Delaware Research Articles

Evaluation & Treatment of Psychological Effects of Stroke.

Strokes are a common medical condition in the United States, including in Delaware. An under-recognized effect of stroke is the impact on mood that often occurs. Many individuals develop depression, anxiety, PTSD, and other psychological sequelae. These disorders can significantly affect their lives and their relationships. The emotional effects of stroke pose a public health problem for our residents, leading to devastating decreases in the quality of life for the patient and the family. These challenges negatively impact the community due to the associated healthcare and economic burdens. The population of the State of Delaware is growing, and the proportion of senior residents, who are also at greater risk for strokes, is also increasing. Strokes will remain an ongoing important clinical concern for our healthcare providers. Emotional changes after a stroke will occur in many Delaware residents who suffer a stroke. The emotional sequelae of stroke are under-treated. It is critical for healthcare professionals to be trained to recognize, assess, and treat the psychological disorders that can result from having a stroke. This article provides an overview of the major psychological effects of stroke, recommended assessment tools, promising treatment trends, and directions for further research. Improving our ability to detect and treat these difficult emotional challenges can facilitate effective treatment and prevention strategies and increase quality of life for stroke survivors, their loved ones, and their communities.

The Camden Merritt, New Jersey’s Premier Nineteenth-Century Baseball Team

With the emergence of baseball as America’s national sporting pastime, Camden civic and business leaders decided in 1881 to organize a professional team. This article examines the brief but spectacular history of the Albert Merritt Base Ball Club, one of the best minor league teams of the nineteenth century. Examined are the social and economic reasons for organizing a professional team, the unique founding of the club, the construction of a playing facility, and team finances including player salaries. The 1883 Merritt, which advanced every player to the major leagues, was a juggernaut, dominating the inaugural season of the Inter-State Association, one of two officially organized minor leagues. But despite success on the field with a 27-8 (.771) record, the team suddenly disbanded on July 21. The case study of the promise and perils of professional baseball as a civic and community enterprise culminates in a discussion of the club’s demise because of internal financial problems and inability to compete with two major league teams across the Delaware River in Philadelphia.

Sea Level Rise-Induced Transition from Rare Fluvial Extremes to Chronic and Compound Floods

Flooding is becoming more frequent along U.S. coastlines due to the rising impacts of fluvial and coastal flood sources, as well as their compound effects. However, we have a limited understanding of mechanisms whereby sea level rise (SLR) changes flood drivers and contributes to flood compounding. Additionally, flood mitigation studies for fluvial floodplains near tidal water bodies often overlook the potential future contribution of coastal water levels. This study investigates the role of SLR in inducing high-tide flooding (HTF) and compound flooding in a neighborhood that lies on a fluvial floodplain. Eastwick, Philadelphia, is a flood-prone neighborhood that lies on the confluence of two flashy, small tributaries of the tidal Delaware River. We develop a combined 1D-2D HEC-RAS fluvial-coastal flood model and demonstrate the model’s accuracy for low-discharge tidal conditions and the extreme discharge conditions of tropical Cyclone (TC) Isaias (2020) (e.g., Root Mean Square Error 0.08 and 0.13 m, respectively). Simulations show that Eastwick may experience SLR-induced HTF as soon as the 2060s, and the flood extent (34.4%) could become as bad as present-day extreme event flooding (30.7% during TC Isaias) as soon as the 2080s (based on 95th percentile SLR projections). Simulations of Isaias flooding with SLR also indicate a trend toward compounding of extreme fluvial flooding. In both cases the coastal flood water enters Eastwick through a different pathway, over a land area not presently included in some fluvial flood models. Our results show that SLR will become an important contributor to future flooding even in fluvial floodplains near tidal water bodies and may require development of compound flood models that can capture new flood pathways.

