Trends in Pediatric Pneumomediastinum Following Cannabis Legalization in Massachusetts.

Many studies examine social determinants of health (SDoH) in isolation, overlooking their interconnected nature. We used a multifactorial approach to construct a neighbourhood-level measure that explores how SDoH jointly impact care received for endometrial cancer (EC) patients in Massachusetts (MA). Using 2015–2019 American Community Survey data, we applied a Bayesian multivariate Bernoulli mixture model to identify MA neighbourhoods with similar SDoH characteristics. Five neighbourhood SDoH (NSDoH) profiles were derived and characterized: (1) advantaged non-Hispanic White; (2) disadvantaged racially/ethnically diverse, more renter-occupied housing with limited English proficiency; (3) working class, lower educational attainment; (4) racially/ethnically diverse and greater economic security and educational attainment; and (5) racially/ethnically diverse, more renter-occupied housing with limited English proficiency. We assigned these profiles to EC patients in the Massachusetts Cancer Registry and used them as the main exposure in a Bayesian logistic regression, adjusting for sociodemographic and clinical characteristics. NSDoH profiles were not associated with optimal care; however, patients in all other profiles had lower odds compared to Profile 1. Our findings demonstrate how a flexible model-based clustering approach captures the multidimensional nature of NSDoH in an interpretable way and may support targeted public health interventions based on neighbourhood-specific social factors to improve healthcare delivery.

To determine the consequences of the Gobeille v. Liberty Mutual Supreme Court decision on the representativeness of the Massachusetts all-payer claims database (APCD). The loss of individuals captured in the APCD may vary demographically, geographically, and in the capture of fatal opioid-related overdose (OOD). We used 2013-2021 data from the Massachusetts Public Health Data Warehouse (PHD), which links person-level APCD records to other datasets. The APCD includes commercially-insured health claims mandatorily reported pre-Gobeille. Post-Gobeille, reporting from self-insured plans, a subset of commercially-insured plans, became voluntary. In a repeated cross-sectional design, we compared the APCD population characteristics in 2015 to each subsequent year 2016-2021. We compared pre-post Gobeille statewide APCD demographic distributions using standardized mean differences and assessed geographic distribution changes by ZIP Code. We identified fatal OOD using death certificates. We used annual and monthly interrupted time-series models with publicly-available state records as the control to quantify the pre- (2013-2015) and post- (2016-2021) Gobeille changes in the total APCD population and in fatal OOD when linked to the APCD within the PHD. Within APCD, the commercially-insured population decreased by 38% post-Gobeille. State-level age increased slightly and sex distributions remained stable, while proportions of White non-Hispanic individuals decreased. Suburban ZIP Codes had the highest losses of individuals. In 2021, under 80% of fatal OODs could be linked to the APCD, compared to 95% linkage pre-Gobeille. The change in monthly fatal OOD rates when linked to the APCD was 0.55 persons higher per 100,000 people post-Gobeille (95% CI: 0.05, 1.05) than the change observed in official statistics. The Gobeille decision negatively impacted APCD geographic and racial representativeness in Massachusetts, which should be addressed to improve external validity in Massachusetts and other states using APCDs to assess health services.

Lithium-ion battery fires present increasing safety engineering challenges, with U.S. incident rates rising 86% between 2020 and 2023, particularly in micromobility devices and urban environments. We analyzed 148 lithium-ion battery fire incidents documented through the Massachusetts State Fire Marshal’s specialized checklist program, employing logistic regression for charging-related risks, spatial clustering for geographic patterns, and time-series analysis for temporal trends. Consumer electronics showed significantly lower odds of charging-related fires (OR = 0.125–0.148, p < 0.05), while micromobility devices had the highest injury rate (IRR = 2.98, 95% CI: 0.837–10.615). Charging was involved in 40.5% of cases, and online purchases were associated with greater risk (OR = 1.87, 95% CI: 1.23–2.84, p = 0.003). Significant urban clustering was observed (Moran’s I = 0.28, p = 0.003) with three metropolitan hotspots. Device-specific risk profiles demonstrate the effectiveness of existing consumer electronics safety standards and highlight critical intervention points for emerging high-risk devices, particularly in dense urban areas where targeted protection strategies are most needed.

