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OBJECTIVE: Identify factors affecting the use of a community resource referral platform among local community-based organizations (CBOs) and test strategies to increase platform use. DATA SOURCES AND STUDY SETTING: Data sources included platform usage data and semi-structured interviews. The study took place in a small city in the Northeastern United States from 2020 to 2022. STUDY DESIGN: We analyzed platform data and conducted interviews with local organizations and organizations in other communities to understand barriers to CBOs use of the referral platform and identify strategies that might increase use. We then tested 4 strategies and assessed impacts via time trend analysis of platform usage and qualitative interviews. DATA COLLECTION/EXTRACTION METHODS: Platform usage data were obtained from the platform. Semi-structured interviews were conducted with staff and leaders of 36 local CBOs and 9 external organizations. PRINCIPAL FINDINGS: Four years after launch, platform use remained relatively low. None of the tested strategies (data insight reports, a referral hub, tailored training, and a communication campaign) noticeably increased platform use. The main barrier to the use of the platform was the lack of perceived usefulness, mostly because existing processes for identifying resources and referring clients worked well enough and because many organizations were already required to use a client management or referral tool. Additional barriers included the lack of comfort with and, in some cases, active dislike of e-referrals, and lack of comfort with technology tools overall. Organizations that were most likely to find the platform useful and to use it were those that provided referrals for a wide range of needs and whose staff were not already familiar with local resources. CONCLUSIONS: Organizations seeking to implement referral platforms should not assume that local CBOs will automatically take up these platforms. For these platforms to succeed, much more attention needs to be paid to ensuring the platforms provide value to the CBOs they seek to engage.

Aim: This study aimed to determine clinical nurse and nurse manager perspectives on missed nursing care (MNC) during the COVID‐19 pandemic. Design: This study utilized a qualitative exploratory descriptive design. Methods: Data were obtained through focus groups and virtual interviews. Purposive sampling was used to select nurse and nurse manager participants in COVID‐19 units and the Emergency Department in one large healthcare organization in the northeastern United States of America. Results: A total of 15 nurses and nurse managers participated in the study. Results revealed five categories: medication delivery, turning patients, double checks, communication and rapport, and patient surveillance. Conclusions: A variety of factors contributed to the perceptions and experiences of MNC of COVID‐19 patients during the early stage of the pandemic. The COVID‐19 crisis put additional and unparalleled pressure on a strained nursing workforce. Hospital leaders are responsible for ensuring their frontline nurses have the resources they need to feel supported in their roles regardless of the presenting circumstances. Implications for the Profession: Nurse leaders should employ evidence‐based strategies such as promoting and championing teamwork to support staff and reduce incidences of MNC during crises. Our current work may serve as a basis for informing future revisions of pre‐pandemic measurement tools when applied in a pandemic‐specific context. Reporting Methods: This manuscript adheres to the standards for reporting qualitative research (SRQR); a synthesis of recommendations. Public Contribution: There was not patient or public contribution for this study. [ABSTRACT FROM AUTHOR]

Background: Clinical judgment is declining in new graduate nurses, which affects patient safety and is therefore tested on the Next Generation NCLEX. There is limited research describing barriers and facilitators impacting nursing faculty's experiences teaching clinical judgment. Aims: The purpose of this study was to explore barriers and facilitators affecting undergraduate nursing faculty's clinical judgment teaching methods. Methods: Sixteen qualitative interviews were conducted with full-time nursing faculty at seven universities in the Northeast and Southeast regions of the United States. Results: The findings revealed program, student, and faculty factors affecting clinical judgment teaching methods. Subthemes included time, class size, students' class preparation, critical thinking, task orientation, professional development, and faculty resistance. Conclusion: Minimizing barriers and strengthening facilitators based on participants' practices and previous research can support more effective clinical judgment pedagogy, which has the potential to achieve Next Generation NCLEX success and potentially increase patient safety. [ABSTRACT FROM AUTHOR]

Background: Approximately one-half of all adults with HIV experience chronic pain. Needed are nonpharmacological approaches to improve pain management in this population. Methods: For this study, we conducted in-depth qualitative interviews (n = 20) with thirteen adults with HIV and 7 HIV care providers regarding their perceptions of Tai Chi for chronic pain management. The interviews were audio recorded, transcribed, double-coded, and analyzed using applied thematic analysis. Results: HIV patients had limited prior exposure to Tai Chi and had not previously considered this practice for pain management. However, after viewing a brief video demonstration of Tai Chi, patients recognized potential benefits, including relaxation, stress reduction, and pain lessening. Patients were surprised by the gentle nature of Tai Chi and expressed enthusiasm to learn more about Tai Chi. HIV healthcare providers similarly had limited knowledge of Tai Chi for pain management. HIV care providers shared several helpful insights on the potential implementation of Tai Chi with this population. Conclusions: Adults with HIV and healthcare providers were optimistic that Tai Chi would reduce stress and ease chronic pain. These data suggest that Tai Chi would be of interest to HIV patients and care providers as a novel pain management strategy. [ABSTRACT FROM AUTHOR]

Background: The extent of past Indigenous cultural burning in the eastern US remains contested. Historical documents (e.g. early histories, journals, and reports) contain descriptions of burning. Scholars have summarised descriptions, but few have compiled them into databases. Aims: This paper presents efforts to compile descriptions of past Indigenous burning in the eastern US and early results from mapped descriptions. Methods: Utilising previously cited descriptions and those discovered from digitised historical texts, the current dataset mapped >250 descriptions of burning in the northeastern US. Most were historical summaries from 19th century authors, and fewer were firsthand observations. Descriptions are currently shared as a GIS data layer, a tabular file, and an interactive web map. Key results: Descriptions correspond with fire-adapted vegetation, and clusters of descriptions suggest burning over large extents (e.g. southern New England, western New York). Estimated dates of burning or initial Euro-American settlement show an east–west succession in Indigenous fire exclusion and replacement with early Euro-American burning. Conclusions: Historical descriptions suggest regional-extent influence of Indigenous burning upon past forested ecosystems, but the veracity of descriptions should be carefully evaluated. Implications: This study provides a dataset for further examination of Indigenous burning and comparison with other methodologies for historical cultural fire reconstruction. This study creates a dataset of historical descriptions of Indigenous wildland burning from digitised historical texts in the eastern US. The current version of the dataset contains >250 descriptions in the northeastern US, mainly from 19th century historians. Descriptions correspond with geographic patterns in past fire-adapted vegetation. [ABSTRACT FROM AUTHOR]

CHRISTOPHER DAWSON was an English historian in the middle of the last century, one of those intellectuals prominent in his own day--T. S. Eliot called him 'the most powerful intellectual [...]

