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We investigate two research questions using a recent statewide transition from paper to computer-based testing: first, the extent to which test mode effects found in prior studies can be eliminated; and second, the degree to which online and paper assessments offer different information about underlying student ability. We first find very small mode effects for a more recent transition in Massachusetts. Second, we investigate the predictive evidence of validity for paper and online tests for predictions of future test scores and grades. We generally find minimal differences for the extent to which scores on paper tests can differentially predict future online versus paper test scores. Finally, online and paper test scores are similarly predictive of future grade point average. We conclude that the online test penalty can vary substantially by test and that extreme care should be taken when administering online tests to some students and paper tests to others.

We investigate two research questions using a recent statewide transition from paper to computer-based testing: first, the extent to which test mode effects found in prior studies can be eliminated; and second, the degree to which online and paper assessments offer different information about underlying student ability. We first find very small mode effects for a more recent transition in Massachusetts. Second, we investigate the predictive evidence of validity for paper and online tests for predictions of future test scores and grades. We generally find minimal differences for the extent to which scores on paper tests can differentially predict future online versus paper test scores. Finally, online and paper test scores are similarly predictive of future grade point average. We conclude that the online test penalty can vary substantially by test and that extreme care should be taken when administering online tests to some students and paper tests to others. [ABSTRACT FROM AUTHOR]

Building extraction aims to extract building pixels from remote sensing imagery, which plays a significant role in urban planning, dynamic urban monitoring, and many other applications. UNet3+ is widely applied in building extraction from remote sensing images. However, it still faces issues such as low segmentation accuracy, imprecise boundary delineation, and the complexity of network models. Therefore, based on the UNet3+ model, this paper proposes a 3D Joint Attention (3DJA) module that effectively enhances the correlation between local and global features, obtaining more accurate object semantic information and enhancing feature representation. The 3DJA module models semantic interdependence in the vertical and horizontal dimensions to obtain feature map spatial encoding information, as well as in the channel dimensions to increase the correlation between dependent channel graphs. In addition, a bottleneck module is constructed to reduce the number of network parameters and improve model training efficiency. Many experiments are conducted on publicly accessible WHU,INRIA and Massachusetts building dataset, and the benchmarks, BOMSC-Net, CVNet, SCA-Net, SPCL-Net, ACMFNet, MFCF-Net models are selected for comparison with the 3DJA-UNet3+ model proposed in this paper. The experimental results show that 3DJA-UNet3+ achieves competitive results in three evaluation indicators: overall accuracy, mean intersection over union, and F1-score. The code will be available at https://github.com/EnjiLi/3DJA-UNet3Plus. [ABSTRACT FROM AUTHOR]

Precise road segmentation is an essential part of many applications related to road information extraction from remote sensing data. The effect of color space on road detection has rarely been studied. In this paper, the effects of different color spaces of aerial images and multitask learning methods were experimented on road segmentation using three deep convolutional neural networks, UNet, DenseU-Net, and RoadVecNet. The color spaces included RGB, HSV, LAB, YCbCr, and YUV. The multitask learning methods adopted in this study involved utilizing multiple inputs, and multiple outputs. Multiple inputs were aerial images from the same area with different color spaces, and multiple outputs were road segmentation and road outline segmentation. As remote sensing data, National Land Survey of Finland's true orthophotos (from 2020), Massachusetts road imagery dataset, and Ottawa dataset were applied. Segmentation masks for National Land Survey of Finland's true orthophotos were extracted from Digiroad vectors with road width information. Road outline masks were generated from the segmentation masks. The studied neural networks were trained with the same data, learning rate, loss function, and optimizer for each color space, and pairs of color spaces. Multiple outputs were experimented with RGB color space. The comparative analysis assessed the performance of various neural networks across different color spaces using the F1-score metric. The experimental findings indicate that the choice of color space has little influence on the results of neural networks Deep learning methods can adapt to different color spaces well. In addition, the use of sharpening and edge enhancement augmentations had a slight effect on the results. [ABSTRACT FROM AUTHOR]

Background: To address the need for interventions for families with parents with mental illness, the evidence-based intervention Let's Talk about Children (LTC) was adapted in the context of adult mental health services in the United States and reframed as the ParentingWell Practice Approach. This study focuses on the early implementation phase of the adapted practice in Massachusetts. Methods: As part of the adaptation and implementation process, practitioners from provider agencies serving adults with mental illness were invited to participate in the ParentingWell Learning Collaborative (PWLC), which included in-person learning collaborative sessions and follow-up virtual coaching sessions. This paper focuses on data obtained during and in response to the PWLC virtual coaching sessions, from 29 participants. Specific research questions included: (1) What themes emerged in coaching sessions related to practitioners' experiences during the early implementation of the ParentingWell Practice Approach (2) In what ways are coaching sessions helpful to the practitioners as they implement the ParentingWell Practice Approach? Coaching sessions were recorded, and transcribed, and the data were analyzed qualitatively to identify early implementation themes. Practitioners completed feedback surveys online (which included Likert scale items and open-ended questions) following virtual coaching sessions to evaluate the usefulness of coaching sessions. Results: Coaching sessions reflected the following themes related to practitioners' experiences during the early implementation of ParentingWell: (1) practitioners identify and share concrete approaches to supporting parents; (2) practitioners reflect on parents' needs related to support, advocacy, problemsolving, and parenting skills; (3) practitioners reflect on their own personal experiences; and (4) practitioners' recognize the importance of self-care strategies for themselves and for parents served. Practitioners indicated that coaching sessions were useful in supporting the implementation of a new practice. Conclusion: This study provides preliminary evidence for the benefits of coaching in the implementation of ParentingWell. Future research will explore the impact of ParentingWell on outcomes for parents and families served. [ABSTRACT FROM AUTHOR]

The complex environmental impact makes it difficult to predict wind speed with high precision for multiple wind turbines. Most existing research methods model the temporal dependence of wind speeds, ignoring the spatial correlation between wind turbines. In this paper, we propose a multi-wind turbine wind speed prediction model based on Weighted Diffusion Graph Convolution and Gated Attention Network (WDGCGAN). To address the strong nonlinear correlation problem among multiple wind turbines, we use the maximal information coefficient (MIC) method to calculate the correlation weights between wind turbines and construct a weighted graph for multiple wind turbines. Next, by applying Diffusion Graph Convolution (DGC) transformation to the weight matrix of the weighted graph, we obtain the spatial graph diffusion matrix of the wind farm to aggregate the high-order neighborhood information of the graph nodes. Finally, by combining the DGC with the gated attention recurrent unit (GAU), we establish a spatio-temporal model for multi-turbine wind speed prediction. Experiments on the wind farm data in Massachusetts show that the proposed method can effectively aggregate the spatio-temporal information of wind turbine nodes and improve the prediction accuracy of multiple wind speeds. In the 1h prediction task, the average RMSE of the proposed model is 28% and 33.1% lower than that of the Long Short-Term Memory Network (LSTM) and Convolutional Neural Network (CNN), respectively. [ABSTRACT FROM AUTHOR]