Purpose Cannabis use in pregnancy and lactation is under-researched and politically taboo, resulting in a challenging context for information seeking and health decision-making. This study explored the information needs and information seeking, assessing and triangulation behaviors of individuals considering cannabis use while pregnant or lactating within a challenging legal context. Design/methodology/approach Reflexive thematic analysis (RTA) was used to qualitatively analyze 23 in-depth interview transcripts with individuals in the state of Massachusetts who were considering cannabis use while pregnant or lactating. Themes from the study analysis were used to develop a new model of Everyday Triangulation (ET). Findings Four overarching themes were developed through RTA: (1) information needs are complex and contextual, (2) many information behaviors contribute to ET, (3) ET is complex, relational and intuitive, and (4) Complex information needs lead to complex and dynamic decisions. Themes were used to develop a novel model of ET as applied to this study’s population and context. Research limitations/implications This study presents several implications for information scientists to work collaboratively within public health contexts to better support health information seeking. Areas in need of further research within a public health context are also identified. Originality/value This study explores information needs and seeking behavior in a rarely studied population and unique legal context. A novel information behavior model is presented and applied, contributing robustly to the field of information science.

Baseline plasma ACTH concentrations are frequently utilized as part of the diagnostic evaluation of equids when PPID is suspected. Baseline ACTH can be impacted by many factors including time of year, i.e., ACTH has generally been found to be elevated during late summer through early autumn in the northern hemisphere. An understanding of ACTH concentrations in healthy equids over the course of a year is useful for the proper interpretation of concentrations in PPID-suspect animals. Previous studies assessing ACTH concentrations in healthy donkeys (Equus asinus) and hybrids (E. asinus × E. caballus) are limited, often utilizing very small numbers, equids from specific and limited geographical regions, limited timeframes or unspecified donkey types (miniature, standard, or mammoth). We aimed to characterize the seasonal variation in baseline ACTH concentrations in healthy miniature donkeys, standard donkeys and hybrids in the United States (US) and to compare those concentrations across these groups. Following outlier removal, 19 standard donkeys (from California (CA), Massachusetts (MA), New York (NY)), 14 miniature donkeys (CA and NY), and 28 hybrids (Texas (TX) and NY) were utilized for analysis. Samples were collected from each equid twice per month from June to November 2019 and once per month from December 2019 through May 2020. The mean ACTH concentration of all equids was higher from mid-August through the end of October compared to the rest of the year (being the highest in the second half of September with the mean (standard deviation) values of 109.6 (52.6), 134.6 (67.4), and 100.8 (189.6) in standard donkeys, miniature donkeys, and hybrids, respectively). Additionally, ACTH concentrations in hybrids were 23% (95% Confidence Interval (CI): 4-38%) and 51% (95% CI: 36-63%) lower than in standard and miniature donkeys, respectively, from mid-August through October. During the rest of the year, hybrids similarly showed 31% (95% CI: 16-43%) and 30% (95% CI: 15-42%) lower ACTH concentrations compared with standard and miniature donkeys, respectively.

Any programme that runs the risk of mistreating already-marginalized persons deserves significant moral scrutiny. So, when a proposal was put forth in the Massachusetts state legislature that would incentivise organ donations from prisoners, it was quite reasonable for the initial reaction to be against the proposal. However, does this initial reaction survive moral analysis? In this paper, I argue that it can be morally permissible to implement programmes that incentivise organ donations from prisoners. I reach this conclusion by considering eight objections against this proposal, offering three reasons in favour of it, and then giving three guidelines for the permissible implementation of these programmes. Still, I conclude that the permissible implementation of these programmes would need to also include the input of many others, including prisoners and those who advocate for them.

Measuring State Cannabis Policy Design Variation for Research and Policy: A Bundles Approach.

Zoning Report: Massachusetts

Abstract Rural residents report higher depression rates than their urban counterparts. The present descriptive study will compare community and neighborhood-level 65+ “ever-diagnosed” depression rates in five New England states: Connecticut (CT), Massachusetts (MA), Maine (ME), New Hampshire (NH), and Rhode Island (RI). The Healthy Aging Data Reports (HADRs) (www.healthyagingdatareports.org) are a comprehensive tool to spur community and policy action as they calculate community-level prevalence of 38 chronic diseases for each community in a state. Using Medicare Beneficiary Summary File (2020-2021), representing 100% of traditional beneficiaries. Small area estimation techniques were used to calculate age-sex adjusted community depression rates and over 150 other health indicators. Results varied across states with NH reporting the lowest community rate of 65+ depression in the sample (20.01%) and MA reporting the highest (54.46%). CT and MA reported the largest range in 65+ depression (CT:23.68-42.65%; MA:21.90-54.46%) with the highest rate clusters located near the biggest cities, in urban areas (CT:25.62-42.65%; MA:26.39-54.46%). Conversely, in ME and NH, the highest rate clusters were found in rural areas (NH:29.60-38.08%; ME:36.99-43.40%), states with a more traditional rural/urban threshold compared to the population dense states of CT, MA, and RI. In sum, the 2025 HADRs identified geographic disparities and overall high rate of 65+ community-level depression, with some communities reporting 65+ depression rates higher than 50% (neighborhoods in Springfield &amp; Worcester, MA). The 2025 HADRs provide visualizations to make disparities evident; in this way, they can guide policy efforts to treat and address the growing mental health needs of the aging population.

