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The design strategies for flood risk reduction in coastal towns must be informed by the likelihood of flooding resulting from both precipitation and coastal storm surge. This paper discusses various bivariate extreme value methods to investigate the joint probability of the exceedance of thresholds in both precipitation and sea level and estimate their dependence structure. We present the results of the dependence structure obtained using the observational record at Bridgeport, CT, a station with long data records representative of coastal Connecticut. Furthermore, we evaluate the dependence structure after removing the effects of harmonics in the sea level data. Through this comprehensive analysis, our study seeks to contribute to the understanding of the joint occurrence of sea level and precipitation extremes, providing insights that are crucial for effective coastal management. [ABSTRACT FROM AUTHOR]

We share our collective stories as instructors and graduate students with an interest in decolonial education on how we learned together in a course on Indigenous knowledge systems (IKS). The course occurred in the environmental studies department at a predominantly White graduate school in the Connecticut river basin in the area now known as the USA. The topic of IKS is steadily gaining interest in the environmental education (EE) field, as evidenced by an increase (albeit small) in the number of publications in peer-reviewed journals. At the same time, decolonial educators are looking for ways to teach IKS in an ethical and respectful manner. Our goal for this paper was to share how we grappled with questions around ethics and cultural appropriation. For instance, as decolonial educators who are not Indigenous to communities where we work and reside, can we facilitate lessons on IKS? If so, how can we do it in a manner that honors IKS and knowledge holders, is ethical, respectful and not appropriating? We learned that applying decolonization factors was crucial. Specifically, our work revealed four key decolonization factors: centering programs in Indigenous philosophies of education, privileging Indigenous voices and engaging Elders as experts, promoting Etuptmumk/two-eyed seeing, and employing Indigenous ways of teaching and learning. This paper makes contributions to the environmental education field, particularly decolonial educators who are seeking respectful and ethical ways to engage with Indigenous knowledge systems. [ABSTRACT FROM AUTHOR]

Demand response (DR) program empowers the dynamic prices to actively optimize the consumption. This optimized consumption plays a vital role in resolving the complex operation and reliability issues in the electricity market. The human behavior aspect of consumers explained by several models that have been reported in the literature. These models depend on the classical utility factor. The effect of price on the consumer's decision in the field of energy efficiency and reduction of consumption based on behavioral characteristics are two important aspects of DR programs. In absence of such characteristics, results become non‐viable. In this paper, the footprint of two time‐based DR programs is explored on the peak reduction namely; Real‐Time Pricing (RTP) and Peak Time Rebate (PTR). Artificial Neural Network (ANN) based topologies for two DR programs are proposed. The proposed topologies employ variation in demand and price, subsequently for simulating an online DR simulator. Demand before and after the RTP and PTR was calculated and compared with four ANN‐based DR topologies namely; Radial Basis Function Neural Network‐Demand Response (RBFN‐DR), Feedforward Backprop‐Demand Response (FFBP‐DR), Layer Recurrent‐Demand Response (LR‐DR), and Generalized Regression‐Demand Response (GR‐DR). The proposed models are tested on three test cases. The first case tested on hourly data of New England ISO of Connecticut on August 18, 2014, the second case tested on hourly data of the same system on August 18, 2020, and the third case tested on hourly residential data of test smart grid. By assessing the results from all three test cases, depicted that RBFN‐DR proved its efficacy by giving better results for both price‐based programs namely; RTP and PTR. [ABSTRACT FROM AUTHOR]

Purpose: Vaccine effectiveness (VE) studies are often conducted after the introduction of new vaccines to ensure they provide protection in real-world settings. Control of confounding is often needed during the analyses, which is most efficiently done through multivariable modeling. When many confounders are being considered, it can be challenging to know which variables need to be included in the final model. We propose an intuitive Bayesian model averaging (BMA) framework for this task. Patients and Methods: Data were used from a matched case–control study that aimed to assess the effectiveness of the Lyme vaccine post-licensure. Cases were residents of Connecticut, 15– 70 years of age with confirmed Lyme disease. Up to 2 healthy controls were matched to each case subject by age. All participants were interviewed, and medical records were reviewed to ascertain immunization history and evaluate potential confounders. BMA was used to systematically search for potential models and calculate the weighted average VE estimate from the top subset of models. The performance of BMA was compared to three traditional single-best-model-selection methods: two-stage selection, stepwise elimination, and the leaps and bounds algorithm. Results: The analysis included 358 cases and 554 matched controls. VE ranged between 56% and 73% and 95% confidence intervals crossed zero in < 5% of all candidate models. Averaging across the top 15 models, the BMA VE was 69% (95% CI: 18– 88%). The two-stage, stepwise, and leaps and bounds algorithm yielded VE of 71% (95% CI: 21– 90%), 73% (95% CI: 26– 90%), and 74% (95% CI: 27– 91%), respectively. Conclusion: This paper highlights how the BMA framework can be used to generate transparent and robust estimates of VE. The BMA-derived VE and confidence intervals were similar to those estimated using traditional methods. However, by incorporating model uncertainty into the parameter estimation, BMA can lend additional rigor and credibility to a well-designed study. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted the weaknesses of the U.S. national food system, with grocery store shelves emptied in March and April 2020 and COVID outbreaks reported throughout the summer of 2020 at meat processing plants across the country. Fleetingly, Americans turned to local farms to ensure they could access food safely in a time of uncertainty. This paper examines the economies of community that formed around local farms and how direct engagements between consumers and producers in the face of the pandemic deepened these economic structures that often put community well-being above profits. Within a capitalist system that prioritizes efficient mass production, economies of community illustrate that solidarity can improve local food system resilience. Based on qualitative and quantitative research carried out in the summer of 2020 in New London County in southeastern Connecticut, this research draws on ethnographic interviews with small-scale farmers who developed innovative ways to feed some of their community's most vulnerable members. Community economies show that we should not only depend on standardized large-scale farms and giant retail distribution; the American food system needs to continue to cultivate smallscale local production in order to improve resilience and food access. At present, the sustainability of producing and distributing food occurs at the farmer's expense. The government needs to support local food producers so they can continue to play an integral part in community well-being. [ABSTRACT FROM AUTHOR]

In 2020, Connecticut became the first U.S. state to require all public high schools to offer Black and Latinx studies. This monumental decision has raised a fair amount of concern over what constitutes effective and conscionable teaching practices for Black and Latinx studies at the classroom level. In this paper, I propose several teaching strategies, all grounded in critical, dialectical, and responsive theories of pedagogical praxis. I deliberate on the strengths and potential weaknesses of each approach with equal attention, and at the end of each section I offer some examples of how these strategies can be applied in the classroom. I conclude by restating how important Black and Latinx studies are in facilitating the reimagining of educational practice and classroom pedagogies throughout Connecticut. [ABSTRACT FROM AUTHOR]