Long before kindergarten, many of us experimented with mud. Its squishiness, the fact that we could launch airborne blobs with a kick or a stomp--and the satisfying thwuuck sounds that [...]

Sea‐level change threatens the U.S. East Coast. Thus, it is important to understand the underlying causes, including ocean dynamics. Most past studies emphasized links between coastal sea level and local atmospheric variability or large‐scale circulation and climate, but possible relationships with local ocean currents over the shelf and slope remain largely unexplored. Here we use 7 years of in situ velocity and sea‐level data to quantify the relationship between northeastern U.S. coastal sea level and variable Shelfbreak Jet transport south of Nantucket Island. At timescales of 1–15 days, southern New England coastal sea level and transport vary in anti‐phase, with magnitude‐squared coherences of ∼0.5 and admittance amplitudes of ∼0.3 m Sv−1. These results are consistent with a dominant geostrophic balance between along‐shelf transport and coastal sea level, corroborating a hypothesis made decades ago that was not tested due to the lack of transport data. Plain Language Summary: Sea‐level rise is an imminent threat to coastal communities worldwide, including the U.S. East Coast. Therefore, it is crucial to understand the processes driving regional sea‐level change. While past studies documented how coastal sea level may be influenced by large‐scale ocean circulation, less attention has been paid to the role of more local currents over the shelf and slope. Here we explore the relationship between coastal sea level along the northeastern U.S. and the Shelfbreak Jet, a current that flows along the shelfbreak from the Labrador Sea to Cape Hatteras (North Carolina). From 7 years of in situ data of both current velocities and water levels, we see that as coastal sea level rises, Shelfbreak Jet transport increases westward (and vice versa) on timescales of days to weeks. Our results lay the groundwork for understanding relationships between coastal sea level and local ocean dynamics elsewhere. Key Points: Daily Shelfbreak Jet transports and Southern New England coastal sea levels are anti‐correlated during 2014–2022The observed relationship between these two variables is consistent with geostrophic balanceFor this region, coastal sea levels are more sensitive to local ocean dynamics than to large‐scale circulation [ABSTRACT FROM AUTHOR]

Introduction: To characterize the impact of rural patients' travel time to obtain healthcare on their reported utilization of preventive healthcare services and personal health outcomes. Methods: Online survey data from rural adults ages 50+ years living in the Northeastern United States were collected from February to August 2021. Study measures included self-reported travel time to obtain healthcare, use of preventive healthcare, and health outcomes. The associations between travel time with use of preventive care and health outcomes were assessed using linear, Poisson, and logistic regression analyses controlling for demographic variables. Results: Our study population included 1052 rural adults, with a mean travel time of 18.5 min (range: 0-60). Travel time was greater for racial/ethnic minority participants and for higher-income participants (both P <.05), but it was not associated with use of preventive healthcare. Greater travel time was associated with poorer mental health and more comorbidities, including cancer and diabetes (all P <.05). Conclusions: Travel time varied by patient demographic factors, and it was associated with mental health and comorbidities. There was no association between travel time and preventive care use, suggesting that other barriers likely contribute to suboptimal use of these services within rural communities. Further research is needed to elucidate the causal pathways linking travel time to mental health and comorbidities within rural communities, as increased travel may exacerbate intrarural health disparities. [ABSTRACT FROM AUTHOR]

Representation is an important role of the nonprofit sector as these organizations can give voice to the priorities of their constituents. This is particularly important for disadvantaged communities that may lack access to traditional democratic processes. What advocacy tactics are most utilized by nonprofit organizations serving disadvantaged populations? Given variation in nonprofit advocacy tactics, which tactics are perceived as most effective? To answer these questions, we look to the framework of tactical repertoires from sociological studies of social movements. Analysis of a survey of New England nonprofits (N = 656, 55 % response rate) indicates that nonprofits serving disadvantaged populations use similar tactics to organizations advocating for other constituencies but employ them at higher rates. These tactics cluster into three tactical repertoires, each a different combination of advocacy tactics. Perceptions of advocacy effectiveness are associated with the size and nature of tactical repertoires, client participation in advocacy, government funding, and perceptions of the policy environment. [ABSTRACT FROM AUTHOR]

It is unknown to what extent medical researchers generalize study findings beyond their samples when their sample size, sample diversity, or knowledge of conditions that support external validity do not warrant it. It is also unknown to what extent medical researchers describe their results with precise quantifications or unquantified generalizations, i.e., generics, that can obscure variations between individuals. We therefore systematically reviewed all prospective studies (n = 533) published in the top four highest ranking medical journals, Lancet, New England Journal of Medicine (NEJM), Journal of the American Medical Association (JAMA), and the British Medical Journal (BMJ), from January 2022 to May 2023. We additionally reviewed all NEJM Journal Watch clinical research summaries (n = 143) published during the same time. Of all research articles reporting prospective studies, 52.5% included generalizations beyond specific national study populations, with the numbers of articles with generics varying significantly between journals (JAMA = 12%; Lancet = 77%) (p < 0.001, V = 0.48). There was no evidence that articles containing broader generalizations or generics were correlated with larger or more nationally diverse samples. Moreover, only 10.2% of articles with generalizations beyond specific national populations reported external validity strengthening factors that could potentially support such extrapolations. There was no evidence that original research articles and NEJM Journal Watch summaries intended for practitioners differed in their use of broad generalizations, including generics. Finally, from the journal with the highest citation impact, articles containing broader conclusions were correlated with more citations. Since there was no evidence that studies with generalizations beyond specific national study populations or with generics were associated with larger, more nationally diverse samples, or with reports of population similarity that may permit extensions of conclusions, our findings suggest that the generalizations in many articles were insufficiently supported. Caution against overly broad generalizations in medical research is warranted. [ABSTRACT FROM AUTHOR]

