An Analysis of Orientation and Preceptorship Influence on Nurse Job Satisfaction Across Two States

A large public nursing data set was used to determine whether orientation and/or preceptor programs impact job satisfaction among registered nurses in Maine and Massachusetts. There was no association between orientation and preceptor programs and satisfaction, nor evidence that new nurse status modified the relationship. There is a need for evaluation of orientation and preceptor programs' structure and effectiveness, and innovation is needed in promoting job satisfaction, thereby increasing nurse retention.

The distribution of sediment microplastics assemblages is driven by location and hydrodynamics, not sediment characteristics, in the Gulf of Maine, USA

Microplastics (MP) are found in marine sediments across the globe, but we are just beginning to understand their spatial distribution and assemblages. In this study, we quantified MP in Gulf of Maine, USA sediments. MP were extracted from 20 sediment samples, followed by polymer identification using Raman spectroscopy. We detected 27 polymer types and 1929 MP kg-1 wet sediment, on average. Statistical analyses showed that habitat, hydrodynamics, and station proximity were more important drivers of MP assemblages than land use or sediment characteristics. Stations closer to one another were more similar in their MP assemblages, tidal rivers had higher numbers of unique plastic polymers than open water or embayment stations, and stations closer to shore had higher numbers of MP. There was little evidence of relationships between MP assemblages and land use, sediment texture, total organic carbon, or contaminants.

Population Structure and Reproductive Biology of Monilinia vaccinii-corymbosi in Vaccinium angustifolium in Maine

The fungus Monilinia vaccinii-corymbosi (Mvc) causes mummy berry disease in blueberries including lowbush blueberry, Vaccinium angustifolium, and is a significant pathogen of concern for Maine lowbush blueberry growers. This disease is typically managed with fungicides or by burning of plant debris containing overwintering pseudosclerotia. The population structure of Mvc in various fields in Maine was investigated using microsatellites and isolates collected from three stages in the Mvc lifecycle. The impacts of management strategies were also examined. A high level of genetic diversity was observed in Mvc from 12 lowbush blueberry fields with 199 unique multilocus haplotypes (MLHs) occurring in an original sample of 232 isolates. Twelve private alleles, including six private alleles with frequencies above 0.05, which indicated gene flow, were observed in six out of 12 fields. The population of Mvc in Maine as a whole is mostly a sexual, outcrossing population, as was seen in the diversity of MLHs and low amounts of linkage disequilibrium, although some apothecia appear to result from selfing. Three fields appear to have some clonal reproduction but were not strictly clonal, as multiple MLHs were noted in these fields. Management does not appear to affect population structure, and Mvc may be one large statewide population in Maine.

Does Implementation Matter? Associations Between Implementation of Maine's Anti- Bullying Law and Bullying Victimization Among High School Youth

PURPOSE

To characterize the relationship between implementation of an antibullying law and bullying rates among high school youth.

METHODS

School staff (administrators, counselors, and teachers) from public high schools in Maine completed a survey assessing: (1) the frequency with which they implemented 17 components of their district's antibullying policy as mandated by state law; and (2) confidence in implementing the law. Their responses were linked to data on bullying victimization among high school respondents to the Maine Integrated Youth Health Survey, which created a population-based dataset of 84 high schools with 29,818 student responses.

RESULTS

Students in schools where administrators (adjusted odds ratio = 0.93; 95% CI: 0.89, 0.97) and counselors (adjusted odds ratio = 0.86; 95% CI: 0.81, 0.92) reported implementing more mandated components of the law experienced notable reductions in the odds of bullying, controlling for student-level characteristics (sex, race, grade) and for school-level bullying rates assessed prior to the passage of the law. With respect to specific implementation components, bullying was most consistently reduced in schools where staff reported increased referrals for counseling and other supports for targets of bullying and in schools where counselors and teachers were interviewed as part of bullying investigations. Students in schools where teachers reported increased confidence in implementing the antibullying law also had reduced odds of bullying.

DISCUSSION

These data provide some of the first evidence that the efficacy of a state's antibullying law depends in part on the extent to which school personnel implement the law.

Characteristics of Maine and Massachusetts nurses interested in advanced nursing degrees

BACKGROUND

Maine (ME) and Massachusetts (MA) nursing programs aim to develop collaborative training programs, but need to identify which nurses have interest in such programs.

PURPOSE

We sought to determine sociodemographics of nurses seeking advanced nursing degrees nationally, and in ME and MA using the 2018 publicly available, National Sample Survey of Registered Nurses (NSSRN).

METHODS

Weighted multivariable logistic regression for advanced degree-seeking, adjusted for sociodemographics.

RESULTS

Of the n = 47,274 nurses (weighted n [Wn] = 3,608,633), 90.7 % were female, 74.1 % were white, and 15.8 % sought an advanced nursing degree on average 12.7 (SD 0.2) years after their first. Females vs. males had lower odds (OR 0.63, 95%CI [0.44-0.90]) and Black vs. White race had higher odds (OR 1.30, 95%CI [1.05-1.60]) of seeking doctorates. In Maine (Wn = 20,389), age 24-29 had higher odds (OR 2.98 (95%CI [1.06-3.74]), but in Massachusetts (Wn = 101,984), age 30+ had lower odds (OR 0.32, 95%CI [0.13-0.78]) of degree-seeking vs. <24 years. Initial nursing degrees earned between 1980 and 1989 had higher odds (OR 1.99, 95%CI [1.06-3.74]) in Maine, but between 2010 and 2014 had lower odds (OR 0.32, 95%CI [0.14-0.72]) in Massachusetts of degree-seeking, vs. before 1980.

CONCLUSIONS

Targets for advanced nursing training programs may vary by state and sociodemographic profile.

Management of per- and polyfluoroalkyl substances (PFAS)-laden wastewater sludge in Maine: Perspectives on a wicked problem

This article discusses the challenges and potential solutions for managing wastewater sludge that contains per- and polyfluoroalkyl substances (PFAS), using the experience in Maine as a guide toward addressing the issue nationally. Traditional wastewater treatment, designed to remove excess organic waste and nutrients, does not eliminate persistent toxic pollutants like PFAS, instead partitioning the chemicals between discharged effluent and the remaining solids in sludge. PFAS chemistry, the molecular size, the alkyl chain length, fluorine saturation, the charge of the head group, and the composition of the surrounding matrix influence PFAS partitioning between soil and water. Land application of sludge, incineration, and storage in a landfill are the traditional management options. Land application of Class B sludge on agricultural fields in Maine peaked in the 1990s, totaling over 2 × 106 cu yd over a 40-year period and has contaminated certain food crops and animal forage, posing a threat to the food supply and the environment. Additional Class A EQ (Exceptional Quality) composted sludge was also applied to Maine farmland. The State of Maine banned the land application of wastewater sludge in August 2022. Most sludge was sent to the state-owned Juniper Ridge Landfill, which accepted 94 270 tons of dewatered sludge in 2022, a 14% increase over 2019. Between 2019 and 2022, the sum of perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) concentrations in sludge sent to the landfill ranged from 1.2 to 104.9 ng/g dw. In 2022, the landfill generated 71.6 × 106 l of leachate. The concentration of sum of six PFAS in the leachate increased sixfold between 2021 and 2022, reaching 2 441 ng/l. The retention of PFAS within solid-waste landfills and the potential for long-term release of PFAS through liners into groundwater require ongoing monitoring. Thermal treatment, incineration, or pyrolysis can theoretically mineralize PFAS at high temperatures, yet the strong C-F bond and reactivity of fluorine require extreme temperatures for complete mineralization. Future alternatives may include interim options such as preconditioning PFAS with nonpolar solvents prior to immobilization in landfills, removing PFAS from leachate, and interrupting the cycle of PFAS moving from landfill, via leachate, to wastewater treatment, and then back to the landfill via sludge. Long-term solutions may involve destructive technologies such as electron beam irradiation, electrochemical advanced oxidation, or hydrothermal liquefaction. The article highlights the need for innovative and sustainable solutions for managing PFAS-contaminated wastewater sludge.