Background: Although Good Samaritan laws (GSLs) have been widely adopted throughout the United States, their efficacy in individual states is often unknown. This paper offers an approach for assessing the impact of GSLs and insight for policy-makers and public health officials who wish to know whether they should expect to see outcomes from similar policy interventions.Methods: Utilizing a system dynamics (SD) modeling approach, the research team conducted a policy evaluation to determine the impact of GSLs on opioid use disorder (OUD) in Connecticut and evaluated the GSL based upon the following health outcomes: (1) emergency department (ED) visits for overdose, (2) behavioral changes of bystanders, and (3) overdose deaths.Results: The simulation model suggests that Connecticut's GSL has not yet affected overdose deaths but has resulted in bystander behavioral changes, such as increased 911 calls for overdose. ED visits have increased as the number of opioid users has increased.Conclusions: The simulation results indicate that the number of opioid-related deaths will continue to increase and that the GSL alone cannot effectively control the crisis. However, the SD approach that was used will allow policymakers to evaluate the effectiveness of the GSL over time using a simulation framework. This SD model demonstrates great potential by producing simulations that allow policymakers to assess multiple strategies for combating the opioid crisis and select optimal public health interventions. [ABSTRACT FROM AUTHOR]

To support public health policymakers in Connecticut, we developed a flexible county-structured compartmental SEIR-type model of SARS-CoV-2 transmission and COVID-19 disease progression. Our goals were to provide projections of infections, hospitalizations, and deaths, and estimates of important features of disease transmission and clinical progression. In this paper, we outline the model design, implementation and calibration, and describe how projections and estimates were used to meet the changing requirements of policymakers and officials in Connecticut from March 2020 to February 2021. The approach takes advantage of our unique access to Connecticut public health surveillance and hospital data and our direct connection to state officials and policymakers. We calibrated this model to data on deaths and hospitalizations and developed a novel measure of close interpersonal contact frequency to capture changes in transmission risk over time and used multiple local data sources to infer dynamics of time-varying model inputs. Estimated epidemiologic features of the COVID-19 epidemic in Connecticut include the effective reproduction number, cumulative incidence of infection, infection hospitalization and fatality ratios, and the case detection ratio. We conclude with a discussion of the limitations inherent in predicting uncertain epidemic trajectories and lessons learned from one year of providing COVID-19 projections in Connecticut. [ABSTRACT FROM AUTHOR]

Alcohol-associated liver disease is currently the leading cause of liver transplantation and liver deaths both in Europe and the United States. Efficacious treatments exist for alcohol use disorder, but they are seldomly prescribed for patients who need them. Besides, the presence of liver cirrhosis can complicate pharmacological treatment choices. In this review, we discuss established and innovative treatment strategies to treat unhealthy alcohol use in patients with alcohol-associated liver disease. We also describe the experience of our own institutions, Hospital Universitari Germans Trias i Pujol in Badalona (Spain) and Yale-New Haven Health and Yale Medicine (Connecticut. United States of America). [ABSTRACT FROM AUTHOR]

Introduction: The United States is currently facing an opioid overdose crisis. Research suggests that multiple interventions are needed to reduce overdose deaths including increasing access and retention to medications to treat opioid use disorders (MOUD, i.e., methadone, buprenorphine, and naltrexone) and increasing the distribution and use of naloxone, a medication that can reverse the respiratory depression that occurs during opioid overdoses. However, barriers to MOUD initiation and retention persist and discontinuations of MOUD carry a heightened risk of overdose. Many times, MOUD is not sought as a first line of treatment by people with opioid use disorder (OUD), many of whom seek treatment from medically managed withdrawal (detox) programs. Among those who do initiate MOUD, retention is generally low. The present study examines the treatment experiences of people who use opioids in three states, Connecticut, Kentucky, and Wisconsin. Methods: We conducted in-depth interviews with people who use opioids in a rural, urban, and suburban area of three states: Connecticut, Kentucky and Wisconsin. Data analysis was collaborative and key themes were identified through multiple readings, coding of transcripts and discussion with all research team members. Results: Results reveal a number of systemic issues that reduce the likelihood that people initiate and are retained on MOUD including the ubiquity of detox as a first step in drug treatment, abstinence requirements and requiring patients to attend group treatment. MOUD-related stigma was a significant factor in the kinds of treatment participants chose and their experiences in treatment. Conclusions: Interventions to reduce MOUD stigma are needed to encourage MOUD as a first course of treatment. Eliminating abstinence-based rules for MOUD treatment may improve treatment retention and decrease overdose risk. [ABSTRACT FROM AUTHOR]

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Thermal refuges provide critical habitat for cold‐water‐dependent salmonids in marginal riverscapes during extreme heat events globally. Studies of thermal refuge use by salmonids are complicated by short‐term changes in weather conditions during heat waves, intermittent fish use, and the use of different analytical endpoints. We passively surveyed cold‐water‐dependent brown, rainbow, and brook trout (hereafter "trout") thermoregulating in several thermal refuges along the Housatonic River, Connecticut, USA, during a two‐week heatwave using underwater action cameras (UACs). Using these data, we assessed the influence of various short‐term riverscape conditions on the abundance of trout within thermal refuges using a zero‐inflated Poisson, time‐stratified N‐mixture model in a Bayesian framework that accounts for imperfect detection. We detected at least one trout per sampling occasion, and estimated abundances summed across all thermal refuges ranged from 63.99 (95% credible interval [CRI] = 55.0–79.0) to 182.04 (167.0–199.0). We estimated higher trout abundances in larger thermal refuges located in low‐gradient river sections, and refuges that were deeper and cooler than the Housatonic River during the sampling occasion (all β estimates >0.0 and did not overlap zero). We also found evidence that less variable and cooler temperature regimes in the nearby Housatonic River led to higher estimated trout abundances within thermal refuges (all β estimates <0.0 and did not overlap zero). Last, we found that trout detection probabilities within thermal refuges were moderate (range = 0.521–0.634) when using UAC surveys and that the video image brightness negatively influenced detection (αbright = −0.193, 95% CRI = −0.330 to −0.058). To aid in trout population persistence in dynamic, marginal riverscapes as the climate changes, focusing on modifiable refuge attributes (e.g., depth, cold‐water plume area), and strategically targeting refuges in riverscape segments beneficial to trout may be tactics that could enhance conservation strategies globally. [ABSTRACT FROM AUTHOR]