Power systems exhibit nonlinearity. causing dynamic instability and complex power oscillations. This research proposes an innovative strategy using the Novel Bat Algorithm (NBA) to achieve ideal Power System Stabilizers (PSSs) in a multimachine power system. The approach shifts electromechanical modes to specific areas in the s-plane. Enhancing the multi-machine power system and establishing stabilizer parameters for dynamic performance. The study examines the designed approach aptitude for standard lead-lag PSSs configurations. In order to elevate the global search problem and transfer some static operators for the optimum optimization process. the chaos mapping. also known as CNBA. is introduced into NBA. Four different forms of chaos maps are compared in experiments to resolve unconstrained mathematical issues in order to illustrate CNBA performance. In any other case. the challenge of designing PSS under a wide range of loading situations is transformed into an optimization challenge with the damping ratio of electromechanical modes with low damping as the target function. The optimal stabilizers' gains are gotten by employing the CNBA algorithm. Second plan. an effective technique is astutely established to delineate the PSS location and quantity using CNBA and another side using participation factor. To examine the efficacy of the proposed CNBA-based PSS on a large system; it is tested on the interconnected of New-England/New-York (16 generators and 68 buses) power grid. and verified by comparative study with NBA through eigenvalue analysis and nonlinear simulation to provide evidence the algorithmic competence of CNBA. The CNBA approach yields a minimum damping ratio of 37%. which is consistent with the its eigenvalue. In contrast, the NBA approach achieves a minimum damping ratio of 31%. The simulation results reveal the fine performance of the proposed CNBA-PSS in a convincing manner and its capacity to provide an excellent damping for inter-area and local oscillations under diverse operating cases compared to NBA-PSS then in the case of PSS location. [ABSTRACT FROM AUTHOR]

The central role of natriuretic peptides (NPs) in the complex cardio‐renal integrated physiology and organ failure has been revealed over the last four decades. Atrial natriuretic peptide (ANP), the oldest representative of the NPs family, is produced through conversion of proANP to the mature peptide by corin, a trans‐membrane protease localized to the cardiac myocyte membrane. Similarly, brain natriuretic peptide (BNP) is generated by furin, which cleaves proBNP to BNP in myocytes. Though the components of NPs system, their synthesis and target organs are well established, understanding their role in the interplay between the heart and the kidney is steadily evolving. In this context, Feldman et al. (New England Journal of Medicine, 389, 1685) recently described patients with hypertension, cardiomyopathy, atrial arrhythmia and left atrial fibrosis, associated with a homozygous loss‐of‐function variant of the gene encoding corin (Cor−/−). Notably, reduced baseline urinary electrolyte and creatinine excretion have been observed in one of the studied patients. This renal excretory functional impairment could be attributed to the lack of cardiac‐derived ANP in these patients, as implied by Feldman et al. Yet, in this mini‐review we suggest that this aberrant renal manifestation may principally stem from lack of local ANP production at renal tissue, as corin is normally expressed in proximal tubules, Henle's loop and collecting ducts, with locally produced ANP provoking Na+ and water exertion. Collectively, it seems that beside the classic well‐established cardio‐renal axis, the renal NPs system functions as local endocrine machinery in the regulation of sodium excretion. [ABSTRACT FROM AUTHOR]

Ecological theory predicts that kelp forests structured by trophic cascades should experience recovery and persistence of their foundation species when herbivores become rare. Yet, climate change may be altering the outcomes of top‐down forcing in kelp forests, especially those located in regions that have rapidly warmed in recent decades, such as the Gulf of Maine. Here, using data collected annually from 30+ sites spanning >350 km of coastline, we explored the dynamics of Maine's kelp forests in the ~20 years after a fishery‐induced elimination of sea urchin herbivores. Although forests (Saccharina latissima and Laminaria digitata) had broadly returned to Maine in the late 20th century, we found that forests in northeast Maine have since experienced slow but significant declines in kelp, and forest persistence in the northeast was juxtaposed by a rapid, widespread collapse in the southwest. Forests collapsed in the southwest apparently because ocean warming has—directly and indirectly—made this area inhospitable to kelp. Indeed, when modeling drivers of change using causal techniques from econometrics, we discovered that unusually high summer seawater temperatures the year prior, unusually high spring seawater temperatures, and high sea urchin densities each negatively impacted kelp abundance. Furthermore, the relative power and absolute impact of these drivers varied geographically. Our findings reveal that ocean warming is redefining the outcomes of top‐down forcing in this system, whereby herbivore removal no longer predictably leads to a sustained dominance of foundational kelps but instead has led to a waning dominance (northeast) or the rise of a novel phase state defined by "turf" algae (southwest). Such findings indicate that limiting climate change and managing for low herbivore abundances will be essential for preventing further loss of the vast forests that still exist in northeast Maine. They also more broadly highlight that climate change is "rewriting the rules" of nature, and thus that ecological theory and practice must be revised to account for shifting species and processes. [ABSTRACT FROM AUTHOR]

Much has been written on the skills and capabilities of a new generation raised with social media, smartphones, and immediate access to data and information via the Internet. Today's college students grew up using the Internet, where they both generate and consume data. But do incoming college students have the skills necessary to thrive in a digital world that requires the ability to generate, analyze, and share insights from data? This paper presents a study, performed at two small New England institutions each with a business focus, which examines the digital skill sets of first-year college students in relation to the skills they have developed before entering college. The authors also consider whether there is a "digital divide" among first-year college students in relation to their previous technology skills. When applying the Databilities framework for evaluating data literacy competencies, results show that teaching data literacy skills to first-year college students will be critical to their academic success as future information technology workers. [ABSTRACT FROM AUTHOR]

Objective: In 2020, one study by Strait and colleagues raised awareness that the clinical images in rheumatology educational materials underrepresent people with skin of color (P‐SOC). Since then, publishers of rheumatology educational materials have focused on addressing this shortcoming. This study investigates the change in representation of P‐SOC following the review of Strait et al. Methods: We used the methods of the aforementioned study to collect images from commonly referenced rheumatology educational materials and categorized the skin tones within them as "light" or "dark." We calculated the proportional change in images depicting dark skin tones between 2020 and 2022 from the American College of Rheumatology (ACR) Image Library, the 10th edition of Kelley's Textbook of Rheumatology, and New England Journal of Medicine (NEJM) as well as between 2020 and 2024 from rheumatology articles within UpToDate. We compared results using one‐sided Z‐tests. Results: Overall, the proportion of images depicting dark skin tones increased 40.6% (P < 0.0001). The 10th edition of Kelley's Textbook of Rheumatology most significantly increased inclusion of P‐SOC (90.1%; P = 0.0039), with ACR Image Library, UpToDate, and NEJM also enhancing representation (41.9%, P < 0.0001; 31.0%, P = 0.0083; 28.2%, P = 0.3046, respectively). Conclusion: This study assesses the progress of rheumatology educational materials toward equitable representation of P‐SOC. It demonstrates that awareness coupled with focused efforts from educational publishers can enhance the proportion of images depicting dark skin tones, thereby enriching the quality of foundational knowledge relayed to rheumatology providers with the goal of improving health experiences and outcomes for P‐SOC with rheumatic diseases. [ABSTRACT FROM AUTHOR]