High-resolution remote sensing images (HRRSI) have important theoretical and practical value in urban planning. However, current segmentation methods often struggle with issues like blurred edges and loss of detailed information due to the intricate backgrounds and rich semantics in high-resolution remote sensing images. To tackle these challenges, this paper proposes an end-to-end attention-based Convolutional Neural Network (CNN) called Double Hybrid Attention U-Net (DHAU-Net). We designed a new Double Hybrid Attention structure consisting of dual-parallel hybrid attention modules to replace the skip connections in U-Net, which can eliminate redundant information interference and enhances the collection and utilization of important shallow features. Comprehensive experiments on the Massachusetts remote sensing building dataset and the Inria aerial image labeling dataset demonstrate that our proposed method achieves effective pixel-level building segmentation in urban remote sensing images by eliminating redundant information interference and making full use of shallow features, and improves the segmentation performance without significant time costs (approximately 15%). The evaluation metrics reveal significant results, with an accuracy rate of 0.9808, precision reaching 0.9300, an F1 score of 0.9112, a mean intersection over union (mIoU) of 0.9088, and a recall rate of 0.8932. [ABSTRACT FROM AUTHOR]

Automatic extraction of building contours from high-resolution images is of great significance in the fields of urban planning, demographics, and disaster assessment. Network models based on convolutional neural network (CNN) and transformer technology have been widely used for semantic segmentation of buildings from high resolution remote sensing images (HRSI). However, the fixed geometric structure and the local receptive field of the convolutional kernel are not good at global feature extraction, and the transformer technique with self-attention mechanism introduces computational redundancies and extracts local feature details poorly in the process of modeling the global contextual information. In this paper, a dual-branch fused reconstructive transformer network, DFRTNet, is proposed for efficient and accurate building extraction. In the encoder, the traditional transformer is reconfigured by designing the local and global feature extraction module (LGFE); the branch of global feature extraction (GFE) performs dynamic range attention (DRA) based on the idea of top-k attention for extracting global features; furthermore, the branch of local feature extraction (LFE) is used to obtain fine-grained features. The multilayer perceptron (MLP) is employed to efficiently fuse the local and global features. In the decoder, a simple channel attention module (CAM) is used in the up-sampling part to enhance channel dimension features. Our network achieved the best segmentation accuracy on both the WHU and Massachusetts building datasets when compared to other mainstream and state-of-the-art methods. [ABSTRACT FROM AUTHOR]

The aim of the paper is to derive minimization algorithms based on the Nesterov accelerated gradient flow [Y. Nesterov, Gradient methods for minimizing composite objective function. Core discussion paper, (2007). Available at ; Y. Nesterov, A method of solving a convex programming problem with convergence rate $ \mathcal {O}(1/k^2) $ O (1 / k 2). In Doklady Akademii Nauk, Vol. 269, Russian Academy of Sciences, 1983, pp. 543–547; Y. Nesterov, Introductory Lectures on Convex Optimization: A basic course, Kluwer Academic Publishers, Massachusetts, 2004.] to compute the ground state of nonlinear Schrödinger equations, which can potentially include a fractional laplacian term. A comparison is developed with standard gradient flow formulations showing that the Nesterov accelerated gradient flow has some interesting properties but at the same time finds also some limitations due to the nature of the problem. A few simulations are finally reported to understand the behaviour of the algorithms and open the path to further complicate questions that require more advanced studies concerning the application of the Nesterov accelerated gradient flow to nonlinear Schrödinger equations. [ABSTRACT FROM AUTHOR]

Building footprint information is crucial for comprehending global urban development processes. Deep learning algorithms have shown significant potential in building extraction from high spatial resolution imagery. However, the requirement for large-scale annotated data has been a limitation for applying deep learning methods to city-level or national-level building mapping. The dynamic change and distinct landscape variation of cities in different geographic locations further emphasizes the need for automatic building footprint extraction. In this paper, we propose a Self-supervised Knowledge Transfer (SKTrans) framework for extracting building footprints from unlabeled remote sensing images over large areas. To address building tone differences cross regions and time periods, a tone shift mechanism is introduced to reduce the contrast, brightness, and saturation differences between buildings. Furthermore, considering building style diversity across different cities, a knowledge integration module is proposed to develop a comprehensive depiction including tonal differences, multi-scale variance, structural attributes and semantic confusion between roads and buildings. The effectiveness of SKTrans is demonstrated on three public datasets of WHU, Massachusetts, and Inria. To further evaluate the feasibility of large-scale mapping for automatic building footprint, global generalization experiments cross regions and time periods, which is based on imagery from five countries of different continents were implemented. The comprehensive results demonstrate that SKTrans surpasses existing state-of-the-art methods, supporting the time-series city-level building mapping without labeled dataset. Additionally, the architectural landscape pattern changes can be quantitatively analyzed based on the generalization results to facilitate sustainable urban development. Overall, SKTrans provides a new insight to meet the needs of high-precision label-free building mapping and update from large-scale multi-style remote sensing images. [ABSTRACT FROM AUTHOR]

Background: Use of the National Healthcare Safety Network (NHSN) has been essential to the success of the Massachusetts Hemovigilance Program and has allowed for the timely identification of signals and trends over a defined population that correlate with national and international hemovigilance (HV) data. Here, we outline how the NHSN system is used for monitoring HV data in Massachusetts and encourage adoption of NHSN for nationwide HV surveillance. Study Design and Methods: A collaboration that grew over time between local HV stakeholders and the Massachusetts Department of Public Health (MDPH) resulted in the change from a paper‐based method of reporting adverse reactions and monthly transfusion activity for compliance with state requirements to replacement with statewide adoption of reporting via NHSN. Results: Over 1.5 million blood products were transfused in Massachusetts between 2017 and 2021, with 3000 adverse reactions among 10 defined types reported. Using NHSN, MDPH has been able to produce numerous reports, publications, and presentations that have made previously non‐obtainable HV and blood utilization data available. Discussion: Although limitations to these self‐reported data exist, such as lack of external validation, successful statewide implementation of NHSN for hospital blood bank reporting is possible and has benefits beyond those for regulatory oversight. It results in standardized, actionable data at both the hospital and state level, enabling inter‐facility comparisons, benchmarking, and opportunities for practice improvement. [ABSTRACT FROM AUTHOR]

The authors reflect on the past achievements, disappointments, failures, and successes of the journal after assuming the position of Editors-in-Chief in 2023. They talk about the intense process of learning and analysis they have gone through over the past 12 months, their commitment to strengthening the journal's reputation and expanding its reach, and article types they are planning to include to broaden the scope, and impact of the journal.

While scholars have found that undergraduate involvement in research is beneficial, the lack of such experiences in the social sciences and humanities is glaring. This paper analyzes how an emphasis on community through cohort models impacts undergraduate student experience in research, taking from the Emerging Scholars Program, an interdisciplinary research program where cohorts of undergraduates are matched with faculty and attend meetings, workshops, and presentations together. We find that the cohort model created a robust community that fosters positive relationships that develop professional skills and emotional support, allowing students to collaborate and aim more toward their professional goals. The results from this study offer valuable insights into how universities can ensure that students have meaningful research experience beyond the classroom.