Background: The experiences and perceived support needs of harm reduction workers in the USA have been understudied. While previous research has explored staff burnout and role-related stress, there is a research gap around potential supports for staff wellbeing and individual longevity in their roles. This is especially critical given the growing overdose crisis and the need for sustainable harm reduction programming. Thus, we sought to describe the experiences of harm reduction staff and identify the perceived support that could empower harm reduction staff to successfully navigate their roles. Methods: Purposive sampling methods were used to recruit harm reduction staff working in Connecticut. Seventeen semi-structured, one-on-one interviews were conducted between December 2022 and March 2023. Participants were asked about their experiences with role-related stressors and supports. Informed by the Social-Ecological Model, transcripts were coded using both inductive and deductive codes, and themes were developed using thematic analysis approaches. Results: Study participants described their experiences working in harm reduction and the numerous ways they already are or could be receiving support in their roles. These experiences were organized into eight themes according to the levels of the Social-Ecological Model. At the individual level, participants explained that support could help them navigate the variability of the physical environment, boundary setting, and self-care. Relationships between clients and co-workers were both identified as means of support at the interpersonal level, helping participants navigate difficult situations and feelings of stress. At the organizational level, study participants explained how they look to their organization to provide sufficient support by way of training, staffing, compensation, and benefits. Additionally, participants stressed the importance of having supervisors who valued their work and provided emotional support. Lastly, at the community level, participants discussed how support was needed to help them navigate complex systems while working with a stigmatized population in an often-stigmatized field. Conclusions: To best support harm reduction staff in their day-to-day roles, our findings underscore the need for support on multiple levels. Future research could explore how the provision of support to harm reduction staff impacts not only staff perceptions of support but also the success of clients accessing harm reduction services. [ABSTRACT FROM AUTHOR]

Brownfield redevelopment projects are often perceived as more risky than greenfield investment, and financing opportunities may be more limited and expensive. Different financial support projects have been developed to support regeneration projects, and empirical evidence has shown that all buildings near the intervention area may benefit from an increase in prices once the brownfield project is complete. The article considers the Connecticut market and evaluates the characteristics of the brownfield projects that had access to a financial support program (loan or grant), the impact of the regeneration process on the liquidity of the housing market, and the gap between the price and the appraisal value of the residential unit. Target areas for this type of financing program are mainly characterized by low income, a high density of population, a high incidence of homeowners, and a high crime rate. Once completed, the brownfield requalification has an impact on the housing market because the brownfield recovery reduces the number of house sales due to the increase in the average price in the surrounding area and makes the selling price more consistent with the appraisal valuation. The empirical evidence provided may be useful for public institutions that are suffering from budget constraints and have to prioritize areas for financial support solutions. [ABSTRACT FROM AUTHOR]

Background: Extant research suggests that disparities in healthcare utilization and experiences of mental health disorders such as depression exist across sociodemographic groups. One understudied pathway that may have significant implications for these disparities is the role of family functioning. How families interact, communicate, and adapt may vary, but these relationships remain integral for vulnerable subsets of the population due to their seemingly protective properties. Yet, few studies have examined the relationship between family functioning and health. Objective: The aim of this study was to explore family functioning as a predictor for healthcare utilization and depression among young mothers and as a moderator of disparities for each of these outcomes. Design/methods: This analysis uses data from a prospective cohort study which was conducted with 296 pregnant young women recruited from obstetrics clinics in Connecticut between July 2007 and February 2011 and followed 1-year postpartum. Logistic regression models were used to assess family functioning, race/ethnicity, and immigrant status as predictors of healthcare utilization and depression. Family functioning was evaluated as a moderator for both outcomes. Results: Black and Latina mothers had decreased odds of using physical healthcare services (odds ratioBlack = 0.13, p < 0.001; odds ratioLatina = 0.31, p = 0.02). Family functioning was associated with decreased odds of using mental healthcare services (odds ratio = 0.97, p = 0.04) and had a protective effect against depression (odds ratio = 0.96, p = 0.003). Family functioning significantly moderated the relationship between immigrant status and physical healthcare utilization, Black race/ethnicity and physical healthcare utilization, and Other race/ethnicity and depression. Conclusion: Family functioning is a significant factor associated with both healthcare utilization and depression among young mothers. It should be a strongly considered component within healthcare settings to mitigate risks among vulnerable populations. [ABSTRACT FROM AUTHOR]

Adolescents who engage in non-opioid substance misuse and/or experience mental health symptoms are at greater risk of misusing opioids and/or developing opioid use disorder. Adolescence is a critical developmental period to both prevent the initiation of opioid misuse and target mental health. To date, there are no digital health games targeting both conditions. We describe the protocol for a randomized controlled trial designed to assess the efficacy of an original digital health game, PlaySmart. Five hundred and thirty-two adolescents aged 16–19 years old, who are at greater risk for initiating opioid misuse are recruited from 10 Connecticut school-based health sites. Participants are randomized to PlaySmart or a set of time/attention control videogames. Randomization was stratified by sex at birth and school grade. Participants play their assigned game or games for up to six weeks (300 minutes) and complete assessment questions over a 12-month period (baseline, post-gameplay, 3, 6, and 12 months). The primary outcome is perception of risk of harm of opioid misuse at 3 months. Secondary outcome measures specific to opioid misuse include intentions, self-efficacy, attitudes, knowledge, and perceived norms. Mental health outcomes include measures of depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7), help-seeking behaviors, stigma, measures of self-regulation, self-efficacy to seek professional help for mental health, and knowledge around coping skills. PlaySmart has the potential to significantly reduce the risk of initiation of opioid misuse, improve mental health outcomes, and given its high levels of engagement and accessibility, holds the promise for extensive reach, scale, and impact for adolescents. Trial registration: ClinicalTrials.gov: NCT04941950. Registered on 23 June 2021. [ABSTRACT FROM AUTHOR]

The crystallization of hematite from precursor ferrihydrite was studied using time-resolved, angle-dispersive synchrotron X-ray difraction in aqueous solutions at pH 10 and 11 and at temperatures ranging from 80 to 170 °C. Rietveld analyses revealed a non-classical crystallization pathway involving vacancy infilling by Fe as defective hematite nanocrystals evolved. At 90 °C and pH 11, incipient hematite particles exhibited an Fe site occupancy as low as 0.68(2), and after 30 min, Fe occupancy plateaued at 0.84(1), achieving a metastable steady state with a composition corresponding to "hydrohematite." During crystal growth, unit-cell volume increased with an increase in Fe occupancy. The increase in Fe occupancy in hydrohematite was accomplished by deprotonation, resulting in a shortening of the long Fe-O(H) bonds and decreased distortion of the octahedral sites. Once the occupancy stabilized, the unit-cell volume contracted following further nanoparticle growth. Our study documented various synthetic routes to the formation of "hydrohematite" with an Fe vacancy of 10–20 mol% in the final product. The structure refined for synthetic hydrohematite at 90 °C and pH 11 closely matched that of natural hydrohematite from Salisbury, Connecticut, with a refined Fe occupancy of 0.83(2). Dry heating this natural hydrohematite generated anhydrous, stoichiometric hematite, again by continuous infilling of vacancies. The transformation initiated at 150 °C and was complete at 700 °C, and it was accompanied by the formation of a minor amorphous phase that served as a reservoir for Fe during the inoculation of the defective crystalline phase. [ABSTRACT FROM AUTHOR]