Abstract HIV/AIDS is a significant public health concern in the U.S., particularly among aging populations. While New England has lower overall HIV/AIDS incidence, disparities persist among racial and ethnic minority group members, LGBTQ+ individuals, and those affected by the opioid epidemic. This study calculates community and state HIV/AIDS prevalence trends among adults aged 65+ across Massachusetts (MA), Connecticut (CT), Rhode Island (RI), New Hampshire (NH), Vermont (VT), and Maine (ME). Data sources included: the Centers for Medicare &amp; Medicaid Services (2012-2021), the American Community Survey (2018-2022), and the CDC’s Behavioral Risk Factor Surveillance System (2010-2022) (see healthyagingdatareports.org). Small area estimation techniques were used to calculate age and sex adjusted rates. ArcGIS was used to map community rates across the region. Results found a steady increase in HIV prevalence across all six states from 2014-2015 to 2020-2021. In 2014-2015, MA (0.17%) and CT (0.18%) had the highest prevalence, while NH (0.05%) and VT (0.08%) were lower. By 2020-2021, the increase in older adults living with HIV/AIDS was most significant in MA (+0.13%) and CT (+0.1%), while ME (+0.08%), NH (+0.05%), and VT (+0.05%) experienced slower growth. These findings highlight geographic disparities in HIV/AIDS prevalence among older adults, with MA and CT showing the fastest increases. State-level factors such as healthcare access, socioeconomic conditions, and policies may contribute. New England’s healthcare infrastructure offers a model for policy-driven prevention. Further research is needed to inform targeted public health strategies and improve outcomes for aging populations infected with HIV/AIDS.

Abstract The negative health consequences of social isolation are increasingly recognized, and internet use is often cited as a potential intervention to enhance social connectivity, particularly for at-risk older adults. This study examines the relationship between internet use, depression, and the proportion of older adults living alone across 367 communities in Massachusetts (MA). Data were drawn from the 2025 Massachusetts Healthy Aging Data Reports (healthyagingdatareports.org). Internet use in the past month was derived from BRFSS data (2018–2022), the percentage of older adults living alone was obtained from the American Community Survey (2018–2022), and depression diagnoses were sourced from Centers for Medicare &amp; Medicaid Services data (2020–2021). Across MA, the prevalence of depression ranged from 21.90% to 54.46% (state average: 34.64%), while internet use varied from 40.83% to 88.95% (state average: 70.57%). Regression analyses showed a significant negative association between community rates of internet use and depression among older adults in MA (β = -0.10, p &amp;lt; .000), which remained significant after adjusting for gender distribution and educational attainment. However, when stratified by the proportion of older adults living alone, this relationship was only significant in communities with a higher-than-average proportion of older adults living alone (β = -0.11, p &amp;lt; .001), while no significant association was observed in communities with lower proportions. These findings suggest that internet use may be particularly beneficial in reducing community rates of depression among older adults experiencing greater social isolation, highlighting its potential as a mental health resource for those living alone.

Abstract An estimated two thirds of people living with Alzheimer’s disease or related dementias (ADRD) live and are cared for at home. For public health action and community programming to assist those living with ADRD, accurate disease rates must be known. The Healthy Aging Data Reports (HADR) (www.healthyagingdatareports.org) are a comprehensive tool to spur community and policy action as they calculate community-level prevalence of 38 chronic diseases for each community in a state. The present descriptive study will compare community and neighborhood-level 65+ prevalence of ADRD in five New England states: Connecticut (CT), Massachusetts (MA), Maine (ME), New Hampshire (NH), and Rhode Island (RI). Using Medicare Beneficiary Summary File (MBSF) (2020-2021), representative of 100% of traditional Medicare beneficiaries, small area estimation techniques were used to calculate age-sex adjusted community rates of ADRD and over 150 other health indicators. Results varied across states with NH reporting the lowest community rate of 65+ ADRD in the sample (5.41%) and CT reporting the highest (27.10%). CT and MA reported the largest range in 65+ ADRD (CT: 6.90-27.10%; MA: 6.69-25.54%) with the highest rate clusters located near the biggest cities, in urban areas (CT:13.11-27.10%; MA: 12.93-25.54%). Conversely, in Maine and NH, the highest rate clusters were found in rural areas (NH: 15.82-21.16%; ME: 15.33-18.98%). The 2025 HADR’s found geographic disparities in 65+ community-level ADRD across New England. Communities with high rates can be targeted for additional supports like caregiver support programming, adult day health centers, and educational programming on the prevention and treatment of ADRD.

