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1.
Sci Total Environ ; 767: 145440, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33636758

RESUMO

Urbanization and agricultural intensification can transform landscapes. Changes in land-use can lead to increases in storm runoff and nutrient loadings which can impair the health and function of stream ecosystems. Microorganisms are an integral component of stream ecosystems. Due to the sensitivity of microorganisms to perturbations, changes in hydrology and water chemistry may alter microbial activity and structure. These shifts in microbial community dynamics may alter stream metabolism and water quality, potentially impacting higher trophic levels. Here we examine the effects of land-use and associated changes in water chemistry on sediment microbial communities by studying the West Run Watershed (WRW) a mixed-land-use system in West Virginia, USA. Streams were sampled throughout the growing season at six sites within the WRW spanning different levels of land use intensification. The proportion of land impacted by agricultural and urban development was positively correlated with temporal variation in stream sediment microbial community composition (adj R2 = 0.65), suggesting development can destabilize microbial communities. Moreover, streams in developed watersheds had an increased metabolic quotient (20-50% higher), this indicates that microorganisms have greater respiration per unit biomass and signifies reduced metabolic efficiency. Further, our results suggest that land use associated changes in water chemistry alter microbial function both directly and indirectly via changes in microbial community composition and biomass. Taken together our results suggest that highly developed watersheds with elevated conductivity, metal ion concentration, and pH impose stress on microbial communities resulting in reduced microbial efficiency and elevated respiration.


Assuntos
Biodiversidade , Rios , Agricultura , Urbanização , West Virginia
2.
MMWR Morb Mortal Wkly Rep ; 70(8): 269-272, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33630818

RESUMO

Hepatitis A is a vaccine-preventable disease caused by the hepatitis A virus (HAV). Transmission of the virus most commonly occurs through the fecal-oral route after close contact with an infected person. Widespread outbreaks of hepatitis A among persons who use illicit drugs (injection and noninjection drugs) have increased in recent years (1). The Advisory Committee on Immunization Practices (ACIP) recommends routine hepatitis A vaccination for children and persons at increased risk for infection or severe disease, and, since 1996, has recommended hepatitis A vaccination for persons who use illicit drugs (2). Vaccinating persons who are at-risk for HAV infection is a mainstay of the public health response for stopping ongoing person-to-person transmission and preventing future outbreaks (1). In response to a large hepatitis A outbreak in West Virginia, an analysis was conducted to assess total hepatitis A-related medical costs during January 1, 2018-July 31, 2019, among West Virginia Medicaid beneficiaries with a confirmed diagnosis of HAV infection. Among the analysis population, direct clinical costs ranged from an estimated $1.4 million to $5.6 million. Direct clinical costs among a subset of the Medicaid population with a diagnosis of a comorbid substance use disorder ranged from an estimated $1.0 million to $4.4 million during the study period. In addition to insight on preventing illness, hospitalization, and death, the results from this study highlight the potential financial cost jurisdictions might incur when ACIP recommendations for hepatitis A vaccination, especially among persons who use illicit drugs, are not followed (2).


Assuntos
Custos e Análise de Custo/estatística & dados numéricos , Surtos de Doenças , Hepatite A/economia , Medicaid/economia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Hepatite A/epidemiologia , Hepatite A/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos , West Virginia/epidemiologia , Adulto Jovem
3.
Rural Remote Health ; 21(1): 6122, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33455406