AbstractDespite the fact that most police departments in the U.S. serve jurisdictions with fewer than 10,000 residents, policing practices in small towns are understudied. This is due in part to data limitations and technological barriers that exist in the small-town context. In this article we focus on one small town police department in New England with a history of misconduct, and develop a comprehensive data science pipeline that addresses the stages from design and collection to reporting. We present the reader with specific tools in the open-source Python ecosystem for replicating this pipeline. Once these data are processed, we perform two statistical analyses in an attempt to better understand the provisions of service by the small-town police department of focus. First, we perform ecological inference to estimate the rate at which residents are placing calls for service. Second, we model wait times using a negative binomal regression model to account for overdispersion in the data. We discuss data and model limitations arising through the pipeline creation and analysis process. [ABSTRACT FROM AUTHOR]

Maintaining stability in modern power systems is challenging due to complex structures, rising power demand, and load disturbances. The integration of renewable energy sources further threatens stability by causing imbalances between generation and demand. Conventional load frequency stabilization methods fall short in such scenarios. This paper proposes an optimal fractional‐order proportional‐integral‐derivative‐acceleration (FOPIDA) controller, enhanced by a robust adaptive neuro‐fuzzy inference system (ANFIS), to improve load frequency control and reliability in power systems with wind and solar generators. First, the dynamical model of a multi‐area interconnected power system, including a thermal power plant, wind turbine, and solar photovoltaic generators, is developed. A decentralized ANFIS‐FOPIDA controller is then designed for load frequency control objectives. The gains of this controller are optimized using the whale optimization algorithm (WOA), focusing on frequency deviation and tie‐line power exchange. Simulations on a New England IEEE 10‐generator 39‐bus power system demonstrate the approach's effectiveness under various disturbances, including random load‐generation disturbances and nonlinear generation behaviors. Comparisons with other strategies, such as fractional order (FO) beetle swarm optimization algorithm (FOBSOA)‐FOPIDA, WOA‐PIDA, and WOA‐ANFIS‐PIDA, and recent control approaches highlight the superior performance of the WOA‐ANFIS‐FOPIDA method in enhancing power system stability. [ABSTRACT FROM AUTHOR]

This phenomenological qualitative study examined the lived experience of pediatric nurse residents' transition to practice during the COVID-19 pandemic. The purposive sample included nine pediatric nurses, participating in a nurse residency program, who entered the nursing profession during the first year of the pandemic. The setting was a free-standing, Magnet-recognized, pediatric academic medical center in the Northeastern U.S. Individual interviews were audio recorded and transcribed. Narratives were analyzed using a hermeneutic phenomenological approach. Five themes emerged from the data: Our New Normal; The Rules Keep Changing; I'm Not Ready for This (transition to practice); The Toll of COVID; and Shattered Family-Centered Care. Sub-themes emerged in The Toll of COVID theme: COVID and the Nursing Care Environment, Emotional Toll of COVID, Burnout: A Universal Truth, and The Pandemic within the Pandemic. The nurse residents' narratives uncovered the essence of their uncertainty, sorrow, growth, and resilience. Through the eyes of pediatric nurse residents, this study illuminated the experiences of these novices as they entered the nursing profession amid a pandemic. [ABSTRACT FROM AUTHOR]

The concept of "Less is more" has been gaining increasing awareness and acceptance in Critical Care. In 2017, we attempted to systematically answer the question "Can less be more in intensive care" with empirical data. We reviewed all the critical care randomized clinical trials (RCTs) between 1 January 2008 and 5 October 2016 in the New England Journal of Medicine (NEJM). This article attempts to repeat the earlier exercise using data from 5 October 2016 to 31 December 2023. This analysis of critical care RCTs in the NEJM has shown three findings. Approximately three-quarter of RCTs in critical care in the NEJM between 2008 and 2023 failed to show benefit or harm. In the years 2008-2016, patients in the intervention cohort had a higher mortality compared to controls, but in the years 2016-2023, the difference in overall mortality in patients in the intervention and control arms was not statistically significant. Compared to the years 2008-2016, in the years from 2016 to 2023, the number of RCTs showing harm decreased and those showing benefit increased. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Cardiovascular risk factors and history of cardiovascular disease are associated with greater morbidity and mortality in patients hospitalized with COVID-19. Limited English proficiency (LEP) has also been associated with worse outcomes in this setting, including requiring intensive care unit (ICU) level of care and in-hospital death. Whether non-- English-language preference (NELP) modifies the association between cardiovascular risk factors or disease and outcomes in patients hospitalized with COVID-19 is unknown. STUDY DESIGN: Retrospective cohort study of adult patients admitted to a large New England health system between March 1 and December 31, 2020, who tested positive for COVID-19. NELP was defined as having a preferred language that was not English noted in the electronic health record. METHODS: Cardiovascular risk factors, history of cardiovascular disease, and NELP were related to the primary composite clinical outcome--death or ICU admission--using multivariable binary logistic regression adjusted for demographic and clinical characteristics. Interaction terms for NELP and model covariates were evaluated. RESULTS: Of 3582 patients hospitalized with COVID-19, 1024 (28.6%) had NELP; 812 (79.3%) of the patients with NELP received interpreter services. Death or ICU admission occurred in 794 (22.2%) of the hospitalized patients. NELP was not significantly associated with the primary composite outcome in unadjusted or adjusted analyses. In the adjusted analyses, only male gender, coronary artery disease, pulmonary circulatory disease, and liver disease significantly predicted the primary outcome. NELP did not modify the effect of these associations. CONCLUSIONS: NELP was not significantly associated with odds of death or ICU admission, nor did it modify the association between cardiovascular risk factors or history of cardiovascular disease and this composite outcome. Because most patients with NELP received interpreter services, these findings may support the role of such services in ensuring equitable outcomes. [ABSTRACT FROM AUTHOR]