The Maine Cancer Genomics Initiative: Implementing a Community Cancer Genomics Program Across an Entire Rural State

PURPOSE

The Maine Cancer Genomics Initiative (MCGI) aimed to overcome patient- and provider-level barriers to using genomic tumor testing (GTT) in rural practices by providing genomic tumor boards (GTBs), clinician education, and access to comprehensive large-panel next-generation sequencing to all patients with cancer in Maine. This paper describes the successful implementation of the initiative and three key services made operative between 2016 and 2020.

METHODS

A community-inclusive, hub-and-spoke approach was taken to implement the three program components: (1) a centralized GTB program; (2) a modular online education program, designed using an iterative approach with broad clinical stakeholders; and (3) GTT free of charge to clinicians and patients. Implementation timelines, participation metrics, and survey data were used to describe the rollout.

RESULTS

The MCGI was launched over an 18-month period at all 19 oncology practices in the State. Seventy-nine physicians (66 medical oncologists, 5 gynecologic oncologists, 1 neuro-oncologist, and 7 pediatric oncologists) enrolled on the study, representing 100% of all practicing oncologists in Maine. Between July 2017 and September 2020, 1610 patients were enrolled. A total of 515 cases were discussed by 47 (73%) clinicians in 196 GTBs. Clinicians who participated in the GTBs enrolled significantly more patients on the study, stayed in Maine, and reported less time spent in clinical patient care.

CONCLUSION

The MCGI was able to engage geographically and culturally disparate cancer care practices in a precision oncology program using a hub-and-spoke model. By facilitating access to GTT, structured education, and GTBs, we narrowed the gap in the implementation of precision oncology in one of the most rural states in the country.

Risk Evaluation of Benzovindiflupyr Resistance of Verticillium dahliae Population in Maine

Verticillium dahliae causes Verticillium wilt, resulting in significant losses to potato production. Benzovindiflupyr, a succinate dehydrogenase inhibitor, effectively controls V. dahliae. However, frequent applications of the chemical may expedite the development of fungicide resistance in the pathogen population. To evaluate the risk of benzovindiflupyr resistance, 38 V. dahliae strains were obtained from diseased potatoes in Maine. The sensitivity of the field population was determined based on effective concentration for 50% inhibition (EC₅₀), which ranged from 0.07 to 11.28 μg ml^-1 with a median of 1.08. Segregated clusters of EC₅₀ values indicated that Maine V. dahliae populations have developed benzovindiflupyr resistance. By exposing conidia of V. dahliae to a high concentration of benzovindiflupyr, 18 benzovindiflupyr-resistant mutants were obtained. To examine their fitness, the mutants were continuously subculture-transferred for up to 10 generations. Mycelial growth, conidial production, competitiveness, pathogenicity, and cross resistance of the 10th generation mutants were examined. Results showed that 50% of the resistant mutants retained an adaptive level in mycelial growth, and 60% maintained conidial production similar to their parents. Pathogenicity did not change for any of the mutants. No cross resistance was detected between benzovindiflupyr and either azoxystrobin, boscalid, fluopyram, or pyrimethanil. Thus, the resistance risk in V. dahliae to benzovindiflupyr should be considered in Maine potato production.

Driver, roadway, and weather factors on severity of lane departure crashes in Maine

INTRODUCTION

In Maine, lane departure crashes account for over 70% of roadway fatalities. The majority of roadways in Maine are rural. Moreover, Maine has aging infrastructure, houses the oldest population in the United States, and experiences the third coldest weather in the United States.

METHODS

This study analyzes the impact of roadway, driver, and weather factors on the severity of single-vehicle lane departure crashes occurring from 2017 to 2019 on rural roadways in Maine. Rather than using police reported weather, weather station data were utilized. Four facility types: Interstates, minor arterials, major collectors, and minor collectors were considered for analysis. The Multinomial Logistic Regression model was used for the analysis. The property damage only (PDO) outcome was considered as the reference (or base) category.

RESULTS

The modeling results show that the odds of a crash leading to major injury or fatality (KA outcome) increases by 330%, 150%, 243%, and 266% for older drivers (65 or above) compared to young drivers (29 or less) on Interstates, minor arterials, major collectors, and minor collectors, respectively. During the winter period (October to April), the odds of KA severity outcome (with respect to the PDO) decreases by 65%, 65%, 65%, and 48% on Interstates, minor arterials, major collectors, and minor collectors, respectively, presumably due to reduced speeds during winter weather events.

CONCLUSION

In Maine, factors such as older drivers, operating under the influence, speeding, precipitation, and not wearing a seatbelt showed higher odds of leading to injury.

PRACTICAL APPLICATIONS

This study provides safety analysts and practitioners in Maine a comprehensive study of factors that influence the severity of crashes in Maine at different facilities to improve maintenance strategies, enhance safety using proper safety countermeasures, or increase awareness across the state.

Patterns and Ecological Mechanisms of Tick-Borne Disease Exposure Risk in Acadia National Park, Mount Desert Island, Maine, United States

National parks are unique and significant vector-borne pathogen transmission settings, engaging over 300 million people in outdoor recreation per year. In this study, we integrated vector surveys and ecological habitat feature data in spatial models to characterize tick-borne disease exposure risk in Acadia National Park (ANP), Maine. To determine the broad-scale patterns of blacklegged tick Ixodes scapularis Say (Acari: Ixodidae) densities in ANP, we conducted host-seeking tick collections at 114 sites across the park over two years. Using these tick survey data and geospatial landscape feature data (i.e., land cover, elevation, forest patch size, and aspect) we developed a random forest model of nymphal tick density. We found that host-seeking tick density varies significantly across the park and is particularly high in areas characterized by deciduous forest cover and relatively low elevation. To explore potential fine-scale ecological drivers of tick density spatial patterns, we quantified microclimate conditions, host activity, and vegetation characteristics at a subset of 19 sites. We identified significant differences in microclimate conditions but not host activity or vegetation metrics across broad-scale landscape feature classes. Mean temperature and mean humidity were correlated to nymphal densities and therefore may provide a mechanistic link between landscape features and blacklegged tick densities. Finally, we detected multiple tick-borne pathogens in both ticks and small mammals sampled in ANP, including Borrelia burgdorferi, Babesia microti, and Anaplasma phagocytophilum. Our findings demonstrate the value of using ecological metrics to estimate vector-borne disease exposure risk and provide insight into habitat characteristics that may drive tick-borne disease exposure risk.

The impact of ABO and RhD blood types on Babesia microti infection

BACKGROUND

Babesiosis is an emerging infectious disease caused by intraerythrocytic Babesia parasites that can cause severe disease and death. While blood type is known to affect the mortality of Plasmodium falciparum malaria patients, associations between red blood cell (RBC) antigens and Babesia microti infection and disease severity are lacking.

METHODS

We evaluated RhD and ABO blood types of Babesia-infected (18S rRNA reactive) blood donors in 10 endemic states in the Northeastern and northern Midwestern United States. We also assessed possible associations between RhD and ABO blood types and disease severity among hospitalized babesiosis patients in Connecticut.

RESULTS

A total of 768 Babesia-infected blood donors were analyzed, of which 750 (97.7%) had detectable B. microti-specific antibodies. B. microti-infected blood donors were more likely to be RhD- (OR of 1.22, p-value 0.024) than RhD+ donors. Hospitalized RhD- babesiosis patients were more likely than RhD+ patients to have high peak parasitemia (p-value 0.017), which is a marker for disease severity. No differences in RhD+ blood type were noted between residents of the Northeast (OR of 0.82, p-value 0.033) and the Midwest (OR of 0.74, p-value 0.23). Overall, ABO blood type was not associated with blood donor B. microti infection, however, B. microti-infected donors in Maine and New Jersey were more likely to be blood type B compared to non-type B (OR 2.49 [p = 0.008] and 2.07 [p = 0.009], respectively), while infected donors from Pennsylvania were less likely to be type B compared to non-type B (OR 0.32 [p = 0.02]).

CONCLUSIONS

People expressing RhD antigen may have a decreased risk of B. microti infection and babesiosis severity. The association of B antigen with B. microti infection is less clear because the antigen appeared to be less prevalent in infected Pennsylvania blood donors but more prevalent in Maine and New Jersey infected donors. Future studies should quantify associations between B. microti genotypes, RBC antigens, and the frequency and severity of B. microti infection to increase our understanding of human Babesia pathogenesis and improve antibody, vaccine, and RBC exchange transfusion strategies.