We examine the effect of attending stand-alone technical high schools in Connecticut using regression discontinuity. Male students are 10 percentage points more likely to graduate from high school and have half a semester less time enrolled in college. Male students have 32% higher average quarterly earnings. Earnings effects may in part reflect general skills: male students have higher attendance rates and test scores, industry fixed effects explain less than one-third of earnings gains, and large earnings gains persist past traditional college going years. Attending a technical high school does not affect the outcomes of female students. [ABSTRACT FROM AUTHOR]

Background: Numerous bioassay methods have been used to test the efficacy of repellents for ticks, but the comparability of results across different methods has only been evaluated in a single study. Of particular interest are comparisons between bioassays that use artificial containers (in vitro) with those conducted on a human subject (in vivo) for efficacy testing of new potential unregistered active ingredients, which most commonly use in vitro methods. Methods: We compared four different bioassay methods and evaluated three ingredients (DEET [N,N-Diethyl-meta-toluamide], peppermint oil and rosemary oil) and a negative control (ethanol) over a 6-h period. Two of the methods tested were in vivo bioassay methods in which the active ingredient was applied to human skin (finger and forearm bioassays), and the other two methods were in vitro methods using artificial containers (jar and petri dish bioassays). All four bioassays were conducted using Ixodesscapularis nymphs. We compared the results using nymphs from two different tick colonies that were derived from I.scapularis collected in the US states of Connecticut and Rhode Island (northern origin) and Oklahoma (southern origin), expecting that ticks of different origin would display differences in host-seeking behavior. Results: The results between bioassay methods did not differ significantly, even when comparing those that provide the stimulus of human skin with those that do not. We also found that tick colony source can impact the outcome of repellency bioassays due to differences in movement speed; behavioral differences were incorporated into the assay screening. DEET effectively repelled nymphs for the full 6-h duration of the study. Peppermint oil showed a similar repellent efficacy to DEET during the first hour, but it decreased sharply afterwards. Rosemary oil did not effectively repel nymphs across any of the time points. Conclusions: The repellency results did not differ significantly between the four bioassay methods tested. The results also highlight the need to consider the geographic origin of ticks used in repellency bioassays in addition to species and life stage. Finally, our results indicate a limited repellent efficacy of the two essential oils tested, which highlights the need for further studies on the duration of repellency for similar botanically derived active ingredients and for evaluation of formulated products. [ABSTRACT FROM AUTHOR]

Background: We investigated the interaction between arrests for technical violations vs. receiving new charges with receiving community-based methadone treatment on time-to reincarceration (TTR) in a cohort of men with opioid use disorder (OUD) released from custody from two Connecticut jails from 2014 to 2018. Methods: Hazard ratios (HR) were estimated for time to reincarceration for technical violations/infractions, misdemeanors only, felonies only, and both misdemeanors and felonies after adjusting for age, race/ethnicity, and receiving methadone treatment during incarceration or in the community following release. Moderation analyses tested the hypotheses that the benefits of receiving methadone in jail or the community on TTR were significantly different for people with only technical violations and infractions compared to misdemeanor and felony charges. Results: In the sample of 788 men who were reincarcerated, 29.4% received technical violations with no new charges (n = 232) with the remainder of the sample receiving new charges consisting of 26.9% new misdemeanor charges, 6.5% felony charges, and 37.2% both felony and misdemeanor charges. Compared to men who received new misdemeanor charges, TTR was significantly shorter among those who received technical violations and infractions with no new charges amounting to a 50% increase in TTR (334.5 days, SD = 321.3 vs. 228.1 days, SD = 308.0, p < 0.001; aHR = 1.5, 95% CI = 1.3, 1.8, p < 0.001). TTR of men who resumed methadone and were charged with a new crime was 50% longer than those who resumed methadone and received technical violations/infractions with no new charges. (230.2 days, SD = 340.2 vs. 402.3 days, SD = 231.3; aHR = 1.5, 95%CI = 1.0, 2.2, p = 0.038). Conclusions: Reducing technical violations may enhance the benefits of providing community-based methadone following release from incarceration on extending the time between incarcerations during the vulnerable time post-incarceration and reduce the burden on correctional systems. [ABSTRACT FROM AUTHOR]

Constraining the timing and rate of Laurentide Ice Sheet (LIS) retreat through the northeastern United States is important for understanding the co-evolution of complex climatic and glaciologic events that characterized the end of the Pleistocene epoch. However, no in situ cosmogenic 10Be exposure age estimates for LIS retreat exist through large parts of Connecticut or Massachusetts. Due to the large disagreement between radiocarbon and 10Be ages constraining LIS retreat at the maximum southern margin and the paucity of data in central New England, the timing of LIS retreat through this region is uncertain. Here, we date LIS retreat through south-central New England using 14 new in situ cosmogenic 10Be exposure ages measured in samples collected from bedrock and boulders. Our results suggest ice retreated entirely from Connecticut by 18.3 ± 0.3 ka (n = 3). In Massachusetts, exposure ages from similar latitudes suggest ice may have occupied the Hudson River Valley up to 2 kyr longer (15.2 ± 0.3 ka, average, n = 2) than the Connecticut River Valley (17.4 ± 1.0 ka, average, n = 5). We use these new ages to provide insight about LIS retreat timing during the early deglacial period and to explore the mismatch between radiocarbon and cosmogenic deglacial age chronologies in this region. [ABSTRACT FROM AUTHOR]