RESUMO

INTRODUCTION: Older adults, especially those aged 85 years or older, remain at significantly higher risk for COVID-19. This group, along with those with pre-existing heart and lung disease and diabetes, have accounted for 80% of hospitalizations and an even higher percentage of COVID-19 related deaths in the USA. West Virginia, the only state in the USA located completely within Appalachia, has a higher percentage of elderly than all but two states in the nation. Rural seniors are hesitant to use hospital emergency departments and attend routine care visits for fear of exposure to the virus. Restricted cell phone and internet service may limit effective technological outreach to more isolated rural older adults. More information is needed to develop effective, safe, and acceptable approaches to care for rural, isolated older adults. METHODS: Telephone interviews were conducted with 124 community-dwelling residents in four counties in rural Appalachia between 1 and 22 April 2020. Participants were aged 75 years or older. Descriptive statistics were calculated and Fisher's Exact Test was used to examine for associations among variables. RESULTS: Participants consisted of 86 (69.4%) women and 38 (30.6%) men with an average age of 82.5 years. Telephone contact was the preferred method of contact among all but four participants (96.8%). Seventeen calls (13.7%) resulted in some form of intervention, including arranging for emergent home repairs, treatment of severe hypertension, scheduling urgent laboratory testing, arranging for terminal care, treating acute conditions, and providing durable medical equipment. The 17 participants requiring intervention were significantly more likely to be aged 85 years or older (p=0.004), and report two or more chronic conditions (p<0.001). Those describing themselves as 'lonely' were significantly more likely to live alone (p=0.009) and describe themselves as 'anxious' or 'depressed' (p<0.001). CONCLUSION: A telephone call appears to be the most effective means of communication with patients in these rural Appalachian counties. Patients aged 85 years or older and those living alone should be given highest priority for regular outreach by healthcare providers. In this population, systematically calling rural elderly patients during the COVID-19 epidemic and its aftermath represents an effective strategy for providers who care for elderly rural patients.


Assuntos
/prevenção & controle , Acesso aos Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , População Rural/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Região dos Apalaches , Feminino , Serviços de Saúde para Idosos/organização & administração , Humanos , Masculino , West Virginia
4.
Am Surg ; 86(9): 1057-1061, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33049163

RESUMO

BACKGROUND: Timely access to emergency general surgery services, including trauma, is a critical aspect of patient care. This study looks to identify resource availability at small rural hospitals in order to improve the quality of surgical care. METHODS: Forty-five nonteaching hospitals in West Virginia were divided into large community hospitals with multiple specialties (LCHs), small community hospitals with fewer specialties (SCHs), and critical access hospitals (CAHs). A 58-question survey on optimal resources for surgery was completed by 1 representative surgeon at each hospital. There were 8 LCHs, 18 SCHs, and 19 CAHs with survey response rates of 100%, 83%, and 89%, respectively. RESULTS: One hundred percent of hospitals surveyed had respiratory therapy and ventilator support, computerized tomography (CT) scanner and ultrasound, certified operating rooms, lab support, packed red blood cells (PRBC), and FFP accessible 24/7. Availability of cryoprecipitate, platelets, tranexamic acid (TXA), and prothrombin complex concentrate (PCC) decreased from LCHs to CAHs. The majority had board-certified general surgeons; however, only 86% LCHs, 53% SCHs, and 50% CAHs had advanced trauma life support (ATLS) certification. One hundred percent of LCHs had operating room (OR) crew on call within 30 minutes, emergency cardiovascular equipment, critical care nursing, on-site pathologist, and biologic/synthetic mesh, whereas fewer SCHs and CAHs had these resources. One hundred percent of LCHs and SCHs had anesthesia availability 24/7 compared to 78% of CAHs. DISCUSSION: Improving access to the aforementioned resources is of utmost importance to patient outcomes. This will enhance rural surgical care and decrease emergency surgical transfers. Further education and research are necessary to support and improve rural trauma systems.


Assuntos
Recursos em Saúde/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Hospitais Rurais/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Humanos , Inquéritos e Questionários , Estados Unidos , West Virginia
5.
MMWR Morb Mortal Wkly Rep ; 69(37): 1300-1304, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32941409