Abstract Human longevity makes it possible for us to keep working longer, enjoying the relationships and satisfaction of productive activity. However, for some older adults, the high cost of living may require working past age 65 to make ends meet. This study examined and compared community employment rates in four New England states: Rhode Island (RI), Connecticut (CT), New Hampshire (NH), and Massachusetts (MA). Better understanding older adult employment rates at the community level can inform local policies and services. Rates of being employed in the past year among adults 65+ were calculated from data from the 5-year files in the American Community Survey (2012-2016 MA&amp;NH, and 2014-2018 CT&amp;RI). Small area estimation techniques were used to calculate age-sex adjusted community rates. Statewide rates showed that nearly one in four (24.8%) older adults in CT and NH were employed in the past year, which was higher than MA (24.3%) and RI (21.9%). However, MA reported the largest range in 65+ employment (4.5%-63.8%) compared to NH (0.0%-52.2%), CT (14.0%-44.2%), and RI (10.0%-46.3%). Aquinnah MA had the highest community rate in the four states (66.73%). Communities in these four states with the highest rates of older workers reported smaller older populations, lower rates of Hispanic/Latino adults 65+, lower rates living below the poverty line, with higher depression, ADRD, diabetes, and higher median household income (in RI and CT only). The future of work will increasingly include older workers. We think employers should consider flexible work arrangements as inducements to attract and retain older workers.

Abstract In 2023, the Surgeon General declared an “epidemic of loneliness” as a poll reported about one in three older adults’ experiences feeling socially isolated. The Healthy Aging Data Reports (HADR) (www.healthyagingdatareports.org) are a rich data source to study rates of older adult rates of depression. The HADR calculates the prevalence of 38 chronic diseases for each community in a state using Medicare Beneficiary Summary File (MBSF), representing 100% of traditional Medicare beneficiaries in a state, aggregating the prevalence to the community and neighborhood-levels using small area estimation techniques. The present descriptive study will compare community and neighborhood-level 65+ “ever-diagnosed” prevalence of depression over three time points (Time 1: 2014-2015; Time 2: 2017-2018; Time 3: 2020-2021) in five New England states: Connecticut (CT), Massachusetts (MA), Maine (ME), New Hampshire (NH), and Rhode Island (RI). Over the three time points, 65+ depression increased for all states. CT (T1:27.75%; T2:29.32%; T3:31.63%), MA (T1:29.52%; T2:31.2%; T3:33.02%), ME (T1:32.50%; T2:33.48%; T3:33.83%), NH (T1:26.84%; T2:27.82%; T3:28.7%), and RI (T1:31.16%; T2:31.7%; T3: 33.37%). While rates increased overtime for all states, CT reported the largest increase from time 1 to time 3 (3.9%). NH had the lowest 65+ depression prevalence in time 3 (28.7%), and Maine reported the highest (33.83%). These trends demonstrate that depression among older adults was highest during the COVID-19 pandemic (Time 3: 2020-2021) and are continuing to increase. The 2025 HADRs can be used to direct policy efforts to treat and address the growing mental health needs of the aging population.

Abstract Description Neutrophil accumulation is associated with worse prognosis and immunotherapy resistance in many cancer types. Tumor-associated neutrophils (TANs) emerge systemically in the tumor-bearing host, and have been shown to promote tumor progression and metastasis through suppression of the anti-tumor immune response. However, it is unclear how neutrophil progenitors develop into TANs and if there are targetable markers differentiating normal neutrophils and TANs. Here, we performed single-cell RNA sequencing on neutrophils from bone marrow, spleen, lymph nodes, blood, mammary gland, tumor, and lungs from wild-type and breast tumor-bearing MMTV-PyMT mice. We describe five transcriptional states, N0-N4, which encompass normal neutrophil maturation, as well as a sixth state composed of TANs. From this dataset, we identified novel differentially expressed genes including IL-1R2 on mature mammary gland neutrophils, and IFITM1 and AMWAP on MMTV-PyMT TANs. IFITM1+ neutrophils were found to be expanded in tumor-bearing mice and suppressed T cell proliferation and activation compared to their wild-type counterparts. Taken altogether, this work provides a systemic, multi-organ perspective into TAN development and identifies TAN-specific markers which may be potential targets to inhibit cancer-induced immunosuppression. Funding Sources NIH T32CA009054 Topic Categories Tumor Immunology: Cellular Responses and Tumor Microevironment (TIME)

