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Purpose: This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among African immigrants in Western countries. The present study examines the perspectives of Congolese immigrant parents on adolescent mental health in Brussels, Belgium, and Raleigh, North Carolina, USA – two geographic regions with relatively large Congolese migrant populations. This study highlights a needed understanding of cultural and acculturative context in shaping the beliefs of Congolese immigrants and explores potential barriers of seeking health services. Additionally, it recognizes health issues among this underrepresented and underserved population. Design/methodology/approach: Fifteen Congolese immigrant parents, eight in the USA and seven in Belgium, participated in structured qualitative interviews using an adapted version of Kleinman Questions and behavioral scenarios on depression, post-traumatic stress disorder and oppositional defiant disorder. Interviews were audio recorded, and participants were assigned pseudonyms to de-identify responses. English interviews were transcribed verbatim by a trained team of undergraduate research assistants, and French interviews were transcribed verbatim by the first author and a graduate research assistant. Following transcription, the first and second authors used a rapid analytic approach (Hamilton, 2013). The first and second authors conducted a matrix analysis to observe thematic patterns. Findings: Parents interpreted adolescent behavior to be more problematic when the scenarios were overtly outside of their cultural realm of values and beliefs. Parents preferred methods of intervention through religious practices and/or family and community efforts rather than seeking mental health services in their host countries as a secondary option. The authors' findings provide an understanding of the values and beliefs of this underrepresented demographic, which may be useful to guide health professionals on how to support this community in a culturally responsive way. Research limitations/implications: Limitations to the current study include the structured nature of the interview guide that did not allow for in-depth qualitative exploration. Interviewed participants had lived in their host countries for more than 10+ years. Thus, the authors' findings are not reflective of new immigrants' experiences. Parents' perspectives were likely shaped by exposure to Western beliefs related to support for mental health (e.g. knowledge of psychologists). Future studies should focus on recent refugees due to exposure to traumatic events and experiences reflective of the Democratic Republic of Congo's (DRC's) current socio-political situation, and how these are understood in the context of adolescent mental health. Further, due to the hypothetical nature of the scenarios, the authors cannot be sure that participants would engage in the identified approaches with their children. Additionally, hearing from the youth's perspective would provide a clearer insight on how mental health and seeking professional help is viewed in a parent–child relationship. Finally, the data for this study were collected in 2019, prior to the COVID-19 pandemic. Although the authors cannot speak directly to Congolese refugee and immigrant experiences during this significant historical period, given the rise in mental health concerns in refugee populations more broadly (Logie et al., 2022), the authors' findings speak to how parents may have responded to increased mental health symptoms and point to additional barriers that these populations may have faced in accessing support. The authors' study emphasizes the need for dedicating resources and attention to this population, especially the development of culturally tailored messaging that invites community members to support the mental health needs of their community. Practical implications: The authors' findings provide important implications for mental health professionals. This study provides a clearer understanding of how Congolese immigrant parents view mental health and help-seeking within their cultural frame. Although parents may seek professional help, a distrust of mental health services was expressed across both cohorts. This suggests that mental health professionals should acknowledge potential distrust among this population and clarify their role in supporting the mental health of adolescent immigrants. Clinicians should inquire about familial cultural beliefs that are parent- and child-centered and modify their interventions to fit these belief structures. Originality/value: This paper addresses the gap in knowledge about mental health perspectives of Sub-Saharan African immigrant populations, specifically those from the DRC. [ABSTRACT FROM AUTHOR]

While the literature on entrepreneurial support organizations (ESOs) proliferates, we still do not understand whether local ESOs benefit some founders more than others. Drawing on organizational sponsorship and inclusive ecosystems literatures, this paper empirically examines whether founder characteristics of gender, immigrant, and racial minority group membership moderate the relationship between participation in different types of ESO services (incubator, mentoring, and education programs) and funding received from state, federal, and venture capital (VC) sources. Relying on a detailed database of life sciences firms founded in North Carolina's Research Triangle region, the paper uncovers how funding outcomes differ depending on the funding source and the moderating ESO and founder traits. The paper concludes with practical implications for how women, immigrant, and minority founders may be better supported by ESOs for broader, inclusive ecosystem building. Plain English Summary: Do entrepreneurial support organizations (ESOs) have different benefits for different founders? This paper finds the answer is yes, which has implications for how to create a more inclusive entrepreneurial ecosystem. While the literature continues to reveal more about the role of organizations like accelerators, business incubators, and mentoring programs for entrepreneurial success, we lack understanding of the different roles these organizations might play in fostering more inclusive entrepreneurial regions. This research analyzes whether women, immigrant, and racial minority founders benefit differently from participating in different types of mainstream entrepreneurial support organization programs including incubation, education, and mentoring. Results show great variation in how founders benefit from these programs with implications for inclusive ecosystem building. Since these organizations are often publicly funded or supported, the findings have implications for policy and economic development practice as well as for entrepreneurial firm strategy. [ABSTRACT FROM AUTHOR]

Local sales tax bases are determined by factors including businesses, residential populations, and nonresidential visitors. This paper capitalizes on the COVID‐19 pandemic, using the sudden absence of in‐commuters, tourists, and college students to estimate the contributions these populations have on the sales tax base in North Carolina's 100 counties. The findings suggest that losing one in‐commuter results in a loss of roughly $1000 a month in taxable sales. Similarly, the loss of one hotel night booking results in a loss in taxable sales of approximately $525. This translates, for the median county, to exporting 17% to in‐commuters and 12% to tourists. The impact on the loss of a residential college student is less clear. Key Takeaways: Nonresidents, such as commuters, tourists, and college students, are important components to many local governments' sales tax base.A single in‐commuter is estimated to contribute approximately $1000 to the local sales tax base, which translates to about 17% of the tax base for the median county in our sample.The contribution to local sales for a hotel night stay, our proxy for tourism, is estimated to be approximately $525 to the local sales tax base, which translates to about 12% of the tax base for the median county in our sample.We do not find evidence that college students contribute meaningfully to the local sales tax base.This paper informs policy conversations around tax leakage, revenue‐raising capacity, and the benefits and costs of local sales taxes. [ABSTRACT FROM AUTHOR]

This research delves into the intricate dynamics of landslides, emphasizing their consequences on transportation infrastructure, specifically highways and roadway bridges in North Carolina. Based on a prior investigation of bridges in Puerto Rico after Hurricane Maria, we found that bridges above water and situated in valleys can be exposed to both landslide and flooding risks. These bridges faced heightened vulnerability to combined landslides and flooding events due to their low depth on the water surface and the potential for raised flood heights due to upstream landslides. Leveraging a dataset spanning more than a century and inclusive of landslide and bridge information, we employed logistic regression (LR) and random forest (RF) models to predict landslide susceptibility in North Carolina. The study considered conditioning factors such as elevation, aspect, slope, rainfall, distance to faults, and distance to rivers, yielding LR and RF models with accuracy rates of 76.3% and 82.7%, respectively. To establish that a bridge's location is at the bottom of a valley, data including landform, slope, and elevation difference near the bridge location were combined to delineate a bridge in a valley. The difference between bridge height and the lowest river elevation is established as an assumed flooding potential (AFP), which is then used to quantify the flooding risk. Compared to traditional flood risk values, the AFP, reported in elevation differences, is more straightforward and helps bridge engineers visualize the flood risk to a bridge. Specifically, a bridge (NCDOT ID: 740002) is found susceptible to both landslide (92%) and flooding (AFT of 6.61 m) risks and has been validated by field investigation, which is currently being retrofitted by North Carolina DOT with slope reinforcements (soil nailing and grouting). This paper is the first report evaluating the multi-hazard issue of bridges in valleys. The resulting high-fidelity risk map for North Carolina can help bridge engineers in proactive maintenance planning. Future endeavors will extend the analysis to incorporate actual flooding risk susceptibility analysis, thus enhancing our understanding of multi-hazard impacts and guiding resilient mitigation strategies for transportation infrastructure. [ABSTRACT FROM AUTHOR]

The share of students attending charter schools has been rising. There is evidence that charter school growth has increased socioeconomic segregation of students between schools. In this paper, we assess whether charter school growth affects how students are organized within nearby traditional public schools (TPS). We use administrative data from North Carolina to estimate the impact of charter school openings on segregation by income within nearby TPS. Our models exploit variation in the presence and location of charter schools over time between 2007 and 2014 for students in Grades 3 to 8. We find limited evidence that the segregation of students by income at the classroom level increases when charters open nearby. We find some evidence of increasing segregation in third grade and fourth grade math and third grade ELA classrooms at TPS within 2 miles of new charters in large urban districts schools. Our results vary somewhat depending on how we control for underlying trends and measure segregation. We find no effect of charter school growth on income segregation in higher grades. [ABSTRACT FROM AUTHOR]