Persistent organic pollutants in female humpback whales Megaptera novaeangliae from the Gulf of Maine

Contaminant studies in cetaceans can provide information about pollutant levels and patterns in a given region. Due to the confounding effects of reproductive status and maternal offloading in females, these studies typically focus on males. However, an improved understanding of contaminant burdens in female cetaceans is needed to better assess potential impacts to populations. The objectives of this study were to characterize concentrations of persistent organic pollutants (POPs) in blubber of female humpback whales across age classes and to also better characterize maternal offloading of these pollutants to their offspring. A total of 36 blubber biopsy samples of female humpback whales (Megaptera novaeangliae) from the Gulf of Maine were analyzed to examine contaminant loads across females of different ages. Sampled individuals were individually-identified from longitudinal studies and assigned to age class (i.e., adult, subadult, juvenile, calf). Analysis was performed using gas chromatography/mass spectrometry (GC/MS) of POPs including polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethanes (DDTs), chlordanes (CHLDs), polybrominated diphenyl ethers (PBDEs), hexachlorocyclohexanes (HCHs). The most abundant POPs were PCB congeners, with summed values ranging from 280 to 12,000 ng/g, lipid weight, which is above recent estimates of the threshold for adverse health effects. We found significant differences in mean values between adults and juveniles and between adults and subadults, with the exception of the less persistent HCHs for the latter. We also found significant differences in mean levels of ∑HCHs between the juveniles and subadults. Changes over age are consistent with maternal offloading and potentially important for evaluating population health and viability.

Degree and direction of overlap between social vulnerability and community resilience measurements

An ongoing debate in academic and practitioner communities, centers on the measurement similarities and differences between social vulnerability and community resilience. More specifically, many see social vulnerability and community resilience measurements as conceptually and empirically the same. Only through a critical and comparative assessment can we ascertain the extent to which these measurement schemas empirically relate to one another. This paper uses two well-known indices—the social vulnerability index (SoVI) and the Baseline Resilience Indicators for Communities (BRIC) to address the topic. The paper employs spatio-temporal correlations to test for differences or divergence (negative associations) and similarities or convergence (positive associations), and the degree of overlap. These tests use continental U.S. counties, two timeframes (2010 and 2015), and two case study sub-regions (to identify changes in measurement associations going from national to regional scales given the place-based nature of each index). Geospatial analytics indicate a divergence with little overlap between SoVI and BRIC measurements, based on low negative correlation coefficients (around 30%) for both time periods. There is some spatial variability in measurement overlap, but less than 2% of counties show hot spot clustering of correlations of more than 50% in either year. The strongest overlap and divergence in both years occurs in few counties in California, Arizona, and Maine. The degree of overlap in measurements at the regional scale is greater in the Gulf Region (39%) than in the Southeast Atlantic region (21% in 2010; 28% in 2015) suggesting more homogeneity in Gulf Coast counties based on population and place characteristics. However, in both study areas SoVI and BRIC measurements are negatively associated. Given their inclusion in the National Risk Index, both social vulnerability and resilience metrics are needed to interpret the local community capacities in natural hazards risk planning, as a vulnerable community could be highly resilient or vice versa.

Spatiotemporal Trends of Legacy and Alternative Flame Retardants in Harbor Seals from the Coasts of California, the Gulf of Maine, and Sweden

Temporal trends of polybrominated diphenyl ethers (PBDEs) have been extensively studied in various environmental compartments globally. However, despite the increasing use of alternative flame retardants following PBDE bans, the spatiotemporal trends of these replacements have rarely been studied, and the available results are often inconsistent. In the present study, we retrospectively investigated the spatiotemporal trends of PBDEs and a suite of alternative brominated FRs (aBFRs) and chlorinated FRs (i.e., dechloranes or DECs) in three harbor seal (Phoca vitulina) populations from the coasts of California, the Gulf of Maine, and southern Sweden during 1999-2016. We observed significantly decreasing trends of ΣPBDEs in all the three populations at an annual rate of 9-11%, which were predominantly driven by the declining concentrations of tetra- and penta-BDEs. The levels of ΣaBFRs decreased significantly in seals from California (mainly 1,3,5-tribromobenzene) and Sweden (mainly hexabromobenzene), while no trend was observed for those from Maine. By contrast, DECs (dominated by DEC 602) did not decrease significantly in any population. Compared with the consistent PBDE congener profiles across regions, aBFRs and DECs exhibited varying compositional profiles between regions, likely indicating region-specific sources of these alternative FR mixtures. Spatial analysis also revealed regional differences in the concentrations of PBDEs, aBFRs, and DECs in harbor seals. Our reconstructed spatiotemporal trends suggest the effective regulation of commercial penta-BDE mix in these regions and warrant further monitoring of the higher brominated BDEs and alternative FRs.

Rapid adaptation to crisis events: Insights from the bait crisis in the Maine lobster fishery

Climate change, overfishing, and other anthropogenic drivers are forcing marine resource users and decision makers to adapt-often rapidly. In this article we introduce the concept of pathways to rapid adaptation to crisis events to bring attention to the double-edged role that institutions play in simultaneously enabling and constraining swift responses to emerging crises. To develop this concept, we draw on empirical evidence from a case study of the iconic Maine lobster (Homarus americanus) industry. In the Gulf of Maine, the availability of Atlantic herring (Clupea harengus) stock, a key source of bait in the Maine lobster industry, declined sharply. We investigate the patterns of bait use in the fishery over an 18-year period (2002-2019) and how the lobster industry was able to abruptly adapt to the decline of locally-sourced herring in 2019 that came to be called the bait crisis. We found that adaptation strategies to the crisis were diverse, largely uncoordinated, and imperfectly aligned, but ultimately led to a system-level shift towards a more diverse and globalized bait supply. This shift was enabled by existing institutions and hastened an evolution in the bait system that was already underway, as opposed to leading to system transformation. We suggest that further attention to raceways may be useful in understanding how and, in particular, why marine resource users and coastal communities adapt in particular ways in the face of shocks and crises.

Emergence of Ixodes scapularis (Acari: Ixodidae) in a Small Mammal Population in a Coastal Oak-Pine Forest, Maine, USA

In the United States, surveillance has been key to tracking spatiotemporal emergence of blacklegged ticks [Ixodes scapularis Say (Ixodida:Ixodidae)] and their pathogens such as Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt & Brenner (Spirochaetales: Spirochaetaceae), the agent of Lyme disease. On the Holt Research Forest in midcoastal Maine, collection of feeding ticks from live-trapped small mammal hosts allowed us to track the emergence and establishment of I. scapularis, 1989-2019. From 1989-1995, we collected only I. angustus Neumann (Ixodida: Ixodidae)(vole tick), Dermacentor variabilis Say (Ixodida: Ixodidae) (American dog tick), and I. marxi Banks (Ixodida: Ixodidae) (squirrel tick) from seven species of small mammals. The most abundant tick host was the white-footed mouse [Peromyscus leucopus Rafinesque (Rodentia:Cricetidae)] followed by the red-backed vole (Myodes gapperi Vigors (Rodentia: Cricetidae)). Emergence of I. scapularis was signaled via the appearance of subadult I. scapularis in 1996. Emergence of B. burgdorferi was signaled through its appearance in I. scapularis feeding on mice in 2005. There was a substantial increase in I. scapularis prevalence (proportion of hosts parasitized) and burdens (ticks/host) on white-footed mice and red-backed voles in 2007. The ~11-yr time-to-establishment for I. scapularis was consistent with that seen in other studies. White-footed mice comprised 65.9% of all captures and hosted 94.1% of the total I. scapularis burden. The white-footed mouse population fluctuated interannually, but did not trend up as did I. scapularis prevalence and burdens. There were concurrent declines in I. angustus and D. variabilis. We discuss these results in the broader context of regional I. scapularis range expansion.