Background and aims: Nongenerative speech is the rote repetition of words or phrases heard from others or oneself. The most common manifestations of nongenerative speech are immediate and delayed echolalia, which are a well-attested clinical feature and a salient aspect of atypical language use in autism. However, there are no current estimates of the frequency of nongenerative speech, and the individual characteristics associated with nongenerative speech use in individuals across the autistic spectrum are poorly understood. In this study, we aim to measure and characterize spontaneous and nongenerative speech use in minimally verbal and verbally fluent autistic children and adolescents. Methods: Participants were 50 minimally verbal and 50 verbally fluent autistic individuals aged 6 to 21 years. Spontaneous and nongenerative speech samples were derived from SALT transcripts of ADOS-2 assessments. Participants' intelligible speech utterances were categorized as spontaneous or nongenerative. Spontaneous versus nongenerative utterances were compared between language subgroups on frequency of use and linguistic structure. Associations between nongenerative speech use and a series of individual characteristics (ADOS-2 subscale scores, nonverbal IQ, receptive vocabulary, and chronological age) were investigated over the whole sample and for each language subgroup independently. Results: Almost all participants produced some nongenerative speech. Minimally verbal individuals produced significantly more nongenerative than spontaneous utterances, and more nongenerative utterances compared to verbally fluent individuals. Verbally fluent individuals produced limited rates of nongenerative utterances, in comparison to their much higher rates of spontaneous utterances. Across the sample, nongenerative utterance rates were associated with nonverbal IQ and receptive vocabulary, but not separately for the two language subgroups. In verbally fluent individuals, only age was significantly inversely associated with nongenerative speech use such that older individuals produced fewer nongenerative utterances. In minimally verbal individuals, there were no associations between any of the individual characteristics and nongenerative speech use. In terms of linguistic structure, the lexical diversity of nongenerative and spontaneous utterances of both language subgroups was comparable. Morphosyntactic complexity was higher for spontaneous compared to nongenerative utterances in verbally fluent individuals, while no differences emerged between the two utterance types in minimally verbal individuals. Conclusions: Nongenerative speech presents differently in minimally verbal and verbally fluent autistic individuals. Although present in verbally fluent individuals, nongenerative speech appears to be a major feature of spoken language in minimally verbal children and adolescents. Implications: Our results advocate for more research on the expressive language profiles of autistic children and adolescents who remain minimally verbal and for further investigations of nongenerative speech, which is usually excluded from language samples. Given its prevalence in the spoken language of minimally verbal individuals, nongenerative speech could be used as a way to engage in and maintain communication with this subgroup of autistic individuals. [ABSTRACT FROM AUTHOR]

Background: Fatal opioid-involved overdose rates increased precipitously from 5.0 per 100,000 population to 33.5 in Massachusetts between 1999 and 2022. Methods: We used spatial rate smoothing techniques to identify persistent opioid overdose-involved fatality clusters at the ZIP Code Tabulation Area (ZCTA) level. Rate smoothing techniques were employed to identify locations of high fatal opioid overdose rates where population counts were low. In Massachusetts, this included areas with both sparse data and low population density. We used Local Indicators of Spatial Association (LISA) cluster analyses with the raw incidence rates, and the Empirical Bayes smoothed rates to identify clusters from 2011 to 2021. We also estimated Empirical Bayes LISA cluster estimates to identify clusters during the same period. We constructed measures of the socio-built environment and potentially inappropriate prescribing using principal components analysis. The resulting measures were used as covariates in Conditional Autoregressive Bayesian models that acknowledge spatial autocorrelation to predict both, if a ZCTA was part of an opioid-involved cluster for fatal overdose rates, as well as the number of times that it was part of a cluster of high incidence rates. Results: LISA clusters for smoothed data were able to identify whether a ZCTA was part of a opioid involved fatality incidence cluster earlier in the study period, when compared to LISA clusters based on raw rates. PCA helped in identifying unique socio-environmental factors, such as minoritized populations and poverty, potentially inappropriate prescribing, access to amenities, and rurality by combining socioeconomic, built environment and prescription variables that were highly correlated with each other. In all models except for those that used raw rates to estimate whether a ZCTA was part of a high fatality cluster, opioid overdose fatality clusters in Massachusetts had high percentages of Black and Hispanic residents, and households experiencing poverty. The models that were fitted on Empirical Bayes LISA identified this phenomenon earlier in the study period than the raw rate LISA. However, all the models identified minoritized populations and poverty as significant factors in predicting the persistence of a ZCTA being part of a high opioid overdose cluster during this time period. Conclusion: Conducting spatially robust analyses may help inform policies to identify community-level risks for opioid-involved overdose deaths sooner than depending on raw incidence rates alone. The results can help inform policy makers and planners about locations of persistent risk. [ABSTRACT FROM AUTHOR]

Background: Asians and Asian Americans have the lowest rate of mental health service utilization (25%) in the US compared to other racial/ethnic groups (39 − 52%), despite high rates of depression, anxiety, and suicidal ideation. The lack of culturally-responsive mental health trainings hinders access to mental health services for these populations. We assessed the mental health priorities of Asian communities in Greater Boston and evaluated cultural responsiveness of the Mental Health First Aid (MHFA), a first-responder training teaching participants skills to recognize signs of mental health and substance use challenges, and how to appropriately respond. Methods: This is community-based participatory research with the Boston Chinatown Neighborhood Center (BCNC), Asian Women For Health (AWFH), and the Addressing Disparities in Asian Populations through Translational Research (ADAPT) Coalition. We conducted focus groups with community-based organization staff and community members to assess mental health priorities of Asian populations in Boston, MA. We then evaluated the utility and cultural-responsiveness of the English-language MHFA for Asian populations through pre- and post-training questionnaires and focus groups with community participants. Paired t-tests were used to evaluate questionnaire responses. Thematic analysis was used to analyze interviews. Results: In total, ten staff and eight community members participated in focus groups, and 24 community members completed the MHFA and pre- and post-training questionnaires. Common mental health challenges in the Asian communities reported by participants were loneliness, high stigma around mental illnesses, academic pressure, and acculturation stress. Compared to pre-training, MHFA participants demonstrated lower personal mental health stigma (p < 0.001) and higher mental health literacy (p = 0.04) post-training. Participants also noted the lack of data statistics and case studies relevant to Asian populations in the training, and desired the training be offered in languages spoken by Asian ethnic subgroups (e.g., Chinese, Vietnamese). Conclusion: Cultural-responsiveness of the MHFA for Asian populations could be improved with the inclusion of data and case studies that capture common mental health challenges in the Asian communities and with translation of the MHFA to non-English languages predominant in Asian communities. Increasing the cultural relevance and language accessibility of the MHFA could facilitate wider adoption of these trainings across communities and help to reduce mental health stigma and gaps in literacy and service utilization. [ABSTRACT FROM AUTHOR]