Driver characteristics have been linked to the frequency and severity of car crashes. Among these, age and gender have been shown to impact both the possibility and severity of a crash. Previous studies have used standard ordered probit (OP) models to analyze crash data, and some research has suggested heteroskedastic ordered probit (HETOP) could provide improved model fit. The objective of this paper is to evaluate potential improvements of the heteroskedastic ordered probit (HETOP) model compared to the standard ordered probit (OP) model in crash analysis, by examining the effect of gender across age on injury severity among drivers. This paper hypothesizes that the HETOP model can provide a better fit to crash data, by allowing heteroskedasticity in the distribution of injury severity across driver age and gender. Data for 20,222 crashes were analyzed for North Carolina from 2016 to 2018, which represents the state with the highest number of fatalities per 100 million vehicle miles traveled amongst available crash data from the Highway Safety Information System. Darker lighting conditions, severe road surface conditions, and less severe weather were associated with increased injury severity. For driver demographics, the probability of severe injuries increased with age and for male drivers. Moreover, the variance of severity increased with age disproportionately within and across genders, and the HETOP was able to account for this. The results of the two applied approaches revealed that HETOP model outperformed the standard OP model when measuring the effects of age and gender together in injury severity analysis, due to the heteroskedasticity in injury severity within gender and age. The HETOP statistical method presented in this paper can be more broadly applied across other contexts and combinations of independent variables for improved model prediction and accuracy of causal variables in traffic safety. [ABSTRACT FROM AUTHOR]

The nationwide shortage of psychiatric providers delays patients from receiving vital mental health (MH) treatments. Mental Health clinical pharmacist practitioners (CPPs) are qualified to provide comprehensive medication management (CMM) services and expand care; however, many MH interdisciplinary teams have not incorporated MH CPPs or have not optimized their role. The purpose of this paper is to highlight how MH CPPs leveraged telemedicine to provide CMM to outpatient MH clinics requiring provisional coverage for other prescribing providers. This paper also reviews supplemental services and barriers to implementation. The Veterans Integrated Services Network (VISN) 6 Clinical Resource Hub‐Telemental Health (CRH‐TMH) is a centralized interdisciplinary team that provides telemental health services to veterans through coordination with their local Veterans Health Administration Health Care Systems located in North Carolina and Virginia. The MH CPPs serve as advanced practice providers with a scope of practice that authorizes prescriptive authority including controlled substances. The VISN 6 CRH‐TMH program was initiated in 2020 and expanded from one MH CPP to include three MH CPPs and a MH CPP supervisor. Since initiation, the MH CPPs have supported 10 outpatient MH clinics. From October 2021 to March 2023, the MH CPPs have completed 5080 clinical encounters. The MH CPPs decreased phone appointments and increased the percentage of video‐to‐home encounters from 56% in fiscal year 2021 to 91% by March fiscal year 23. Virtual same‐day access was implemented at three locations and the substance use disorder program provided timely access to life‐saving treatments. The joint intake clinic optimized veterans' intake into the MH clinic by the therapist providing diagnostic services and the CPP performing CMM during the same appointment. The telehealth learning experience increased training opportunities for residents. The success of this initiative further supports the expansion of MH CPPs as advanced practice providers. [ABSTRACT FROM AUTHOR]

South Africa's Just Energy Transition (JET) from coal to renewable energy in response to climate change mitigation policies comes packaged with social costs that these mitigation policies tend to overlook, considering their focus on carbon emission reduction. The paper argues that Social Impact Assessments (SIAs), a component of Environmental Impact Assessments (EIAs) focused on social impact mitigation, can be a long-term approach to closing the social cost gap. Against this backdrop, the paper's arguments were informed by a literature analysis on SIAs and the Just Energy Transition, semi-structured interviews, and surveys with 230 participants, including experts, from Kriel and Carolina in Mpumalanga, South Africa. The findings point to skills development barriers such as poor school attendance, a lack of alignment between existing curriculum design and labour markets, and students' low aptitude for STEM subjects. It also identifies community sustainability issues linked to poor public participation, gender inequalities in land reform and economic participation, and culturally disruptive displacements that will intensify as the energy shift unfolds. The paper submits that SIAs, if incorporated into mainstream energy transition planning, might be a long-term approach to mitigating societal costs and can support socially responsible policies. [ABSTRACT FROM AUTHOR]

The floods caused by Hurricane Matthew in 2016 affected Lumberton, a socioeconomically diverse city in North Carolina with 729 public housing units. Public housing residents face unique challenges in accessing resources and post-disaster temporary accommodations, further delaying their recovery compared to other survivors. This paper investigates the obstacles to public housing recovery and the residents' recovery challenges using descriptive statistics, mapping, and qualitative analysis in Lumberton. Findings show the dependency of public housing units' recovery on assistance policies and decisions of various organizations, including local housing authorities. Multiple changes in recovery plans and limited, uncertain, delayed funding and bureaucratic obstacles to funding allocation slow the units' recovery and prolong the residents' displacement, adversely affecting their recovery. Hence, pre-disaster resilience initiatives should address these vulnerabilities and the recovery policy's limitations to support public housing units and residents' recovery. Moreover, affordable housing recovery must become a priority in national housing recovery policies. [ABSTRACT FROM AUTHOR]

Like other minoritized populations, American Indian/Alaska Native (AI/AN) females experience disparate morbidity and mortality outcomes to that of the general US population. This study identified discrepancies in reporting of AI/AN female decedents between the North Carolina Violent Death Reporting System (NC-VDRS) and an online, user-generated database. Female AI/AN decedent data of all ages were collected from the NC-VDRS and compared against that of the publicly available North Carolina Missing and Murdered Indigenous Women (MMIW NC) database for the study period, 2004–2019. Twenty-four of the 72 cases matched between data systems (33.3%). Substantive differences between the NC-VDRS and the MMIW NC database were found. Future efforts should be directed towards supporting Indigenous communities with the comprehensive data the NC-VDRS can provide. This paper highlights statewide public health systems like the NC-VDRS supporting community efforts to understand, advocate for, and disseminate information on MMIW. [ABSTRACT FROM AUTHOR]

Community health workers are responsible for finding, processing, and transferring health information to communities with limited access to health‐related resources, including farmworkers. This paper is the culmination of an undergraduate student research project to explore the learning processes and preferences of farmworker‐serving community health workers in the USA. The project was designed for students from farmworker or agricultural backgrounds at two North Carolina universities and was supported by a North Carolina Department of Health and Human Services workforce development grant. Semi‐structured interviews were conducted, in person and virtually, with a convenience sample of 17 current and former community health workers. The interview data were analysed thematically and identified a preference for a combination of learning styles, with visual and hands‐on learning being the most preferred. Community health workers also identified the importance of learning preferences in relation to their responsibilities as health educators. This study provides librarians, along with public health and medical professionals, with useful information about learning preferences to inform the creation of new and varied learning materials for community health workers. [ABSTRACT FROM AUTHOR]

Background. Health equity impact assessments (HEIAs) inform the reduction of health inequities by evaluating programs or policies that affect target populations. Local health departments (LHD) receiving funding through the Improving Community Outcomes for Maternal and Child Health (ICO4MCH) Program conducted HEIAs for evidence-based strategies (EBSs). This paper describes the impact of HEIAs on the implementation of EBSs and highlights lessons learned during implementation of HEIA modifications. Methods. We conducted a content analysis using data from the HEIA Modification Tracker and focus groups to identify themes and lessons learned. Results. Fifteen HEIAs were conducted by five LHDs between 2016 and 2020. The most common modifications to EBS implementation were 1) increasing education and training for community members and 2) altering messaging mediums and language to reach intended audiences. Discussion. Health equity impact assessments serve as a systematic and tangible way to center health equity, reflect on past processes, and inform improvements. [ABSTRACT FROM AUTHOR]