Impact of Medicaid Eligibility Changes on Long-acting Reversible Contraception Use in Massachusetts and Maine

BACKGROUND

Availability of long-acting reversible contraception (LARC) is an important indicator of high-quality women's health care. There are limited data on the impact of state-level Medicaid eligibility changes on LARC use.

STUDY DESIGN

We used All-Payers Claims Databases to examine LARC insertions among women enrolled in Medicaid in Massachusetts, which expanded Medicaid in 2014, and Maine, which restricted Medicaid eligibility in 2013. We used interrupted time series (ITS) analyses to determine the impact of Medicaid eligibility changes on level and trends in LARC insertions in these states.

RESULTS

In Massachusetts, graphical evidence demonstrates that after Medicaid expansion, there was an immediate increase in mean monthly LARC insertions and insertions per 1000 enrollees. In ITS regression adjusting for age, LARC insertions per enrollee increased immediately after Medicaid expansion by 32% (P<0.001). After expansion, as the number of enrollees continued to rise, mean monthly LARC insertions rose, but there was a slightly decreasing trend in insertions per enrollee by 1% per month (P<0.001). In Maine, graphical evidence shows that initial reductions in Medicaid eligibility were associated with an immediate drop in LARC insertion numbers and rates per 1000, with ITS regression demonstrating an immediate 17% drop in insertions per enrollee (P<0.001). As Maine's Medicaid enrollment declined from 2013 to 2015, the number of LARC insertions remained flat, leading to an increasing trend in insertions per enrollee, similar to pre-2013 trends (P=0.17).

CONCLUSIONS

Medicaid eligibility changes were associated with immediate changes in LARC uptake. Medicaid expansion may help ensure access to this effective contraceptive method.

Maine's Bumble Bee (Hymenoptera: Apidae) Assemblage-Part 1: Composition, Seasonal and Regional Distribution, and Resource Use

Global declines of bumble bees place natural and agricultural ecosystems at risk. Given bumble bees importance to Maine's major agricultural crops, we conducted a statewide, quantitative survey of bumble bee species seasonal and ecoregional abundance, richness, diversity, and floral resource use. We recorded 11 Bombus species at 40 survey sites across Maine's three ecoregions, with Bombus ternarius Cresson, 1863 and Bombus impatiens Cresson, 1863 being the most common and Bombus citrinus Smith, 1854 the least commonly encountered. Bumble bee species richness did not differ as a function of ecoregion, but did decline over the season, while species diversity differed by ecoregion and also declined over the season. Multiple response permutation procedure (MRPP) indicated ecoregional differences in species composition of bumble bee assemblages and nonmetric multidimensional scaling produced a stable ordination suggesting assemblage differences were associated with survey site variables including forage plant cover, forage plant richness, elevation, development, and deciduous forest cover. Both MRPP and correspondence analysis also revealed differences in the floral resources utilized by bumble bee species in each ecoregion. Low connectance and nestedness levels indicated low stability pollinator networks in each ecoregion, suggesting Maine bumble bee assemblages may be at risk of decline in response to additional external perturbations.

Maine's Bumble Bees (Hymenoptera: Apidae)-Part 2: Comparisons of a Common (Bombus ternarius) and a Rare (Bombus terricola) Species

As part of a quantitative survey of Maine's bumble bee fauna (Butler et al. 2021), we compared and contrasted genetic diversity, parasite and pathogen burdens, and pesticide exposure of the relatively common Bombus ternarius Say, 1937 and the spatially rare Bombus terricola Kirby, 1837. We recorded 11 Bombus species at 40 survey sites across three Maine ecoregions, and B. ternarius was the most common species, while B. terricola was spatially rare. Nonmetric multidimensional scaling indicated that B. terricola was associated with higher elevation sites in Maine, while B. ternarius was more broadly distributed in the state. Pollinator networks constructed for each bee indicated B. ternarius foraged on more plant species than B. terricola, but that there was considerable overlap (73%) in plant species visited. Genetic diversity was greater in the spatially restricted B. terricola, whereas the widely distributed B. ternarius was characterized by greater genetic differentiation among regions. Bombus terricola had higher molecular marker levels of the microsporidian fungi Nosema spp. and the trypanosome Crithidia spp., and both species had high levels of Trypanosoma spp. exposure. No Western Honey Bee (Apis mellifera, Linnaeus, 1758) viruses were detected in either species. Pesticides were not detected in pollen samples collected from workers of either species, and B. ternarius worker tissue samples exhibited only trace levels of diflubenzuron.

Community oncologists' perceptions and utilization of large-panel genomic tumor testing

PURPOSE

Large-panel genomic tumor testing (GTT) is an emerging technology with great promise but uncertain clinical value. Previous research has documented variability in academic oncologists' perceptions and use of GTT, but little is known about community oncologists' perceptions of GTT and how perceptions relate to clinicians' intentions to use GTT.

METHODS

Community oncology physicians (N = 58) participating in a statewide initiative aimed at improving access to large-panel GTT completed surveys assessing their confidence in using GTT, attitudes regarding the value of GTT, perceptions of barriers to GTT implementation, and future intentions to use GTTs. Descriptive and multivariable regression analyses were conducted to characterize these perceptions and to explore the relationships between them.

RESULTS

There was substantial variability in clinicians' perceptions of GTT. Clinicians generally had moderate confidence in their ability to use GTT, but lower confidence in patients' ability to understand test results and access targeted treatment. Clinicians had positive attitudes regarding the value of GTT. Clinicians' future intentions to use GTT were associated with greater confidence in using GTT and greater perceived barriers to implementing GTT, but not with attitudes about the value of GTT.

CONCLUSIONS

Community oncologists' perceptions of large-panel genomic tumor testing are variable, and their future intentions to use GTT are associated with both their confidence in and perceived barriers to its use, but not with their attitudes towards GTT. More research is needed to understand other factors that determine how oncologists perceive and use GTT in clinical practice.

Factors Influencing the Population Fluctuations of Euproctis chrysorrhoea (Lepidoptera: Erebidae) in Maine

The browntail moth (Euproctis chrysorrhoea (L.)) is a forest pest that was accidentally introduced in the late 1800's and spread throughout New England in the early part of the 20th Century. At its peak range expansion in 1915 it encompassed an area of 150,000 km2 after which populations declined. By the 1960s, its distribution had receded to relic populations on outer Cape Cod, MA, and islands in Casco Bay, ME. In 1989 browntail moth resurged in Maine, with periodic, moderate outbreaks before a dramatic increase of the population occurred in 2016. We examined the pattern of annual defoliation by browntail moth since its resurgence in the 1990s as well as variation in populations throughout infested areas in Maine during three years of the recent outbreak, 2016-2018, relative to differences in weather, parasitism and habitat characteristics. Levels of defoliation over 24 yr were predicted by the preceding spring precipitation (-, negative effect) and the year's previous late summer and early fall temperatures (+, positive effect) when first to third instar larvae feed and then construct winter hibernacula. Late summer temperatures predicted the abundance of hibernacula across outbreak areas (+). Early spring temperatures (+) and early and late spring precipitation (-) predicted early summer larval and pupal nest abundance. Warmer fall temperatures result in more mature populations coming out of winter hibernacula in the spring, whereas spring precipitation drives epizootic outbreaks of Entomophaga aulicae (Reichardt in Bail) Humber (Entomophthorales: Entomophthoraceae). with parasitoids playing a lesser role. Climate trends indicate continued increases in fall temperatures since browntail moth resurgence.

Detection of SARS-CoV-2 in Wastewater at Residential College, Maine, USA, August-November 2020

We used wastewater surveillance to identify 2 coronavirus disease outbreaks at a college in Maine, USA. Cumulative increases of >1 log₁₀ severe acute respiratory syndrome coronavirus 2 RNA in consecutive 24-hour composite samples preceded the outbreaks. For 76% of cases, RNA was identified in grab samples from residence halls <7 days before case discovery.

Exceptions and exemptions under the ballast water management convention - Sustainable alternatives for ballast water management?