Background: Psilocybin may help treat obsessive-compulsive disorder (OCD). To date, only one open-label study of psilocybin for OCD exists, necessitating further investigation with a randomized controlled design. The neural correlates of psilocybin's effects on OCD have also not been studied. Objectives: This first-of-its-kind trial aims to evaluate the feasibility, safety, and tolerability of psilocybin in the treatment of OCD, provide preliminary evidence on the effects of psilocybin on OCD symptoms, and elucidate neural mechanisms that may mediate psilocybin's effects on OCD. Design: We use a randomized (1:1), double-blind, placebo-controlled, noncrossover design to examine the clinical and neural effects of either a single dose of oral psilocybin (0.25 mg/kg) or active placebo-control agent (250 mg of niacin) on OCD symptoms. Methods and analysis: We are enrolling 30 adult participants at a single site in Connecticut, USA who have failed at least one trial of standard care treatment (medication/psychotherapy) for OCD. All participants will also receive unstructured, non-directive psychological support during visits. Aside from safety, primary outcomes include OCD symptoms over the past 24 h, assessed by the Acute Yale-Brown Obsessive-Compulsive Scale and Visual Analog Scale ratings. These are collected by blinded, independent raters at baseline and the primary endpoint of 48 h post-dosing. Total follow-up is 12 weeks post-dosing. Resting state neuroimaging data will be collected at baseline and primary endpoint. Participants randomized to placebo will be offered the chance to return for an open-label dose of 0.25 mg/kg. Ethics statement: All participants will be required to provide written informed consent. The trial (protocol v. 5.2) was approved by the institutional review board (HIC #2000020355) and registered with ClinicalTrials.gov (NCT03356483). Discussion: This study may represent an advance in our ability to treat refractory OCD, and pave the way for future studies of neurobiological mechanisms of OCD that may respond to psilocybin. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma (HCC) is a heterogeneous disease that typically arises in the setting of chronic liver disease, making treatment selection complex. Multidisciplinary liver tumor boards (MDLTB) have been shown to improve outcomes in patients with HCC. However, in many cases, patients evaluated by MDLTBs ultimately do not receive the board's recommended treatment. Purpose: This study aims to assess adherence to MDLTB recommendations for the treatment of HCC, the reasons for non-adherence, and the survival of Barcelona Clinic Liver Cancer (BCLC) Stage A patients treated with curative treatment compared to palliative locoregional therapy. Patients and Methods: A single-site, retrospective cohort study was conducted of all patients with treatment-naïve HCC who were evaluated by an MDLTB at a tertiary care center in Connecticut between 2013 and 2016, of which 225 patients met inclusion criteria. Investigators conducted a chart review and recorded adherence to the MDLTB's recommendations, and in cases of discordance, evaluated and recorded the underlying cause; investigators assessed MDLTB recommendations' compliance with BCLC guidelines. Survival data was accrued through February 1st of 2022 and analyzed via Kaplan–Meier analysis and multivariate Cox regression. Results: Treatment adherent to MDLTB recommendations occurred in 85.3% of patients (n=192). The majority of non-adherence occurred in the management of BCLC Stage A disease. In cases where adherence was possible but the recommendation was not followed, most discrepancies were whether to treat with curative or palliative intent (20/24), with almost all discrepancies occurring in patients (19/20) with BCLC Stage A disease. For patients with Stage A unifocal HCC, those who received curative therapy lived significantly longer than patients who received palliative locoregional therapy (5.55 years vs 4.26 years, p=0.037). Conclusion: Most forms of non-adherence to MDLTB recommendations were unavoidable; however, treatment discordance in the management of patients with BCLC Stage A unifocal disease may present an opportunity for clinically significant quality improvement. [ABSTRACT FROM AUTHOR]

Social and cultural capital are critical components of success among college students. In this paper, we examine the creation, accumulation, and distribution of social and cultural capital by and among underserved college students who participated in a summer bridge program at one regional public state university. Using qualitative data from interviews with participants, the analysis highlights the importance of trust, sense of belonging and use of noncognitive strategies. We argue that in addition to traditional achievement measures such as GPA and test scores, social and cultural capital need to be considered. While quantitative measures often label these students as below benchmarks, this study highlights how social and cultural capital are assets to be nurtured and facilitated. [Note: The publication year (2021) shown on the PDF is incorrect. The correct publication year for this article is 2022.]

Cultures recreate themselves constantly, sometimes through natural transformations, sometimes through imposition. While colonialism was atrocious, partly because it transformed cultures by imposing disfigured identities and understandings (Fanon, 1963), we cannot reset cultures to how they were before conquest. That would require erasing languages now spoken for generations, dismantling religions and beliefs now practiced for hundreds of years, and purifying food habits now valued by the palettes of those formerly colonized. We can, however, work towards decolonizing our present-day society. Specifically, we can identify how colonialism continues to position some populations and their cultures as inferior (minoritized) and others as superior (majoritized; Vaccaro, 2021). We can also explore how colonized cultures adapted to colonialism, leading to the fusion or mestizaje of cultures that, in spite of colonial atrocities, led to new, intersectional identities that have now fallen prey to the same hegemonic perspectives of the past. And we can examine how natural mestizaje that occurs with immigration can be subject to contradictory pressures to assimilate to colonial ideals and to resist colonial influences. This paper proposes that Catholic schools are in a privileged position to contribute to decolonization by aiding students' transcultural acculturation (Mudambi, 2021a; Mudambi, 2021b). Furthermore, this article offers specific actions in which Catholic schools can engage to mobilize education towards decolonization and, in doing so, foster a Christian culture of equity and justice, while serving as a model for other education systems.

Youth homelessness is a significant problem in most United States communities. Health problems are both a contributor to and a consequence of homelessness. Responses to youth homelessness are typically fragmentary. Different agencies deal with various causes and consequences of the problem. Stakeholders in Connecticut sought a more coherent approach. This article describes the development and use of a system dynamics simulation model as a decision-support tool that: (1) brings stakeholders together from diverse service sectors and allows them to see the system as a whole, (2) enables them to explore how delivery systems interact to affect homeless and unstably housed youth, (3) lets them test the impact of different intervention alternatives on reducing the problem, and (4) helps develop insights about coherent approaches to youth homelessness. The model's development is described as a phased process including stakeholder engagement, causal mapping, and creation of the quantitative simulation model. The resulting model is presented along with an interface that enables stakeholders to use the model in a Learning Lab setting. Results of an initial set of Learning Labs are presented, including types of insights gained by participants from using the simulation model. Conclusions include limitations of the model and plans for its future use. [ABSTRACT FROM AUTHOR]