The floodplains of the Southeast's stream network once hosted immense brakes of rivercane (Arundinaria gigantea), a disturbance-dependent native bamboo with both cultural and ecological significance. Ecologically, rivercane alters its local environments, boosts biodiversity and biomass, and protects streambanks from erosion and storm damage. Indigenous peoples of the Southeast have used rivercane for millennia, for material and cultural purposes, and formerly maintained its health and extent through harvesting and fire. Settler-colonial incursions largely destroyed rivercane, through the more intense disturbance of different land management practices, and brakes now exist mainly in relatively small areas. While numerous rivercane restoration projects are in process throughout its natural range, no comprehensive inventory of living rivercane exists. In this paper, we present both human context and the results of LiDAR analysis that identifies canebrakes based on the physical characteristics of the plant and brake. In our study area on the Little Tennessee River in western North Carolina, we found rivercane on about 9 percent of the floodplain area, based on QL1 LiDAR data available from the state of North Carolina. The technique can be applied in any part of rivercane's range, and the resulting inventory used in support of both cultural and ecological goals. [ABSTRACT FROM AUTHOR]

Objectives: To describe how the UNC Horizons program, a comprehensive women-centered program for pregnant and parenting women with substance use disorders, and its patient population have changed over time and summarize basic neonatal outcomes for infants born to women in treatment at Horizons. Methods: Yearly Annual Reports from fiscal years of 1994 to 2017 were abstracted. Patient characteristics and infant outcomes compared to normative North Carolina data were examined. Results: Highlights of findings include: The percentage of women for whom opioids were the primary substance of use increased from 0% in 1995–1996 to 62% in 2016–17, while cocaine decreased from 66 to 12%. Intravenous substance use history increased from 7% in 1994–1995 to 41% in 2016–2017. The number of women reporting a history of incarceration rose from 10–20% in the early years to 40%-50% beginning in 2007–2008. The proportion of women reporting a desire to hurt themselves rose from 20% in 2004–2005 to 40% in 2016–2017. Self-reported suicide attempt history remained consistent at 32% across years. While reporting of childhood physical abuse remained at 38% across years, reporting of sexual abuse and domestic violence trended upward. Horizons did not differ from North Carolina in the likelihood of patients giving birth prematurely [χ2(13) = 20.6,p =.082], or the likelihood of a patient giving birth to a low birthweight infant [χ2(13) = 14.7,p =.333]. Conclusions for Practice: Breaking the cycle of addiction for women and children must focus on helping women with substance use problems develop a sense of hope that their lives can improve, and a sense of feeling safe and nurtured. Significance: Systematic examinations of programs that provide treatment services to pregnant and parenting women with substance use disorders have typically been focused on a limited set of outcomes and have been cross-sectional in nature. The current paper presents a detailed examination of the patient populations over a 23-year period, with particular attention to the changes over time in the women served. The birth weight and prematurity of infants born to the women in this program were likewise examined over time, and in comparison to state-level data. [ABSTRACT FROM AUTHOR]

In this qualitative study, the experiences of students of color at a predominantly white university in North Carolina are used to expose the ways in which white homogeneity and white normativity work to maintain hidden white privileges in various campus settings. Through the counternarratives obtained during nine focus group meetings with a total of thirty-one selfidentified students of color, these students are able to expose and describe a host of unnoticed burdens associated with being Brown and Black in white campus settings. They experience racial othering, extreme visibility, and stereotypes associated with their race and gender, and they explain ways they have devised to navigate through the university in the face of daily and routine manifestations of racism. Their voices effectively counter the ideologies of majoritarian stories that consistently deny the existence and effects of racism, to reveal some of the ways in which college life is in an unequal, racialized experience. The paper concludes by acknowledging limitations of this research as well as by discussing implications for the use of experiential knowledge through counterstories of those affected by injustice to help oppose false ideologies that work to promote racialized college experiences and outcomes. [ABSTRACT FROM AUTHOR]

The Train-the-Trainer approach is widely used in Cooperative Extension education to efficiently disseminate research-based information to many clientele groups, including farmers. This paper compares the traditional Train-the-Trainer model to a comprehensive Collaborative Train-the-Trainer model and discusses weaknesses of the traditional model that are addressed in the Collaborative model. Sources of information used by farmers (growers) and overall effectiveness were measured through a survey instrument created and distributed to farmers in South and North Carolina. The Collaborative Train-the-Trainer model, which emphasizes peer-to-peer interaction and feedback loops, represents an enhanced approach for conceptualizing and implementing Extension educational programs.

Traffic accidents are usually unique events with unpredictable geographical and temporal dimensions; thus, accident injury severity level (INJ-SL) analysis presents formidable categorization and data stability problems. Classical statistical models are limited in their ability to correctly model INJ-SL, whilst sophisticated machine learning approaches do not appear to have any equations to prioritize/analyze multiple contributing factors to forecast accidents accompanying INJ-SLs. In addition, the intercorrelations between the input variables may render the conclusions of a formal sensitivity analysis incorrectly. Rear-end collisions are the most common form of traffic accidents; consequently, their linked INJ-SL requires more research. This paper provides a complex technique based on a deep learning paradigm paired with different indicators of Global Sensitivity Analysis to address all of these concerns. Unlike existing neural network designs, this technique presents a deep residual neural network structure that employs residual shortcuts (i.e., connections). The connections enable the DRNNs to sidestep a few levels of the deep network architecture, evading the regular training with high accuracy issues. Using the trained DRNNs model, a Latin Hypercube sampling simulation was undertaken to determine each explanatory component's influence on the resulting INJ-SL. The latest available data from 2011 to 2018 is used to assess all rear-end collisions in North Carolina. A comparison was made between the performance of two different schemes of data categorization using a set of global sensitivity metrics. It was determined that the devised technique overcame the data heterogeneity problems to achieve an accuracy of 87%. In addition, the proposed sensitivity analysis identified the most relevant factors associated with INJ-SL rear-end collisions. [ABSTRACT FROM AUTHOR]

Here we present the palynological composition of a single sample of the elusive purple honey collected in southern North Carolina and discuss how it fits within a nearby statewide South Carolina melissopalynological study. 302 samples were collected by nineteen beekeepers participating in this year-long project, submitting honey samples while honeybees were actively collecting nectar. The absence of pollen of Pueraria (kudzu) in the purple honey dismisses the often-suggested link between the unique tint of the purple honey and kudzu's purple pollen. A second hypothesis hinting that the tint could be linked to ripened berries is not reinforced by our investigation as pollen of Ericaceae (eg blueberries) and Rosaceae (eg blackberries) were not found in the purple honey sample but were commonly found in classic golden honey analyzed. The presence of Vitis pollen supports the possibility that bees forage on wild muscadine grapes (Vitis rotundifolia) which was available in the foraging area. This study cannot discredit the possibility that bees were foraging on berry juices or other sugar sources containing purple pigments because these sources contain little or no pollen. A third hypothesis proposes a link between purple honey and the sourwood tree, Oxydendrum arboretum. This hypothesis is supported by this investigation as the dominant pollen type recovered in the purple honey was sourwood, with 19% in relative abundance, a significant percentage for this plant. We suggest chemical analysis of purple honey samples be conducted to determine if berry juice or sourwood is the more likely source of the pigmentation. [ABSTRACT FROM AUTHOR]

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There is great interest in the development of executive function (EF) in the preschool period. Accordingly, multiple performance-based measures of EF have been developed for this age group, yet little is known about how they compare to one another. This study used a large and diverse sample of 3-to-5-year-old children (N = 846), who completed subtests of the National Institutes of Health's Toolbox Cognition Battery (NTCB), the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV), and the EF Touch battery. Scores across the three batteries were compared and associations with age, income, and race/ethnicity were examined. Results revealed that (1) the three tasks were moderately correlated (r = 0.44–0.51, all p < 0.001), but children had higher mean accuracy scores on EF Touch than on the NTCB or the WPPSI-IV. (2) Mean accuracy scores on all batteries were linearly associated with child age (all F > 32.68, all p < 0.0001). (3) Comparisons by income and race/ethnicity showed lower accuracy for low-income children on the WPPSI-IV and lower accuracy for White children on the NTCB. Across all batteries, there was consistently lower accuracy for Hispanic children. In conclusion, the three batteries we examined performed similarly across several metrics. EF Touch may be more appropriate for younger children, while the NTCB performed well with older children. [ABSTRACT FROM AUTHOR]