BACKGROUND: Parametric g-computation is an attractive analytic framework to study the health effects of air pollution. Yet, the ability to explore biologically relevant exposure windows within this framework is underdeveloped. OBJECTIVES: We outline a novel framework for how to incorporate complex lag-responses using distributed lag models (DLMs) into parametric g-computation analyses for survival data. We call this approach “g-survival-DLM” and illustrate its use examining the association between PM2.5 during pregnancy and the risk of preterm birth (PTB). METHODS: We applied the g-survival-DLM approach to estimate the hypothetical static intervention of reducing average PM2.5 in each gestational week by 20% on the risk of PTB among 9,403 deliveries from Beth Israel Deaconess Medical Center, Boston, Massachusetts, 2011–2016. Daily PM2.5 was taken from a 1-km grid model and assigned to address at birth. Models were adjusted for sociodemographics, time trends, nitrogen dioxide, and temperature. To facilitate implementation, we provide a detailed description of the procedure and accompanying R syntax. RESULTS: There were 762 (8.1%) PTBs in this cohort. The gestational week-specific median PM2.5concentration was relatively stable across pregnancy at ~7μg/m³. We found that our hypothetical intervention strategy changed the cumulative risk of PTB at week 36 (i.e., the end of the preterm period) by -0.009 (95% confidence interval: -0.034, 0.007) in comparison with the scenario had we not intervened, which translates to about 86 fewer PTBs in this cohort. We also observed that the critical exposure window appeared to be weeks 5–20. DISCUSSION: We demonstrate that our g-survival-DLM approach produces easier-to-interpret, policy-relevant estimates (due to the g-computation); prevents immortal time bias (due to treating PTB as a time-to-event outcome); and allows for the exploration of critical exposure windows (due to the DLMs). In our illustrative example, we found that reducing fine particulate matter [particulate matter (PM) with aerodynamic diameter ≤2.5 μm (PM2.5)] during gestational weeks 5-20 could potentially lower the risk of PTB. [ABSTRACT FROM AUTHOR]

Coteaching, in which a general education teacher and special education teacher collaboratively provide instruction to students with and without disabilities in the same classroom, is widely endorsed as a strategy to give instructional support to students with disabilities within inclusive environments. We leverage longitudinal administrative data in Massachusetts to provide the first causal estimate for the effect of coteaching across a large public school system. We find evidence that coteaching leads to statistically significant test score improvements for both students with and without disabilities. However, the benefits for students with disabilities are much smaller than reported in prior studies. [ABSTRACT FROM AUTHOR]

In a 2023 sequential explanatory mixed-methods study in four US states, we identified barriers and facilitators experienced by Vaccines for Children (VFC) program providers in reporting vaccination data to state immunization information systems (IISs). We found the following: VFC providers value accurate, robust, and widely used IISs. IIS reporting is easier with but does not require an electronic health record. Negative interactions with IISs and VFC officials and limited practice capacity are barriers to reporting. The COVID-19 pandemic highlighted the need for a nationwide vaccination database. (Am J Public Health. 2024;114(6):569–574. https://doi.org/10.2105/AJPH.2024.307638) [ABSTRACT FROM AUTHOR]

We evaluate the predictive validity of the Massachusetts Candidate Assessment of Performance (CAP), a practice-based assessment of teaching skills that is now a requirement for teacher preparation program completion in Massachusetts. We find that candidates' performance on the CAP significantly predicts their in-service summative performance evaluations in their first 2 years in the teaching workforce, but it is not predictive of their value added to student test scores in these years. These findings suggest that the CAP captures aspects of candidates' skills and competencies that are better reflected in their future performance evaluations than by their impacts on student performance. [ABSTRACT FROM AUTHOR]

Purpose: This project addressed the uses of a loudspeaker array for audiometric measurements. It sought to evaluate a prototype compact array in terms of the reliability of test results across sound booths. Method: A seven-loudspeaker array was developed to deliver sounds from -60° to +60° on an arc with a radius of 0.5 m. The system was equipped with a head position sensing system to maintain the listener's head near the optimal test position. Three array systems were distributed to each of the two test sites for within-subject assessments of booth equivalence on tests of sound localization, speech reception in noise, and threshold detection. A total of 36 subjects participated, 18 at each test site. Results: Results showed excellent interbooth consistency on tests of sound localization using speech and noise signals, including conditions in which one or both ears were covered with a muff. Booth consistency was also excellent on sound field threshold measurements for detecting quasi-diffuse noise bands. Nonequivalence was observed in some cases of speech-in-noise tests, particularly with a small one-person booth. Acoustic analyses of in situ loudspeaker responses indicated that some of the nonequivalent comparisons on speech-innoise tests could be traced to the effects of reflections. Conclusions: Overall, the results demonstrate the utility and reliability of a compact array for the assessment of localization ability, speech reception in noise, and sound field thresholds. However, the results indicate that researchers and clinicians should be aware of the reflection effects that can influence the results of sound field tests in which signal and noise levels from separate loudspeakers are critical. [ABSTRACT FROM AUTHOR]

Climate change brings intense hurricanes and storm surges to the US Atlantic coast. These disruptive meteorological events, combined with sea level rise (SLR), inundate coastal areas and adversely impact infrastructure and environmental assets. Thus, storm surge projection and associated risk quantification are needed in coastal adaptation planning and emergency management. However, the projections can have large uncertainties depending on the planning time horizon. Excessive uncertainties arise from inadequately quantified ocean-climatic processes that control hurricane formation, storm track, and SLR in time of climate change. For this challenge, we propose an objective-based analytical-statistical approach using the National Oceanic and Atmospheric Administration's (NOAA)'s Sea, Lake, and Overland Surge from Hurricanes (SLOSH) model in scenario analysis of the storm surge impacts. In this approach, synthetic hurricanes (wind profile and track direction) are simulated to yield the likely range of the maximum envelope of water (MEOW), the maximum of the maximum (MOM), local wind speed, and directions. The surge height and time progression at a location are analyzed using a validated SLOSH model for a given adaptation or planning objective with a set of uncertainty tolerance. We further illustrate the approach in three case studies at Mattapoisett (MA), Bridgeport (CT), and Lower Chesapeake Bay along the US Atlantic coast. Simulated MOMs as the worst-case surge scenarios defined the long-term climate risk to the shoreside wastewater plants in Bridgeport and environmental assets in the Lower Chesapeake Bay. The wind-surge probability envelopes in simulated MEOWs provide location-specific estimates of the storm surge probability for local adaptation analysis at four locations in Lower Chesapeake Bay and at Mattapoisett of the southeastern Massachusetts coast. Using the constraints of local bathymetry and topography, the wind-surge probability curves and time progression also provide quantitative probability estimates for emergency response planning, as illustrated in the Mattapoisett case study. [ABSTRACT FROM AUTHOR]

Objective To pilot measurement of hair cortisol concentration (HCC) in pregnant women with opioid use disorder and their infants over time and study the potential utility of hair cortisol as a biomarker of chronic stress in this population. Study Design In this pilot prospective cohort study of mother–infant dyads with and without prenatal opioid exposure, we obtained mother–infant HCCs at delivery and again within 1 to 3 months' postpartum. HCCs were compared between the opioid and control groups and between the two time points. Results There were no significant differences between opioid and control group maternal or infant HCCs at either time point. However, within the opioid-exposed group, there was a significant increase in infant HCCs across the two time points. Conclusion This pilot study describes our experience with the measurement of HCCs in opioid-exposed mother–infant dyads. Key Points Maternal stress impacts fetal and child health. Many stressors in pregnant women with opioid use disorder. Hair cortisol may be a useful stress biomarker. [ABSTRACT FROM AUTHOR]

This article delves into content-based instruction (CBI) as a didactic methodology employed for teaching foreign languages within a North American state school situated in Massachusetts. It provides an account of the challenges confronted by a specific cohort of teachers during the implementation of this methodology. While a substantial body of literature advocates for CBI as an effective teaching method, scant attention has been directed toward analyzing the practical working conditions of teachers and the dynamics within classrooms where this method is applied. We ran a qualitative analysis on the evaluations and suggestions of specific teachers. To achieve this goal, interviews were conducted, and lesson plans and didactic materials were examined. The analysis resulted in a study that pointed out the handicaps and risks associated with CBI, emphasizing that the implementation process in the school demanded considerable effort from teachers without commensurate benefits for students. This study sheds light on aspects such as curriculum innovation, education leadership, and the clarification of the concept of what it means to be a teacher. It holds relevance for any stakeholder concerned with related issues stemming from curriculum program changes, alongside the professional well-being and motivation of the teaching participants in this setting. [ABSTRACT FROM AUTHOR]