The coherent recombination of a direct and seabed reflected path is sensitive to the geophysical properties of the seabed. The concept of feature-based inversion is used in the analysis of acoustic data collected on a vertical line array (VLA) on the New England continental shelf break in about 200 m of water. The analysis approach for the measurements is based on a ray approach in which a direct and bottom reflected path is recombined, resulting in constructive and destructive interference of the acoustic amplitudes with frequency. The acoustic features have the form of prominent nulls of the measured received levels as a function of frequency as a broadband (500–4500 Hz) source passes the closest point of approach to the VLA. The viscous grain shearing (VGS) model is employed to parameterize a two-layer seabed model. The most likely seabed is a sand sediment with a porosity of about 0.42. There is a possibility of a thin (less than 0.5 m) surface layer having a slightly higher porosity between 0.45 and 0.50. Using the estimates for the VGS parameters inferred from the short-range frequency features, a normal mode model is used to predict the received acoustic levels over larger range scales. [ABSTRACT FROM AUTHOR]

Accurate short-term load forecasting (STLF) plays an essential role in sustainable energy development. Specifically, energy companies can efficiently plan and manage their generation capacity, lessening resource wastage and promoting the overall efficiency of power resource utilization. However, existing models cannot accurately capture the nonlinear features of electricity data, leading to a decline in the forecasting performance. To relieve this issue, this paper designs an innovative load forecasting method, named Prophet–CEEMDAN–ARBiLSTM, which consists of Prophet, Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (CEEMDAN), and the residual Bidirectional Long Short-Term Memory (BiLSTM) network. Specifically, this paper firstly employs the Prophet method to learn cyclic and trend features from input data, aiming to discern the influence of these features on the short-term electricity load. Then, the paper adopts CEEMDAN to decompose the residual series and yield components with distinct modalities. In the end, this paper designs the advanced residual BiLSTM (ARBiLSTM) block as the input of the above extracted features to obtain the forecasting results. By conducting multiple experiments on the New England public dataset, it demonstrates that the Prophet–CEEMDAN–ARBiLSTM method can achieve better performance compared with the existing Prophet-based ones. [ABSTRACT FROM AUTHOR]

The U.S. Inflation Reduction Act (IRA) of 2022 provides a wide array of tax credits and other incentives for low-carbon energy. The technology-neutral clean generation production tax credit (PTC) (Section 45Y of the U.S. Internal Revenue Code) and the technology-neutral investment tax credit (ITC) (Section 48E) lower the net cost of new electricity generation projects with zero or negative greenhouse gas emission rates. We evaluate the impact of the IRA legislation--specifically the PTC and ITC--on the cost-competitiveness of small modular reactors (SMRs). We use the Argonne Low-carbon Energy Analysis Framework (A-LEAF) model to calculate the capacity factor of an SMR with a range of hypothetical variable operating and maintenance (O&M) costs in the Electric Reliability Council of Texas (ERCOT) electricity market. We selected ERCOT for market modeling because of its competitive structure, available data, and extensive use in prior literature. We use a discounted cash flow model to calculate the SMR's net present value based on the market prices and capacity factors from A-LEAF, hypothetical ranges of capital and variable O&M costs, and other input parameters, with or without the IRA tax credits. We determine the SMR owner's optimal choice of PTC or ITC for the hypothetical ranges of capital and variable O&M costs. We also evaluate potential shifts in the SMR owner's optimal choice of PTC or ITC based on historical patterns of nuclear capital cost overruns in the United States. We also assess the sensitivity of our results to longer PTC period and electricity prices from the New England market, which tend to be higher than electricity prices in ERCOT. We find that even with the IRA tax credits, only SMRs with low capital and variable O&M costs would be economically feasible in the low-price ERCOT market scenario modeled. A longer PTC period and higher-price market such as New England, however, would significantly expand the economic feasibility of SMRs in the United States. [ABSTRACT FROM AUTHOR]

The optimal PMU placement problem is placing the minimum number of PMUs in the network to ensure complete network observability. It is an NP-complete optimization problem. PMU placement based on cost and critical nodes is solved separately in the literature. This paper proposes a novel approach, a degree of centrality in the objective function, to combine the effect of both strategies to place PMUs in the power network optimally. The contingency analysis and the effect of zero-injection buses are solved to ensure the reliability of network monitoring and attain a minimum number of PMUs. Integer linear programming is used on the IEEE 7-bus, IEEE 14-bus, IEEE 30-bus, New England 39-bus, IEEE 57-bus, and IEEE 118-bus systems to solve this problem. The results are evaluated based on two performance measures: the bus observability index (BOI) and the sum of redundancy index (SORI). On comparison, it is found that the proposed methodology has significantly improved results, i.e., a reduced number of PMUs and increased network overall observability (SORI). This methodology is more practical for implementation as it focuses on critical nodes. Along with improvement in the results, the limitations of existing indices are also discussed for future work. [ABSTRACT FROM AUTHOR]

An ocean acoustics experiment in 2017 near a shipping lane on the New England continental shelf in about 75 m of water provided an opportunity to evaluate a methodology to extract source signatures of merchant ships in a bottom-limited environment. The data of interest are the received acoustic levels during approximately 20 min time intervals centered at the closest position of approach (CPA) time for each channel on two 16-element vertical line arrays. At the CPA ranges, the received levels exhibit a frequency-dependent peak and null structure, which possesses information about the geophysical properties of the seabed, such as the porosity and sediment thickness, and the characterization of the source, such as an effective source depth. The modeled seabed is represented by two sediment layers, parameterized with the viscous grain shearing (VGS) model, which satisfies causality, over a fixed deep layered structure. Inferred estimates of the implicit source levels require averaging an error function over the full 20 min time intervals. Within the 200–700 Hz band, the Wales–Heitmeyer model captures the inferred frequency dependence of the source levels. [ABSTRACT FROM AUTHOR]

What is this summary about? This summary describes the results of a clinical study called MANDALA that was published in the New England Journal of Medicine in 2022. In the MANDALA study, researchers looked at a new asthma rescue inhaler that contains both albuterol and budesonide in a single inhaler (known as albuterol–budesonide, AIRSUPRA™). This summary describes the results for people aged 18 yearsand older who took part in the study. [ABSTRACT FROM AUTHOR]

