response (landmarks) can be easily identified. This approach has two main parts: modeling the aligned (using the landmarks) functional data, and modeling the functions that map the misaligned data to the aligned space (warping functions). As the warping functions are required to be monotonic, we give special attention to modeling monotonic functional response data. We discuss how our approach can be easily applied for a variety of typical emulators, such as Gaussian processes, Bayesian multivariate adaptive regression splines, and Bayesian additive regression trees, and how sensitivity analysis can be performed. We demonstrate our approach by building emulators for two applications: (1) a high-energy-density physics computer model used to simulate inertial confinement fusion ignition experiments, where model outputs are highly misaligned, and (2) a multiphysics continuum hydrocode used to simulate high-velocity impact experiments, where model outputs are only slightly misaligned. In case (1) traditional methods cannot be applied, while in (2) they can be applied, but the proposed method performs significantly better.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2023

Concordance

Dimension reduction techniques have long been an important topic in statistics, and active subspaces (AS) have received much attention this past decade in the computer experiments literature. The most common approach towards estimating the AS is to use Monte Carlo with numerical gradient evaluation. This software takes a new approach towards estimating the active subspace, in which Multivariate Adaptive Regression Splines (MARS) is used as a surrogate model, and relevant calculation are obtained analytically. Using a MARS surrogate has many advantages including improved scaling, better estimation of active subspaces in high dimensions and the ability to handle a large number of prior distributions in closed form. This software is also capable of conducting a so-called "concordance analysis", using a generalization of ASs which we refer to as "Co-Active" subspaces.

Rumsey, Kelin↗
DOE OSTI2021

Spatial and temporal trends and variabilities of hailstones in the United States Northern Great Plains and their possible attributions

Following on our study of hail for the Southern Great Plains (SGP), we investigated the spatial and temporal hail trends and variabilities for the Northern Great Plains (NGP) and the contributing factors for summer seasons (June–August) over 2004–2016 using two independent hail datasets. Both severe hail (1 < diameter = 2 inches) and significant severe hail (diameter > 2 inches) were examined and similar results were obtained. The hailstones in the NGP demonstrate a large interannual variability, with an overall increasing trend over 2004–2016. Spatially, the positive trend is mainly located in the western part of South Dakota and North Dakota. We find the three major dynamical factors that most likely contribute to the hail interannual variability in the NGP are the El Niño-Southern Oscillation (ENSO), North Atlantic subtropical high (NASH), and low-level jet (LLJ). With a thermodynamical variable integrated water vapor transport (IVT) that is strongly controlled by LLJ, the four factors can explain 76% of the hail interannual variability from the hail reports based on the multivariate linear regression. Hail occurrences are 73% higher during the cold phase of ENSO (La Nin~a) than the warm phase of ENSO (El Nin~o). When the NASH has a larger northwestward expansion or stronger intensity, more hail occurs over the NGP, because the increases of latitudinal gradient of pressure leads to a stronger LLJ. Interestingly, the important factors impacting hail interannual variability over the NGP are quite different from those for the SGP, except ENSO.

Jeong, Jong-Hoon↗
DOE OSTI2020

Factors Influencing Willingness to Pool in Ride-Hailing Trips

In the past decade, transportation network companies (TNCs) such as Uber, Lyft, and Via have established themselves as a viable transportation alternative to other modes. However, the popularity of these services has come with a fair share of criticism for their negative externalities such as increasing vehicle miles traveled and congestion in cities. Pooled ride-hailing trips, in which all or a part of two individual (or group) trips are combined in and served by a single vehicle, have the potential to reduce these externalities. Pooling of rides is an effective solution to reduce congestion and travel cost, but pooled rides still represent a small percentage of the total trips served (and miles driven) by TNCs relative to single-occupancy (and without customer) vehicle miles. Both TNCs and cities alike will benefit from understanding what factors encourage or deter pooling a ride-hailing trip. In this study, newly available Chicago transportation network provider data were explored to identify the extent to which different socioeconomic, spatiotemporal, and trip characteristics affect willingness to pool (WTP) in ride-hailing trips. Furthermore, multivariate linear regression and machine-learning models were employed to understand and predict WTP based on location, time, and trip factors. The results show intuitive trends, with income level at drop-off and pickup locations and airport trips as the most important predictors of WTP. Results from this study can help TNCs and cities devise strategies that increase pooled ride-hailing, thereby reducing adverse transportation and energy impacts from ride-hailing modes.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
DOE OSTI2023

Predicting Postoperative Injury and Military Discharge Status After Knee Surgery in the US Army