Could Coaching Improve Consumer Credit Use Behavior? Evidence From a State Program

Financial coaching, a hands-on financial wellness approach, has emerged as a go-to strategy to help clients establish and reach their personal financial goals. We analyzed the borrowing and repayment behavior of 1,790 clients who received financial coaching through a program sponsored by the state of Delaware. Relative to a matched comparison group, financial coaching clients cure 0.24 more delinquent accounts, reduce credit card utilization by 5 percentage points, reduce the number of debts in collections by an additional 0.37 accounts, and have $422 less in credit card debt. Findings also show a 7 percentage point increase in the share of clients with a credit card and a 6 percentage point increase in the share of clients with a student loan. We do not see consistent differences in personal installment loans or mortgage holding. These estimates provide evidence that financial coaching can provide benefits for clients while being provided on a state-wide scale, illustrating the potential of public–private programs to provide services.

Ensuring Access to Opioid Treatment Program Services Among Delawareans Vulnerable to Flooding.

To quantify potential flood-related access disruptions to medication-assisted treatment for opioid use disorder (OUD) among Delawareans. Spatial flood risk maps and infrastructure, services, and hazard risk, transportation networks, opioid treatment programs (OTPs) for the State of Delaware were integrated to visually display the relationship between these layers. A complex network theory-based simulation model was used to assess both direct (e.g., inundation with flood water) and indirect (e.g., isolation) impacts of floods. Delaware is at increasing risk from flooding associated with storms and sea-level rise, which can lead to sunny day flooding during high tides. Of the 18 OTPs in Delaware, 4 are expected to be flooded in a 100-year flood and 7 are expected to be severely disrupted, increasing to 9 by 2035 and to 10 by 2050, with service reachability less than 15 square miles due to flood-induced isolation. Individuals utilizing OTPs for OUDs must be able to access treatment programs regardless of external disruptors like floods. Because these programs require consistent treatment adherence and in-person oversight by clinicians, timely restoration of services and continuity of operations for treatment facilities in post-disaster settings is critical for treatment compliance. The State of Delaware has the third highest rate of drug overdose mortality in the U.S., with three-quarters of all drug-related deaths involving opioids. Impeded access to opioid treatment during a flood disaster can lead to relapse, overdose, and death. Hazard planning must develop policies and practices to address these risks.

Evaluating Approaches to Linking Evictions Records:: Assessing the Feasibility of Research with Integrated Data.

This study investigates different approaches to integrating evictions data with Medicaid and homeless shelter utilization records at the individual level for the state of Delaware. We especially focus on evaluating the feasibility of creating an integrated dataset focused on children and adolescents through different approaches to matching. We attempt to link existing statewide records on evictions, Medicaid, and shelter from 2017-2019. We first compare direct match and probabilistic match approaches to linking evictions and Medicaid records, and then incorporate shelter records. Finally, we consider a limited set of characteristics relevant to potential future public health research among children who experienced eviction, had a shelter stay, and were enrolled in Medicaid. Direct matching resulted in a lower match (14%) rate than probabilistic matching (22%) of eviction records to Medicaid data. Homeless shelter records had a high match rate to Medicaid records, even when using a direct match (75%). A sizeable subset of children (n=216) were linked across the three data sources, though this was from a small percentage of cases in the evictions data. Among this subset of children, most (71%) were enrolled in Medicaid in all three years considered by this study and Black children were greatly overrepresented (75%). Integrating evictions records with other health and human service data involves a number of challenges. Probabilistic matching yielded a considerably higher number of matches after manual review, resulting in a possible study sample of children who have experienced eviction, a homeless shelter stay, and were enrolled in Medicaid. Strategies to increase the match rate for eviction records through using records from other, more universal services may be necessary for investigations that require more comprehensive coverage of the population.

Providing a Home for Good.

In a small state, collaboration is imperative to address complex public policy programs. In Delaware, homelessness is one of the state's most complex problems. The Delaware State Housing Authority (DSHA) and the Federal Home Loan Bank of Pittsburgh's (FHLBank) Home4Good program is a case study in how, through collaboration, innovative homelessness solutions can be implemented to help unhoused members of our community find stable housing. This commentary will outline the Home4Good program and explain its success. Finally, the commentary will speak to the need to continue working together to further assist Delaware's homeless population.