Manure relocation strategies are needed to mitigate excessive phosphorus (P) application to agricultural land in areas of intensive animal agricultural production. This requires conceptual frameworks such as the manureshed, which categorizes agricultural areas according to the potential to export or receive manure for P fertilization. To further understand how the manureshed concept could be utilized, assessments of the potential implementation and necessity of the manureshed model are needed. With North Carolina at the center of the largest manureshed in the United States, North Carolina is an ideal test case to identify areas of concern for manure relocation under the manureshed framework. Swine and poultry dominate North Carolina's agricultural production, and because the vast majority of North Carolina producers are not required to limit manure applications to a P‐based rate, P accumulates. Therefore, soil test data from samples submitted to the North Carolina Department of Agriculture and Consumer Services (NCDA&CS) from 2017 to 2019 were used to determine how manureshed classes defined by Spiegal et al. correspond to current soil test P levels. It was determined that 36% of counties experience very high (>100 mg P kg−1; N = 36) median P concentrations in soil. Furthermore, fields cultivated with warm‐season forages had the highest mean P concentration (188 mg kg−1) and high median P trended toward counties with high animal production. Lastly, while mean soil P for all manureshed classifications fell into the very high category, manure source counties had the highest mean soil P concentrations (188 mg kg−1), which was 39%–52% higher than the other classifications. This suggests that, in addition to manuresheds classification, soil test data are needed to design and promote manure redistribution strategies. Core Ideas: Soil tests confirm the accumulation of phosphorus in areas of intense livestock production.Redistribution of manure based on the manuresheds concept should include counties identified for within county transfers adjacent to manure source counties.Soil test reports add valuable context when making decisions regarding manure relocation strategies. [ABSTRACT FROM AUTHOR]

Geotechnical sediment properties, morphological change, and hydrodynamics were measured as part of the During Nearshore Event Experiment (DUNEX) in October 2021 at the sandy Atlantic side beach in Duck, North Carolina. In this study, direct relationships were explored between in situ soil properties and direct erodibility measurements in the context of morphological change. Moisture content, grain size, total density, relative density, void ratio, and sediment strength were compared to bed-level change using ground-based LiDAR and erodibility parameters from laboratory jet erosion tests (JETs) conducted along a cross-shore transect stretching from the dune toe to the lower intertidal zone. Directly relating changes in sediment properties to changes in morphology from LiDAR proved inconclusive due to the complex interactions between sediments, hydrodynamics, and morphology, even on a local scale, but initial observations and possibly impacting factors were discussed. Void ratio and total unit weight correlated well with the detachment rate coefficient from JETs, with denser sediments testing as less erodible. In situ sediment strength measurements related—as expected—to total unit weight, void ratio, and water content, with increases in firmness factor associated with increases in total unit weight, void ratio, and water content. These strength measurements were also found to have a correlation with the detachment coefficient from the JET, with stronger/firmer sediments being less erodible than weaker ones. [ABSTRACT FROM AUTHOR]

Background: HIV, opioid use disorder (OUD), and mental health challenges share multiple syndemic risk factors. Each can be effectively treated with routine outpatient appointments, medication management, and psychosocial support, leading implementers to consider integrated screening and treatment for OUD and mental health in HIV care. Provider perspectives are crucial to understanding barriers and strategies for treatment integration. Methods: We conducted in-depth qualitative interviews with 21 HIV treatment providers and social services providers (12 individual interviews and 1 group interview with 9 participants) to understand the current landscape, goals, and priorities for integrated OUD, mental health, and HIV care. Providers were purposively recruited from known clinics in Mecklenburg County, North Carolina, U.S.A. Data were analyzed using applied thematic analysis in the NVivo 12 software program and evaluated for inter-coder agreement. Results: Participants viewed substance use and mental health challenges as prominent barriers to engagement in HIV care. However, few organizations have integrated structured screening for substance use and mental health into their standard of care. Even fewer screen for opioid use. Although medication assisted treatment (MAT) is effective for mitigating OUD, providers struggle to connect patients with MAT due to limited referral options, social barriers such as housing and food insecurity, overburdened staff, stigma, and lack of provider training. Providers believed there would be clear benefit to integrating OUD and mental health treatment in HIV care but lacked resources for implementation. Conclusions: Integration of screening and treatment for substance use and mental health in HIV care could mitigate many current barriers to treatment for all three conditions. Efforts are needed to train HIV providers to provide MAT, expand resources, and implement best practices. [ABSTRACT FROM AUTHOR]

Background: There is limited understanding of how social determinants of health (SDOH) impact family decision-making when seeking surgical care for children. Our objectives of this study are to identify key family experiences that contribute to decision-making when accessing surgical care for children, to confirm if family experiences impact delays in care, and to describe differences in family experiences across populations (race, ethnicity, socioeconomic status, rurality). Methods: We will use a prospective, cross-sectional, mixed methods design to examine family experiences during access to care for children with appendicitis. Participants will include 242 parents of consecutive children (0–17 years) with acute appendicitis over a 15-month period at two academic health systems in North Carolina and Virginia. We will collect demographic and clinical data. Parents will be administered the Adult Responses to Children's Symptoms survey (ARCS), the child and parental forms of the Adverse Childhood Experiences (ACE) survey, the Accountable Health Communities Health-Related Social Needs Screening Tool, and Single Item Literacy Screener. Parallel ARCS data will be collected from child participants (8–17 years). We will use nested concurrent, purposive sampling to select a subset of families for semi-structured interviews. Qualitative data will be analyzed using thematic analysis and integrated with quantitative data to identify emerging themes that inform a conceptual model of family-level decision-making during access to surgical care. Multivariate linear regression will be used to determine association between the appendicitis perforation rate and ARCS responses (primary outcome). Secondary outcomes include comparison of health literacy, ACEs, and SDOH, clinical outcomes, and family experiences across populations. Discussion: We expect to identify key family experiences when accessing care for appendicitis which may impact outcomes and differ across populations. Increased understanding of how SDOH and family experiences influence family decision-making may inform novel strategies to mitigate surgical disparities in children. [ABSTRACT FROM AUTHOR]

Genetic diversity can modulate a population's response to a changing environment and plays a critical role in its ecological function. While multiple processes act to maintain genetic diversity, sexual reproduction remains the primary driving force. Eelgrass (Zostera marina) is an important habitat‐forming species found in temperate coastal ecosystems across the globe. Recent increases in sea surface temperatures have resulted in shifts to a mixed‐annual life‐history strategy (i.e., displaying characteristics of both annual and perennial meadows) at its southern edge‐of‐range. Given that mating systems are intimately linked to standing levels of genetic variation, understanding the scope of sexual reproduction can illuminate the processes that shape genetic diversity. To characterize edge‐of‐range eelgrass mating systems, developing seeds on flowering Z. marina shoots were genotyped from three meadows in Topsail, North Carolina. In all meadows, levels of multiple mating were high, with shoots pollinated by an average of eight sires (range: 3–16). The number of fertilized seeds (i.e., reproductive success) varied significantly across sires (range: 1–25) and was positively correlated with both individual heterozygosity and self‐fertilization. Outcrossing rates were high (approx. 70%) and varied across spathes. No clones were detected, and kinship among sampled flowering shoots was low, supporting observed patterns of reproductive output. Given the role that genetic diversity plays in enhancing resistance to and resilience from ecological disturbance, disentangling the links between life history, sexual reproduction, and genetic variation will aid in informing the management and conservation of this key foundation species. This study provides a thorough description of fine‐scale patterns in Zostera marina's mating system at the species' southern edge‐of‐range, an area where eelgrass experiences frequent summer heat stress. Sampled populations displayed a reliance on sexual recruitment, and male quality was linked to reproductive success. Our findings serve as stepping stones to further understand the evolutionary processes underpinning seagrass genetic composition and life history, which is essential for informed conservation and management. [ABSTRACT FROM AUTHOR]

Background: Experiencing a miscarriage can have profound psychological implications, and the added strain of the COVID-19 pandemic may have compounded these effects. This study aimed to explore the psychological experiences, assess the levels of psychological distress (depression, anxiety, and post-traumatic stress disorder), and examine the relationships of personal significance of miscarriage and perceived stress with psychological distress of women in North Carolina who suffered a miscarriage of a desired pregnancy between March 30, 2020, and February 24, 2021, of the COVID-19 pandemic, at 14 to 31 months after the loss. Methods: We conducted a cross-sectional mixed-methods study using a convergent parallel design. A total of 71 participants from North Carolina completed the online survey and 18 completed in-depth interviews. The survey assessed demographics, mental health and reproductive history, personal significance of miscarriage, perceived stress, anxiety, depression, and PTSD. Interview questions asked about the psychological experience of the miscarriage and how the COVID-19 pandemic affected them and their experience. Results: Findings indicated moderate to severe levels of depression, anxiety, and PTSD, which persisted 14 to 31 months post-miscarriage. After conducting hierarchical binary logistic regressions, we found that perceived stress and prior trauma increased the odds of depression, perceived stress increased the odds of anxiety, and personal significance and prior trauma increased the odds of PTSD symptoms 14–31 months post-miscarriage. Notably, a subsequent successful childbirth emerged as a protective factor against depression, anxiety, and PTSD. Qualitative findings depicted emotions such as profound isolation, guilt, and grief. Women noted that additional pandemic-specific stressors exacerbated their distress. The categories identified via conventional content analysis fell under five broader thematic groups: mental health disorders, negative emotions/feelings, positive emotions/feelings, thoughts, and other experiences. Conclusions: Miscarriage during the COVID-19 pandemic intensified and added complexity to the psychological distress experienced by affected women. The study underscores the need for comprehensive mental health screenings, specialized support for vulnerable groups, and the necessity of trauma-informed care. Providers are strongly encouraged to adopt a multifaceted, individualized approach to patient care that is cognizant of the unique stressors introduced by the pandemic. [ABSTRACT FROM AUTHOR]