Background: Researchers have assessed postoperative injury or disability predictors in the military setting but typically focused on 1 type of surgical procedure at a time, used relatively small sample sizes, or investigated mixed cohorts with civilian populations. Purpose: To identify the relationship between baseline variables and injury incidence or military discharge status in US Army soldiers after knee surgery. Study Design: Case-control study; Level of evidence, 3. Methods: Data were obtained from a repository containing personnel, performance, and medical records for all active-duty US Army soldiers. Multivariate logistic regressions were used to estimate the effects of numerous variables on postoperative injury or on medical discharge. Variable selection and model validation were conducted using the k-fold method. Results: A total of 7567 soldiers underwent knee surgery between 2017 and 2019. Meniscal procedures were the most common type of surgery (39%), and approximately 71% of the cohort had a postoperative injury. Significant predictors for sustaining a postoperative injury included having a previous nonknee injury (odds ratio [OR], 1.5), female sex (OR, 1.3), and Black race (OR, 1.2). Within 4 years after surgery, 17% of soldiers were discharged from the military because of knee-related disability. Significant predictors for discharge from duty included enlisted rank (OR, 2.3), recent fitness test failure (OR, 1.9), number of previous knee surgeries (OR, 1.7), and having a previous nonknee injury (OR, 1.6). Conclusion: After knee surgery, nearly three-fourths of the soldiers in this cohort sustained a postoperative injury and almost one-fifth of soldiers were medically discharged from the military within 4 years. This study identified variables that indicate statistically increased risk for these postoperative outcomes and highlighted potentially modifiable factors.

Orthopedics↗
DOE OSTI2023

Contraceptive Sabotage and Contraceptive Use at the Time of Pregnancy: An Analysis of People with a Recent Live Birth in the United States

Contraceptive sabotage and other forms of intimate partner violence (IPV) can interfere with contraceptive use. We used 2012 to 2015 Pregnancy Risk Assessment Monitoring System data from 8,981 people residing in five states who reported that when they became pregnant, they were not trying to get pregnant. We assessed the relationships between ever experiencing contraceptive sabotage and physical IPV 12 months before pregnancy (both by the current partner) and contraceptive use at the time of pregnancy using multivariable logistic regression. We also assessed the joint associations between physical IPV 12 months before pregnancy and ever experienced contraceptive sabotage with contraceptive use at the time of pregnancy. Few people ever experienced contraceptive sabotage (1.8%; 95% confidence interval [CI]: 1.4, 2.3) or physical IPV 12 months before pregnancy (2.8%; 95% CI: 2.3, 3.3). In models adjusted for age, race/ethnicity, marital status, education, and state of residence, ever experiencing contraceptive sabotage was associated with contraceptive use at the time of pregnancy (adjusted odds ratio [aOR]: 1.73; 95% CI: 1.06, 2.82), but not with physical IPV 12 months before pregnancy (aOR: 0.69; 95% CI: 0.46, 1.02). When examining the joint association, compared to not ever experiencing contraceptive sabotage or physical IPV 12 months before pregnancy, ever experiencing contraceptive sabotage was significantly related to contraceptive use at the time of pregnancy (aOR: 1.72; 95% CI: 1.00, 2.95). However, it was not associated with experiencing physical IPV 12 months before pregnancy (aOR: 0.68; 95% CI: 0.45, 1.04) or with experiencing both contraceptive sabotage and physical IPV 12 months before pregnancy (aOR: 1.21; 95% CI: 0.42, 3.50), compared to not ever experiencing contraceptive sabotage or physical IPV 12 months before pregnancy. Our study highlights that current partner contraceptive sabotage may motivate those not trying to get pregnant to use contraception; however, all people in our sample still experienced a pregnancy.

Huber-Krum, Sarah↗
DOE OSTI2023

COVID-19 prevention at institutions of higher education, United States, 2020–2021: implementation of nonpharmaceutical interventions

Background, In early 2020, following the start of the coronavirus disease 2019 (COVID-19) pandemic, institutions of higher education (IHEs) across the United States rapidly pivoted to online learning to reduce the risk of on-campus virus transmission. We explored IHEs’ use of this and other nonpharmaceutical interventions (NPIs) during the subsequent pandemic-affected academic year 2020–2021. Methods, From December 2020 to June 2021, we collected publicly available data from official webpages of 847 IHEs, including all public (n = 547) and a stratified random sample of private four-year institutions (n = 300). Abstracted data included NPIs deployed during the academic year such as changes to the calendar, learning environment, housing, common areas, and dining; COVID-19 testing; and facemask protocols. We performed weighted analysis to assess congruence with the October 29, 2020, US Centers for Disease Control and Prevention (CDC) guidance for IHEs. For IHEs offering ≥50% of courses in person, we used weighted multivariable linear regression to explore the association between IHE characteristics and the summated number of implemented NPIs. Results, Overall, 20% of IHEs implemented all CDC-recommended NPIs. The most frequently utilized NPI was learning environment changes (91%), practiced as one or more of the following modalities: distance or hybrid learning opportunities (98%), 6-ft spacing (60%), and reduced class sizes (51%). Additionally, 88% of IHEs specified facemask protocols, 78% physically changed common areas, and 67% offered COVID-19 testing. Among the 33% of IHEs offering ≥50% of courses in person, having < 1000 students was associated with having implemented fewer NPIs than IHEs with ≥ 1000 students. Conclusions, Only 1 in 5 IHEs implemented all CDC recommendations, while a majority implemented a subset, most commonly changes to the classroom, facemask protocols, and COVID-19 testing. IHE enrollment size and location were associated with degree of NPI implementation. Additional research is needed to assess adherence to NPI implementation in IHE settings.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2021