The International Convention for the Control and Management of Ships' Ballast Water and Sediments (BWM Convention) aims to mitigate the introduction risk of harmful aquatic organisms and pathogens (HAOP) via ships' ballast water and sediments. The BWM Convention has set regulations for ships to utilise exceptions and exemptions from ballast water management under specific circumstances. This study evaluated local and regional case studies to provide clarity for situations, where ships could be excepted or exempted from ballast water management without risking recipient locations to new introductions of HAOP. Ships may be excepted from ballast water management if all ballasting operations are conducted in the same location (Regulation A-3.5 of the BWM Convention). The same location case study determined whether the entire Vuosaari harbour (Helsinki, Finland) should be considered as the same location based on salinity and composition of HAOP between the two harbour terminals. The Vuosaari harbour case study revealed mismatching occurrences of HAOP between the harbour terminals, supporting the recommendation that exceptions based on the same location concept should be limited to the smallest feasible areas within a harbour. The other case studies evaluated whether ballast water exemptions could be granted for ships using two existing risk assessment (RA) methods (Joint Harmonised Procedure [JHP] and Same Risk Area [SRA]), consistent with Regulation A-4 of the BWM Convention. The JHP method compares salinity and presence of target species (TS) between donor and recipient ports to indicate the introduction risk (high or low) attributed to transferring unmanaged ballast water. The SRA method uses a biophysical model to determine whether HAOP could naturally disperse between ports, regardless of their transportation in ballast water. The results of the JHP case study for the Baltic Sea and North-East Atlantic Ocean determined that over 97% of shipping routes within these regions resulted in a high-risk indication. The one route assessed in the Gulf of Maine, North America also resulted in a high-risk outcome. The SRA assessment resulted in an overall weak connectivity between all ports assessed within the Gulf of the St. Lawrence, indicating that a SRA-based exemption would not be appropriate for the entire study area. In summary, exceptions and exemptions should not be considered as common alternatives for ballast water management. The availability of recent and detailed species occurrence data was considered the most important factor to conduct a successful and reliable RA. SRA models should include biological factors that influence larval dispersal and recruitment potential (e.g., pelagic larval duration, settlement period) to provide a more realistic estimation of natural dispersal.

Risks from mercury in anadromous fish collected from Penobscot River, Maine

Levels of total mercury were measured in tissue of six species of migratory fish (alewife, American shad, blueback herring, rainbow smelt, striped bass, and sea lamprey), and in roe of American shad for two consecutive years collected from the Penobscot River or its estuary. The resultant mercury levels were compared to reference doses as established in the U.S. Environmental Protection Agency (EPA) Integrated Risk Information System and wildlife values. Mercury concentrations ranged from 4 μg/kg ww in roe to 1040 μg/kg ww in sea lamprey. Sea lamprey contained the highest amounts of mercury for both seasons of sampling. Current health advisories are set at sufficient levels to protect fishers from harmful consumption of the fish for mercury alone, except for sea lamprey. Based upon published wildlife values for mink, otter, and eagle, consumption of rainbow smelt, striped bass, or sea lamprey poses a risk to mink; striped bass and sea lamprey to otter; and sea lamprey to eagle. For future consideration, the resultant data may serve as a reference point for both human health and wildlife risk assessments for the consumption of anadromous fish. U.S. EPA works with federally recognized Tribes across the nation greatly impacted by restrictions on sustenance fishing, to develop culturally sensitive risk assessments.

Dental Fluoride Varnish Application During Medical Visits Among Children Who Are Privately Insured

This cross-sectional study examines fluoride varnish application rates during well-child medical visits and identify characteristics associated with fluoride varnish receipt.

Essential and non-essential heavy metal levels in key organs of winter flounder (Pseudopleuronectes americanus) and their potential impact on body condition

This study explored whether winter flounder, a benthic species, are potentially exposed to contaminants such as heavy metals released from the sediment of the Bay of Fundy/Gulf of Maine, both critical habitats identified to have increases in heavy metal levels. Experimentally in fish, exposure to certain heavy metals resulted in reduced weight for length and structural abnormalities, but it is unknown if this occurs in wild fish. Winter flounder (n = 72), harvested between 2015 and 2018 from the aforementioned western Atlantic region of Canada/USA, had detectable levels of most heavy metals, with some exhibiting levels of concern (arsenic, cadmium, lead, selenium, zinc) in muscle, liver, and kidney. A 1.4% incidence of structural abnormalities was noted. When compared to 1980 regionally matched flounder data, the 2018 flounder had significantly reduced weight for length, exacerbated with age. Clearly winter flounder are affected by worsening heavy metal contaminant levels in this geographic area.

Differences in microbial community response to nitrogen fertilization result in unique enzyme shifts between arbuscular and ectomycorrhizal-dominated soils

While the effect of nitrogen (N) deposition on belowground carbon (C) cycling varies, emerging evidence shows that forest soils dominated by trees that associate with ectomycorrhizal fungi (ECM) store more C than soils dominated by trees that associate with arbuscular mycorrhizae (AM) with increasing N deposition. We hypothesized that this is due to unique nutrient cycling responses to N between AM and ECM-dominated soils. ECM trees primarily obtain N through fungal mining of soil organic matter subsidized by root-C. As such, we expected the largest N-induced responses of C and N cycling to occur in ECM rhizospheres and be driven by fungi. Conversely, as AM trees rely on bacterial scavengers in bulk soils to cycle N, we predicted the largest AM responses to be driven by shifts in bacteria and occur in bulk soils. To test this hypothesis, we measured microbial community composition, metatranscriptome profiles, and extracellular enzyme activity in bulk, rhizosphere, and organic horizon (OH) soils in AM and ECM-dominated soils at Bear Brook Watershed in Maine, USA. After 27 years of N fertilization, fungal community composition shifted across ECM soils, but bacterial communities shifted across AM soils. These shifts were mirrored by enhanced C relative to N mining enzyme activities in both mycorrhizal types, but this occurred in different soil fractions. In ECM stands these shifts occurred in rhizosphere soils, but in AM stands they occurred in bulk soils. Additionally, ECM OH soils exhibited the opposite response with declines in C relative to N mining. As rhizosphere soils account for only a small portion of total soil volume relative to bulk soils, coupled with declines in C to N enzyme activity in ECM OH soils, we posit that this may partly explain why ECM soils store more C than AM soils as N inputs increase.

Geographic Variation in Dominance of Spinosad Resistance in Colorado Potato Beetles (Coleoptera: Chrysomelidae)

Eastern New York State is frequently the site of Colorado potato beetle (Leptinotarsa decemlineata, Say) populations with the highest observed levels of insecticide resistance to a range of active ingredients. The dominance of a resistant phenotype will affect its rate of increase and the potential for management. On organic farms on Long Island, L. decemlineata evolved high levels of resistance to spinosad in a short period of time and that resistance has spread across the eastern part of the Island. Resistance has also emerged in other parts of the country as well. To clarify the level of dominance or recessiveness of spinosad resistance in different parts of the United States and how resistance differs in separate beetle populations, we sampled in 2010 beetle populations from Maine, Michigan, and Long Island. In addition, a highly resistant Long Island population was assessed in 2012. All populations were hybridized with a laboratory-susceptible strain to determine dominance. None of the populations sampled in 2010 were significantly different from additive resistance, but the Long Island population sampled in 2012 was not significantly different from fully recessive. Recessive inheritance of high-level resistance may help manage its increase.

Guiding riparian management in a transboundary watershed through high resolution spatial statistical network models

The United States Environmental Protection Agency and the Houlton Band of Maliseet Indians (HBMI) built a stream temperature spatial statistical network (SSN) model for the Meduxnekeag Watershed. The headwaters of the Meduxnekeag Watershed are in Maine, United States of America and the outlet is in New Brunswick, Canada, creating an additional challenge because many datasets are constrained to political boundaries. The release of the High-Resolution National Hydrology Dataset Plus included transboundary watersheds and enabled creation of fine resolution (1:24,000) SSN temperature models consistent with management scales for riparian buffers. SSN models were developed for July, August, and September median stream temperatures and the growing season maximum (GSM). Fitted SSN models had relatively high R² values (0.88-0.96) and all final models included significant parameters for shade-attenuated solar radiation, reference flow, air temperature, and bankfull depth or width. Fitted models predicted stream temperatures during a dry (2010) and wet (2011) year. Monthly models predicted the fewest cold water (<19.0 °C) reaches in July with 28% in the dry and 68% in the wet year. September had >99% cold water reaches, and August results were intermediate between July and September. GSM predictions found 81% of stream reaches could not support salmonid survival (>27.0 °C) in the dry year and 59% of the reaches were warmwater (22.5-27.0 °C) in the wet year. The model was used to predict stream temperatures following restoration scenarios of a forested 30-m or 90-m buffer of stream segments bordered by agricultural or developed land. The restoration scenarios expanded cold water habitat based on monthly median temperatures and decreased the habitat area with GSM above survival thresholds, with little difference in effectiveness of the two buffer widths. These results will guide riparian restoration projects by the HBMI to expand habitat for cold water fishes.