The combined region of eastern Tennessee and western North Carolina has a persistently high risk of pediatric La Crosse virus neuroinvasive disease (LACV-ND). To guide public health intervention in this region, the objectives of this retrospective ecological study were to investigate the geographic clustering and predictors of pediatric LACV-ND risk at the ZIP code tabulation area (ZCTA) level. Data on pediatric cases of LACV-ND reported between 2003 and 2020 were obtained from Tennessee Department of Health and North Carolina Department of Health and Human Services. Purely spatial and space-time scan statistics were used to identify ZCTA-level clusters of confirmed and probable pediatric LACV-ND cases from 2003–2020, and a combination of global and local (i.e., geographically weighted) negative binomial regression models were used to investigate potential predictors of disease risk from 2015–2020. The cluster investigation revealed spatially persistent high-risk and low-risk clusters of LACV-ND, with most cases consistently reported from a few high-risk clusters throughout the entire study period. Temperature and precipitation had positive but antagonistic associations with disease risk from 2015–2020, but the strength of those relationships varied substantially across the study area. Because LACV-ND risk clustering in this region is focally persistent, retroactive case surveillance can be used to guide the implementation of targeted public health intervention to reduce the disease burden in high-risk areas. Additional research on the role of climate in LACV transmission is warranted to support the development of predictive transmission models to guide proactive public health interventions. Author summary: La Crosse virus (LACV) is the most common cause of mosquito-borne neuroinvasive disease (e.g., encephalitis or meningitis) among children in the United States, but the spatial patterns and population-level risk factors for LACV infections are not well understood. In this study, we investigated the spatial patterns and areal risk factors of pediatric LACV neuroinvasive disease (LACV-ND) in eastern Tennessee and western North Carolina, a persistent hotspot of LACV-ND. We found that from 2003–2020, the highest risks of pediatric LACV-ND consistently occurred in a few areas within the study region. We also found that precipitation and temperature had positive but antagonistic relationships with area-level risk from 2015–2020, although the strength of those associations varied significantly across the study area. The results of this study have important implications for public health policy. Most notably, because LACV-ND consistently occurs in the same geographic areas over extended time periods, areas where cases have been previously reported should be prioritized for disease prevention programs to prevent continuous transmission. This study also provides initial evidence that climate may be related to the distribution of LACV-ND risk, but additional research is needed to better understand the complex relationship between climate and LACV epidemiology. [ABSTRACT FROM AUTHOR]

A putative glufosinate‐resistant Amaranthus palmeri population was reported in 2015 in Anson County, North Carolina. The results from dose–response assays conducted in the field suggested plants were surviving lethal rates of glufosinate. Dose–response assays conducted in the glasshouse determined the Anson County accession exhibited reduced susceptibility to glufosinate compared to three glufosinate‐susceptible populations. The LD50 values (210–316 g ai ha−1) for the Anson County population were always higher than the LD50 values (118–158 g ai ha−1) for the tested susceptible populations from the dose–response assays. Anson County plants that survived lethal glufosinate rates were reciprocally crossed with susceptible plants to create F1 genotypes and treated with a lethal rate of glufosinate (267 g ai ha−1; ascertained from glasshouse dose–response assay) to determine the distribution of injury and survival for each cross compared to a cross of susceptible parents. The distribution of injury was non‐normal for the crosses containing an Anson County plant compared to the cross with a susceptible parent. Survival was 68%–84% for crosses containing an Anson County plant, whereas the survival was significantly reduced to 35% for the susceptible plant cross. Chi‐square goodness of fit tests were used to test inheritance models to describe the responses of the genotypes. The resistant × susceptible crosses were best described with a heterozygous two loci with incomplete dominance model compared to the resistant × resistant cross that was best described with a heterozygous single locus with incomplete dominance model. The Anson County population has evolved resistance to glufosinate that is heritable and likely conferred by an oligogenic mechanism with incomplete dominance. [ABSTRACT FROM AUTHOR]

A community engaged research (CER) approach was used to provide an exposure assessment of poly- and perfluorinated (PFAS) compounds in North Carolina residential drinking water. Working in concert with community partners, who acted as liaisons to local residents, samples were collected by North Carolina residents from three different locations along the Cape Fear River basin: upper, middle, and lower areas of the river. Residents collected either drinking water samples from their homes or recreational water samples from near their residence that were then submitted by the community partners for PFAS analysis. All samples were processed using weak anion exchange (WAX) solid phase extraction and analyzed using a non-targeted suspect screening approach as well as a quantitative approach that included a panel of 45 PFAS analytes, several of which are specific to chemical industries near the collection site locations. The non-targeted approach, which utilized a suspect screening list (obtained from EPA CompTox database) identified several PFAS compounds at a level two confidence rating (Schymanski scale); compounds identified included a fluorinated insecticide, a fluorinated herbicide, a PFAS used in polymer chemistry, and another that is used in battery production. Notably, at several locations, PFOA (39.8 ng/L) and PFOS (205.3 ng/L) were at levels that exceeded the mandatory EPA maximum contaminant level (MCL) of 4 ng/L. Additionally, several sites had detectable levels of PFAS that are unique to a local chemical manufacturer. These findings were communicated back to the community partners who then disseminated this information to the local residents to help empower and aid in making decisions for reducing their PFAS exposure. [ABSTRACT FROM AUTHOR]

Plain Language Summary: Diseases and weeds can reduce yield of peanut (Arachis hypogaea L.) if effective control measures including fungicides and herbicides are not used. A survey of 76 farmers in North Carolina and Virginia at Cooperative Extension Service meetings was completed relative to fungicide and herbicide use in 2021. Eighty‐two percent of farmers made between three and five herbicide applications, while 68% of farmers made between four and five fungicide applications. 2,4‐DB was the herbicide applied most frequently. The fungicide chlorothalonil was applied the most often. Pydiflumetofen was applied by 61% of farmers. Results from this survey can be used to inform regulatory agencies on pesticide use patterns by defining the relative importance of individual or groups of pesticides currently used to suppress pests and prevent or mitigate associated economic losses. [ABSTRACT FROM AUTHOR]

New Hanover County, North Carolina, has been experiencing rapid population growth and is expected to continue this growth, leading to increased land use and development in the area. The county is also threatened by sea level rise (SLR) and its effects because of its coastal location and frequent occurrences of major storms and hurricanes. This study used a land change modeler to map the land cover change throughout the county over a period of 20 years, and predicted land cover distribution in the area in the years 2030 and 2050. Statistics revealed that the developed land in the area increased by 85 km2 between 2000 and 2010, and by 60 km2 between 2010 and 2020. Such land is predicted to increase by another 73 km2 by 2030, and 63 km2 by 2050. This increase in development is expected to occur mainly in the central area of the county and along the barrier islands. Modeling of SLR illustrated that the northwestern part of New Hanover County along the Cape Fear River, as well as the beach towns located on the barrier islands, are estimated be the most affected locations. Results indicate that sections of major highways throughout the county, including I-140 near downtown Wilmington and US-421 in Carolina Beach, may be inundated by SLR, which might delay residents during mandatory evacuations for emergency situations such as hurricanes. Some routes may be unusable, leading to traffic congestion on other routes, which may impede some residents from reaching safety before the emergency. Wrightsville Beach and Carolina Beach are estimated to have the highest levels of inundation, with 71.17% and 40.58% of their land being inundated under the most extreme SLR scenario of 3 m, respectively. The use of the present research approach may provide a practical, quick, and low-cost method in modeling rapidly growing urban areas along the eastern United States coastline and locating areas at potential risk of future SLR inundation. [ABSTRACT FROM AUTHOR]

