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Special education administrators have an influence over adapted physical education (APE) services, however little research to date has assessed special education administrators' knowledge of APE services. Thus, the purpose of this study was to determine special education administrators' knowledge of APE services. Fifty-one special education administrators completed a 21-question content knowledge test about key areas within the field of APE. A series of exploratory t-tests were used to determine whether their overall test scores differed significantly by a variety of demographic variables (e.g., gender, prior APE training). In addition, a repeated measures ANOVA was used to determine whether there were any significant differences between the three subsections of the test. Participants' overall test scores were approximately 40% (M = 8.41, SD = 2.28), which was similar to all three sub-sections within the test ('federal laws and APE' = 43%, M = 3.04, SD = 1.34; 'best teaching practices in APE' = 38%, M = 2.76, SD = 1.29; 'inclusion and least restrictive environment and APE' = 39%, M = 2.63, SD = 1.06). Test scores did not significantly differ by any of the demographic variables, p > 0.05. Recommendations for future research and professional development are discussed.

Medication-assisted treatment program clinicians work with challenging clients and deliver valuable, life changing services to those with opioid use and misuse. However, there is a paucity of research into this population's experiences. Eight Texas providers were interviewed using a series of open ended questions. Data was analyzed using investigator triangulation to ascertain and affirm common themes. Themes included the value of medication-assisted treatment and improved quality of life, client complexity, and challenges within medication-assisted treatment programs, as well as the significance of treating the client as a person. Implications and recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

This study indicates that the state-mandated high-stakes social studies assessments in four states do not require students to demonstrate that they have met the cognitive demands articulated in the state-mandated learning standards. Further, the assessments do not allow students to demonstrate the critical thinking skills required by the standards. In this study, researchers from four states with high-stakes social studies tests questioned how well their states' tests measured and aligned with expressed expectations for students related to this objective. They analyzed the nature of four states' high school social studies standards and high-stakes tests for higher or lower cognitive demands and the alignment between them. The analysis showed that the primary expectation for student learning in the standards is for higher cognitive activity than that represented in the tests, which are dominated by low cognitive level items.

Middle school teachers tend to rely heavily on texts that have become increasing more visual. There is little information available about the graphical demands of general middle grades' science texts. The purpose of this study was to quantify the type and quality of the graphical representations and how they interacted with the textual material in middle school science texts. Four State of Texas-approved sixth-grade science texts were examined using a researcher-developed instrument, Graphical Analysis Protocol (GAP). Results produced reasons for concern (least analytic forms of graphics dominated, one third of all graphics were decorative in nature, most graphics were static in nature, and approximately one third were not connected to the text spatially or semantically) and reasons for optimism (approximately one third of the time more analytic forms of graphics were used, two thirds served a specific cognitive function, and over half of the graphics were connected to the text and indexically referenced). Further research is warranted on a larger sample of texts from different states, publishers, grade levels, and subjects. It is also important to establish a connection to increased student learning and/or teacher preference due to higher incidences of any of the variables or principles that make up the GAP instrument. (Contains 6 tables.)

There is an assumption that the police work environment, which now includes cell phone videos, social media posts, and heightened media attention, is causing police officers to avoid activity that risks exposing them to negative publicity. Commonly referred to as 'de-policing' or 'the Ferguson effect," officers are assumed to be retreating from proactive law enforcement tactics. In order to uncover the views of law enforcement, police personnel from New York and Texas responded to an online survey that included a vignette. The scenario described several conditions that might impact an officer's decision-making, and a final decision by the officer in the vignette. The findings suggest two somewhat contradictory views of law enforcement personnel with respect to de-policing. First, respondents clearly disagree with an officer's decision to simply avoid a suspicious incident. Second, police officers may also be framing their decisions based on a potential threat to their career. Implications for law enforcement leaders are also discussed. [ABSTRACT FROM AUTHOR]