Background: Physical abuse of children is reported to occur in 30%–60% of homes with intimate partner violence (IPV). IPV in adult victims presenting to emergency departments (EDs) represents a critical opportunity to evaluate for child safety. Objectives: The primary objective was to determine the frequency of child safety assessments (CSAs), defined as any documented inquiry about the presence of children in the household, when adults presented to EDs for IPV. The secondary aims were to assess (1) the impact of demographic factors, ED type, and social work (SW) involvement on the likelihood of CSAs; (2) the nature of children's exposure; and (3) the frequency of child protective services (CPS) reports. Methods: We performed a chart review of encounters with ICD‐10‐CM codes for patients aged 18–60 with IPV presenting to three EDs in Connecticut from 2017 through 2019. Results: CSAs were completed in 179/277 encounters (78.9%) and were more likely to be completed in encounters with SW involvement than without (162/171 [94.7%] vs. 17/56 [30.3%], p < 0.001). A total of 143 children lived in the home at the time of the incident; of the 107 children for whom the nature of exposure was known, 10 (9.3%) were physically involved and 26 (24.2%) were direct witnesses to the violence. CPS reports were made in 52.4% of the encounters in which children lived in the home. Conclusions: CSAs were omitted in one‐fifth of encounters for IPV. Given the high prevalence of children involved in IPV episodes, ED encounters for IPV represent an opportunity to improve the safety of children. [ABSTRACT FROM AUTHOR]

Background: Arabic-speaking refugees are the largest group of refugees arriving in the United States since 2008, yet little is known about their rates of healthcare access, utilization, and satisfaction after the end of the Refugee Medical Assistance (RMA) period.Methods: This study was a cross-sectional observational study. From January to December 2019, a household survey was conducted of newly arrived Arabic-speaking refugees in Connecticut between 2016 and 2018. Households were interviewed in Arabic either in person or over the phone by one of five researchers. Descriptive statistics were generated for information collected on demographics, prevalence of chronic conditions, patterns of health seeking behavior, insurance status and patient satisfaction using the Patient Satisfaction Questionnaire (PSQ-18).Results: Sixty-five households responded to the survey representing 295 Arabic-speaking refugees - of which 141 (48%) were children. Forty-seven households (72%) reported 142 chronic medical conditions among 295 individuals, 62 persons (21%) needed daily medication, 285 (97%) persons were insured. Median patient satisfaction was > 4.0 out of 5 for 6 of 7 domains of the PSQ-18 but wide variation (scores from 1.0 - 5.0).Conclusion: Arabic-speaking refugees in Connecticut participating in this study were young. The majority remained insured after their Refugee Medical Assistance lapsed. They expressed median high satisfaction with health services but with wide variation. Inaccessibility of health services in Arabic and difficulty obtaining medications remain areas in need of improvement. [ABSTRACT FROM AUTHOR]

Due to the variability of working conditions and the scarcity of fault samples, the existing diagnosis models still have a big gap under the condition of covering more practical application scenarios. Therefore, it is of great significance to study an intelligent diagnosis scheme that takes few samples in the training source domain and zero samples in the test target domain (FST-ZST) into account. A Brownian correlation metric prototypical network (BCMPN) algorithm based on a multi-scale mask preprocessing mechanism is proposed for the above problem. First, this paper constructs a multi-scale mask preprocessing mechanism (MMP) to improve the optimization starting point. Second, the multi-scale feature embedding is realized through the dilation convolution module and the effective light channel attention (ELCA) module. Third, based on the Brownian distance similarity measurement, we learn the feature representation by measuring the difference between the joint feature function and the edge product in the field of diagnosis. Finally, based on the gear data set of the Connecticut university (UConn) and the data collected in the laboratory, it is proved that the BCMPN has better performance in the problem of FST-ZST. [ABSTRACT FROM AUTHOR]

Deep learning networks are widely used to realize the intelligent diagnosis of gear faults. However, the problem of the insufficient number of typical fault samples and strong noise often occur in practical applications. Thence, this paper proposes an adaptive anti-noise gear fault diagnosis method based on attention residual prototypical network (ARPN) under the limited sample. In order to maximize the characterization of implicit classification information under fewer samples, frequency slice wavelet transform is applied to convert the vibration signal into a time–frequency image. Then, the Bayesian optimization algorithm is introduced to automatically adjust hyperparameters to meet different application conditions. And the feature embedding stage combined with the improved Non-Local-Pooling-Attention module is constructed to capture the effective feature information better under strong noise conditions. Finally, the internal principle of the proposed model is analyzed based on the visualization process. Meanwhile, the initial application of an interpretable deep learning network in the classification of gear health status has been realized. The ARPN is verified on the Connecticut standard gear data set and the data set collected actually by the laboratory. The results show that the diagnostic accuracy of the ARPN is higher and has stronger recognition ability under different loads. • A novel adaptive-parameter-adjustment gear fault diagnosis method is proposed. • The NLPA module is developed to capture remote dependent features in limited noisy samples. • The improved prototypical network is applied to learn the internal relationships of fewer samples. • The proposed method has superior performance in generalization and robustness. [ABSTRACT FROM AUTHOR]

Simple Summary: Pollen is the main source of protein, fats, and many micronutrients for honey bees, and it also has the potential to be a major route of exposure to pesticides. The objective of this study was to quantify to what extent honey bee colonies use ornamental nursery plants as sources of pollen over the season. We put honey bee colonies at two large commercial ornamental plant nurseries and used a pollen-trapping device to collect pollen from foraging honey bees as they returned to the hive. Pollen was collected each week from June until September in 2015 and 2018. Samples from the pollen collected were identified to genus by a pollen specialist. By counting and measuring the pollen grains, we could quantify how much of the pollen came from what plant source. We found that most of the pollen in July and August was collected from plant genera not grown at the nursery, including clover (Trifolium), maize (Zea), buckwheat (Fagopyrum), and jewelweed, and related species (Impatiens). Genera grown at the nurseries and found in the honey bee-collected pollen in June and early July included roses (Rosa), sumac (Rhus), and hollies (Ilex), but each of these genera also include native or naturalized species that are abundant in the surrounding area, so the pollen probably came from both the nursery and the surroundings. Ornamental nursery plants are both a major agricultural industry in the U.S. and a major feature of the urban and suburban landscape. Interest in their relationship with pollinators is two-fold: the extent to which they provide a nutritional benefit to pollinators, and the extent to which they have the potential to harm pollinators by exposing them to pesticide residues in nectar and pollen. We identified plant genera as sources of trapped pollen collected by honey bee colonies located at commercial ornamental plant nurseries in Connecticut in 2015 and 2018 and quantified the percentage of pollen volume collected from each genus for each weekly sample over two seasons. Plant genera grown at these nurseries, particularly Rosa, Rhus, and Ilex, contributed substantially to pollen volume during weeks 23–27 of the year. Among the genera not grown in nurseries, Toxicodendron was also important during weeks 23 and 24, and Trifolium was important in both frequency and quantity throughout the season. Zea was a major component of pollen volume from weeks 28–36 in both sites, even though cropland was not over 11% of land cover at either site. [ABSTRACT FROM AUTHOR]