RESUMO

Nursing homes are high-risk settings for outbreaks of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1,2). During the COVID-19 pandemic, U.S. health departments worked to improve infection prevention and control (IPC) practices in nursing homes to prevent outbreaks and limit the spread of COVID-19 in affected facilities; however, limited resources have hampered health departments' ability to rapidly provide IPC support to all nursing homes within their jurisdictions. Since 2008, the Centers for Medicare & Medicaid Services (CMS) has published health inspection results and quality ratings based on their Five-Star Quality Rating System for all CMS-certified nursing homes (3); these ratings might be associated with facility-level risk factors for COVID-19 outbreaks. On April 17, 2020, West Virginia became the first state to mandate and conduct COVID-19 testing for all nursing home residents and staff members to identify and reduce transmission of SARS-CoV-2 in these settings (4). West Virginia's census of nursing home outbreaks was used to examine associations between CMS star ratings and COVID-19 outbreaks. Outbreaks, defined as two or more cases within 14 days (with at least one resident case), were identified in 14 (11%) of 123 nursing homes. Compared with 1-star-rated (lowest rated) nursing homes, the odds of a COVID-19 outbreak were 87% lower among 2- to 3-star-rated facilities (adjusted odds ratio [aOR] = 0.13, 95% confidence interval [CI] = 0.03-0.54) and 94% lower among 4- to 5-star-rated facilities (aOR = 0.06, 95% CI = 0.006-0.39). Health departments could use star ratings to help identify priority nursing homes in their jurisdictions to inform the allocation of IPC resources. Efforts to mitigate outbreaks in high-risk nursing homes are necessary to reduce overall COVID-19 mortality and associated disparities. Moreover, such efforts should incorporate activities to improve the overall quality of life and care of nursing home residents and staff members and address the social and health inequities that have been recognized as a prominent feature of the COVID-19 pandemic in the United States (5).


Assuntos
Infecções por Coronavirus/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Qualidade da Assistência à Saúde/normas , Idoso , Centers for Medicare and Medicaid Services, U.S. , Humanos , Casas de Saúde/normas , Pandemias , Medição de Risco/métodos , Estados Unidos/epidemiologia , West Virginia/epidemiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-32887328

RESUMO

The Supplemental Nutrition Assistance Program (SNAP) is a critical program that helps reduce the risk of food insecurity, yet little is known about how SNAP addresses the needs of rural, food-insecure residents in the United States (U.S.). This study examines how rural, food-insecure residents perceive SNAP. Semi-structured interviews were conducted with 153 individuals living in six diverse rural regions of Arkansas, Montana, North Carolina, Oregon, Texas, and West Virginia. SNAP was described as a crucial stop-gap program, keeping families from experiencing persistent food insecurity, making food dollars stretch when the family budget is tight, and helping them purchase healthier foods. For many rural residents interviewed, SNAP was viewed in a largely positive light. In efforts to continue improving SNAP, particularly in light of its relevance during and post-coronavirus (COVID-19) pandemic, policymakers must be aware of rural families' perceptions of SNAP. Specific improvements may include increased transparency regarding funding formulas, budgeting and nutrition education for recipients, effective training to improve customer service, connections among social service agencies within a community, and increased availability of automation to streamline application processes.


Assuntos
Assistência Alimentar , Abastecimento de Alimentos , Pobreza , Arkansas , Infecções por Coronavirus/epidemiologia , Humanos , Montana , North Carolina , Oregon , Pandemias , Pneumonia Viral/epidemiologia , Texas , West Virginia
7.
Ecotoxicol Environ Saf ; 203: 110992, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32771767

RESUMO

In 2011, the U.S. EPA Office of Research and Development released a field-based method for deriving aquatic life benchmarks for conductivity. Since its release, it has been verified, validated, and corroborated by the authors, reviewers, and independent researchers. However, the method and published results have been recently challenged as being artifacts of small sample sizes, prompting this re-evaluation. This paper supplements prior causal analyses by weighing evidence that specifically addresses the hypothesis that the benchmark is a statistical artifact. Four types of evidence are presented: (1) Permutation analyses show that the data sets are able to reliably estimate the extirpation of 5% of genera. (2) Analyses show that 25 occurrences of a genus are sufficient to estimate extirpation. (3) Coherent ecological explanations show that the claimed influence of sample size is actually a result of community ecology. (4) A review of relevant independent studies supports the benchmark. The permutation test is a useful test of the adequacy of field data sets. Furthermore, this weight-of-evidence approach and the individual types of evidence can be a model for analysis of other field-based benchmark values.