Early intervention in youth psychosis: Novel approaches to understanding change

Untreated psychosis in adolescents and young adults is associated with significant and progressive impairment. Early intervention to provide support and treatment for those at risk of psychosis is essential. Several early intervention models have been developed for those at-risk and those who are victims of a recent episode - including the Portland Identification and Early Referral model (PIER; McFarlane, 2001). This study extends previous work demonstrating a variety of positive treatment outcomes achieved by PIER in the context of a large-scale implementation across the state of Delaware. The sample included 108 youth and young adults who were either at risk for psychosis or had already experienced a first episode within the past two years. Participants received the PIER treatment model and were followed from baseline to six months after they were discharged from treatment. Researchers predicted that PIER participants would experience an increase in functioning and a decrease in positive psychosis symptoms. Change over time was examined through the lens of two analytic techniques: the Reliable Change Index (RCI) analyses and Growth Curve Modeling (GCM). Results show improvement on a number of outcomes over the course of the intervention as expected. Clinical implications, limitations, and suggestions for further research are discussed.

Simulating basin-scale linkages of the food-energy-water nexus with reduced complexity modeling

There is a rapidly growing need to communicate to the public and policymakers on the nature and impact of climate change and its associated extremes, which manifest themselves across essential Food-Energy-Water Systems (FEWS). The complexity of this nexus demands analytical tools that can capture the essence of FEWS with the climate system, which may be difficult to stage and implement from a computationally efficient point-of-view. Reduced Complexity Models (RCMs) can synthesize important facets of a system quickly and with less dependence on difficult-to-assign inputs. We report on the development of an RCM framework for the FEWS nexus, to serve as a basic research tool in facilitating parameter sensitivity experiments as well as a means to establish more insightful dialogue with stakeholders through joint scenario construction. Three stand-alone and coupled models at the basin scale have been configured using Stella Architect software to simulate: 1) major flows and storage of water, 2) power plant operations and subsequent impacts on river reaches; and 3) nitrogen (N) mobilization and transport from atmospheric and landmass sources to riverine receiving waters. The Delaware River Basin is chosen for a contemporary simulation test case. Modeled results are calibrated and validated using observed stream gauge data, indicating reliable model performance at the monthly and annual time steps (0.57 < NSE < 0.98). A set of single and multi-factor climate, technology, and policy experiments are then explored using the RCM framework. Basin-scale system sensitivities are investigated across a set of intensified climate extremes, revealing the crucial roles of sewage treatment and energy infrastructure for climate resilience, significant exacerbations as well as mitigations of thermal and N pollution under opposing climate extremes, and important tradeoffs between river temperature and electricity production that are explored with technology and policy scenarios.

Rapid estimation of minimum depth-to-bedrock from lidar leveraging deep-learning-derived surficial material maps

Previously glaciated landscapes often share similar surficial characteristics, including large areas of exposed bedrock, blankets of till deposits, and alluvium-floored valleys. These materials play significant roles in geologic and hydrologic resources, geohazards, and landscape evolution; however, the vast extents of many previously glaciated landscapes have rendered comprehensive, detailed field mapping difficult. While recent advances in remote sensing have facilitated mapping of surficial materials and landforms, manual map creation has remained a time-intensive task.The development of convolutional neural networks (CNNs) for image classification has provided a new opportunity for rapid characterization of digital elevation models, thus enabling efficient mapping of surficial materials and landforms. We have developed a methodology that leverages existing geologic maps and high-resolution (1–3 m) lidar data to train a U-Net CNN to classify alluvium and exposed bedrock in previously glaciated regions. Coupled with U.S. Geological Survey-developed geomorphometry tools capable of approximating stream incision depths, these classifications can be used to estimate the minimum thicknesses of stream-proximal hillslope sediments in areas where streams have undergone minimal incision into bedrock.We validate this approach in the context of the Neversink River watershed, a subbasin of the Delaware River Basin and significant water source for New York City. Evaluation of deep learning model performance demonstrates substantial agreement with manually drawn maps of alluvium and exposed bedrock. Validation of the minimum sediment thickness map using borehole data and passive seismic measurements shows the greatest performance for shallow materials and decreased performance in deep sediments, as well as in areas where bedrock exposures were too small to be resolved by lidar. To resolve these issues and create more accurate surficial maps, we are training new CNNs with additional geologic data and exploring advanced approaches for estimating depths of stream incision.