Estuaries routinely receive discharges of contaminants of emerging concern from urban regions. Within these dynamic estuarine systems, salinity and pH can vary across spatial and temporal scales. Our previous research identified bioaccumulation of the calcium channel blocker diltiazem and the antihistamine diphenhydramine in several species of fish residing in multiple urban estuaries along the Gulf of Mexico in Texas, where field-measured observations of diltiazem in fish plasma exceeded human therapeutic plasma doses. However, there remains a limited understanding of pharmaceutical bioaccumulation in estuarine environments. Here, we examined the influence of pH and salinity on bioconcentration of three pharmaceuticals in the Gulf killifish, Fundulus grandis. F. grandis were exposed to low levels of the ionizable pharmaceuticals carbamazepine, diltiazem, and diphenhydramine at two salinities (5 ppt, 20 ppt) and two pH levels (6.7, 8.3). pH influenced bioconcentration of select weak base pharmaceuticals, while salinity did not, suggesting that intestinal uptake via drinking does not appear to be a major exposure route of these pharmaceuticals in killifish. Compared to our previous pH dependent uptake observations with diphenhydramine in the fathead minnow model, killifish apparent volume of distribution values were markedly lower than fatheads, though killifish bioconcentration factors were similar at high pH and four fold higher at low pH than freshwater fish. Advancing an understanding of environmental gradient influences on pharmacokinetics among fish is necessary to improve bioaccumulation assessments and interpretation of toxicological observations for ionizable contaminants. • Urban coastal systems continuously receive effluent discharges of diverse quality. • Bioaccumulation of ionizable contaminants is poorly understood in estuarine species. • pH, but not salinity, altered uptake of ionizable pharmaceuticals by Gulf killifish. • Inhalational exposure route is important, compared to drinking and intestinal uptake. • Differential uptake of ionizables in freshwater and marine fish deserve future study. [ABSTRACT FROM AUTHOR]

Pregnant women living with HIV are at risk for loss to follow-up and viral rebound after delivery. We conducted a retrospective cohort study of women with HIV who delivered at Parkland Hospital, Dallas, to identify factors associated with postpartum loss to HIV care 1 year after delivery. Logistic regression was used to identify factors predicting loss to follow-up. For a subset of women, we compared odds of viremia detectable at delivery and postpartum among women with higher versus lower pill burden regimens. We included 604 women with HIV who delivered between 2005 and 2015. Three hundred ninety-one (65%) women completed at least one visit with an HIV provider within 1 year of delivery. The follow-up rate among black, non-Hispanic women was 65%; 57% for white, non-Hispanic women; and 78% for Hispanic women. Women without follow-up presented for prenatal care later (17 vs. 11 weeks, p < 0.001), and were less likely to be on antiretroviral therapy at initial prenatal visit (29% vs. 49%, p < 0.001). Factors predicting loss to follow-up in multivariate analysis included low-level viremia at delivery [adjusted odds ratio (aOR) = 2.85, 95% confidence interval (CI) = 1.73–4.71] and failure to return for a postpartum visit (aOR = 3.19, 95% CI = 2.07–4.94). High antiretroviral pill burden (≥6 pills daily) was associated with viremia (>1000 copies/mL) at the first prenatal visit (OR = 8.7, 95% CI = 4.6–16.6) through 1 year postpartum (OR = 2.3, 95% CI = 1.2–4.4). Viremia at delivery, failure to return for a postpartum visit, and high pill burden during pregnancy are predictors of postpartum loss to HIV care. [ABSTRACT FROM AUTHOR]

Amid robust debates about the impact of music on the lives of young people, empirically validated measures of music engagement are absent. The present study builds on the construction of the Individual and Community Empowerment (ICE) inventory, a measure to capture different types of empowerment and different types of risk potential from rap music engagement. The scientific intent of the scale development and the present validation study was to test the simultaneous presence of empowerment and risk associated with music engagement and its application to the individual and community. A unique sample existed for the present study in comparison to the original, with the bulk of respondents being first-year college students and White. Results of the present study suggest that the ICE inventory is an effective and comparative measure of risk and empowerment. Major findings about the instrument’s utility were replicated, but results were divergent from original research on certain demographic trends with respect to gender, age, and race/ethnicity. Empowering and risky music engagement scale means were higher among male and younger respondents. White respondents had significantly lower mean scores than all other groups on empowerment scales, and African Americans had lower scores on the individual risk scale than other groups. Each result suggests the need for additional research. The validation of the ICE inventory offers promise for helping to collect, organize, and interpret new data on associations between music engagement and desirable health and well-being outcomes. [ABSTRACT FROM AUTHOR]

The article discusses research which was conducted to investigate the capability of an automated system to improve the efficiency of field expedient tests that may help predict injury risk and provide corrective strategies for identified deficits. Researchers found that automation of the injury screening system enhanced the efficiency of injury screening and was useful in developing an injury risk mitigation strategy.