A natural wetland receiving drainage from a 24-ha urbanized catchment in the Falls Lake Watershed of North Carolina was evaluated to determine if it was providing ecosystem services with regards to phosphate and Escherichia coli (E. coli) attenuation. Inflow and outflow characteristics including nutrient and bacteria concentrations along with physicochemical properties (discharge, pH, oxidation reduction potential, temperature, and specific conductance) were assessed approximately monthly for over 2 years. The median exports of phosphate (0.03 mg/s) and E. coli (5807 MPN/s) leaving the wetland were 85% and 57% lower, respectively, relative to inflow loadings, and the differences were statistically significant (p < 0.05). Hydraulic head readings from three piezometers installed at different depths revealed the wetland was a recharge area. Phosphate and E. coli concentrations were significantly greater in the shallowest piezometer relative to the deepest one, suggesting treatment occurred during infiltration. However, severe erosion of the outlets is threatening the stability of the wetland. Upstream drainageway modifications were implemented to slow runoff, and septic system repairs and maintenance activities were implemented to improve water quality reaching the wetland and Lick Creek. However, more work will be needed to conserve the ecosystem services provided by the wetland. [ABSTRACT FROM AUTHOR]

Coastal Zone Soil Survey mapping provides interpretive information that can be used to increase coastal resiliency and quantify how coastal ecosystems are changing over time. North Carolina has approximately 400,500 ha of land within 500 m of the tidal coastline that is expected to undergo some degree of salinization in the next century. This study examined 33 tidal wetlands in the Albemarle–Pamlico Sound along a salinity gradient to provide a coastal zone mapping framework to quantify shoreline change rates. The primary ecosystems evaluated include intact tidal forested wetlands (average water salinity, 0.15–1.61 ppt), degraded "ghost forest" wetlands (3.51–8.28 ppt), and established mesohaline marshes (11.73–15.47 ppt). The average shoreline rate of change (m/yr) was significantly different among estuary ecosystems (p = 0.004), soil type (organic or mineral) (p < 0.001), and shore fetch category (open or protected) (p < 0.001). From 1984 to 2020, a total of 2833 ha of land has been submerged due to sea level rise in the Albemarle–Pamlico Sound with the majority (91.6%) of this loss coming from tidal marsh and ghost forest ecosystems. The results from this study highlight the importance of maintaining healthy coastal forests, which have higher net accretion rates compared to other estuarine ecosystems. [ABSTRACT FROM AUTHOR]

Bluff landforms, sought-after for housing and development, present a hazard management challenge due to erosional processes despite the perceived safety of elevated land. This study focuses on the Neuse River Estuary in North Carolina, exploring coastal risk perception and erosion. A survey protocol was developed, and questionnaires targeted 246 residents with property within 100 m of the shoreline and 54 land use professionals in Craven County. To explore the connection of individual experiences with erosion, we use openly accessible LiDAR to quantify bluff retreat and erosion between 2014 and 2020, a period that encompasses Hurricane Florence in 2018. Our findings show: 1) survey results reveal a consensus among residents, with 90% observing alterations attributed to storm impacts, 2) preferences for addressing erosion lean towards structural measures, aligning with existing protection strategies (e.g., bulkheads, rip-rap) as opposed to nature-based solutions, 3) bluff tops are eroding at a higher median rate of -0.59 m per year, compared to -0.19 m per year for high sediment banks, and 4) an overall net volume decrease of approximately -1.89 cubic meters per year for Craven County, slightly more than the overall net loss for the Neuse River Estuary, which was -1.74 cubic meters per year. The findings underscore the need for a cohesive bluff erosion management plan, emphasizing the complexity of challenges and the importance of a holistic approach that combines technical studies with effective risk communication. [ABSTRACT FROM AUTHOR]

Appalachian State University's Nexus project designed an efficient greenhouse heating system that integrated renewable energy and root zone heating technology to reduce the greenhouse heating energy burden on local farmers and installed it at local cooperative farms. This study analyzed 5 years of data from 2018 to 2022 to investigate the energy savings and microclimate control effectiveness of the Nexus heating system installed at Springhouse Farm in North Carolina, USA. By varying bench cover materials, bottom insulation, and the number of loops of root zone tubing, the different soil temperatures required for plant types and growth stages were achieved with a single temperature controller. A root zone heating fluid of 32.2 ℃ satisfactorily maintained the germination soil between 20 and 25 ℃ in March 2019 with an average outside temperature of 4.8 ℃ and an average low temperature of − 0.4 ℃. Growing soil maintained an average temperature of 15 ℃ with bottom insulation and an average of 11–12 ℃ without bottom insulation. Compared to the conventional heating system (a forced-air propane unit heater alone), weather-adjusted propane consumption (propane usage divided by heating degree days) was reduced by 65% with the Nexus system alone and 45% with the Nexus system and unit heater together. It shows that the Nexus system has significantly reduced greenhouse heating energy consumption and maintained productive conditions. The renewable energy fraction ranged only 9–13% of the total thermal energy used due to the high inlet temperature entering the solar thermal collector. This can be improved by separating the heat storage and backup heat source. [ABSTRACT FROM AUTHOR]

Virginia spiraea (Spiraea virginiana Britton, Rosaceae) is a putative shade-intolerant, disturbance-adapted, riparian shrub species native to the southern Appalachian Mountains. This species was listed as threatened in 1990, and a federal recovery plan was developed in 1992. Current reassessment of the recovery plan includes proposals for propagation and out-planting to supplement and restore wild populations. Genotypes with greater shade acclimation would likely have higher survival in natural populations, would require less frequent shade-reduction management, and could be integrated into populations that need restoration. In summer 2022, we examined steady-state (maximum light-saturated photosynthetic, dark respiration rates, quantum yield, light compensation point) and dynamic (photosynthetic induction and loss patterns) photosynthetic characteristics, pigment concentrations, and specific leaf mass of cloned propagules from five elements of occurrence along the South Fork of the New River in Ashe County, North Carolina, along an artificial light gradient (100%, 75%, 50%, and 20% of full sun) in a common garden. Data were compared among light treatments using ANOVA or non-parametric tests. Light treatment had significant effects on maximum photosynthesis, dark respiration, specific leaf mass, and light compensation, but not quantum yield, pigment concentrations, or induction and loss times. Some parameters had plasticity similar to that seen in other woody shrubs, while others were less plastic. A surprising finding was that plants performed better under 75% full sunlight suggesting an ability to tolerate, and maybe even a preference for, partial shade in this species. Future studies should examine photosynthetic characteristics of individuals from genetically contrasting source populations. [ABSTRACT FROM AUTHOR]

Bridges are essential portions of a nation's infrastructure systems. Although general rules and guidelines are available for bridge preservation activity prediction, due to the intricate interdependencies among bridge elements, defects, and preservation activities, departments of transportation (DOTs) rely heavily on bridge engineers' experience to determine preservation needs. Hence, identifying and organizing the unwritten and experience-based domain knowledge is essential to automate bridge preservation planning. This research collected 13,994 defects for 442 bridges in North Carolina. A graph neural network (GNN) model was developed to predict preservation activities using a defect dependency graph. This research created a bridge preservation ontology to further leverage experience-based domain knowledge to derive 80 unwritten activity-triggering rules via ontology axioms. A heterogeneous graph was constructed considering the semantics related to bridge defects and elements from the axioms. Tests revealed that, with a domain ontology, the GNN model improved prediction accuracy, precision, recall, and F1 score by 4.78%, 4.03%, 15.03%, and 11.62%, respectively. This research contributes to the body of knowledge by proposing a new graph theory–based bridge inspection database to enable GNN learning considering spatial and logical dependencies. Construction practitioners can instantly access and clearly comprehend bridge maintenance contextual information using the ontology database and machine learning models. The framework provides a systematic model for bridge preservation activity planning and enhances the robustness and reliability of bridge preservation decision-making. This research will assist DOT engineers and managers in improving knowledge sharing and automatic planning in bridge management. [ABSTRACT FROM AUTHOR]

Banks are one of the key drivers of economic development across communities. Banking deserts—defined by inadequate banking access—limit access to capital, inhibit wealth accumulation, and increase exposure to predatory lending. Banking desert formation could be profit-driven, with lower-income and less densely populated regions more likely to become banking deserts. Discrimination could also play a role here: banks may have less presence in areas with higher minority populations. The authors use a panel, census tract-level data set for the entire state of North Carolina to investigate how these forces impact banking access and banking desert formation. Panel methodologies are incorporated to investigate the extent to which profit and discrimination mechanisms each drive banking access and banking desert formation. Profit and discrimination mechanisms are shown to play roles, highlighting the need for policies that mitigate bank branch losses in underserved neighborhoods. [ABSTRACT FROM AUTHOR]