To assess whether a measure of leadership support for worker safety, health, and well-being predicts staff turnover in nursing homes after controlling for other factors. This paper uses administrative payroll data to measure facility-level turnover and uses a survey measure of nursing home leadership commitment to workers. In addition, we use data from Medicare to measure various nursing home characteristics. Nursing homes with at least 30 beds serving adults in California, Ohio, and Massachusetts were invited to participate in the survey. The analysis sample included 495 nursing homes. We used a multivariable ordinary least squares model with turnover rate as the dependent variable. We used an indicator for nursing homes who scored above the median on the measure of leadership that supports worker safety, health, and well-being. Control variables include bed count (deciles), ownership (corporate/noncorporate × for-profit/not-for-profit), percent of residents on Medicaid, state, being in a nonmetropolitan county, and total nurse staffing per patient day in the 2 quarters before the survey. The unadjusted turnover rate was lower for those nursing homes that scored higher on leadership commitment to worker safety, health, and well-being. After controlling for additional variables, greater leadership commitment was still associated with lower turnover but with some attenuation. We find that nursing homes with leadership that communicated and demonstrated commitment to worker safety, health, and well-being had relatively fewer nurses leave during the study period, with turnover rates approximately 10% lower than homes without. These findings suggest that leadership may be a valuable tool for reducing staff turnover. [ABSTRACT FROM AUTHOR]

Background: Automatic extraction of roads from remote sensing images can facilitate many practical applications. However, thus far, thousands of kilometers or more of roads worldwide have not been recorded, especially low-grade roads in rural areas. Moreover, rural roads have different shapes and are influenced by complex environments and other interference factors, which has led to a scarcity of dedicated low level category road datasets. Methods: To address these issues, based on convolutional neural networks (CNNs) and tranformers, this article proposes the Dual Path Information Fusion Network (DPIF-Net). In addition, given the severe lack of low-grade road datasets, we constructed the GaoFen-2 (GF-2) rural road dataset to address this challenge, which spans three regions in China and covers an area of over 2,300 km, almost entirely composed of low-grade roads. To comprehensively test the low-grade road extraction performance and generalization ability of the model, comparative experiments are carried out on the DeepGlobe, and Massachusetts regular road datasets. Results: The results show that DPIF-Net achieves the highest IoU and F1 score on three datasets compared with methods such as U-Net, SegNet, DeepLabv3+, and D-LinkNet, with notable performance on the GF-2 dataset, reaching 0.6104 and 0.7608, respectively. Furthermore, multiple validation experiments demonstrate that DPIF-Net effectively preserves improved connectivity in low-grade road extraction with a modest parameter count of 63.9 MB. The constructed low-grade road dataset and proposed methods will facilitate further research on rural roads, which holds promise for assisting governmental authorities in making informed decisions and strategies to enhance rural road infrastructure. [ABSTRACT FROM AUTHOR]

Automated radio telemetry systems have become a popular and invaluable tool in tracking the activity and movement of wild animals. However, many environmental conditions can hinder accuracy when tracking with this technology. For instance, study sites may contain multiple habitat types, each habitat uniquely affecting the signal strength received from tagged species. To investigate the influence of a structurally diverse study site on an automated radio telemetry system, we conducted this project at a restored and managed pine barren habitat that consisted of a mix of mature pitch pine, treated pitch pine, scrub oak, and hardwood forests. This site, Montague Plains Wildlife Management Area, Montague, Massachusetts, is also a known breeding ground for Eastern whip-poor-will (Antrostomus vociferus). To measure the relationship of radio signal strength with distance across each habitat, we used radio telemetry equipment manufactured by Cellular Tracking Technologies. We produced negative exponential decay functions measuring radio signal strength over distance and tested for differences among habitat types on radio signal strength (RSS). We found that decay function parameters significantly differed by habitat type, prompting us to investigate if accounting for these differences improved location estimate accuracy. To test this, we estimated known locations using trilateration methods with and without habitat calibration. Comparing these tests indicates that habitat-specific adjustments significantly improved location accuracy. Lastly, we visualized estimated RSS-based locations of 1 week of whip-poor-will data and compared them to GPS data generated from the same individual. Previous studies have accounted for types of environmental interference (like elevation) in the field but have avoided incorporating habitat-specific factors by working with node networks covering a relatively small area, but in this study, we examined the potential to scale up for larger areas and in more complex habitats. [ABSTRACT FROM AUTHOR]

Between 1773 and 1777, a group of Black men presented four petitions to the Massachusetts legislature for the abolition of slavery. Although they have been examined for over two centuries, the story of these "freedom petitioners" and their place in their colony's patriot politics has frequently been misconstrued by historians or sidelined in larger histories of American abolitionism. Tracing the political, social, and discursive career of what in fact became the first organized, interracial, and successful abolition campaign in American history, I argue that a reevaluation is needed. The freedom petitions were not used to embarrass the patriot cause. They helped to bring about the downfall of royal government in Massachusetts. The American Revolution's "language of liberty" did not infect these actors. It was a discourse that they contributed to and helped create. And the freedom petitioners did not fundamentally fail to achieve their objectives. Their campaign played a crucial role in the effective as well as legal demise of slavery in their state. Between 1773 and 1777, a group of Black men presented four petitions to the Massachusetts legislature for the abolition of slavery. Despite having been examined extensively for nearly two centuries, the story of these "freedom petitioners" and their place in their colony's patriot politics has frequently been misconstrued by historians or sidelined in larger histories of American abolitionism. Tracing the political, social, and discursive career of what in fact became the first organized, interracial, and successful abolition campaign in American history, I argue a reevaluation is needed. The freedom petitions were not used to embarrass the patriot cause. They helped to bring about the downfall of royal government in Massachusetts. The American Revolution's "language of liberty" did not infect these actors. It was a discourse that they contributed to and helped create. And the freedom petitioners did not fundamentally fail to achieve their objectives. Their campaign played a crucial role in the effective as well as legal demise of slavery in their state. [ABSTRACT FROM AUTHOR]