Introduction: Measures of endurance, flexibility, strength, and power may be of value in predicting injury risk, but application to the military setting has been limited. The purpose of this study was to assess the reliability and precision of lower quarter physical performance measures among novice raters. Methods: Sixty-four (53 male, 11 female) healthy active duty Soldiers (aged 25.2±3.8 years, 25.1±3.1 kg/m²) were recruited while in training at Fort Sam Houston, Texas. Subjects completed 13 lower quarter physical performance measures in a counterbalanced order. Measures included indicators of lumbopelvic endurance (trunk flexion, trunk extension, and trunk lateral flexion), lower extremity flexibility (gastrocnemius, soleus, iliotibial band, hamstring, and quadriceps), hip strength (hip external rotation, hip abduction), quality of movement (lateral step down), and lower extremity power (timed hop test and crossover hop test). Interrater test-retest reliability was assessed between baseline scores and those obtained 48 hours later using intraclass correlation coefficients (ICC) and standard errors of measurements (SEM). Results: Measures of lumbopelvic endurance had ICC(2,1) values ranging from 0.77 to 0.79 with SEM ranging from 18.3 to 24.5 seconds. Measures of flexibility had ICC(2,2) values ranging from 0.27 to 0.59 with SEM ranging from 4.1° to 9.9°. Measures of hip strength had ICC(2,3) values ranging from 0.61 to 0.82 with SEM ranging from 1.3 kg to 3.0 kg. Measures of power had ICC(2,3) values ranging from 0.78 to 0.93 with SEM values of 0.2 seconds and 27.4 cm. Conclusions: The majority of measures assessed had adequate reliability in this sample of uniformed service members assessed by novice raters. The measures of strength and power had moderate to good reliability with small measurement error, indicating the possibility of these measures to detect change over time. Although the measures of lumbopelvic endurance had good reliability, they were associated with relatively large SEM values compared to the group mean, thus limiting the ability of these tests to detect change over time. The measures of flexibility had limited reliability which may be associated with a restriction in range of the underlying scores that could artificially underestimate reliability. These results can help inform which physical performance measures should be used in future research to assess injury prediction and human performance optimization among uniformed service members. [ABSTRACT FROM AUTHOR]

The article presents an analysis on the liability of the owner to protect its tenant in Texas. It examines the use of the premises-liability law in the lawsuit of Del Lago Partners Inc. specifically on the community social obligations. It provides a discussion on the factors that limit the Court's ability to define the duty of care owed by premises owners and the methods to practice the ad hoc duty for the owners.

In this study, we determined the biologic activity of dichloromethane-extracted particulate matter < 10 µm in aerodynamic diameter (PM[sub 10]) obtained from filters at three sites in the Paso del Norte airshed, which includes El Paso, Texas, USA; Juarez, Chihuahua, Mexico, and Sunland Park, New Mexico, USA. The extracts were rich in polycyclic aromatic hydrocarbons (PAHs) and had significant biologic activity, measured using two in vitro assay systems: ethoxyresorufin-O-deethylase (EROD) induction and the aryl hydrocarbon-receptor luciferase reporter system. In most cases, both EROD (5.25 pmol/min/mg protein) and luciferase activities (994 relative light units/mg) were highest in extracts from the Advance site located in an industrial neighborhood in Juarez. These values represented 58% and 55%, respectively, of induction associated with 1 µM β-naphthoflavone exposures. In contrast, little activity was observed at the Northeast Clinic site in El Paso, the reference site. In most cases, luciferase and EROD activity from extracts collected from the Tillman Health Center site, situated in downtown El Paso, fell between those observed at the other two sites. Overall, a statistically significant correlation existed between PM[sub 10] and EROD and luciferase activities. Chemical analysis of extracts collected from the Advance site demonstrated that concentrations of most PAHs were higher than those reported in most other metropolitan areas in the United States. Calculations made with these data suggest a cancer risk of 5-12 cases per 100,000 people. This risk estimate, as well as comparisons with the work of other investigators, raises concern regarding the potential for adverse health effects to the residents of this airshed. Further work is needed to understand the sources, exposure, and effects of PM[sub 10] and particulate organic material in the Paso del Norte airshed. [ABSTRACT FROM AUTHOR]