Utilizing a macro-scale energy model alongside 44 years of New England’s hourly weather data from MERRA-2, this study investigates the benefits of various combinations of renewable energy technologies, particularly wind and solar, and their integration with long-duration energy storage (LDES) systems. The potential of these renewable energy sources to enhance both the reliability and affordability of New England’s power system is evaluated. The findings demonstrate that incorporating LDES into the technology mix leads to a remarkable 55% reduction in overall system costs compared to relying solely on short-duration energy storage (SDES), such as lithium-ion batteries. Additionally, the cost reductions of LDES lead to approximately a 35% increase in the utilization of solar generation. The results suggest that total system costs for LDES are more responsive to relative decreases in power-capacity costs than decreases in energy-capacity costs. Furthermore, the analysis indicates that a combination of different LDES storage technologies can offer the most cost-effective solution for wind-solar power systems. Overall, by examining the interplay between different storage technologies and their impact on system costs, this research contributes significantly to the discourse on sustainable energy solutions.

Graduate students are faced with many stressors, including school, work, and home roles. They may not have the self-care skills and support to manage the increased stress from school. Self-care goal setting check-ins were implemented in a graduate course to support students’ stress management. Student resilience levels, wellness, and burnout were moderate. Students indicated the check-ins were helpful, yet still found challenges in completing self-care. They also stated less assignments and integrating more wellness into the curriculum would be helpful in supporting their self-care goals. Nursing educators can impact student wellness by providing skills and support in the curriculum. [ABSTRACT FROM AUTHOR]

Identifying a blood vessel growth factor The discovery of the potent angiogenic factor VEGFA and the subsequent studies that led to the development and successful translation of VEGF inhibitors into the clinic illustrate the invaluable role physician-scientists play in advancing human health. In 1972, pediatric surgeon and cancer pioneer Judah Folkman published an editorial in the New England Journal of Medicine, where he introduced the concept of antiangiogenic therapy to slow the growth of solid tumors (1). Based on work performed in his own laboratory and clinical observation, he had isolated a tumor angiogenic factor (TAF) that promoted endothelial cell proliferation and neovascularization. Folkman, in collaboration with pathologist Hal Dvorak, also recognized the importance of vascular permeability with ensuing extravascular clotting to lay down the necessary tumor stroma to support angiogenesis and tumor growth and metastasis, and the two began their quest to identify the vascular permeability factor (VPF) (2). To accomplish this, tumor cells were cultured in serum-free media and supernatants were tested for the presence of a vascular permeability--inducing factor(s) secreted by the cells (3, 4). They soon found that several tumor types possessed this vascular permeability--promoting activity, and they went on to successfully isolate the factor, demonstrating that VPF was 50,000 times more potent than histamine on a molar basis. Following the discovery of VPF, Connolly et [ABSTRACT FROM AUTHOR]

This paper examines the determinants of inequality in the distribution of [CO.sub.2] emissions across U.S. regions. We implement a factorial decomposition of [CO.sub.2] per capita based on extended Kaya factors, that is, carbon intensity of fossil fuel consumption, energy mix, energy intensity of GDP, economic growth in terms of labor productivity and employment rate. Results reveal that U.S. states display marked differences in most factors. We identify energy intensity as the main source of emissions inequality. Based on the within and between group inequality components we also explore the effect of geographical, geological, climatic and human development partitions of U.S. states' groups. Findings indicate that the within-group inequality had been the main contributor to the whole inequality. Finally, some economic policy implications are also discussed; explaining the unequal distribution of emissions is vital to establish differentiated targets and work towards successful mitigation proposals. Keywords: [CO.sub.2] emissions, Theil Index, Inequality decomposition, Kaya factors, 1. INTRODUCTION In recent years, a number of international initiatives and abatement methods have been postulated to condense emissions from anthropogenic sources, such as the 1997 Kyoto Protocol and the [...]

OBJECTIVE: To understand providers perceptions of how a patients experience of racism may impact the successful implementation of a brief posttraumatic stress disorder (PTSD) treatment in the safety net integrated primary care setting. To conduct a developmental formative evaluation prior to a hybrid type I effectiveness-implementation trial. DATA SOURCES AND STUDY SETTING: From October 2020 to January 2021, in-depth qualitative interviews were conducted with integrated primary care stakeholders (N = 27) at the largest safety net hospital in New England, where 82% of patients identify as racial or ethnic minorities. STUDY DESIGN: Interviews with clinical stakeholders were used to (a) contextualize current patient and provider experiences and responses to racism, (b) consider how racism may impact PTSD treatment implementation, (c) gather recommendations for potential augmentation to the proposed PTSD treatment (e.g., culturally responsive delivery, cultural adaptation), and (d) gather recommendations for how to shift the integrated primary care practice to an antiracist framework. DATA COLLECTION/EXTRACTION METHODS: Interview data were gathered using remote data collection methods (video conferencing). Participants were hospital employees, including psychologists, social workers, primary care physicians, community health workers, administrators, and operations managers. We used conventional content analysis. PRINCIPAL FINDINGS: Clinical stakeholders acknowledged the impact of racism, including racial stress and trauma, on patient engagement and noted the potential need to adapt PTSD treatments to enhance engagement. Clinical stakeholders also characterized the harms of racism on patients and providers and provided recommendations such as changes to staff training and hiring practices, examination of racist policies, and increases in support for providers of color. CONCLUSIONS: This study contextualizes providers perceptions of racism in the integrated primary care practice and provides some suggestions for shifting to an antiracist framework. Our findings also highlight how racism in health care may be a PTSD treatment implementation barrier.