Assuntos
Organismos Aquáticos/efeitos dos fármacos , Monitoramento Ambiental/métodos , Benchmarking , Tamanho da Amostra , West Virginia
8.
PLoS One ; 15(8): e0236104, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776939

RESUMO

There is an increasing emphasis on effects-based monitoring to document responses associated with exposure to complex mixtures of chemicals, climate change, pathogens, parasites and other environmental stressors in fish populations. For decades aquatic monitoring programs have included the collection of tissues preserved for microscopic pathology. Consequently, formalin-fixed, paraffin-embedded (FFPE) tissue can be an important reservoir of nucleic acids as technologies emerge that utilize molecular endpoints. Despite the cross-linking effects of formalin, its impact on nucleic acid quality and concentration, amplification, and sequencing are not well described. While fresh-frozen tissue is optimal for working with nucleic acids, FFPE samples have been shown to be conducive for molecular studies. Laser capture microdissection (LCM) is one technology which allows for collection of specific regions or cell populations from fresh or preserved specimens with pathological alterations, pathogens, or parasites. In this study, smallmouth bass (Micropterus dolomieu) liver was preserved in three different fixatives, including 10% neutral buffered formalin (NBF), Z-Fix® (ZF), and PAXgene® (PG) for four time periods (24 hr, 48 hr, seven days, and 14 days). Controls consisted of pieces of liver preserved in RNALater® or 95% ethanol. Smallmouth bass were chosen as they are an economically important sportfish and have been utilized as indicators of exposure to endocrine disruptors and other environmental stressors. Small liver sections were cut out with laser microdissection and DNA and RNA were purified and analyzed for nucleic acid concentration and quality. Sanger sequencing and the NanoString nCounter® technology were used to assess the suitability of these samples in downstream molecular techniques. The results revealed that of the formalin fixatives, NBF samples fixed for 24 and 48 hr were superior to ZF samples for both Sanger sequencing and the Nanostring nCounter®. The non-formalin PAXgene® samples were equally successful and they showed greater stability in nucleic acid quality and concentration over longer fixation times. This study demonstrated that small quantities of preserved tissue from smallmouth bass can be utilized in downstream molecular techniques; however, future studies will need to optimize the methods presented here for different tissue types, fish species, and pathological conditions.


Assuntos
Bass/genética , DNA/efeitos dos fármacos , Monitoramento Ambiental/métodos , Fixadores/efeitos adversos , RNA/efeitos dos fármacos , Animais , Clivagem do DNA/efeitos dos fármacos , Disruptores Endócrinos/toxicidade , Formaldeído/efeitos adversos , Perfilação da Expressão Gênica/métodos , Fígado/efeitos dos fármacos , Fígado/patologia , Microdissecção , Desnaturação de Ácido Nucleico/efeitos dos fármacos , RNA/isolamento & purificação , Estabilidade de RNA/efeitos dos fármacos , Análise de Sequência de DNA , Fatores de Tempo , Fixação de Tecidos/métodos , West Virginia
10.
Am Surg ; 86(6): 611-614, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32683967

RESUMO

The coronavirus epidemic has taken the world by storm and has overwhelmed health systems in a number of first world countries. As a consequence, individual communities in the United States and the world have had to develop response plans to meet this extreme challenge. In these circumstances and in an effort to best prepare for the community's needs, it becomes necessary to critically analyze the specific and unique aspects of individual regions, their population characteristics and demographics, and the geography of the area. Once assessed, these data may be applied to formulating best practices for a given community and resource pool. The following manuscript describes how this challenge was met in a large tertiary care teaching hospital located in rural West Virginia.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Hospitais de Ensino/organização & administração , Pandemias , Saúde da População Rural , Centros de Atenção Terciária/organização & administração , Humanos , Pobreza , Centro Cirúrgico Hospitalar/organização & administração , Procedimentos Cirúrgicos Operatórios , West Virginia/epidemiologia
11.
BMJ ; 370: m2436, 2020 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-32699008