Background: Ventricular hypertrophy is a known sequela of long-standing chronic hypertension with associated morbidity and mortality.Objective: We sought to assess the frequency and importance of left ventricular hypertrophy in gravidas treated for chronic hypertension during pregnancy.Study Design: This was a retrospective study of pregnant women with chronic hypertension who were delivered at our hospital from January 2009 through February 2015. All women who were given antihypertensive therapy underwent maternal echocardiography and were managed in a dedicated, high-risk prenatal clinic. Left ventricular hypertrophy was defined using the criteria of the American Society of Echocardiography as left ventricular mass indexed to maternal body surface area with a value of >95 g/m2. Maternal and infant outcomes were then analyzed according to the presence or absence of left ventricular hypertrophy.Results: Of 253 women who underwent echocardiography, 48 (19%) met criteria for left ventricular hypertrophy. Women in this latter cohort were significantly more likely to be African American (P = .031), but there were no other demographic differences. More than 85% of the entire cohort had a body mass index >30 kg/m2 and a third of all women had class III obesity with a body mass index of >40 kg/m2. Importantly, duration of chronic hypertension (P = .248) and gestational age at time of echocardiography (P = .316) did not differ significantly between the groups. Left ventricular function was preserved in both groups as measured by left ventricular ejection fraction (P = .303). Those with ventricular hypertrophy were at greater risk to be delivered preterm (P = .001), to develop superimposed preeclampsia (P = .028), and to have an infant requiring intensive care (P = .023) when compared with women without ventricular hypertrophy. These findings persisted after adjustment for age, race, and parity. The gestational age at delivery according to measured left ventricular size was also examined and with increasing ventricular mass there was a significant association with the severity of preterm birth (P < .001).Conclusion: Left ventricular hypertrophy was identified in 1 in 5 women given antepartum treatment for chronic hypertension. Further analysis showed that these women were at significantly greater risk for superimposed preeclampsia and its attendant perinatal sequelae of preterm birth. [ABSTRACT FROM AUTHOR]

The toxic haptophyte Prymnesium parvum regularly forms fish-killing blooms in inland brackish water bodies in the south-central USA. Along the Texas coast smaller blooms have occurred in isolated areas. There appears to be an increasing risk that harmful P. parvum blooms will propagate into open coastal waters with implementation of future water plans. These plans will include increased interbasin water transfers from the Brazos River, regularly impacted by P. parvum blooms, to the San Jacinto-Brazos Coastal Basin, which ultimately flows into Galveston Bay (GB). Persisting source populations of P. parvum in inland waters elevates this risk. Thus, there is a need for an increased understanding of how P. parvum might perform in coastal waters, such as those found in GB. Here, two in-field experiments were conducted to investigate the influence of various plankton size-fractions of GB water on inoculated P. parvum during fall and winter, periods when blooms are typically initiating and developing inland. Stationary- and log-growth phase P. parvum were used to represent high and low toxicity initial conditions. Results revealed that P. parvum could grow in GB waters and cause acute mortality to silverside minnows ( Menidia beryllina ). Depending on season and growth phase, however, P. parvum growth and toxicity varied in different size fractions. During the fall, P. parvum inoculated from stationary-, but not log-growth phase culture, was negatively affected by bacteria-sized particles. During the winter, bacteria and nanoplankton together had a negative effect on P. parvum inoculated from stationary- and, to a lesser degree, log-growth phase cultures. Intermediate- and large-sized grazers when combined with bacteria and nanoplankton had complex relationships with inoculated P. parvum , sometimes stimulating and sometimes suppressing population growth. Toxicity to fish occurred in almost all plankton size fractions. The inclusion of progressively larger sized plankton fractions resulted in trends of decreased toxicity in treatments inoculated with stationary-, but not log-growth phase P. parvum in the fall. In the winter, however, inclusion of larger sized plankton fractions resulted in trends of increased toxicity to fish in treatments inoculated with both stationary- and log-growth phase P. parvum . This study indicates that understanding P. parvum population dynamics in open waters of estuaries and bays will be challenging, as there appears to be complex relationships with naturally occurring components of the plankton. The observations that P. parvum is able to grow to high population density and produce fish-killing levels of toxins underscores the need for advanced risk assessment studies, especially in light of water use plans that will result in P. parvum invasions of greater size. [ABSTRACT FROM AUTHOR]

