Distribution, movements, and habitat use of small striped bass (Morone saxatilis) across multiple spatial scales

Distribution, movements, and habitat use of small (<46 cm, juveniles and individuals of unknown maturity) striped bass (Morone saxatilis) were investigated with multiple techniques and at multiple spatial scales (surveys and tag-recapture in the estuary and ocean, and telemetry in the estuary) over multiple years to determine the frequency and duration of use of non-natal estuaries. These unique comparisons suggest, at least in New Jersey, that smaller individuals (<20 cm) may disperse from natal estuaries and arrive in non-natal estuaries early in life and take up residence for several years. During this period of estuarine residence, individuals spend all seasons primarily in the low salinity portions of the estuary. At larger sizes, they then leave these non-natal estuaries to begin coastal migrations with those individuals from nurseries in natal estuaries. These composite observations of frequency and duration of habitat use indicate that non-natal estuaries may provide important habitat for a portion of the striped bass population

Predicting Suicide Among Privately Insured Residents of North Carolina Using Machine Learning.

Suicide is a major public health problem. In North Carolina, age-adjusted suicide mortality rates increased by 31% from 1999 to 2022. While decades of research have identified many risk factors for suicide, more work is needed to explore how predictive algorithms can help clinicians identify an appropriate time to intervene and prevent suicide-related behaviors in their patients. Our objective was to predict risk of suicide in a privately insured population in North Carolina. We conducted a nested case-control study of covered people aged 12 and older. Cases (n=1,296) were all deaths by suicide, and controls (n=129,600) were identified using an incidence-density risk-set sampling approach. We used super learning, an ensemble machine-learning process that forms a weighted average of several algorithms to achieve the best possible predictions for a performance metric of interest (negative log likelihood). We included diagnoses, procedures, and prescriptions known to be associated with suicide in the model. The super learner ensemble improved on the best single algorithm by 59%. At 95% specificity, the model had 20.4% sensitivity and 3.9% positive predictive value. These results demonstrate the ability for ensemble machine learning methods to optimize predictions that could be used to identify patients at high risk of suicide

Drug overdose mortality in North Carolina among healthcare patients and publicly and privately insured people: 2006-2022

Background: The drug overdose epidemic claimed approximately 108,000 lives in the U.S. in 2022 alone and costs the country around $1 trillion annually. We compared overdose death rates among three separate cohorts defined as a healthcare patient population, a privately insured cohort and a cohort of Medicaid enrollees in North Carolina (NC) from 2006-2022.Methods: Records from a large, integrated, healthcare delivery system, Medicaid and privately insured NC individuals, were linked to death certificate data . Overdose deaths from all drugs, opioids, and multiple drugs (polydrug overdose) were identified using International Classification of Disease Version 10 (ICD-10) codes for primary and contributing causes of death. Polydrug overdoses were defined as those where the ICD-10 codes included more than one drug. Indirect standardization with the NC general population as the reference group was used to report age, sex, and calendar year adjusted mortality rates and standardized mortality ratios (SMRs) between 2006-2022.Results: Between 2014-2022, for individuals aged 12 to 64, the overall drug, opioid, and polydrug overdose mortality rates in the NC general population were 28.8 , 25.0, and 18.0 per 100,000 person-years (PY), respectively. The corresponding mortality rates among healthcare patients  were 105.5, 86.6, and 63.1 per 100,000 PY, respectively - with SMRs of 3.7, 3.5, and 3.5 compared to the general population. Among Medicaid enrollees, the adjusted mortality rates for any drug, opioid, and polydrug overdoses were 85.3, 63.5, and 46.2 per 100,000 PY, respectively. Corresponding SMRs were 3.0, 2.5, and 2.6. Among those with private health insurance, the adjusted mortality rates were lower compared to the general population—16.1, 12.3, and 8.6 per 100,000 PY respectively—with SMRs of 0.6, 0.5, and 0.5.Conclusions: Individuals receiving care within the health system experienced the highest overdose mortality rates, followed by those with Medicaid insurance, with both substantially exceeding the rates observed among privately insured individuals. These findings highlight significant socioeconomic health inequities that could benefit from targeting overdose prevention interventions among resource-limited populations.