Redox processes, aqueous and solid‐phase chemistry, and pH dynamics are key drivers of subsurface biogeochemical cycling and methanogenesis in terrestrial and wetland ecosystems but are typically not included in terrestrial carbon cycle models. These omissions may introduce errors when simulating systems where redox interactions and pH fluctuations are important, such as wetlands where saturation of soils can produce anoxic conditions and coastal systems where sulfate inputs from seawater can influence biogeochemistry. Integrating cycling of redox‐sensitive elements could therefore allow models to better represent key elements of carbon cycling and greenhouse gas production. We describe a model framework that couples the Energy Exascale Earth System Model (E3SM) Land Model (ELM) with PFLOTRAN biogeochemistry, allowing geochemical processes and redox interactions to be integrated with land surface model simulations. We implemented a reaction network including aerobic decomposition, fermentation, sulfate reduction, sulfide oxidation, methanogenesis, and methanotrophy as well as pH dynamics along with iron oxide and iron sulfide mineral precipitation and dissolution. We simulated biogeochemical cycling in tidal wetlands subject to either saltwater or freshwater inputs driven by tidal hydrological dynamics. In simulations with saltwater tidal inputs, sulfate reduction led to accumulation of sulfide, higher dissolved inorganic carbon concentrations, lower dissolved organic carbon concentrations, and lower methane emissions than simulations with freshwater tidal inputs. Model simulations compared well with measured porewater concentrations and surface gas emissions from coastal wetlands in the Northeastern United States. These results demonstrate how simulating geochemical reaction networks can improve land surface model simulations of subsurface biogeochemistry and carbon cycling. Plain Language Summary: Coastal wetlands can store carbon rapidly but are difficult to represent in current models for accurate accounting of how much carbon can be trapped. This difficulty is due to the complex interactions between tides, chemical reactions, and water salinity, which strongly affect the decay of organic matter and the production of greenhouse gases. We enhanced an existing model by linking it to a powerful chemical reaction simulator such that organic matter decomposition was tightly connected to chemical reactions involving key components such as sulfur, iron, oxygen, and methane. We used this model to compute the effect of salinity on organic matter decomposition and greenhouse gas production in saline and freshwater wetlands. The model predicted much lower methane emissions from saltwater‐affected wetlands, which compared well to field measurements from coastal wetland sites in Massachusetts, USA. This model improves the accounting of carbon in wetland ecosystems and opens a broad range of possibilities for representing complex chemistry in land models. Key Points: Coastal wetlands store large amounts of carbon and are sensitive to chemical interactions driven by salinity and tidal fluctuationsWe coupled a land surface model to a reactive transport model to simulate biogeochemical cycling in saline and fresh tidal wetlandsSulfate availability in saline wetlands lowered simulated methane emissions, which compared well with site measurements [ABSTRACT FROM AUTHOR]

Infectious bronchitis virus (IBV) is a highly contagious Gammacoronavirus causing moderate to severe respiratory infection in chickens. Understanding the initial antiviral response in the respiratory mucosa is crucial for controlling viral spread. We aimed to characterize the impact of IBV Delmarva (DMV)/1639 and IBV Massachusetts (Mass) 41 at the primary site of infection, namely, in chicken tracheal epithelial cells (cTECs) in vitro and the trachea in vivo. We hypothesized that some elements of the induced antiviral responses are distinct in both infection models. We inoculated cTECs and infected young specific pathogen-free (SPF) chickens with IBV DMV/1639 or IBV Mass41, along with mock-inoculated controls, and studied the transcriptome using RNA-sequencing (RNA-seq) at 3 and 18 h post-infection (hpi) for cTECs and at 4 and 11 days post-infection (dpi) in the trachea. We showed that IBV DMV/1639 and IBV Mass41 replicate in cTECs in vitro and the trachea in vivo, inducing host mRNA expression profiles that are strain- and time-dependent. We demonstrated the different gene expression patterns between in vitro and in vivo tracheal IBV infection. Ultimately, characterizing host–pathogen interactions with various IBV strains reveals potential mechanisms for inducing and modulating the immune response during IBV infection in the chicken trachea. [ABSTRACT FROM AUTHOR]

Road extraction is a crucial aspect of remote sensing imagery processing that plays a significant role in various remote sensing applications, including automatic driving, urban planning, and path navigation. However, accurate road extraction is a challenging task due to factors such as high road density, building occlusion, and complex traffic environments. In this study, a Spatial Attention Swin Transformer (SASwin Transformer) architecture is proposed to create a robust encoder capable of extracting roads from remote sensing imagery. In this architecture, we have developed a spatial self-attention (SSA) module that captures efficient and rich spatial information through spatial self-attention to reconstruct the feature map. Following this, the module performs residual connections with the input, which helps reduce interference from unrelated regions. Additionally, we designed a Spatial MLP (SMLP) module to aggregate spatial feature information from multiple branches while simultaneously reducing computational complexity. Two public road datasets, the Massachusetts dataset and the DeepGlobe dataset, were used for extensive experiments. The results show that our proposed model has an improved overall performance compared to several state-of-the-art algorithms. In particular, on the two datasets, our model outperforms D-LinkNet with an increase in Intersection over Union (IoU) metrics of 1.88% and 1.84%, respectively. [ABSTRACT FROM AUTHOR]

Background: Post-overdose outreach programs engage overdose survivors and their families soon after an overdose event. Staff implementing these programs are routinely exposed to others' trauma, which makes them vulnerable to secondary traumatic stress (STS) and compassion fatigue. The purpose of this study was to explore experiences of STS and associated upstream and downstream risk and protective factors among program staff. Methods: We conducted a post-hoc analysis of semi-structured interviews with post-overdose outreach program staff in Massachusetts. Transcripts were analyzed using a multi-step hybrid inductive-deductive approach to explore approaches and responses to outreach work, factors that might give rise to STS, and compassion fatigue resilience. Findings were organized according to the three main constructs within Ludick and Figley's compassion fatigue resilience model (empathy, secondary traumatic stress, and compassion fatigue resilience). Results: Thirty-eight interviews were conducted with staff from 11 post-overdose outreach programs in Massachusetts. Within the empathy construct, concern for others' well-being emerged as a motivator to engage in post-overdose outreach work – with staff trying to understand others' perspectives and using this connection to deliver respectful and compassionate services. Within the secondary traumatic stress construct, interviewees described regular and repeated exposure to others' trauma – made more difficult when exposures overlapped with staff members' personal social spheres. Within the compassion fatigue resilience construct, interviewees described the presence and absence of self-care practices and routines, social supports, and workplace supports. Job satisfaction and emotional detachment from work experiences also arose as potential protective factors. Interviewees reported inconsistent presence and utilization of formal support for STS and compassion fatigue within their post-overdose outreach teams. Conclusion: Post-overdose outreach program staff may experience secondary traumatic stress and may develop compassion fatigue, particularly in the absence of resilience and coping strategies and support. Compassion fatigue resilience approaches for post-overdose outreach staff warrant further development and study. [ABSTRACT FROM AUTHOR]

Estuaries are a conduit of mercury (Hg) from watersheds to the coastal ocean, and salt marshes play an important role in coastal Hg cycling. Hg cycling in upland terrestrial ecosystems has been well studied, but processes in densely vegetated salt marsh ecosystems are poorly characterized. We investigated Hg dynamics in vegetation and soils in the Plum Island Sound estuary in Massachusetts, USA, and specifically assessed the role of marsh vegetation for Hg deposition and turnover. Monthly quantitative harvesting of aboveground biomass showed strong linear seasonal increases in Hg associated with plants, with a 4-fold increase in Hg concentration and an 8-fold increase in standing Hg mass from June (3.9 ± 0.2 µ g kg -1 and 0.7 ± 0.4 µ g m -2 , respectively) to November (16.2 ± 2.0 µ g kg -1 and 5.7 ± 2.1 µ g m -2 , respectively). Hg did not increase further in aboveground biomass after plant senescence, indicating physiological controls of vegetation Hg uptake in salt marsh plants. Hg concentrations in live roots and live rhizomes were 11 and 2 times higher than concentrations in live aboveground biomass, respectively. Furthermore, live belowground biomass Hg pools (Hg in roots and rhizomes, 108.1 ± 83.4 µ g m -2) were more than 10 times larger than peak standing aboveground Hg pools (9.0 ± 3.3 µ g m -2). A ternary mixing model of measured stable Hg isotopes suggests that Hg sources in marsh aboveground tissues originate from about equal contributions of root uptake (∼ 35 %), precipitation uptake (∼ 33 %), and atmospheric gaseous elemental mercury (GEM) uptake (∼ 32 %). These results suggest a more important role of Hg transport from belowground (i.e., roots) to aboveground tissues in salt marsh vegetation than upland vegetation, where GEM uptake is generally the dominant Hg source. Roots and soils showed similar isotopic signatures, suggesting that belowground tissue Hg mostly derived from soil uptake. Annual root turnover results in large internal Hg recycling between soils and plants, estimated at 58.6 µ g m -2 yr -1. An initial mass balance of Hg indicates that the salt marsh presently serves as a small net Hg sink for environmental Hg of 5.2 µ g m -2 yr -1. [ABSTRACT FROM AUTHOR]