Cold‐air pooling is an important topoclimatic process that creates temperature inversions with the coldest air at the lowest elevations. Incomplete understanding of sub‐canopy spatiotemporal cold‐air pooling dynamics and associated ecological impacts hinders predictions and conservation actions related to climate change and cold‐dependent species and functions. To determine if and how cold‐air pooling influences forest composition, we characterized the frequency, strength, and temporal dynamics of cold‐air pooling in the sub‐canopy at local to regional scales in New England, USA. We established a network of 48 plots along elevational transects and continuously measured sub‐canopy air temperatures for 6–10 months (depending on site). We then estimated overstory and understory community temperature preferences by surveying tree composition in each plot and combining these data with known species temperature preferences. We found that cold‐air pooling was frequent (19–43% seasonal occurrences) and that sites with the most frequent inversions displayed inverted forest composition patterns across slopes with more cold‐adapted species, namely conifers, at low instead of high elevations. We also observed both local and regional variability in cold‐air pooling dynamics, revealing that while cold‐air pooling is common, it is also spatially complex. Our study, which uniquely focused on broad spatial and temporal scales, has revealed some rarely reported cold‐air pooling dynamics. For instance, we discovered frequent and strong temperature inversions that occurred across seasons and in some locations were most frequent during the daytime, likely affecting forest composition. Together, our results show that cold‐air pooling is a fundamental ecological process that requires integration into modeling efforts predicting future forest vegetation patterns under climate change, as well as greater consideration for conservation strategies identifying potential climate refugia for cold‐adapted species. [ABSTRACT FROM AUTHOR]

Transient stability of the electric power system still heavily rests on a timely and correct operation of the relay protection of individual power generators. Power swings and generator pole slips, following network short-circuit events, can initiate false relay activations, with negative repercussions for the overall system stability. This paper will examine the generator's underimpedance (21G) and out-of-step (78) protection functions and will propose a machine learning based classifier for supporting and reinforcing their decision-making logic. The classifier, based on a support vector machine, will aid in blocking the underimpedance protection during stable generator swings. It will also enable faster tripping of the out-of-step protection for unstable generator swings. Both protection functions will feature polygonal protection characteristics. Their implementation will be based on European practice and IEC standards. Classifier will be trained and tested on the data derived from simulations of the IEEE New England 10-generator benchmark power system. [ABSTRACT FROM AUTHOR]

Background: There is a growing, global awareness and recognition of the important, interdependent relationships between our natural world and human health. Several contemporary health organizations have placed calls to action and emphasize an urgent need for collaboration and interdisciplinary research, education, and clinical work to address the increasing degradation of our planetary and human health. With more research dedicated to nature's health impacts, health professions schools would benefit by including such training in their programs while also cultivating a comprehensive mind-body health perspective to support both the health of student practitioners and their future patients. Objective: The present program evaluation investigates a five-day outdoor mini-course covering nature-based health techniques at a medical and dental school in the American Northeast. This unique outdoor course combines nature, creativity, and reflection within the context of modern medicine. Methods: A concurrent mixed-method design using descriptive statistics, quantitative and qualitative data from students' anonymous final course evaluations and final reflection projects are evaluated. Results: Data suggests that students benefitted from their experience during this five-day course. Students provided feedback reinforcing the enjoyment and transformative outcomes gleaned from the course experiences. Students entered the course describing feeling stressed, overwhelmed, and overextended, not uncommon for learners in medical and dental school, and completed the course describing the acquisition of applicable skills, increased attention and mindfulness, creativity, and connection to the natural world. Conclusions: Students described a positive experience of the course. Several areas of personal and professional development were also described, such as improvements within cognitive domains, enhanced connection with nature, others, and themselves, increased mindfulness, and overall improved well-being. Findings have implications for medical and dental programs on how such innovative training may lean into the work of nature-based care to provide for the whole person. [ABSTRACT FROM AUTHOR]

Background: Randomised controlled trials (RCTs) aim to estimate the causal effect of one or more interventions relative to a control. One type of outcome that can be of interest in an RCT is an ordinal outcome, which is useful to answer clinical questions regarding complex and evolving patient states. The target parameter of interest for an ordinal outcome depends on the research question and the assumptions the analyst is willing to make. This review aimed to provide an overview of how ordinal outcomes have been used and analysed in RCTs. Methods: The review included RCTs with an ordinal primary or secondary outcome published between 2017 and 2022 in four highly ranked medical journals (the British Medical Journal, New England Journal of Medicine, The Lancet, and the Journal of the American Medical Association) identified through PubMed. Details regarding the study setting, design, the target parameter, and statistical methods used to analyse the ordinal outcome were extracted. Results: The search identified 309 studies, of which 144 were eligible for inclusion. The most used target parameter was an odds ratio, reported in 78 (54%) studies. The ordinal outcome was dichotomised for analysis in 47 ( 33 % ) studies, and the most common statistical model used to analyse the ordinal outcome on the full ordinal scale was the proportional odds model (64 [ 44 % ] studies). Notably, 86 (60%) studies did not explicitly check or describe the robustness of the assumptions for the statistical method(s) used. Conclusions: The results of this review indicate that in RCTs that use an ordinal outcome, there is variation in the target parameter and the analytical approaches used, with many dichotomising the ordinal outcome. Few studies provided assurance regarding the appropriateness of the assumptions and methods used to analyse the ordinal outcome. More guidance is needed to improve the transparent reporting of the analysis of ordinal outcomes in future trials. [ABSTRACT FROM AUTHOR]

Fossil fuels, the predominant energy source in the United States, have been identified as major contributors to environmental pollution through the release of harmful emissions. As a countermeasure, there has been an increasing focus on the exploration and development of cleaner energy alternatives to alleviate the environmental degradation caused by fossil fuels and to satisfy the growing energy needs. This study conducted scenario analyses to evaluate the impact of integrating solar energy into specific US power grids on reducing carbon emissions. The analysis encompassed electrical systems within California, New England, New York, and the Southwest, utilizing datasets from the Energy Information Administration and National Renewable Energy Laboratory. The Energy Information Administration dataset includes information on net generation according to each source and carbon emissions according to fuel type, whereas the National Renewable Energy Laboratory dataset provides hourly projections for 6000 theoretical photovoltaic installations and detailed solar energy output data every five minutes over a year. Our findings indicated a notable decrease in carbon dioxide emissions following the introduction of solar power facilities. The most significant reductions were observed in the Southwest and California, attributed to solar plant integration. Conversely, New York and New England were identified as regions requiring additional policy measures and incentives to meet the emission reduction goals. [ABSTRACT FROM AUTHOR]