Abstract: We evaluate the economics of drilling new wells in the Barnett Shale, Fort Worth Basin, Texas. The analysis is the most granular public study to date because it is based on 10 productivity tiers and it treats low and high Btu (British thermal unit) segments of the play differently. The study is unique in its use of transient linear drainage production profiles that match the physics of the system and fit the production history in the Barnett very well. Average low Btu wells in the top two tiers are viable at $4/MMBtu, whereas average high Btu wells in the same tiers are economic at $2/MMBtu. Dry gas wells are the most sensitive to fluctuations in the price of natural gas whereas high Btu wells are also sensitive to the prices of oil and natural gas liquids. There is a distribution of productivity within each tier, with better wells requiring a much lower price to be viable than the average well. The granular subdivision of productivity, low versus high Btu, and intra-tier quality variation help to explain historical drilling patterns and also allow us to predict future development patterns in the field accurately as demonstrated for 2011 and 2012 in Browning et al. [4]. [Copyright &y& Elsevier]

In the rapidly urbanizing watersheds and estuaries flowing to the Gulf of Mexico in Texas, USA, instream flows are increasingly influenced by point source and nonpoint source discharges. Spatial and temporal tidal influences on water quality, especially for contaminants of emerging concern (CECs), is poorly understood in estuaries and coastal systems. We selected Dickinson Bayou, an urban estuary in Galveston County, Texas, for study because it has historically impaired water quality, receives point source discharge from one major wastewater treatment plant (WWTP), while also being influenced by high densities of onsite sewage facilities upstream in the watershed. We explored the occurrence and potential hazards of aquatic contaminants, including nutrients, indicator bacteria for pathogens, and CECs, in relation to this point source discharge, across seasons and at high and low tides. Aquatic contaminants and associated hazards varied significantly in relation to the WWTP discharge, and were influenced by onsite systems. In fact, spatiotemporal water quality varied by class of contaminants (e.g., nutrients, indicator bacteria, CECs), which indicates that traditional surface water monitoring activities should account for such environmental complexity. This study provides a diagnostic approach for future studies of emerging water quality challenges across gradients of rapidly urbanizing coastal bays and estuaries., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Though pharmaceuticals are increasingly observed in a variety of organisms from coastal and inland aquatic systems, trophic transfer of pharmaceuticals in aquatic food webs have not been reported. In this study, bioaccumulation of select pharmaceuticals was investigated in a lower order effluent-dependent stream in central Texas, USA, using isotope dilution liquid chromatography-tandem mass spectrometry (MS). A fish plasma model, initially developed from laboratory studies, was tested to examine observed versus predicted internal dose of select pharmaceuticals. Pharmaceuticals accumulated to higher concentrations in invertebrates relative to fish; elevated concentrations of the antidepressant sertraline and its primary metabolite desmethylsertraline were observed in the Asian clam, Corbicula fluminea, and two unionid mussel species. Trophic positions were determined from stable isotopes (δ(15)N and δ(13)C) collected by isotope ratio-MS; a Bayesian mixing model was then used to estimate diet contributions towards top fish predators. Because diphenhydramine and carbamazepine were the only target compounds detected in all species examined, trophic magnification factors (TMFs) were derived to evaluate potential trophic transfer of both compounds. TMFs for diphenhydramine (0.38) and carbamazepine (1.17) indicated neither compound experienced trophic magnification, which suggests that inhalational and not dietary exposure represented the primary route of uptake by fish in this effluent-dependent stream., (© 2014 The Author(s) Published by the Royal Society. All rights reserved.)

Objectives: To determine whether contrast administration was a risk factor for development of acute kidney injury (AKI) in cyanotic congenital heart disease (CHD) patients undergoing cardiopulmonary bypass (CPB)., Background: AKI following CPB or contrast administration is well described. In previous studies, administration of contrast prior to CPB has been shown to increase the risk of AKI. Chronic cyanosis leads to glomerular damage and dysfunction, thus potentially placing this population at increased risk of developing AKI following contrast administration prior to CPB., Methods: One hundred twenty-two patients with cyanotic CHD undergoing preoperative cardiac catheterization (PCC) and subsequent CPB at Children's Medical Center of Dallas from January 1, 2007 until November 30, 2010 were identified, looking specifically at bi-directional Glenn (BDG) anastomoses and Fontan procedures. One hundred thirteen patients undergoing PCC ≤ 48 hr prior to and > 5 days prior to CPB were included. Occurrence of AKI following CPB was the primary outcome variable., Results: Logistic regression analysis revealed pre-catheterization serum creatinine was a risk factor for post-CPB AKI (P < 0.001) in both Fontan and BDG patients. All other variables were not significantly associated with the development of AKI in either BDG or Fontan patients. Length of stay (hospital or ICU) was not different among the groups regardless of the occurrence of AKI., Conclusions: In this study of cyanotic CHD patients, contrast administration within 48 hr prior to CPB was not an additional risk factor for the development of AKI., (© 2014 Wiley Periodicals, Inc.)