A debris slide and subsequent fire on September 18, 2018, destroyed a bank building and damaged property in Warrensville, North Carolina. The slide pushed a propane tank and an electrical generator against the bank. In that collision, an electrical arc caused the propane to explode, which produced a fireball. Employees in the bank narrowly escaped with minor injuries, and slide debris buried part of an unoccupied drive-through lane. North Carolina Geological Survey geologists responded to a request from the Ashe County Emergency Manager and investigated the slide area to assess slope stability for public safety. Aided by uncrewed aerial system imagery, we documented slope and debris slide features and geologic materials and constructed a geologic cross section through the 1,400 m2 debris slide. We concluded that record above-normal precipitation followed by rainfall from the remnants of Hurricane Florence during September 15-18, 2018, induced the slide, and that geologic conditions and hillside modifications over prior decades had predisposed the slope to failure. Colluvial deposits derived from sheared amphibolite bedrock, and curved trees within and adjacent to the 2018 slide indicated preexisting marginally stable hillslope conditions. The 2018 slide included the area of a 2000 slide that involved a cut slope constructed during earlier site development. Stability analyses showed that the described conditions led to an unstable slope at the time of the 2018 slide. A septic leach field involved in the 2018 slide was damaged; however, it is uncertain if it was a causal factor in the slide. [ABSTRACT FROM AUTHOR]

Known from over 50 Triassic localities worldwide, beetles were a significant component of the early Mesozoic paleofauna. Beetle fossils are particularly diverse in the Late Triassic (Norian) Cow Branch and Walnut Cove formations (Solite deposit) of Virginia and North Carolina, with 100 distinct morphotypes sorted from approximately 1000 specimens. The diversity of the Solite Coleoptera is documented, the 100 beetle morphotypes are informally described, and comparisons are made with other beetle communities through geologic time. In comparison with modern beetle communities, the Solite fauna shares two remarkable similarities. First, the distribution of Solite beetle body sizes matches that of some modern beetle communities, with the majority of specimens in both groups measuring between 2 and 4 mm in length. Second, the vast majority of the 100 Solite morphotypes (84%) are known from only a single specimen. This pattern somewhat follows the species abundance distribution of modern animal communities, in which a community is comprised of only a few common species and many rare species. In contrast, the Solite beetle fauna differs markedly from those of other Triassic and Early Jurassic deposits, both in the composition of higher taxa present, as well as in the lack of shared taxa between sites. The uniqueness of the Solite taxa, including the remarkable diversity, demonstrate the importance of the Solite Konservat-Lagerstätte in understanding the evolutionary history of Order Coleoptera. [ABSTRACT FROM AUTHOR]

Background: The timeliness, accuracy, and completeness of data for firearm injury surveillance is crucial for public health surveillance efforts and informing injury prevention measures. While emergency department (ED) visit data can provide near real-time information on firearms injuries, there are concerns surrounding the accuracy of intent coding in these data. We examined whether emergency medical service (EMS) data provide more accurate firearm injury intent coding in comparison to ED data. Methods: We applied a firearm injury definition to EMS encounter data in NC's statewide syndromic surveillance system (NC DETECT), from January 1, 2021, through December 31, 2022. We manually reviewed each record to determine intent, and the corresponding manual classifications were compared to the injury cause codes entered in the EMS data and to ED visit records where EMS-ED record linkage was possible. We then calculated the sensitivity, specificity, positive and negative predictive values for each intent classification in SAS 9.4 using the manually reviewed intent classifications as the gold standard. Results: We identified 9557 EMS encounters from January 1, 2021, through December 31, 2022 meeting our firearm injury definition. After removing false positives and duplicates, 8584 records were available for manual injury classification. Overall, our analysis demonstrated that manual and EMS injury cause code classifications were comparable. However, for the 3401 EMS encounters that could be linked to an ED visit record, sensitivity of the ED ICD-10-CM codes was low for assault and intentional self-harm encounters at 18.2% (CI 16.5–19.9%) and 22.2% (CI 16–28.5%), respectively. This demonstrates a marked difference in the reliability of the intent coding in the two data sources. Conclusions: This study illustrates both the value of examining EMS encounters for firearm injury intent, and the challenges of accurate intent coding in the ED setting. EMS coding has the potential for more accurate intent coding than ED coding within the context of existing hospital-based coding guidance. This may have implications for future firearm injury research, especially for nonfatal firearm injuries. [ABSTRACT FROM AUTHOR]

Artificial reefs can play an important role in marine fisheries management by supplementing or enhancing natural habitats. Despite their increased use in recent years, the choice of structures used at artificial reefs remains largely haphazard due to the lack of information on reef structure performance. Few studies have examined the use of different artificial reef structures by individual fish. From 2021-2022, we acoustically tagged 72 black sea bass (Centropristis striata), 34 gag (Mycteroperca mircrolepis), 27 greater amberjack (Seriola dumerili), nine almaco jack (S. rivoliana), and eight red snapper (Lutjanus campechanus) on four artificial reef complexes near Cape Lookout, North Carolina, U.S. Available artificial reef structures consisted of materials of various sizes and heights made of concrete and metal. We tracked tagged fish using a fine-scale positioning system for ~100 days. Black sea bass exhibited high site fidelity to the artificial structure where we caught them, rarely moving away from that structure. The limited movement resulted in low transition probabilities; we conclude that black sea bass do not select for particular artificial structures. Gag and red snapper moved greater distances away from artificial structures and routinely moved between them. Greater amberjack and almaco jack moved the most within the complexes displaying circling behavior around individual structures and were the only species that regularly moved off the artificial reef complexes. Greater amberjack movements away from artificial sites were most commonly directed to surrounding shipwrecks. Whereas gag, red snapper, almaco jack, and greater amberjack used all available structures, they consistently selected for high relief structures, such as vessels, more than other structures. These results will be useful to managers charged with decisions on what types of structures to place at artificial reef complexes to supplement or enhance habitat for economically important fishes. [ABSTRACT FROM AUTHOR]

In insects vulnerable to dehydration, the mechanistic reaction of blood after wounding is rapid. It allows insects to minimize blood loss by sealing the wound and forming primary clots that provide scaffolding for the formation of new tissue. Using nano-rheological magnetic rotational spectroscopy with nickel nanorods and extensional rheology, we studied the properties of blood dripping from the wound of caterpillars of the Carolina sphinx moth (Manduca sexta) with a high concentration of blood cells. We discovered that wound sealing followed a two-step scenario. First, in a few seconds, the Newtonian lowviscosity blood turns into a non-Newtonian viscoelastic fluid that minimizes blood loss by retracting the dripping blood back into the wound. Next, blood cells aggregate, starting from the interfaces and propagating inward. We studied these processes using optical phase-contrast and polarized microscopy, X-ray imaging, and modeling. Comparative analyses of the cell-rich and cell-poor blood of different insects revealed common features of blood behavior. These discoveries can help design fast-working thickeners for vertebrate blood, including human blood. [ABSTRACT FROM AUTHOR]

Background: Police violence is increasingly recognized as an urgent public health problem. Basic questions about police violence, however, remain unanswered, including which types of law enforcement agency are responsible for fatal police violence deaths. Methods: We estimated the proportion of police violence deaths in the U.S. (2013–2022) that were attributable to local, county, state, federal, or tribal police agencies, using mapping police violence data. We examined proportions overall, by decedent race/ethnicity, and by state. Results: Nationally, 60% of decedents were killed by municipal, 29% by county, 8% by state, and 3% by federal, police, with < 1% killed by tribal or other officers. These proportions varied by race/ethnicity, with 56% of Native American decedents killed by municipal police compared to 70–75% among other racially minoritized people. While municipal police were responsible for most deaths in most states, in the Southeast, county police predominated. In some Northeastern states (and Alaska), state police were responsible for > 40% of deaths. Conclusions: We identify wide geographic & racial/ethnic variation in the agencies responsible for fatal police violence. Findings suggest that the budgetary and infrastructural shifts required to prevent fatal police violence need to occur at multiple levels of government. [ABSTRACT FROM AUTHOR]