Evaluating proxies for the drivers of natural gas productivity using machine-learning models

We report the extensive development of unconventional reservoirs using horizontal drilling and multistage hydraulic fracturing has generated large volumes of reservoir characterization and production data. The analysis of this abundant data using statistical methods and advanced machine-learning (ML) techniques can provide data-driven insights into well performance. Most predictive modeling studies have focused on the impact that different well completion and stimulation strategies have on well production but have not fully exploited the available in situ rock property data to determine its role in reservoir productivity. We have used machine-learning techniques to rank rock mechanical properties, microseismic attributes, and stimulation parameters in the order of their significance for predicting natural gas production from an unconventional reservoir. The data for this study came from a hydraulically fractured well in the Marcellus Shale in Monongalia County, West Virginia. The data classes included measurements aggregated by well completion stage that included (1) gas production, (2) well-log-derived measurements including bulk density, elastic moduli, shear impedance, compressional impedance, brittleness, and gamma measurements, (3) microseismic attributes, (4) long-period long-duration (LPLD) event counts, (5) fracture counts, and (6) stimulation parameters that included the fluid injection volume and average pumping pressure. To identify observable proxies for the drivers of gas production, we evaluated five commonly used ML approaches including multivariate adaptive regression spline, Gaussian mixture model, random forest, gradient boosting, and neural network. We selected five variables including LPLD event count, seismogenic b-value, hydraulic diffusivity, cumulative moment, and fluid volume as the features most likely to impact gas productivity at the stage level in the study area. The data-driven selection of these parameters for their importance in determining gas production can help reservoir engineers design more effective hydraulic-fracture treatments in the Marcellus Shale and other similar unconventional reservoirs. Plain language summary: We use machine-learning methods and data-driven selection of reservoir parameters to rank and better understand their importance in determining gas production, which can help reservoir engineers design more effective hydraulic-fracture treatments in the Marcellus Shale and other similar unconventional reservoirs.

58 GEOSCIENCES↗
DOE OSTI2024

Relationship Between Radiation Dose and Markers of Insulin Resistance and Inflammation in Atomic Bomb Survivors

Abstract Context In recent studies of childhood cancer survivors, diabetes has been considered a late effect associated with high therapeutic doses of radiation therapy. Our recent study of atomic bomb (A-bomb) survivors also suggested an association between radiation dose and diabetes incidence, with exposure city and age at exposure as radiation dose effect modifiers. Insulin resistance mediated by systemic inflammation and abnormal body composition has been suggested as a possible primary mechanism for the incidence of diabetes after total body irradiation; however, no studies have examined low to moderate radiation exposure (<4 Gy) and insulin resistance in A-bomb survivors. Objective To examine the association between radiation dose and markers of inflammation and insulin resistance. Methods This study investigated 3152 survivors who underwent a health examination between 2008 and 2012 and who were younger than 15 years at exposure. Multivariate linear regression analyses were used to evaluate the radiation effects on levels of markers of inflammation and insulin resistance. Results Radiation dose was significantly and positively associated with levels of C-reactive protein, triglycerides, homeostasis model assessment of β-cell function (HOMA-β), and HOMA of insulin resistance (HOMA-IR) after adjustment for relevant covariates including sex, city, and age at exposure. Adiponectin and high-density lipoprotein cholesterol levels were also associated significantly and negatively with radiation dose. However, city was not a dose modifier of the radiation response on these markers of inflammation and insulin resistance. Conclusion Insulin resistance might be a possible factor in radiation-related diabetes incidence in A-bomb survivors.

Endocrinology & Metabolism↗
DOE OSTI2023

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↗
DOE OSTI2020

TBASS: A Robust Adaptation of Bayesian Adaptive Spline Surfaces

The R package TBASS is an extension of the BASS package created by Francom and Sansó (2019). The package is used to fit a Bayesian multivariate adaptive spline to a dataset that either follows a Student’s t-distribution or has outliers. Much of the framework for TBASS is adapted from the concepts of Bayesian Multivariate Adaptive Regression Splines (BMARS), specifically the work done by Denison, Mallick, and Smith (1998). The spline function is fit using a Reversible-Jump Markov Chain Monte Carlo algorithm,. By including this more robust generalization, a dataset with outliers can be accurately fit using the BMARS model, without the possibility of overfitting or variance inflation.

97 MATHEMATICS AND COMPUTING↗