Drug Overdose Mortality Disparities by Sex, Age, and Race/Ethnicity in North Carolina, 2014-2022

Background: Drug overdose mortality, particularly among vulnerable demographic subgroups, is a persisting public health issue. We aimed to examine and describe disparities in drug overdose mortality in three sub-populations in North Carolina (NC) by age, sex, and race and ethnicity. Methods: We examined age, sex, and race and ethnicity-based inequities in drug overdose mortality rates in three NC sub-populations: patients of a large integrated healthcare delivery system; individuals enrolled in Medicaid; and individuals with insurance through a large, statewide, private health insurance provider. We estimated standardized mortality ratios (SMRs) stratified by sex, age group, and race and ethnicity to compare the health system, Medicaid, and private insurance populations to the NC general population. We calculated SMRs for all drug overdose, opioid overdoses, and polydrug overdoses (those involving multiple drugs), identifying overdose types using the International Classification of Disease Code, version 10 (IC-D10). Results: Males had higher age-adjusted overdose mortality rates and SMRs than females in the NC general population and all three sub-populations. In the NC general population, health system population, and private insurance population, the 25 to 34 year-old age group had the highest sex-adjusted overdose mortality rate, while this rate was highest among 45 to 54 year-olds in the Medicaid population. Particularly elevated all drug overdose mortality was observed among Medicaid enrollees aged 45 to 54 years (SMR: 4.66, 95% CI: 4.60, 4.72) and 55 to 64 years (SMR: 4.92, 95% CI: 4.84, 4.99), as well as among health system patients aged 12 to 24 years (SMR: 4.27, 95% CI: 4.15, 4.39). For all populations, White individuals had the highest sex- and age-adjusted overdose mortality rates and SMRs. Conclusions: These findings highlight overdose mortality disparities across demographic subgroups in healthcare and insurance populations in NC, suggesting a need for tailored overdose prevention strategies

Trends in suicide mortality, suicide attempts, suicide ideation, and self-harm in North Carolina among publicly insured, privately insured, and health system patients, 2006-2020.

IMPORTANCE: Tracking changes in suicide deaths, attempts, self-harm, and ideation in populations with varying healthcare access may support resource allocation, identification of both risk and protective factors, and targeted interventions. OBJECTIVE: Compare rates and trends of suicide deaths, attempts, self-harm, and ideation in 3 North Carolina (NC) populations from 2006 through 2020. DESIGN, SETTING, AND PARTICIPANTS: NC-based retrospective cohorts were created to estimate incidence of suicide deaths, attempts, self-harm, and ideation using data linkage from 3 populations: 1) Medicaid, 2) a large, private insurer, and 3) individuals receiving care at a large integrated healthcare delivery system. NC death records were linked with data sources to obtain suicide deaths. Suicide attempts, self-harm, and suicide ideation were identified using diagnostic codes. MAIN OUTCOMES AND MEASURES: Fatal and non-fatal suicide-related outcome rates per 100,000 person-years (PY). RESULTS: Suicide death rates in Medicaid and healthcare system populations were higher than the NC general population (age and sex-adjusted Medicaid SMR: 1.5, 95%CI:1.4,1.5; healthcare system age-adjusted SMR: 1.4, 95%CI:1.3,1.4). Suicide death rates in the privately insured population were lower than the general NC population (age and sex-adjusted SMR: 0.6, 95%CI:0.5,0.6). Suicide death rates remained stable over the study period across populations, but suicide attempts, self-harm, and suicide ideation rates varied considerably. Of the 3 populations, Medicaid had the highest rates of suicide attempts (194.9/100,000 PY), self-harm (261.2/100,000 PY) and ideation (935.4/100,000 PY) diagnostic code visits. Suicide attempts increased between 2010-2020 among privately insured persons (31.5 to 49.2/100,000 PY), decreased among the healthcare system patients (133.0 to 69/100,00 PY), and varied over time in the Medicaid population. Self-harm rates were stable in the privately insured and healthcare system between 2016-2020 (73 and 107/100,000 PY, respectively) while rates decreased in the Medicaid population (from 305 to 233/100,000 PY). Suicide ideation increased in the privately insured and healthcare system populations but varied in Medicaid. CONCLUSIONS AND RELEVANCE: Rates of suicide outcomes in these populations provide surveillance estimates and useful benchmarks for evaluating impact of policy changes such as Medicaid expansion, 988 and other crisis lines, and other future changes in suicide prevention efforts by health systems or insurers