Objective: Recent estimates of the North Carolina blue crab Callinectes sapidus stock found that the stock is overfished and overfishing is occurring. Threats outlined in the 2018 stock assessment include climate change and estrogenic endocrine‐disrupting chemicals (EEDCs). The objective of this study was to use an individual‐based modeling approach to simulate the long‐term effects of climate change and EEDCs on the North Carolina blue crab stock. Methods: To do this, we built an individual‐based model that simulated the life history of individual blue crabs, including but not limited to growth, reproduction, and mortality. We then tested our population of blue crabs against 30 different combinations of temperature and EEDC scenarios over 50 years to determine the long‐term effects on the population. Result: Our simulations suggested that the North Carolina blue crab population may be relatively resilient to climate change‐related temperature shifts but that there may be significant impacts at the population level as summer temperatures become more extreme. Endocrine‐disrupting chemical effects resulted in an alternative stable state of lower catch or the total extinction of the population. Conclusion: These results suggest that management strategy changes may be necessary as temperatures become more extreme in the region. In addition, more research is necessary to fully understand the effects of EEDCs on blue crabs and other crustaceans at the individual and population level. Impact statementThis study used a novel approach to connect fine‐scale blue crab ecology to broadscale population ecology. This model can be a useful predictive tool that allows for assessment of the effects of future threats or regulation changes and can be modified to simulate other important crustacean species. [ABSTRACT FROM AUTHOR]

Background: Community health workers represent a critical part of the health outreach and services for migrant and seasonal farmworkers ('farmworkers') in rural areas of the United States. Purpose: We sought to identify adaptations to farmworker patient engagement and health outreach made by community health workers during the first 18 months of the COVID‐19 pandemic. Methods: In this qualitative study, we used semi‐structured interviews with community health workers from August 2020 to February 2022 (n = 21). Two coders used thematic analysis to identify three themes related to the experiences of community health workers in conducting health education and outreach to farmworkers prior to and following the onset of the pandemic. Findings: We found themes related to pre‐pandemic outreach efforts to provide health education resource sharing with farmworkers and pandemic‐related outreach efforts that included adoption of porch drops and distanced delivery of health education, adaptation of modes of health education and communication through technology and the internet, and taking on new roles related to COVID‐19. Finally, we identified changes that reverted after the pandemic or will continue as adaptations. Conclusions: Community health workers created practice‐based innovations in outreach in response to the COVID‐19 pandemic. These innovations included new COVID‐19 related roles and new modes of health education and outreach, including the use of digital resources. The changes developed for emergency use in COVID‐19, particularly related to internet and technology, have likely altered how community health workers conduct outreach in North Carolina going forward. Funders, community health worker training programs, and researchers should take note of these innovations. Patient or Public Contribution: Community health workers who typically come from patient populations and provide critical navigation and connection with the health care system advised on the design and creation of this research project, including serving on an advisory board. Two authors have experience working as community health workers. [ABSTRACT FROM AUTHOR]

Background: Fluoridation of public water systems is known as a safe and effective strategy for preventing dental caries based on evidence from non-randomized studies. Yet 110 million Americans do not have access to a fluoridated public water system and many others do not drink tap water. This article describes the study protocol for the first randomized controlled trial (RCT) of fluoridated water that assesses its potential dental caries preventive efficacy when delivered in bottles. Methods: waterBEST is a phase 2b proof-of-concept, randomized, quadruple-masked, placebo-controlled, parallel-group trial designed to estimate the potential efficacy of fluoridated versus non-fluoridated bottled water to prevent dental caries incidence in the first 4 years of life. Two hundred children living in eastern North Carolina, USA, and aged 2–6 months at screening are being allocated at random in a 1:1 ratio to receive fluoridated (0.7 mg/L F) or non-fluoridated bottled water sourced from two local public water systems. Throughout the 3.5-year intervention, study water is delivered monthly in 5-gallon bottles to each child's home with instructions to use it whenever the child consumes water as a beverage or in food preparation. Parents are interviewed quarterly to monitor children's water consumption and health. At annual visits, the presence of dental caries is evaluated with a dental screening examination. Clippings from fingernails and toenails are collected to quantify fluoride content as a biomarker of total fluoride intake. The primary endpoint is the number of primary tooth surfaces decayed, missing, or filled due to dental caries measured by the study dentist near the time of the child's fourth birthday. Tooth decay is assessed at the threshold of macroscopic enamel loss. For the primary aim, a least-squares, generalized linear model will estimate efficacy and its one-tailed, upper 80% confidence limit. Discussion: waterBEST is the first evaluation of a randomized intervention of fluoridated drinking water in bottles to prevent dental caries in the primary dentition. This innovative method of delivering fluoridated water has the potential to prevent early childhood caries in a large segment of the US population that currently does not benefit from fluoridated public water. Trial registration: ClinicalTrials.gov NCT04893681. Registered on March 2022. Last update posted on 10 October 2023. https://clinicaltrials.gov/study/NCT04893681?cond=Dental%20Caries%20in%20Children&term=fluoride&locStr=North%20Carolina,%20USA&country=United%20States&state=North%20Carolina&distance=50&rank=1 [ABSTRACT FROM AUTHOR]

Harriet Ann Jacobs, born enslaved in North Carolina, was more than a fugitive freedom seeker. She was also known, loved, and held by Black South ecosystems of witness. Michelle Lanier archivally and ecologically roots the epistolary poem, 'terraqueous,' in an effort to shrink the distance between the commemorative echoes of Jacobs's story and the soils and waters that held her first breaths and acts of resistance. [ABSTRACT FROM AUTHOR]

Soil texture and organic matter are considered overarching factors controlling a diversity of soil processes and properties. However, a more complete understanding of how these factors quantitatively affect other soil properties has been lacking due to either limited scope of land use and management conditions, confounding climate and environmental conditions with management, or narrow range of soil and management conditions. This study evaluated the strength of associations of sand and total soil N concentrations with soil physical, chemical, and biological properties and processes from 310 surface‐soil (0–10‐cm depth) samples (87% Ultisols, 4% Inceptisols, and ≤3% each of Alfisols, Spodosols, Entisols, and Histosols) collected under conventional‐till and no‐till cropland, grassland, and woodland in four physiographic regions of North Carolina. Sand concentration was most strongly associated with dry‐stable mean‐weight diameter (MWD), MWD product, and sieved soil density (|r| > 0.63, p < 0.001). Total soil N concentration was most strongly associated with particulate organic C and N and soil water content at water‐holding capacity (|r| > 0.74, p < 0.001). Soils under unfertilized woodlands deviated the most from general associations, suggesting that organic matter quality could be unique, and requires further investigation. Overall, sand concentration associated more closely with soil physical properties and total soil N concentration associated closely with both soil physical and biogeochemical properties. Soil chemical properties were only weakly associated with either property. This study suggests that soil texture and organic matter would be complementary, additional properties in holistic soil health assessments that already included routine soil chemical analyses. Core Ideas: Soil texture strongly associated with dry‐stable aggregation but weakly associated with water‐stable aggregation.Total soil N strongly associated with particulate organic C and N and soil water content at water‐holding capacity.Sand and total soil N concentrations were strong combined indicators of bulk density, sieved soil density, and cation‐exchange capacity.Sand and total soil N concentrations were unique soil health indicators in addition to routine soil chemical propertiesSieved soil density could be a relatively rapid and inexpensive indicator that combines the influences of soil texture and organic matter. [ABSTRACT FROM AUTHOR]

Children placed with kinship foster parents can experience less disruption and stronger family ties than children in non-kinship placements. However, financial hardship can restrict kinship caregivers from taking in relatives' children. This study investigated (1) kinship caregivers' financial standing compared to a national subsample of caregivers and (2) whether certain factors moderate the likelihood that a kinship caregiver will be able to provide care for additional non-relative children without additional financial assistance from the Department of Social Services (DSS). This study utilized primary data from 345 relatives across North Carolina and nationally representative secondary data on 6394 individuals' financial circumstances. One-sample t-tests and chi-square goodness-of-fit tests revealed that caregivers who participated in our study generally fared better financially than caregivers at the national level. Model-based recursive partitioning results showed that if an additional child is placed in the home, the caregiver's perceived capacity to provide care without extra DSS support decreased by approximately 19%, with a greater decrease (35%) among a subgroup of caregivers with low financial well-being status. The heterogeneity in caregivers' experiences, capacities, and financial needs buttresses the need for nuanced interventions and programs targeting these caregivers, enabling them to provide more stable care for children placed in their homes. [ABSTRACT FROM AUTHOR]