The crust and upper mantle beneath the New England Appalachians exhibit a large offset of the Moho across the boundary between Laurentia and accreted terranes and several dipping discontinuities, which reflect Paleozoic or younger tectonic movements. We apply scattered wavefield migration to the SEISConn array deployed across northern Connecticut and obtain insights not previously available from receiver function studies. We resolve a doubled Moho at a previously imaged Moho offset, which may reflect westward thrusting of rifted Grenville crust. The migration image suggests laterally variable velocity contrasts across the Moho, perhaps reflecting mafic underplating during continental rifting. A west‐dipping feature in the lithospheric mantle is further constrained to have a slab‐like geometry, representing a relict slab subducted during an Appalachian orogenic event. Localized low seismic velocities in the upper mantle beneath the eastern portion of the array may indicate that the Northern Appalachian Anomaly extends relatively far to the south. Plain Language Summary: Tectonic processes in the geologic past, such as the formation and breakup of supercontinents, modified the deep structures of the crust and upper mantle beneath eastern North America. In this study, we use a seismic imaging technique based on scattered wavefield back‐projection to investigate deep structures beneath southern New England. This imaging technique, which relies on seismic wave energy from distant earthquakes, is capable of resolving km‐scale structures when applied to data from closely spaced seismometers (∼10 km station spacing). We image an abrupt, step‐like change of the crustal thickness beneath southern New England; the details of this feature suggest a complicated tectonic history during the formation of the Appalachian Mountains. A west‐dipping interface in the upper mantle suggests the presence of a relict slab beneath southern New England, associated with a past subduction event. A region of low seismic velocity in the upper mantle beneath southeastern New England may reflect past impingement of a mantle plume or modern upwelling of asthenospheric mantle. Key Points: We conducted 2‐D wavefield migration on a dense seismic array across northern Connecticut to investigate crust and upper mantle structuresWe resolved a doubled Moho beneath the Laurentian margin as well as a relict slab and a low‐velocity anomaly in the upper mantleMigration provides insights unattainable by receiver functions, including the Moho velocity contrast and the geometry of the relict slab [ABSTRACT FROM AUTHOR]

Understanding drivers of metapopulation dynamics remains a critical challenge for ecology and conservation. In particular, the degree of synchrony in metapopulation dynamics determines how resilient a metapopulation is to a widespread disturbance. In this study, we used 21 years of egg mass count data across 64 nonpermanent freshwater ponds in Connecticut, USA to evaluate patterns of abundance and growth and to assess regional as well as local factors in shaping the population dynamics of wood frogs (Rana sylvatica = Lithobates sylvaticus). In particular, we asked whether a species known to undergo metapopulation dynamics exhibited spatial synchrony in abundances. With the exception of a single year when breeding took place during severe drought conditions, our analyses revealed no evidence of synchrony despite close proximity (mean minimum distance < 300 m) of breeding ponds across the 3213‐ha study area. Instead, local, pond‐scale conditions best predicted patterns of abundance and population growth rate. We found negative density dependence on population growth rate within ponds as well as evidence that larger neighboring pond populations had a negative effect on focal ponds. Beyond density, pond depth was a critical predictor; deeper ponds supported larger populations. Drought conditions and warm winters negatively affected populations. Overall, breeding ponds vary in critical ways that either support larger, more persistent populations or smaller populations that are not represented by breeding pairs in some years. The infrequency of spatial synchrony in this system is surprising and suggests greater resilience to stressors than would have been expected if dynamics were strongly synchronized. More generally, understanding the characteristics of systems that determine synchronous population dynamics will be critical to predicting which species are more or less resilient to widespread disturbances like land conversion or climate change. [ABSTRACT FROM AUTHOR]

Mammalian mesopredators—mid‐sized carnivores—are ecologically, economically, and socially important. With their adaptability to a variety of habitats and diets, loss of apex predators, and forest regrowth, many of these species are increasing in number throughout the northeastern United States. However, currently the region is seeing extensive landscape alterations, with an increase in residential and industrial development, especially at the expense of existing forest and small‐scale farmland. We sought to understand how important an existing mosaic of working lands (timberland and farmland) in a forested landscape is to mesopredator species. We did this by studying mesopredator occupancy across three land uses (or habitat types): forest reserve (protected), timber harvest (shelterwood cuts), and field (both crop yielding and fallow) in and around a 3200‐ha forest in northeastern Connecticut. We examined coyote (Canis latrans), bobcat (Lynx rufus), fisher (Pekania pennanti), and raccoon (Procyon lotor) occupancy using paired camera traps across juxtaposed reserve, shelterwood, and field units from April 2018 to March 2019. We created a priori habitat variable models for each species and season, as well as analyzed the impact of habitat types on each species. Throughout the year bobcats were positively associated with foliage height diversity and had the highest use in shelterwoods and lowest use in fields. Land use utilization varied seasonally for coyotes and raccoons, with higher use of fields than reserves and shelterwoods for half the year and no difference between land uses and the other half. Both species were not strongly associated with any particular habitat variables. Reserve forest was moderate to highly used by all species for at least half the year, and highly use year‐round by fishers. Our findings reveal that a mosaic of intact forest and working lands, timber harvest, and agriculture can support mesopredator diversity. [ABSTRACT FROM AUTHOR]

Predation pressure from carnivores can shape ecological communities and has significant consequences for prey species that are declining or recovering from historical declines. New England cottontails Sylvilagus transitionalis are a species of greatest conservation need in Connecticut and are experiencing continued decline associated with habitat loss. Restoration of early successional habitat is underway to address the most significant threat to their populations. However, one of the largest documented sources of mortality is associated with several key predators and remains a threat to recovery efforts. We sought to develop species-specific occupancy estimates of carnivores in early successional habitat and relate our findings to the potential recovery of New England cottontails. We conducted camera surveys at 34 sites in early successional habitat in or near New England cottontail focus areas throughout Connecticut and used the program MARK to estimate occupancy and detectability from detection data. We found key predators in early successional habitat, but their detectability was generally low. Occupancy was highest for coyotes Canis latrans, and regional occupancy differed only for bobcats Lynx rufus. Covariates that influenced parameter estimates in our models included high road densities and the intensity of New England cottontail and eastern cottontail Sylvilagus floridanus detections. Expanding carnivores, particularly coyote and bobcat, may place additional pressure on New England cottontail recovery in the state, but restoration efforts that promote contiguous habitat and reduce isolated patches where predation risk is higher will improve their chances of a long-term recovery. [ABSTRACT FROM AUTHOR]