Detection of SARS-CoV-2 in Wastewater at Residential College, Maine, USA, August-November 2020

We used wastewater surveillance to identify 2 coronavirus disease outbreaks at a college in Maine, USA. Cumulative increases of >1 log₁₀ severe acute respiratory syndrome coronavirus 2 RNA in consecutive 24-hour composite samples preceded the outbreaks. For 76% of cases, RNA was identified in grab samples from residence halls <7 days before case discovery.

A case study in participatory science with mutual capacity building between university and tribal researchers to investigate drinking water quality in rural Maine

BACKGROUND

Participatory science or citizen science is increasingly being recognized for providing benefits to scientists and community members alike. However, most participatory science projects include community researchers only in the sample collection phase of the research project. Here we describe how a rural tribal community and urban university utilized participatory science methods to engage community researchers across an entire research study, creating numerous opportunities for mutual capacity building.

OBJECTIVES

Researchers from MIT and the Sipayik Environmental Department, a tribal government department, partnered to co-launch a participatory science project to analyze municipal and private well drinking water quality in households in three Maine communities. The objective was to provide households with information about metals, primarily lead and arsenic, in their drinking water, and to improve public education, community partnerships, and local scientific capacity.

METHODS

MIT and Sipayik researchers engaged local communities through public community meetings, mailed flyers sent to residents, and meetings with local stakeholders. MIT and community researchers worked together to design and implement the study to quantify metals in community drinking water samples, as well as hold capacity-building trainings. Individual drinking water results were communicated to households, and generalized results were discussed at community meetings in the report-back phase.

RESULTS

The study attained a 29% household participation rate in the region. The researchers completed the analysis and report-back on 652 water samples. Isolated incidences of lead and geologically-attributable arsenic exceeding EPA standards were found. Individual report-backs of the results enabled local participatory scientists to make their own informed public health decisions. The study produced methodologies for navigating potential ethical issues, working with diverse communities, and collaborating over challenging geographical distances.

DISCUSSION

This project developed methodologies to build long-term relationships with local scientists and to engage community members and enhance the environmental literacy of rural communities. Both MIT and Sipayik researchers learned from each other throughout the project; Sipayik researchers built technical capacity while MIT researchers gained local and cultural understanding. Community outreach methods were most effective when sent directly to residents as mailed flyers or through Sipayik researchers' outreach.

Spatiotemporal pattern models for bioaccumulation of pesticides in common herbaceous and woody plants

Pesticides are widely used in agriculture, but they can bioaccumulate in plants, entering the food chain and potentially threaten human health. Thus, this study explored the spatiotemporal patterns of pesticide bioaccumulation in plants from soil using a spatiotemporal model. Air temperature (T_Air) and relative humidity (RH_Air) were selected as the principal spatiotemporal indicators to characterize the seasonal and geographical variation of the pesticide bioaccumulation factors (BAFs; i.e., the pesticide concentration ratio of plant to soil) of the leaves of common plants. The simulation results indicate that hot and dry climates typically increase the pesticide BAFs by enhancing the transpiration rate of plants. For example, the annual average BAF of alachlor was 5.75 in Arizona, while the BAFs in states with cold and humid weather, such as Maine, were below 2.00. Additionally, the monthly average BAF of alachlor during hot seasons can be double that of other seasons in the same region. For some pesticides, the simulated BAF intervals were consistent with those reported in the literature, whereas for others, the results were inconsistent. The major reasons for these inconsistencies include differences in the pesticide application scenarios, the distribution of pesticides in different compartments, and insufficient field data for some pesticides. We also applied the simulated BAFs of pesticide in plant leaves to address the seasonal and geographical health risks of herbivores, which could help regulate pesticide standards in ecological soils.

Ski wax use contributes to environmental contamination by per- and polyfluoroalkyl substances

Per- and polyfluoroalkyl substances (PFAS) are used in a wide variety of consumer products, including ski waxes, and are widespread persistent and hazardous environmental contaminants. We examined the environmental impact of ski wax use at an outdoor recreation area with significant cross-country ski activity by measuring PFAS levels in melted snow, soil and water following a collegiate ski race. We found extremely high levels of long- and short-chain PFAS (C4-C14) contamination in snow at the race start line (∑[PFAS] 7600-10,700 ng/L), with the longer-chain analytes (C10-C14) predominating. The complement of 14 PFAS detected in snow matched what has been found in ski wax. This snow contamination was greatly reduced at a point 3.9 km into the race. Soil at the start line contained the four most predominant PFAS in snow at a mean individual concentration of 2.81 ng/g dry weight. Control soil contained only perfluorooctane sulfonic acid (PFOS), not found in other soil samples, at a concentration of 2.80 ng/g. Shallow groundwater from an on-site well contained only the shorter-chain PFAS (C4-C8), with a mean individual concentration of 4.95 ng/L. Our results suggest that ski wax use, from which fluorocarbons abrade at very high levels onto snow during a ski race, are the main source of PFAS contamination at our site. Regulation of ski wax use is warranted to reduce PFAS pollution.

Snowmelt periods as hot moments for soil N dynamics: a case study in Maine, USA

The vernal transition represents the seasonal transition to spring, occurring as temperatures rise at the end of winter. With rapid snowmelt, microbial community turnover, and accelerated nutrient cycling, this is a critical but relatively under-studied period of ecosystem function. We conducted a study over two consecutive winters (2015-2016) at the Bear Brook Watershed in Maine to examine how changing winter conditions (warming winters, reduced snow accumulation) altered soil nitrogen availability and stream N export during winter and the vernal transition, and how these patterns were influenced by ecosystem N status (N-enriched vs. N-limited). Of the two study years, 2016 had a warmer winter with substantially less snow accumulation and a discontinuous snowpack-and as a result, had a longer vernal transition and a snowpack that thawed before the vernal transition began. Across both years, snowmelt triggered a transition, signaled by increased ammonium concentrations in soil, decreased soil nitrate concentrations due to flushing by meltwater, and increased stream nitrate exports. Despite the contrasting winter conditions, both years showed similar patterns in N availability and export, differing only in the timing of these transitions. The vernal transition has conventionally been considered a critical period for biogeochemical cycling, because the associated snowmelt event triggers physicochemical and biochemical changes in soil systems. This was consistent with our results in 2015, but our data for 2016 show that this may not always hold true, and instead, that warmer, low-snow winters may demonstrate a temporal asynchrony between snowmelt and the vernal transition. We also show that ecosystem N status is a strong driver of the seasonal N pattern, and the interaction of N status and changing climate must be further investigated to understand ecosystem function under our current predicted trajectory of warming winters, declining snowfall, and winter thaw events.