Background: Dental personnel have an increased prevalence of upper-extremity (UE) musculoskeletal (MSK) disorders, including carpal tunnel syndrome (CTS). Military dental personnel report more UE MSK complaints than their civilian counterparts. Literature using nerve conduction studies (NCS) to diagnose UE neuropathy in dental personnel is lacking., Purpose: The purpose of this descriptive study was to determine the presence of electrodiagnostic abnormalities of the median and ulnar nerves in active duty military dental personnel assigned to Fort Sam Houston, TX., Subjects: Twenty (14 male, 6 female) active duty, US Army dentists (n=9), preventive dental specialists (n=4), dental assistants (n=3), dental lab technicians (n=3), and dental logistics technician (n=1) assigned to the Dental Command at Fort Sam Houston, TX, volunteered to participate in the study. The mean age of the dental personnel was 38±9.8 years (range: 26 to 56 years). The mean time in dental practice was 13.3±7.96 years (range: 2 to 29 years). The mean length of time in the US Army dental services was 11.8±7.7 years (range: one to 26 years)., Methods and Materials: Subjects completed a history form, were interviewed, and underwent a physical examination of the cervical spine and bilateral upper extremities. Nerve conduction studies of the bilateral median and ulnar nerves were performed. Electrophysiological variables served as the reference standard for median and ulnar neuropathy and included distal sensory latencies, distal motor latencies, amplitudes, conduction velocities, and comparison study latencies. Descriptive statistics for subject demographics and nerve conduction study variables were also calculated., Results: Seven of the 20 subjects (35%) presented with abnormal electrophysiologic values suggestive of an upper extremity mononeuropathy. Five of the subjects had abnormal electrophysiologic values of the median nerve at or distal to the wrist (3 bilateral, 2 unilateral). Two subjects had abnormal ulnar nerve findings at or distal to the wrist (1 bilateral, 1 unilateral). Three of the 7 subjects with electrodiagnostic evidence of median and ulnar neuropathies had positive findings on physical examination. However, there was no significant correlation between the NCS and history/physical examination findings., Conclusions and Clinical Significance: The prevalence of mononeuropathies in this sample of US Army dental personnel is similar to previous research involving dental assistants and preventive dental specialists and far exceeds that reported in the general population. This is the first dental study to report electrodiagnostic findings of ulnar mononeuropathy at or distal to the wrist. The NCS findings did not correlate with subjective or physical exam findings. Prospective research investigating screening, examination items, and injury prevention measures in dental personnel appears to be warranted.

A comparative understanding of effluent quality of decentralized on-site wastewater treatment systems, particularly for contaminants of emerging concern (CECs), remains less understood than effluent quality from centralized municipal wastewater treatment plants. Using a novel experimental facility with common influent wastewater, effluent water quality from a decentralized advanced aerobic treatment system (ATS) and a typical septic treatment system (STS) coupled to a subsurface flow constructed wetland (WET) were compared to effluent from a centralized municipal treatment plant (MTP). The STS did not include soil treatment, which may represent a system not functioning properly. Occurrence and discharge of a range of CECs were examined using isotope dilution liquid chromatography-tandem mass spectrometry during fall and winter seasons. Conventional parameters, including total suspended solids, carbonaceous biochemical oxygen demand and nutrients were also evaluated from each treatment system. Water quality of these effluents was further examined using a therapeutic hazard modeling approach. Of 19 CECs targeted for study, the benzodiazepine pharmaceutical diazepam was the only CEC not detected in all wastewater influent and effluent samples over two sampling seasons. Diphenhydramine, codeine, diltiazem, atenolol, and diclofenac exhibited significant (p<0.05) seasonal differences in wastewater influent concentrations. Removal of CECs by these wastewater treatment systems was generally not influenced by season. However, significant differences (p<0.05) for a range of water quality indicators were observed among the various treatment technologies. For example, removal of most CECs by ATS was generally comparable to MTP. Lowest removal of most CECs was observed for STS; however, removal was improved when coupling the STS to a WET. Across the treatment systems examined, the majority of pharmaceuticals observed in on-site and municipal effluent discharges were predicted to potentially present therapeutic hazards to fish., (© 2013.)