Accurate snow information at high spatial and temporal resolution is needed to support climate services, water resource management, and environmental prediction services. However, snow remains the only element of the water cycle without a dedicated Earth Observation mission. The snow scientific community has shown that Ku-Band radar measurements provide quality snow information with its sensitivity to snow water equivalent and the wet/dry state of snow. With recent developments of tools like the Snow MicroPenetrometer (SMP) to retrieve snow microstructure data in the field and radiative transfer models like the Snow Microwave Radiative Transfer Model (SMRT), it becomes possible to properly characterize the snow and how it translates into radar backscatter measurements. An experiment at Trail Valley Creek (TVC), Northwest Territories, Canada was conducted during the winter of 2018/19 in order to characterize the impacts of varying snow geophysical properties on Ku-Band radar backscatter at a 100-m scale. Airborne Ku-Band data was acquired using the University of Massachusetts radar instrument. This study shows that it is possible to calibrate SMP data to retrieve statistical information on snow geophysical properties and properly characterize a representative snowpack at the experiment scale. The tundra snowpack measured during the campaign can be characterize by two layers corresponding to a rounded snow grain layer and a depth hoar layer. Using Radarsat-2 and TerraSAR-X data, soil background roughness properties were retrieved (mss soil = 0.010±0.002) and it was shown that a single value could be used for the entire domain. Microwave snow grain size polydispersity values of 0.74 and 1.11 for rounded and depth hoar snow grains, respectively, was retrieved. Using the Geometrical Optics surface backscatter model, the retrieved effective soil permittivity increased from C-Band (ε soil = 2.47) to X-Band (ε soil = 2.61), to Ku-Band (ε soil = 2.77) for the TVC domain. Using SMRT and the retrieved soil and snow parameterizations, an RMSE of 2.6 dB was obtained between the measured and simulated Ku-Band backscatter values when using a global set of parameters for all measured sites. When using a distributed set of soil and snow parameters, the RMSE drops to 0.9 dB. This study thus shows that it is possible to link Ku-Band radar backscatter measurements to snow conditions on the ground using a priori knowledge of the snow conditions to retrieve SWE at the 100 m scale. [ABSTRACT FROM AUTHOR]

Purpose: Rehabilitation intervention descriptions often do not explicitly identify active ingredients or how those ingredients lead to changes in patient functioning. The Rehabilitation Treatment Specification System (RTSS) provides guidance to identify the critical aspects of any rehabilitation therapy and supported the development of standardly named ingredients and targets in voice therapy (Rehabilitation Treatment Specification System for Voice Therapy [RTSS-Voice]). This study sought to test the content validity of the RTSS-Voice and determine if the RTSS-Voice can be used to identify commonalities and differences in treatment (criterion validity) across clinicians in everyday clinical practice. Method: Five speech-language pathologists from different institutions videotaped one therapy session for 59 patients diagnosed with a voice or upper airway disorder. Specifications were created for each video, and iterative rounds of revisions were completed with the treating clinician and two RTSS experts until consensus was reached on each specification. Results: All 59 sessions were specified without the addition of any targets or ingredients. There were two frequent targets: (a) increased volition and (b) decreased strained voice quality. There were three frequent ingredients: (a) information regarding the patient's capability and motivation to perform a therapeutic behavior, (b) knowledge of results feedback, and (c) opportunities to practice voicing with improved resonance and mean airflow. Across sessions treating vocal hyperfunction, there was large variability across clinicians regarding the types and number of treatment components introduced, types of feedback provided, and vocal practice within spontaneous speech and negative practice. Conclusions: The RTSS and the RTSS-Voice demonstrated strong content validity, as they comprehensively characterized 59 therapy sessions. They also demonstrated strong criterion validity, as commonalities and differences were identified in everyday voice therapy for vocal hyperfunction across multiple clinicians. Future work to translate RTSS principles and RTSS-Voice terms into clinical documentation can help to understand how clinician and patient variability impacts outcomes and bridge the research--practice gap. [ABSTRACT FROM AUTHOR]

Objective: Residential is a common treatment setting for youth with high-severity substance use disorders (SUD). This study evaluated the prevalence of psychiatric symptoms and medication for youth in residential SUD treatment. Methods: Youth in Massachusetts state licensed and funded SUD residential programs completed questionnaires assessing demographics, primary substance of use, and psychopathology symptoms (Youth Self Report [YSR]/Adult Self Report [ASR]). De-identified medication lists were provided by the programs. Descriptive statistics were used to describe the sample. Results: Among the 47 youth who participated, 51.1% were male, 72.3% white, 83% non-Hispanic, mean age 20.7 years. Opioids were the most common primary substance identified by youth (51.1%), and 75% had at least one clinically elevated subscale on the YSR/ASR. Most youth were prescribed at least one medication (89.4%) with a mean of 2.9 medications. Conclusion: Youth in SUD residential treatment frequently have clinically elevated psychiatric symptoms, and psychotropic medication was commonly prescribed. [ABSTRACT FROM AUTHOR]

The efficient semantic segmentation of buildings in high spatial resolution remote sensing images is a technical prerequisite for land resource management, high-precision mapping, construction planning and other applications. Current building extraction methods based on deep learning can obtain high-level abstract features of images. However, the extraction of some occluded buildings is inaccurate, and as the network deepens, small-volume buildings are lost and edges are blurred. Therefore, we introduce a multi-resolution attention combination network, which employs a multiscale channel and spatial attention module (MCAM) to adaptively capture key features and eliminate irrelevant information, which improves the accuracy of building extraction. In addition, we present a layered residual connectivity module (LRCM) to enhance the expression of information at different scales through multi-level feature fusion, significantly improving the understanding of context and the capturing of fine edge details. Extensive experiments were conducted on the WHU aerial image dataset and the Massachusetts building dataset. Compared with state-of-the-art semantic segmentation methods, this network achieves better building extraction results in remote sensing images, proving the effectiveness of the method. [ABSTRACT FROM AUTHOR]