Trinseo spills latex polymer into the Delaware River

Environmental regulators were forced to monitor drinking water in the Philadelphia area after a chemical plant operated by Trinseo in Bristol, Pennsylvania, spilled more than 30,000 L of an acrylic latex polymer into a tributary of the Delaware River. The spill started the night of March 24 and flowed into the river until the morning of March 26. Trinseo blamed an equipment failure, saying that the liquid overflowed a containment system and went down a storm drain. The Philadelphia Water Department initially warned residents that they may want to avoid drinking tap water but later said it was safe. The department tested the city’s water for butyl acrylate, ethyl acrylate, and methyl methacrylate and didn’t detect any contaminants. The state’s Department of Environmental Protection also didn’t detect any contaminants and hasn’t found any impact on fish or other wildlife. The chemical spill follows the Feb. 3 derailment of a train

Trinseo spills latex polymer into Delaware River

Trinseo spills latex polymer into Delaware River

Stream Temperature Prediction in a Shifting Environment: Explaining the Influence of Deep Learning Architecture

AbstractStream temperature is a fundamental control on ecosystem health. Recent efforts incorporating process guidance into deep learning models for predicting stream temperature have been shown to outperform existing statistical and physical models. This performance is in part because deep learning architectures can actively learn spatiotemporal relationships that govern how water and energy propagate through a river network. However, exploration of how spatiotemporal awareness and process guidance influence a model's generalizability under shifting environmental conditions such as climate change is limited. Here, we use Explainable Artificial Intelligence (XAI) to interrogate how differing deep learning architectures affect a model's learned spatial and temporal dependencies, and how those learned dependencies affect a model's ability to maintain high accuracy when applied to unseen environmental conditions. Using the Delaware River Basin in the northeastern United States as a test case, we compare two spatiotemporally aware process‐guided deep learning models for predicting stream temperature (a recurrent graph convolution network—RGCN, and a temporal convolution graph model—Graph WaveNet). Both models achieve equally high predictive performance when testing data are well represented in the training data (test root mean squared errors of 1.64°C and 1.65°C); however, Graph WaveNet significantly outperforms RGCN in 4 out of 5 experiments where test partitions represent different types of unseen environmental conditions. XAI results show that the architecture of Graph WaveNet leads to learned spatial relationships with greater fidelity to physical processes, and that this fidelity improves the generalizability of the model when applied to shifting and/or unseen environmental conditions.

Interacting Effects of Watershed and Coastal Processes on the Evolution of Compound Flooding During Hurricane Irene

AbstractIn low‐lying estuarine regions, compound flooding (CF) is caused by the co‐occurrence of extreme precipitation, river flooding and storm surge. In recent decades, there has been a rise in the frequency and intensity of pluvial‐coastal CF events in different parts of the U.S. due to the increased frequency of intense precipitation and storm surge events. However, in estuarine and deltaic regions, the CF characteristics depend mainly on the storm tide and river flow interaction. Understanding how the fluvial‐coastal CF may respond to changes to watershed and estuarine characteristics is essential for future CF hazard prediction. This study examined two critical processes: (a) the interplay between antecedent soil moisture conditions and peak river flow, and (b) how the impact of sea level rise (SLR) on storm surge and river flood distribution alters the CF in complex estuaries. As the study area, we selected the Delaware Bay and River, a shallow and convergent estuary in the US Mid‐Atlantic region—where flood hazards during a CF can become more significant than the surge and river flood processes occurring in isolation. For the focal event for the study, we selected Hurricane Irene (2011) because it reportedly produced the most extreme CF over the past two decades in the same region. Ultimately, our results illustrated that the potential changes to the catchment and bay characteristics from the global temperature increase and SLR could significantly modulate the fluvial‐coastal CF variability. The potential increase in global temperature and rainfall intensity might not always exacerbate the CF.