The Femme Fatale in Vogue:Femininity Ideologies in Fin-de-siècle America

This article explores how marketing influences ideologies of femininity. Tracing the evolution of femme fatale images in Vogue magazine in 1890s America, we develop a typology around four archetypal forms of the femme fatale that prevailed during this period. In doing so we respond to calls for more critical historical analyses on femininity. While studies on masculinity ideologies proliferate, there is a paucity of research on dissonant representations of femininity in popular culture media. The femme fatale, often a self-determined seductress who causes anguish to the men who become involved with her, is an intriguing and enduring challenge to traditional notions of femininity. Thus, in studying the femme fatale in her historical context and revealing the multiplicity of feminine ideologies contained within this trope, we contribute to a deeper understanding of marketing’s role in both reflecting and reinforcing societal assumptions, attitudes and problematics around gender norms.</p

Estuarine habitat ecology of adult weakfish (Cynoscion regalis): a multi-scale approach

The habitat ecology of adult weakfish (Cynoscion regalis) remains poorly understood, although they comprise an important ecological and economic portion of estuarine environments. Weakfish are particularly susceptible to confusion over how to best delineate important habitat resources, such as those used for reproduction, because they may change over multiple spatial (coastal and estuary) and temporal (seasonal and diel) scales. In this study, weakfish habitat dynamics were evaluated at multiple scales using acoustic telemetry within the Mullica River-Great Bay estuary in southern New Jersey. At the broader estuary scale, residency, habitat use, and movements were quantified across the reproductive/post-reproductive season. Tagged adult weakfish were resident in bay, lower river, and subtidal creek habitats during reproduction (May through July) and following the reproductive season (August through November) but showed limited use of inlet and upriver habitats in both seasons. Movement rates increased at the end of the post-reproductive season and weakfish apparently moved into fringing, unmonitored habitats within the study area following the reproductive period. Estuarine egress occurred throughout the study period but was lowest during July and highest during the final month of emigration in November. At smaller spatial scales, weakfish displayed patterns of site fidelity both seasonally and daily. At the seasonal scale, a majority of weakfish tagged in 2008 maintained fidelity to their original tagging location or established new “core areas” in other parts of the estuary. In both cases, fish were detected at these areas for the duration of their residency or made short- or long-term excursions before returning to their original core area. At the diel scale, weakfish displayed movements of varying distances from their original tagging location beginning around sundown and returning around the sunrise period, which also corresponds to the timing of nightly weakfish reproduction. These findings represent new evidence of the role that estuary habitats may play in adult weakfish life history and, because weakfish habitat dynamics may be influenced by reproduction, it will be important to incorporate these changes into future management of the fishery.M.S.Includes bibliographical referencesby Jason T. Turnur

Distractibility in the Mentally Retarded: Negative Evidence for an Orienting Inadequacy

Three studies are described in which the orienting behavior of normal and mentally retarded children is investigated under a variety of conditions. An initial study found that, in many cases, the normal children showed nontask orientations to a greater extent than did the retarded children. An examination of those circumstances wherein the retarded had been found to glance more indicated that such circumstances, often observed in the classroom, are inappropriate for adjudging retarded children to be distractible. Further research involving only retarded subjects showed that the inclusion of an adult in the learning situation greatly increased the retarded children's nontask orientations. However, it was also shown that if cues were provided by the adult they would be utilized by the subjects; the retarded children's glancing apparently represented information seeking and not merely vacuous orientations to a salient social stimulus. A new conception of children's attending behaviors was suggested to account for the findings. </jats:p