Background: Implementation of medications for opioid use disorder (MOUD) in jails varies by facility and across states. Organizational climate, including staff attitudes toward change and exposure to education, can influence perceptions of innovations like MOUD in jails. Using a mixed methods design, we aimed to understand the association between organizational climate and jail staff perceptions of MOUD. Methods: Jail staff (n = 111) who operate MOUD programs in 6 Massachusetts jails completed surveys that included the Organizational Readiness for Implementing Change (ORIC) survey. Random effects logistic regression models assessed associations between organizational climate and several outcomes of perceived MOUD efficacy, acceptability, and knowledge, while controlling for covariates. Jail staff (N = 61) participated in qualitative interviews and focus groups focused on organizational climate and knowledge diffusion, which we analyzed using inductive and deductive methods. Results: The results indicate that organizational change readiness on the ORIC was associated with positive perceptions of MOUD, and educational resources facilitated MOUD implementation. Greater ORIC was associated with higher perception of methadone as highly acceptable for jail populations (Odds ratio [OR] 2.3, 95% Confidence Interval [CI] 1.2 to 4.4), and high knowledge of methadone (OR 2.3, 95% CI 1.1 to 4.9), with similar magnitude of effects for buprenorphine. High levels of training for jail staff on methadone and buprenorphine were also associated with higher knowledge of these medications (Methadone: OR 7.2, 95% CI 2.2 to 23.2; Buprenorphine: OR 3.4, 95% CI 1.2 to 9.5). Qualitative results point towards the importance of organizational climate and elucidate educational strategies to improve staff perceptions of MOUD. Conclusion: Results underscore the importance of organizational climate for successful implementation of jail MOUD programs and provide support for medication-specific educational resources as a facilitator of successful MOUD implementation in jail settings. Findings highlight implementation strategies that may improve jail staff perceptions of MOUD. [ABSTRACT FROM AUTHOR]

We examine the relationship between proximity to electronic gambling machines or casino table games within gambling venues and the risk of being a person who experiences gambling problems among participants in a Massachusetts high-risk sample cohort study. The analysis employs data from Wave 2 through Wave 5 of the Massachusetts Gambling Impact Cohort (MAGIC) study conducted from 2015 to 2019. The Problem and Pathological Gambling Measure (PPGM) was employed to categorize participants as non-gamblers, recreational gamblers, at-risk gamblers, or problem/pathological gamblers. No significant relationship was found between the type of gambler and either table game or electronic gambling machine distance or density for either the wave prior to casino introduction or any of the waves subsequent to casino introduction. Results suggest that the Massachusetts population may be desensitized to some of the potential negative effects of casino proximity due to long-term exposure to casinos in neighboring jurisdictions. [ABSTRACT FROM AUTHOR]

Background: Clinical practice guidelines emphasize shared decision-making for kidney replacement treatment, yet little is known about the influence of cultural differences on that process. We undertook a retrospective chart review to explore the process and timing of dialysis decision making and initiation in Chinese American patients to provide quality kidney care for this population. Design: Participants received outpatient care at Tufts Medical Center and dialysis at Dialysis Clinic, Inc. Boston or Somerville, MA from 2001–2021. Clinic chart review sourced demographic, clinical, and end-of-life care information from 180 participants (82 Chinese American, 98 other) from stage 4 chronic kidney disease (CKD) and dialysis initiation. Results: Chinese American participants were older (mean 70 vs. 59, p < 0.0001), less likely to speak English (12% vs. 87%, p < 0.0001), and used interpreter services more (80% vs. 11%, p < 0.0001). Chinese American participants had more visits (median 14 vs. 10, p = 0.005); were more often accompanied by family members (75% vs. 40%, p < 0.001); and had significantly lower rates of healthcare proxy documentation (35% vs. 55%, p = 0.006). There was no statistical difference in months between first CKD 4 visit and first dialysis. Both groups started dialysis at the same average eGFR and with similar rates of permanent dialysis access. Chinese American participants had significantly lower serum albumin at dialysis initiation (mean 3.3 g/dL vs 3.7 g/dL, p = 0.0003). Documentation reflected a low number of conversations about non-dialytic care, end-of-life planning, or palliative care in both groups across all visits. Conclusion: The time between CKD 4 and dialysis initiation was the same in both groups, suggesting a similar overall outcome of care. Chart documentation suggests that Chinese American participants had a significantly higher number of visits with nephrologists where discussion about dialysis was noted and were more likely to have a family member present at the visit. Fewer Chinese American participants completed healthcare proxies. Among all study participants, healthcare proxy, code status, and palliative care discussions were reported less frequently than expected. These findings highlight opportunities for collaboration between palliative care clinicians and nephrologists. [ABSTRACT FROM AUTHOR]

The social pillar of pavement sustainability is understudied compared to economic and environmental pillars, making it difficult to integrate into life-cycle methodologies. While methods such as social life cycle assessment (S-LCA) exist, they usually focus on social governance rather than quantifying the impact of pavement investment decisions on communities. This study introduces a methodology to quantify the impact of road condition on vulnerable communities, specifically Environmental Justice (EJ) communities. The methodology calculates the impact of road condition on residents and analyzes fuel consumption (as an example impact) for road users during recurrent home-work trips as a function of pavement condition for EJ and non-EJ communities. It was found that EJ communities in Massachusetts are twice as likely to live near poor condition roads and consume twice as much excessive fuel during recurrent home-work trips. The proposed method is designed to integrate into existing life-cycle methods and represents a significant step towards integrating equity into pavement management decisions. [ABSTRACT FROM AUTHOR]

The existing literature has considered accountable care organizations (ACOs) as whole entities, neglecting potentially important variations in the characteristics and experiences of the individual practice sites that comprise them. In this observational cross-sectional study, our aim is to characterize the experience, capacity, and process heterogeneity at the practice site level within and between Medicaid ACOs, drawing on the Massachusetts Medicaid and Children's Health Insurance Program (MassHealth), which launched an ACO reform effort in 2018. We used a 2019 survey of a representative sample of administrators from practice sites participating in Medicaid ACOs in Massachusetts (n = 225). We quantified the clustering of responses by practice site within all 17 Medicaid ACOs in Massachusetts for measures of process change, previous experience with alternative payment models, and changes in the practices' ability to deliver high-quality care. Using multilevel logistic models, we calculated median odds ratios (MORs) and intraclass correlation coefficients (ICCs) to quantify the variation within and between ACOs for each measure. We found greater heterogeneity within the ACOs than between them for all measures, regardless of practice site and ACO characteristics (all ICCs ≤ 0.26). Our research indicates diverse experience with, and capacity for, implementing ACO initiatives across practice sites in Medicaid ACOs. Future research and program design should account for characteristics of practice sites within ACOs. [ABSTRACT FROM AUTHOR]

Autistic adults experience challenges in maintaining employment; however, little is known about patterns of competitive employment through late midlife. This longitudinal study examined the change in hours of competitive employment for a cohort of autistic adults over a 22-year period. The study's aims were to provide a fine-grained analysis of competitive employment patterns, to determine whether there was age-related change, and to test whether trajectories differed between those with and without intellectual disability (ID). Using an accelerated longitudinal design, trajectories of hours of competitive employment were estimated from young adulthood through late midlife in a community-based cohort (n = 341; 1327 observations). Results indicated a significant curvilinear trajectory of age-related change in hours of competitive employment, with differences between those with and without ID. For those without ID, the number of competitive employment hours increased from young adulthood until early midlife, then leveled off and decreased into late midlife. For those with ID, engagement in competitive employment was low throughout. Although competitive employment is just one option for vocational engagement, it is a goal often articulated by autistic adults who seek entry into the general workforce. The present research reveals their degree of engagement in the competitive workforce across the decades of adulthood. [ABSTRACT FROM AUTHOR]