Fighting Fire with Fire: Using Film to Counter Film Propaganda

His article explores how effective films are in countering propaganda in films. To organize the discussion, first a simple sketch of propaganda theory is drawn up, in which propaganda can be ranked from completely rational to highly irrational, on six different dimensions. This is how far the propaganda went: evidence-based; Honest; broadly logical; transparent; right on target; and transparent. Then the main propaganda film is reviewed in detail, Gasland. This film is a highly successful documentary attacking the production of natural gas by hydrofracturing, which is referred to in America as "fracking". Gasland was successful in organizing domestic opposition to fracking, actually blocking it in the Delaware River Basin system. The film was also influential abroad, leading to a ban on fracking in France, Bulgaria and elsewhere in Europe. Next, two counter-propaganda films are reviewed in detail—namely, in this case, two pro-fracking documentaries: Truthland and FrackNation. Truthland is a short documentary that refutes many of Gasland's important claims. It was funded by the fracking industry and had limited distribution but manage d to refute most of the longer, better-funded anti-fracking films. A much more successful film in terms of general distribution and debunking efficacy is the much longer pro-fracking documentary FrackNation. It critiques all Gasland's main points, in vivid detail. Due to crowdfunding, it cannot be ignored due to bias because it is supported by the industry. From this article it can be concluded by explaining why pro-fracking documentaries have not resulted in major changes in public opinion.

Unravelling the influence of landscape alteration from flow alteration on benthic macroinvertebrate assemblage response in the Delaware River Basin

Quantifying the effects of streamflow alteration on assemblage response is central to understanding the role humans play in shaping aquatic environments. These changes represent a level of complexity that impedes developing quantitative links between flow and ecological response because stream hydrology is strongly intertwined with natural and anthropogenic factors. Better management outcomes require disentangling these linkages. Benthic macroinvertebrate data were combined with GIS-derived natural and anthropogenic basin characteristics to identify factors associated with changes in flow and assemblage characteristics. Models linking streamflow metrics and macroinvertebrate response at basin- and subregion-scales were developed using boosted regression tree (BRT) analysis. Basin-scale BRT analyses revealed that links between macroinvertebrate response and streamflow metrics were often obscured, whereas more homogeneous subregions were better able to discern relations with flow. Urban land cover was the primary factor accounting for changes in flow characteristics. Elevation, land cover and high flow frequency were the principal variables driving changes in assemblage structure within subregions. Assemblage metrics and traits were equally useful for building response models and were affected similarly by flow alteration. Our results indicate that response models based on upland and lowland subregions performed better than basin-scale models. However, when defining subregions, care should be taken to maintain data sufficiency. Developing practical flow-protection standards that support a balance between human water requirements and ecological integrity requires models that reduce uncertainty and identify management-relevant drivers. However, effective management often differs by location and models developed at the subregion level may be more applicable to management and stakeholder interests.

Consensus statement and clinical pathway for the management of colon cancer with peritoneal metastases in the state of Delaware