Aims: Adherence to pharmacological interventions in clinical trials is crucial for accurate identification of beneficial and adverse outcomes. The ways in which adherence to interventions should be reported in trial publications are described in the Template for Intervention Description and Replication (TIDieR), a 12‐item extension of the Consolidated Standards of Reporting Trials reporting guidelines. The objective of this study was to assess compliance with TIDieR Items 11 and 12 of randomized controlled trials (RCTs) of interventions in SARS‐CoV‐2 infection published in 5 selected journals during 2021. Methods: We assessed pharmacological interventions for SARS‐CoV‐2 infection reported in RCTs published in 2021 in the Annals of Internal Medicine, The BMJ, JAMA, The Lancet and The New England Journal for Medicine for compliance with TIDieR items addressing intervention adherence (Items 11 and 12). We calculated proportional adherence for pharmacological and comparator interventions where available. Results: We found 75 eligible RCTs. Twenty‐eight (37%) reported results of SARS‐CoV‐2 vaccinations. Compliance with Items 11 and 12 could be assessed in 71 of these 75. Of the 71 RCTs, 37 (52%) reported how adherence was assessed (Item 11), and 70 reported adherence rates (Item 12). Only 1 of the 71 RCTs (1.4%, 0–7.6%) fully complied with TIDieR Items 11 and 12. Conclusion: Half of RCTs of SARS‐CoV‐2 pharmacological interventions published in leading medical journals in 2021 complied with reporting of how adherence assessments were made and almost none complied with both TIDieR Items 11 and 12. The implications for interpretation, application and replication of findings based on these publications warrant consideration. [ABSTRACT FROM AUTHOR]

Objective: Energy density (ED) estimates for marine forage species have been limited, impeding our understanding of this important trophic level. We studied the EDs of eight key forage species: Alewife Alosa pseudoharengus, Atlantic Herring Clupea harengus, Silver Hake Merluccius bilinearis, Northern Sand Lance Ammodytes dubius, Atlantic Mackerel Scomber scombrus, Butterfish Peprilus triacanthus, northern shortfin squid Illex illecebrosus, and longfin inshore squid Doryteuthis pealeii (also known as Loligo pealeii). Methods: Samples were obtained during spring and fall bottom trawl surveys across five regions (Gulf of Maine, Georges Bank, southern New England, northern Middle Atlantic Bight, and southern Middle Atlantic Bight) from 2017 to 2019. In the laboratory, we developed predictive relations between the percent dry weight (%DW) and ED (kJ/g wet weight) determined by proximate composition analysis (n = 606; r2 = 0.76–0.98) to estimate the ED of additional samples (n = 4583). For each species, we modeled ED as a function of size, depth, season, and year (as factors) as well as location (latitude, longitude) using generalized additive models (GAMs). Result: Alewife, Atlantic Herring, Northern Sand Lance, Atlantic Mackerel, and Butterfish were classified as high‐quality prey (ED > 6 kJ/g), although Atlantic Herring ED was nearly half the values reported in earlier studies. Silver Hake, northern shortfin squid, and longfin inshore squid were classified as moderate‐quality prey (4 kJ/g < ED < 6 kJ/g). Most species had higher EDs in the fall following summer feeding than in the spring after spawning and/or reduced winter feeding. The best‐fitting GAMs included weight, depth (by season), season, and year effects for most species. Location (by season) explained significant amounts of variation. Conclusion: Observed variation in ED across regions, species, seasons, and years provides the empirical data necessary to consider hypotheses related to "upstream" regulation of ED (via environmental drivers and productivity) and "downstream" effects on recruitment for these forage species as well the species that prey on them. Impact statementForage fish and squid are a link between primary production and upper‐level predators. We used proximate composition analysis to determine energy density of forage species, which varied across species, ontogeny, seasons, and location, affecting their value as prey and the flow of energy in the ecosystem. [ABSTRACT FROM AUTHOR]

Lead isotope values for volcanogenic massive sulfide (VMS) deposits provide important insights into metal sources and the nature of pre-accretionary tectonostratigraphic terranes and underlying basements. Deposits of this type in New England formed in diverse tectonic settings including volcanic arcs and backarcs, a supra–subduction zone arc, a rifted forearc foreland basin, and a rifted continental margin. Following VMS mineralization on or near the seafloor, components of the tectonostratigraphic assemblages—volcanic ± sedimentary rocks, coeval intrusions, sulfide deposits, and underlying basements—were diachronously accreted to the Laurentian margin during the Paleozoic. Lead isotope data for galena show relatively large ranges for 206Pb/204Pb, 207Pb/204Pb, and 208Pb/204Pb. Evaluation of potential lead sources, using for comparison Pb-isotope data from modern and ancient settings, suggests that principal sources include the mantle, volcanic ± sedimentary rocks, and deeper basement rocks. Integration of the Pb-isotope values with published data such as Nd isotopes for the volcanic rocks and from deep seismic reflection profiles points to the involvement of several basements, including those of Grenvillian, Ganderian, Avalonian, and West African (and (or) Amazonian) affinity. Clustering of Pb-isotope data for VMS deposits within individual Cambrian and Ordovician volcanic and volcanosedimentary settings, delineated by differences in 206Pb/204Pb and µ (238U/204Pb) values, are consistent with lead derivation from at least four and possibly five different tectonostratigraphic assemblages with isotopically distinct basements. Collectively, our Pb-isotope data for New England VMS deposits provide a novel window into the nature of subarc basement rocks during pre-accretionary sulfide mineralization outboard of Laurentia during early Paleozoic time. [ABSTRACT FROM AUTHOR]

This paper reflects on the process of designing and implementing an update to the Introduction to Information Technology course at Bentley University, a business university in New England. Driven by a university-wide curriculum reform initiative and following best practices from digital literacy frameworks and IS model curricula, the new CS 100 course, entitled Solving Business Problems with Information Technology, shifted emphasis from a personal computing context to exploring small business applications of technology. Students networked with university alumni at “Topics in Tech” presentations, where they learned about career options as information technology professionals. The authors describe the pilot courses that led to proposing a new CS 100 course and reflect its challenges and successes. Challenges included meeting the university’s goal of transfer friendliness, scaling from a few pilots to multiple sections, consistency of course delivery, and evaluating assessment. Successes include placing course topics in a business context, introducing current technologies, and providing opportunities for students to learn about career opportunities and experiences from university alumni. The paper also describes how CS 100 aligns with the university’s student learning goals for the new curriculum. These include developing future-focused skills, encouraging curiosity and critical analysis, communicating and collaborating in different settings, and demonstrating understanding of issues related to ethical use of technology. [ABSTRACT FROM AUTHOR]