Previous research shows that even expert-level recovery teams can miss osteological evidence. The present research examined recovery rates and distances using dispersed nonhuman (pig [Sus scrofa], white-tailed deer [Odocoileus virginianus], and mule deer [O. hemionus]) bones with different taphonomic color alteration. Searching was done by a Special Emergency Response Team of the Massachusetts State Police during researcher-guided walk-throughs in a simulated outdoor surface scene. The authors hypothesized that sun-bleached bones would be recognized from the greatest distances due to their starker contrast from natural leaf litter as opposed to control bones or those with soil/decomposition staining. The control sample was unaltered, dry bone without significant staining, and the stained bones had variable brown color from decomposition and/or shallow burial. The sun-bleached bones were spotted at an average distance of 8.76 m ± 7.75 m, while soil/decomposition-stained bones were spotted at 4.09 m ± 2.79 m and the control sample at 6.73 m ± 5.40 m. As determined by a two-way ANOVA test, the interaction between bone color and distance was significant (p < 0.001). Sun-bleached bones had a 100.0% recovery rate (60/60), control bones 96.7% (58/60), and soil/decomposition-stained bones 70.0% (42/60). In addition, bone type also had a statistically significant effect on distance (p < 0.001), and therefore the likelihood of being recovered. Even expert-level recovery teams can miss osteological evidence during surface searches, with natural bone camouflage factoring into recovery success rates. As a result, increased training and education surrounding taphonomically altered bones is necessary for all personnel involved in forensic surface searching.

Between 1900 and 1940, African American participants in transatlantic public exhibitions reclaimed a medium that often oppressed non-White bodies: the diorama. This essay traces a transatlantic conversation among African American artists about how to render Black history in diorama form, leveraging the miniature format to make political arguments. In diorama series which circulated on both sides of the Atlantic, such as those designed by Thomas W. Hunster for the Exhibit of American Negroes in the Paris Universal Exposition in 1900 and the Pan-American Exposition in 1901, Meta Vaux Warrick Fuller for the Jamestown Ter-Centennial Exposition in 1907, and Charles C. Dawson for the American Negro Exposition in Chicago in 1940, African American makers selectively used architectural models to signify histories of oppression and liberation as they told transatlantic stories about Black migration and enslavement. This essay argues that this set of dioramas is entwined, growing from 9 to 14 to 33, and that Hunster, Fuller, and Dawson all rendered archetypal buildings, such as slave cabins or plantation homes, to designate the wide and encompassing scope of oppression, while they reference singular buildings associated with public institutions from government to universities—the M Street School in Washington DC, Carnegie Library at Howard University, Mother Bethel AME Church in Philadelphia, the Old Massachusetts State House, and the White House—to signify and emplace spaces of Black liberation. Building on research on the layered functions of miniatures and drawing on burgeoning scholarship on entwinements between race and architecture, the article speculates on how architecture style signifies through the models to reinforce what James C. Scott has parsed as dominant narratives and hidden transcripts. Seeking to build Black futurity, all three series facilitated community participation and collaboration to produce an intersocial construction of transatlantic African American history built through mobile models of architecture.

Traffic congestion and safety pose two of the largest challenges for transportation planners and engineers worldwide, placing significant economic, environmental, and social burdens on the public. In the United States crashes were estimated to have cost the American public $340 billion in 2019, with congestion costs estimated to be over $166 billion in 2017. With funding from the Infrastructure Investment and Jobs Act (IIJA) becoming available to transportation agencies around the country, it is vital that agencies identify the most impactful infrastructure projects on which to prioritize funding to address these costs. At the same time, the United States is seeking to address the lack of infrastructure spending in disadvantaged communities in previous decades. To guide this infrastructure spending, data are required to properly identify the locations most in need of funding. This study assesses the trade-off between data accuracy and data availability in two methodologies to estimate the cost to society of crashes and congestion, focusing on the comparison between county-level location-based aggregation and home address–based approaches. The study assessed crash data in the state of Massachusetts and used the results of the Boston Region Metropolitan Planning Organization’s TDM23 travel demand model to evaluate these trade-offs. The study found that the county-level location-based aggregation acceptably mitigated for the unknown home addresses of those involved when creating a metric for the cost to society of crashes. By contrast, it did not mitigate well for the costs of congestion.

The Behavioral Impact of the Massachusetts Flavored Tobacco Products Ban on Cigarette Smoking Among Adults Aged ≥21 Years.