The Farmington River, located in the northeastern USA, originates from Massachusetts and flows through several towns until it joins the Connecticut River in Windsor, Connecticut. Trace element concentrations within the drainage systems of the Farmington River are a growing concern, largely due to the presence of both historical and present land use activities along the river that include mining, farming, urbanization, industrialization, landfills, and shooting gun ranges. This study examined the impact of land use activities and geology on the chemical signature of major and trace elements within the Farmington River. A total of seventy-eight (78) stream sediment and corresponding water samples were collected and analyzed for twenty-one chemical elements (As, Be, Ca, Cd, Co, Cr, Cu, Fe, Li, Mg, Mn, Mo, Ni, Pb, Sb, Se, Sr, Ti, Tl, V, and Zn) and basic river sediment parameters such as particle size distribution and organic matter contents. Results showed spatial variability in the concentration of elements along the river flow path, with the highest concentrations of As, Cd, Ni, Zn, and Pb determined at location FR31 due to various human activities within the surrounding environment. However, most sampling locations do not pose a major environmental concern. Multivariate statistical analysis showed inter-relationship among most elements, with a weak but significant positive relationship with fine particle sizes in sediment. Results of principal component analysis (PCA) suggested a combination of both geogenic and anthropogenic sources of trace elements to the Farmington River system. [ABSTRACT FROM AUTHOR]

Concrete cores were obtained from houses in eastern Connecticut, USA, that had varying degrees of crumbling foundations and wall cracking. Electron backscatter diffraction (EBSD) was used simultaneously with energy dispersive X‐ray spectroscopy to investigate the degradation of these samples. This combination allowed the precise correlation of elemental composition with mineral crystallography phase mapping. EBSD examination showed the presence of pyrrhotite, pyrite, and marcasite phases in some of the samples, whereas internal sulfate attack (ISA) is triggered by the release of sulfates through the oxidation of such iron sulfides. Secondary expansion products from ISA are associated with foundation cracking, wall bulging, and drastically decreased structural stability. The main contribution of this study is therefore an automated procedure for preparation of concrete samples and analysis of aggregates using EBSD. [ABSTRACT FROM AUTHOR]

Diagnosis codes are used to study SARS-CoV2 infections and COVID-19 hospitalizations in administrative and electronic health record (EHR) data. Using EHR data (April 2020–March 2021) at the Yale-New Haven Health System and the three hospital systems of the Mayo Clinic, computable phenotype definitions based on ICD-10 diagnosis of COVID-19 (U07.1) were evaluated against positive SARS-CoV-2 PCR or antigen tests. We included 69,423 patients at Yale and 75,748 at Mayo Clinic with either a diagnosis code or a positive SARS-CoV-2 test. The precision and recall of a COVID-19 diagnosis for a positive test were 68.8% and 83.3%, respectively, at Yale, with higher precision (95%) and lower recall (63.5%) at Mayo Clinic, varying between 59.2% in Rochester to 97.3% in Arizona. For hospitalizations with a principal COVID-19 diagnosis, 94.8% at Yale and 80.5% at Mayo Clinic had an associated positive laboratory test, with secondary diagnosis of COVID-19 identifying additional patients. These patients had a twofold higher inhospital mortality than based on principal diagnosis. Standardization of coding practices is needed before the use of diagnosis codes in clinical research and epidemiological surveillance of COVID-19. [ABSTRACT FROM AUTHOR]

An increased incidence of chilblains has been observed during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and attributed to viral infection. Direct evidence of this relationship has been limited, however, as most cases do not have molecular evidence of prior SARS-CoV-2 infection with PCR or antibodies. We enrolled a cohort of 23 patients who were diagnosed and managed as having SARS-CoV-2–associated skin eruptions (including 21 pandemic chilblains [PC]) during the first wave of the pandemic in Connecticut. Antibody responses were determined through endpoint titration enzyme-linked immunosorbent assay and serum epitope repertoire analysis. T cell responses to SARSCoV-2 were assessed by T cell receptor sequencing and in vitro SARS-CoV-2 antigen-specific peptide stimulation assays. Immunohistochemical and PCR studies of PC biopsies and tissue microarrays for evidence of SARS-CoV-2 were performed. Among patients diagnosed and managed as “covid toes” during the pandemic, we find a percentage of prior SARS-CoV-2 infection (9.5%) that approximates background seroprevalence (8.5%) at the time. Immunohistochemistry studies suggest that SARS-CoV-2 staining in PC biopsies may not be from SARS-CoV-2. Our results do not support SARS-CoV-2 as the causative agent of pandemic chilblains; however, our study does not exclude the possibility of SARS-CoV2 seronegative abortive infections. [ABSTRACT FROM AUTHOR]

Objective: To develop and test predictive models of discontinuation of behavioral health service use within 12 months in transitional age youth with recent behavioral health service use. Data sources: Administrative claims for Medicaid beneficiaries aged 15–26 years in Connecticut. Study design: We compared the performance of a decision tree, random forest, and gradient boosting machine learning algorithms to logistic regression in predicting service discontinuation within 12 months among beneficiaries using behavioral health services. Data extraction: We identified 33,532 transitional age youth with ≥1 claim for a primary behavioral health diagnosis in 2016 and Medicaid enrollment of ≥11 months in 2016 and ≥11 months in 2017. Principal findings: Classification accuracy for identifying youth who discontinued behavioral health service use was highest for gradient boosting (80%, AUC = 0.86), decision tree (79%, AUC = 0.84), and random forest (79%, AUC = 0.86), as compared with logistic regression (71%, AUC = 0.71). Conclusions: Predictive models based on Medicaid claims can assist in identifying transitional age youth who are at risk of discontinuing from behavioral health care within 12 months, thus allowing for proactive assessment and outreach to promote continuity of care for younger persons who have behavioral health needs. [ABSTRACT FROM AUTHOR]

There continue to be conflicting data regarding the outcomes of people with HIV (PWH) who have COVID-19 infection with most studies describing the early epidemic. We present a single site experience spanning a later timeframe from the first report on January 21, 2020 to January 20, 2021 and describe clinical outcomes and predictors of hospitalization among a cohort of PWH in an urban center in Connecticut, USA. Among 103 PWH with controlled HIV disease, hospitalization occurred in 33% and overall mortality was 1%. HIV associated factors (CD4 count, HIV viral suppression) were not associated with hospitalization. Chronic lung disease (OR: 3.35, 95% CI:1.28–8.72), and cardiovascular disease (OR: 3.4, 95% CI:1.27–9.12) were independently associated with hospitalization. An increasing number of non-communicable comorbidities increased the likelihood of hospitalization (OR: 1.61, 95% CI:1.22–2.13). [ABSTRACT FROM AUTHOR]