Dynamics of an intense Alexandrium catenella red tide in the Gulf of Maine: satellite observations and numerical modeling

In July 2009, an unusually intense bloom of the toxic dinoflagellate Alexandrium catenella occurred in the Gulf of Maine. The bloom reached high concentrations (from hundreds of thousands to one million cells L-1) that discolored the water and exceeded normal bloom concentrations by a factor of 1000. Using Medium Resolution Imaging Spectrometer (MERIS) imagery processed to target chlorophyll concentrations (>2 µg L-1), patches of intense A. catenella concentration were identified that were consistent with the highly localized cell concentrations observed from ship surveys. The bloom patches were generally aligned with the edge of coastal waters with high-absorption. Dense bloom patches moved onshore in response to a downwelling event, persisted for approximately one week, then dispersed rapidly over a few days and did not reappear. Coupled physical-biological model simulations showed that wind forcing was an important factor in transporting cells onshore. Upward swimming behavior facilitated the horizontal cell aggregation, increasing the simulated maximum depth-integrated cell concentration by up to a factor of 40. Vertical convergence of cells, due to active swimming of A. catenella from the subsurface to the top layer, could explain the additional 25-fold intensification (25 × 40=1000-fold) needed to reach the bloom concentrations that discolored the water. A model simulation that considered upward swimming overestimated cell concentrations downstream of the intense aggregation. This discrepancy between model and observed concentrations suggested a loss of cells from the water column at a time that corresponded to the start of encystment. These results indicated that the joint effect of upward swimming, horizontal convergence, and wind-driven flow contributed to the red water event, which might have promoted the sexual reproduction event that preceded the encystment process.

Reduction in drinking water arsenic exposure and health risk through arsenic treatment among private well households in Maine and New Jersey, USA

Over 2 million mostly rural Americans are at risk of drinking water from private wells that contain arsenic (As) exceeding the U.S. Environmental Protection Agency (USEPA) Maximum Contaminant Level (MCL) of 10 micrograms per liter (μg/L). How well existing treatment technologies perform in real world situations, and to what extent they reduce health risks, are not well understood. This study evaluates the effectiveness of household As treatment systems in southern-central Maine (ME, n = 156) and northern New Jersey (NJ, n = 94) and ascertains how untreated well water chemistry and other factors influence As removal. Untreated and treated water samples, as well as a treatment questionnaire, were collected. Most ME households had point-of-use reverse-osmosis systems (POU RO), while in NJ, dual-tank point-of-entry (POE) whole house systems were popular. Arsenic treatment systems reduced well water arsenic concentrations ([As]) by up to two orders of magnitude, i.e. from a median of 71.7 to 0.8 μg/L and from a mean of 105 to 14.3 μg/L in ME, and from a median of 8.6 to 0.2 μg/L and a mean of 15.8 to 2.1 μg/L in NJ. More than half (53%) of the systems in ME reduced water [As] to below 1 μg/L, compared to 69% in NJ. The treatment system failure rates were 19% in ME (>USEPA MCL of 10 μg/L) and 16% in NJ (>NJ MCL of 5 μg/L). In both states, the higher the untreated well water [As] and the As(III)/As ratio, the higher the rate of treatment failure. POE systems failed less than POU systems, as did the treatment systems installed and maintained by vendors than those by homeowners. The 7-fold reduction of [As] in the treated water reduced skin cancer risk alone from 3765 to 514 in 1 million in ME, and from 568 to 75 in 1 million in NJ.

Temporal variability in size and growth of Atlantic herring in the Gulf of Maine

Variability in life history traits and structural diversity of commercially exploited fishes in response to stress can impact their population dynamics and sustainability. Using data from a fishery dependent sampling program from 1978 to 2011, we evaluated temporal variability of size and growth of adult Atlantic herring (Clupea harengus) in the Gulf of Maine. We then developed and tested the hypotheses on the links of such temporal changes to population density and environmental factors and found decreases in size and growth potential. Generalized additive models found that density dependence was the main driver of such changes over sea surface temperature and salinity. Our results highlight the importance of density dependent processes in regulating growth and population size structure for Atlantic herring in the Gulf of Maine.

Redesigning the Clinical Learning Environment to Improve Interprofessional Care and Education: Multi-Method Program Evaluation of the iPACE Pilot Unit

BACKGROUND

In 2016, Maine Medical Center received an Accreditation Council for Graduate Medical Education Pursuing Excellence in Innovation grant to redesign the clinical learning environment to promote interprofessional care and education. The Interprofessional Partnership to Advance Care and Education (iPACE) model was developed and piloted on an adult inpatient medicine unit as an attempt achieve these aims.

OBJECTIVE

We describe the iPACE model and associated outcomes.

METHODS

Surveys and focus groups were employed as part of a multimethod pragmatic observational strategy. Team surveys included relational coordination (RC): a validated proprietary measure of interpersonal communication and relationships within teams. Pre-iPACE respondents were a representative historical sample from comparable inpatient medical units surveyed from March to April 2017. iPACE respondents were model participants surveyed March to August 2018 to allow for adequate sample size.

RESULTS

Surveys were administered to pre-iPACE (N = 113, response rate 74%) and iPACE (N = 32, 54%) teams. Summary RC scores were significantly higher for iPACE respondents (iPACE 4.26 [SD 0.37] vs 3.72 [SD 0.44], P < .0001), and these respondents were also more likely to report a professionally rewarding experience (iPACE 4.4 [SD 0.6] vs 3.5 [SD 1.0], P < .0001). Learners felt the model was successful in teaching interprofessional best practices but were concerned it may hinder physician role development. Patient experience was positive.

CONCLUSIONS

This pilot may have a positive effect on team functioning and team member professional experience and patient experience. Learner acceptance may be improved by increasing autonomy and preserving traditional learning venues.

Long-term monitoring of mercury in adult saltmarsh sparrows breeding in Maine, Massachusetts and New York, USA 2000-2017

Here we report on the results of a long-term study of mercury exposure in a songbird species, the saltmarsh sparrow (Ammodramus caudacutus). We measured total mercury concentrations in blood (n = 840) and feathers (n = 560) of adult saltmarsh sparrows at six locations between 2000 and 2017: Rachel Carson National Wildlife Refuge (RCNWR) in Wells, Maine; Scarborough Marsh State Wildlife Management Area in Scarborough, Maine; Parker River National Wildlife Refuge on Plum Island, Massachusetts; Pine Neck Preserve in Southampton, Long Island, New York; and North Cinder and North Green Sedge Islands off the coast of Long Island, New York. During the 12-17 year sampling periods, we found that mercury exposure differed by site and year but there was no consistent temporal trend across sites. Blood mercury concentrations declined only at RCNWR in Maine. We also found seasonal variation in blood mercury concentrations and a positive relationship between mercury concentrations of blood and innermost primary feather, but not between blood and tail feather.

Behavioral responses of fish to a current-based hydrokinetic turbine under mutliple operational conditions

There is significant international interest in developing current-based marine and hydrokinetic (MHK) technologies to capture the power of tidal energy. However, concerns have been raised regarding the ecological effects of these projects on fish, including the risk of blade collision and behavioral impacts such as the disruption of migratory behavior and food acquisition and displacement from preferred habitats. We conducted mobile hydroacoustic surveys to track fish as they approached a tidal turbine deployed in Cobscook Bay, Maine. There was a significant decline in fish numbers with decreasing distance to the turbine, beginning approximately 140 m from the turbine. Similar declines were not observed at control transects or when the turbine was not spinning. The decline in fish numbers appeared to be the result of horizontal displacement, not vertical, movements to avoid the turbine. Noise rather than visual cues or flow field disturbance seemed to be a likely explanation for the reduced number of fish near the turbine. This finding, combined with near-field blade collision studies indicating a low probability of encounter, suggests that a single turbine poses a low collision risk to pelagic fish and that a single turbine is likely to result in minimal behavioral responses by fish. However, the risk may be different with additional devices, which will become more relevant as commercial-scale MHK arrays come under consideration. Therefore, the risks associated with commercial-scale operations will ultimately have to be evaluated to fully understand the ecological impacts of MHK devices.

Psychosocial and Mental Health Characteristics of RePresent Game Users

The RePresent games are online video games that are publicly available and designed to educate people about legal self-representation in civil court. This study was part of a project to examine use of the RePresent games in Connecticut, Massachusetts, Maine, and New Hampshire from January 2018 to May 2018. Data on game use across the four states were analyzed, and an online survey was conducted to examine characteristics of RePresent game users and nonusers seeking civil legal aid (n = 277). The RePresent games were accessed more than 7,000 times in five months. The most common legal problems reported were related to debt, family, and housing. Compared with nonusers, RePresent game users were significantly more likely to be nonwhite, to have an incarceration history, to have more legal problems, and to screen positive for alcohol use problems. In the total sample, 83 percent screened positive for depression, 81 percent for generalized anxiety disorder, and 45 percent for drug problems. Only 34 percent reported use of mental health services, and 17 percent reported substance abuse treatment in the past year. These findings demonstrate that products like the RePresent games can be widely accessible to adults from disadvantaged backgrounds. In addition, civil legal settings may be a new area for mental health screening and intervention.