BackgroundIncreasing data suggests that the combination of modern systemic therapies and Cytoreductive surgery with or without Hyperthermic Intraperitoneal Chemotherapy (HIPEC) may improve the outcome of patients with colon cancer with peritoneal metastases. Patient selection and sequence of treatments remains ill-defined. Materials and methodsA working group, the State of Delaware Peritoneal Surface Malignancies Task Force (DE-PSM-TF), was created including representatives from medical and surgical oncology from the acute care hospitals in Delaware. An extensive review of all available literature was carried out. Virtual meetings were held, and interpretation and discussion of the data was conducted. ResultsA clinical pathway that includes a multidisciplinary evaluation at the time of diagnosis of colon cancer with peritoneal metastases and reflects a consensus from the Task Force on 7 key points that suggest the management of these patients based on the severity of their peritoneal metastases and incorporates all currently available therapies was created. The sequence of therapies of this multimodality treatment was determined by the Peritoneal Surface Disease Severity Score (PSDSS) (Fig. 1). ConclusionThe current pathway represents a comprehensive, team effort that should improve the outcome of patients with Colon Cancer with peritoneal metastases in the state of Delaware by having multidisciplinary discussions at the time of diagnosis, selecting the best order of sequence of currently available therapies in order to maximize benefits and minimize morbidity.

Bolstering creditor and shareholder protection under the South African and Zimbabwean amalgamation or merger regulatory regimes: Suggestions for company-law reform

This article critically assesses the efficacy of the South African and Zimbabwean merger regulatory regimes in providing suitable shareholder and creditor protection. The article seeks to balance competing goals. On the one hand, merger opportunities should be promoted by reducing regulatory barriers to merger regulation by, for instance, facilitating the implementation of mergers through a less complex procedure and with reduced court interference. On the other hand, the merger regimes ought to guarantee the appropriate and adequate protection of creditors and shareholders, including minority shareholders’ interests. The article focuses on the two comprehensive target shareholder protections — participatory and remedial rights — and two creditor remedies — the creditors’ notice and the solvency and liquidity test. The study establishes that South Africa offers better protection to creditors and shareholders than Zimbabwe. However, in some respects, both jurisdictions can seek lessons from other progressive jurisdictions, including the United States of America, with the state of Delaware as a particular example, and the United Kingdom.

Climate Change and Urban Transport Sustainability

The 2022 Sea Level Rise Technical Document, published by the US National Oceanic and Atmospheric Administration (NOAA), reports sea level along the US coastline is projected to rise, on average, 10 - 12 inches (0.25 - 0.30 meters) in the next 30 years (2020-2050) (NOAA, 2022). This will create coastal flooding by causing tide and storm surge heights to increase and reach further inland. By 2050, “moderate” (typically damaging) flooding is expected to occur, on average, more than 10 times as often as it does today, and can be intensified by local factors. About 2 feet (0.6 meters) of sea level rise along the US coastline is increasingly likely between 2020 and 2100 because of emissions to date. Failing to curb future emissions could cause an additional 1.5 - 5 feet (0.5 - 1.5 meters) of rise for a total of 3.5 - 7 feet (1.1 - 2.1 meters) by the end of this century. At the same time, cities are experiencing rapid urbanization and population growth with increasing levels of private motorized vehicle ownership and use, a major source of emissions. Non-motorized transport is considered one of the important mitigation strategies to reduce the amount of greenhouse gas emissions and make urbanized communities sustainable. This paper examines the impacts of sea level rise on non-motorized transportation facilities along the coastlines of the State of Delaware using Geographic Information System (GIS) supported by the latest data and models. Results show there is significant damage in the number of facilities if sea level rises between 2 and 6 feet. As sea level rise projection gets higher, the number of facilities with major inundation increases. So the question becomes with trails and bikeways disappearing along the coastlines, is there enough space to bring these sites to the cities that are further inland, noting that vehicle use is at an all-time high, and, there are grass roots movements everywhere asking decision-makers, engineers and planners for more non-motorized transport facilities? This paper also examines the challenging policy, engineering and planning implications of creating non-motorized transport sites and capacities in cities with shrinking available land and space for such facilities.

First record of Faxonius propinquus (Girard, 1852) in the Delaware River watershed and new records of another non-native crayfish species, Procambarus acutus (Girard, 1852)

First record of Faxonius propinquus (Girard, 1852) in the Delaware River watershed and new records of another non-native crayfish species, Procambarus acutus (Girard, 1852)