In 2007, the Texas legislature appropriated money for a pilot study to evaluate cardiovascular screening of student athletes to identify those who might be at risk of sudden death using a questionnaire, physical examination, electrocardiography, and limited echocardiography. We sought to determine (1) the feasibility of a state-wide cardiovascular screening program, (2) the ability to reliably identify at-risk subjects, and (3) problems in implementing screening state wide. The data were analyzed using established pediatric electrocardiographic and echocardiographic criteria. Positive results were confirmed by a blinded reviewer. In 31 venues (2,506 students), the electrocardiographic findings met the criteria for cardiovascular disease in 57 (2.3%), with 33 changes suggestive of hypertrophic cardiomyopathy, 14 with long QT syndrome, 7 with Wolff-Parkinson-White syndrome, and 3 with potential ischemic findings related to a coronary anomaly. Of the 2,051 echocardiograms, 11 had findings concerning for disease (9 with hypertrophic cardiomyopathy and 1 with dilated cardiomyopathy). In patients with electrocardiographic findings consistent with hypertrophic cardiomyopathy, the limited echocardiograms were normal in 24 of 33. Of the 33 who remained at risk of sudden death on the electrocardiogram or echocardiogram, 25 (65.8%) pursued the recommended evaluation, which confirmed long QT syndrome in 4, Wolff-Parkinson-White syndrome in 7, and dilated cardiomyopathy in 1. The interobserver agreement was 100% for electrocardiography and 79% for echocardiography. The questionnaire identified 895 (35% of the total) potentially at-risk students, with disease confirmed in 11 (1.23%). In conclusion, in this large state-funded project, electrocardiographic and echocardiographic screening identified 11 of 2,506 patients potentially at risk of cardiovascular disease. The questionnaire was of limited value and had a large number of false-positive results. Interobserver variation was significant for echocardiography and might create problems with limited echocardiographic screening. Finally, many subjects with abnormal screening results declined a follow-up evaluation., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The use of land-use regression (LUR) techniques for modeling small-scale variations of intraurban air pollution has been increasing in the last decade. The most appealing feature of LUR techniques is the economical monitoring requirements. In this study, principal component analysis (PCA) was employed to optimize an LUR model for PM2.5. The PM2.5 monitoring network consisted of 13 sites, which constrained the regression model to a maximum of one independent variable. An optimized surrogate of vehicle emissions was produced by PCA and employed as the predictor variable in the model. The vehicle emissions surrogate consisted of a linear combination of several traffic variables (e.g., vehicle miles traveled, speed, traffic demand, road length, and time) obtained from a road network used for traffic modeling. The vehicle-emissions surrogate produced by the PCA had a predictive capacity greater (R2=.458) than the traffic variable, Traffic Demand summarized for a 1 km buffer, with best predictive capacity (R2=.341). The PCA-based method employed in this study was effective at increasing the fit of an ordinary LUR model by optimizing the utilization of a PM2.5 dataset from small-n monitoring network. In general, the method used can contribute to LUR techniques in two major ways: 1) by improving the predictive power of the input variable, by substituting a principal component for a single variable and 2) by creating an orthogonal set of predictor variables, and thus fulfilling the no colinearity assumption of the linear regression methods. The proposed PCA method, should be universally applicable to LUR methods and will expand their economical attractiveness., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Objective: To examine risk factors for false positive HIV enzyme immunoassay (EIA) testing at delivery., Study Design: A review of pregnant women who delivered at Parkland Hospital between 2005 and 2008 was performed. Patients routinely received serum HIV EIA testing at delivery, with positive results confirmed through immunofluorescent testing. Demographics, HIV, hepatitis B surface antigen (HBsAg), and rapid plasma reagin (RPR) results were obtained. Statistical analyses included Pearson's chi-square and Student's t-test., Results: Of 47,794 patients, 47,391 (99%) tested negative, 145 (0.3%) falsely positive, 172 (0.4%) positive, and 86 (0.2%) equivocal or missing HIV results. The positive predictive value of EIA was 54.3%. Patients with false positive results were more likely nulliparous (43% versus 31%, P < 0.001) and younger (23.9 ± 5.7 versus 26.2 ± 5.9 years, P < 0.001). HIV positive patients were older than false positive patients and more likely positive for HBsAg and RPR., Conclusion: False positive HIV testing at delivery using EIA is associated with young maternal age and nulliparity in this population.