Dihydrodinophysistoxin-1 Produced by Dinophysis norvegica in the Gulf of Maine, USA and Its Accumulation in Shellfish

Dihydrodinophysistoxin-1 (dihydro-DTX1, (M-H)^-m/z 819.5), described previously from a marine sponge but never identified as to its biological source or described in shellfish, was detected in multiple species of commercial shellfish collected from the central coast of the Gulf of Maine, USA in 2016 and in 2018 during blooms of the dinoflagellate Dinophysis norvegica. Toxin screening by protein phosphatase inhibition (PPIA) first detected the presence of diarrhetic shellfish poisoning-like bioactivity; however, confirmatory analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS) failed to detect okadaic acid (OA, (M-H)^-m/z 803.5), dinophysistoxin-1 (DTX1, (M-H)^-m/z 817.5), or dinophysistoxin-2 (DTX2, (M-H)^-m/z 803.5) in samples collected during the bloom. Bioactivity-guided fractionation followed by liquid chromatography-high resolution mass spectrometry (LC-HRMS) tentatively identified dihydro-DTX1 in the PPIA active fraction. LC-MS/MS measurements showed an absence of OA, DTX1, and DTX2, but confirmed the presence of dihydro-DTX1 in shellfish during blooms of D. norvegica in both years, with results correlating well with PPIA testing. Two laboratory cultures of D. norvegica isolated from the 2018 bloom were found to produce dihydro-DTX1 as the sole DSP toxin, confirming the source of this compound in shellfish. Estimated concentrations of dihydro-DTX1 were >0.16 ppm in multiple shellfish species (max. 1.1 ppm) during the blooms in 2016 and 2018. Assuming an equivalent potency and molar response to DTX1, the authority initiated precautionary shellfish harvesting closures in both years. To date, no illnesses have been associated with the presence of dihydro-DTX1 in shellfish in the Gulf of Maine region and studies are underway to determine the potency of this new toxin relative to the currently regulated DSP toxins in order to develop appropriate management guidance.

Forty Years of University of New England's Research and Scholarship and its Impact in Maine, New England, and Beyond

The University of New England College of Osteopathic Medicine (UNE COM) was founded by a group of osteopathic physicians who wanted to ensure that the practice of Osteopathic Medicine would endure in northern New England and that patients in the region would continue to receive the best health care possible. UNECOM merged with St. Francis College in 1978 to form the University of New England (UNE). 1 UNE has grown and developed over the years, building on the shared Franciscan and osteopathic traditions of integrating philosophy and intellect. Following the 1996 merger with Westbrook College in Portland, Maine, UNE now comprises 3 campuses, 13 additional health profession programs, 6 Centers of Excellence in Research, and strong undergraduate programs that link the environment, people, and community in a "One Health" concept.

Possible climate-induced environmental impacts on parasite-infection rates of northern shrimp Pandalus borealis eggs in the Gulf of Maine

The Gulf of Maine northern shrimp Pandalus borealis population once supported a significant commercial winter fishery for the New England states. However, the fishery has been on moratorium since 2014 due to consecutive recruitment failures. The issue of parasite-infected eggs, so-called 'white eggs,' has long been identified for the Gulf of Maine northern shrimp, which makes shrimp eggs nonviable and subsequently hampers the recruitment potential. Furthermore, the proportion of infected females was observed to increase with water temperature. As Gulf of Maine temperatures have been increasing for decades, it is important to re-visit issues related to white eggs to evaluate possible impacts of climate-induced environmental changes on the white egg infection rates. We used biological samples collected by the Northeast Fisheries Science Center in 2012-2016 to evaluate the probability that a female shrimp was infected (Pinf) and the proportion of white eggs in an infected female shrimp (pwe). Although Pinf was high, with an average of 73.81% over the Gulf of Maine, pwe was mostly <5%. The variation in both Pinf and pwe examined in this study was not well explained by environmental factors or female body size. However, the average rates of both Pinf and pwe observed in this study were higher than those observed in the 1960s when the bottom temperatures were cooler. The results can be used to account for egg mortality and provide information on potential impacts of possible climate-induced variability on shrimp population dynamics.

First report of signs of infection by Coccomyxa-like algae in wild blue mussels, Mytilus spp., in the Gulf of Maine (USA, Maine)

In August 2019, visual inspection of intertidal zones of the Gulf of Maine (ME, USA) revealed young and adult wild blue mussels, Mytilus spp., in Alley Bay (Jonesport area) with the distinctive L-shaped shell deformity (LSSD) and green spots (GS) in the mantle and adductor muscle. LSSD is a characteristic sign of current or previous mussel infection by photosynthetic unicellular alga from the group Coccomyxa, while GS are algal colonies. Based on these findings, this study represents the first report of infection signs by pathogenic Coccomyxa-like algae in mussels from the coastal waters of the Northeastern United States, providing a base for future large scale monitoring of the alga in the region.

Plant Origin and Other Attributes Impact Bee Forage Patterns in a Common Garden Study in Maine, United States; Part II

In a common garden study in Maine from 2012 to 2015, we used two bee species (Apis mellifera L. and Bombus ternarius Say (1837)) and three field-recognizable bee categories ('Most Bombus', 'Halictidae', and 'Other Bees') plus an 'All Bees' data aggregation to compare 17 native and 68 introduced plant taxa. Data were from three 1-min timed periods per flowering plant taxon on a given day at a site. We observed 17,792 bees and found that their response varied by bee species or group. Using mixed models to analyze our data, we found that native bees had higher visitation rates on native plants, while A. mellifera visited both native and introduced plants. Most groups visited native late-flowering and native mid-late-flowering plants at higher rates. 'All Bees' were attracted to native perennials (vs annuals and shrubs) and to tall plants, both native and introduced; A. mellifera was attracted to introduced perennials, to introduced tall plants, and to lower-growing native plants. Asclepias tuberosa L. elicited a strong response from B. ternarius. In only two of six pairs of wild types and cultivars, bees visited wild types more. Plants with long bloom periods and with small, densely arranged white flowers attracted higher bee visitation than did other configurations (e.g., Origanum vulgare L., one of our most attractive taxa). A general linear model showed that linear combinations of flower density, floral resource height, flower corolla depth, and flowering duration explained significant variation in visitation rates for each of the different bee taxa groups.

Bee Visitation on Flowers in Maine, United States, Reveals the Relative Attractiveness of Plants Through Space and Time: Part I

Bee reservoirs can be effective in agricultural and habitat restoration projects, but the relative attractiveness of plants is not fully understood. To improve plant selection with better knowledge of spatial, temporal, and competition aspects, we tested up to 90 plant subjects from 2012 to 2015 at four sites in Maine. We recognized Apis mellifera L., Bombus ternarius Say, 1837, 'Most Bombus' (except B. ternarius), 'Halictidae' and 'Other Bees' (collectively the so-called 'bee groups') on open flowers in three 1-min periods per site and day, with numerous repeated observations per plant taxon. In 14,311 observations, we recorded 17,792 bees in 61 species. Most-visited plants included Asclepias tuberosa, Borago officinalis, Clethra alnifolia cv. Hummingbird (especially by A. mellifera), Melilotus officinalis, Origanum vulgare, Rosa palustris (especially before 1400 hours), Spiraea alba var. latifolia, and taxa in the family Asteraceae. Early-flowering shrubs were visited, especially by 'Other Bees'. Bee groups each ranked plants uniquely, with some overlap, and differed in most-visited of six plant taxa that we had included in all 4 yr and sites. For 'All Bees' among 84 plant taxa, the most-visited plants were M. officinalis (June), A. tuberosa (July), and C. alnifolia (August). Indicator Species Analysis revealed low bee fidelity to host plants for all but a few plant taxa. Apis mellifera differed from native bees in plants it visited intensively, with some overlap (e.g., A. tuberosa), and was associated with increased visitation on seven plant taxa by 'Most Bombus' and B. ternarius.