RESUMO

OBJECTIVE: To evaluate the association between US state policies that establish age 18 or 21 years as the minimum purchaser age for the sale of handguns and adolescent suicide rate. DESIGN: Regression discontinuity and difference-in-differences analyses. SETTING: 46 US states without policy changes between 2001 and 2017; Missouri and South Carolina, which lowered the age for handgun sales in 2007 and 2008, respectively; and West Virginia and Wyoming, which increased the age for handgun sales in 2010. PARTICIPANTS: Adolescents aged 13 to 20 years(554 461 961 from 2001 to 2017) in the regression discontinuity analysis, and adolescents aged 18 to 20 years (168 934 041 from 2002 to 2014) in the main difference-in-differences analysis. MAIN OUTCOME MEASURE: Suicide rate per 100 000 adolescents. RESULTS: In the regression discontinuity analysis, state policies that limited the sale of handguns to those aged 18 or older (relative to 21 or older) were associated with an increase in suicide rate among adolescents aged 18 to 20 years equivalent to 344 additional suicides in each state where they were in place between 2001 and 2017. In the difference-in-differences analysis, state policies that limited the sale of handguns to those aged 21 or older were associated with 1.91 fewer suicides per 100 000 adolescents aged 18 to 20 years (95% confidence interval -3.13 to -0.70, permutation adjusted P=0.025). In the difference-in-differences analysis, there were 1.83 fewer firearm related suicides per 100 000 adolescents (-2.66 to -1.00, permutation adjusted P=0.002), with no association between age 21 handgun sales policies and non-firearm related suicides. Separate event study estimates indicated increases in suicide rates in states that lowered the age of handgun sales, with no association in states that increased the age of handgun sales. CONCLUSIONS: A clear discontinuity was shown in the suicide rate by age at age 18 in states that limited the sale of handguns to individuals aged 18 or older. State policies to limit the sale of handguns to individuals aged 21 or older were associated with a reduction in suicide rates among adolescents. Increases in suicide rates were observed after states lowered the age of handgun sales, but no effect was found in states that increased the age of handgun sales.


Assuntos
Comércio/legislação & jurisprudência , Comportamento do Consumidor/economia , Armas de Fogo/legislação & jurisprudência , Suicídio/estatística & dados numéricos , Adolescente , Fatores Etários , Comércio/tendências , Comportamento do Consumidor/estatística & dados numéricos , Estudos de Avaliação como Assunto , Armas de Fogo/economia , Humanos , Missouri/epidemiologia , Políticas , Análise de Regressão , South Carolina/epidemiologia , Suicídio/etnologia , West Virginia/epidemiologia , Wyoming/epidemiologia , Adulto Jovem
12.
J Dent Hyg ; 94(3): 48-55, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32554415

RESUMO

Purpose: Many school-aged children have not received dental care in West Virginia, despite mandated statewide requirements of a dental evaluation and dental treatment before entering school, and the provision of Medicaid/CHIP insurance coverage for children from families below the federal poverty level. An innovative mobile oral health program to educate children, provide preventive care, and bring technology to public schools was developed for West Virginia children in a need shortage area. It was unknown if the unmet dental needs challenge was greater for male or female children residing in that area. The purpose of this study was to determine whether there was a difference by sex in the number of attendees and the incidence of dental caries for children who visited a school-based mobile dental facility.Methods: School-aged children who had not had a dental examination within the previous year were offered school-based examinations/assessments, preventive care, and oral health education via a mobile oral health program following parental/guardian consent. Data were collected concerning the number of current carious teeth in need of restoration. Descriptive statistics and chi square analyses were conducted to analyze the data.Results: There were 429 students evaluated at the school-based mobile dental facility. Half (50.3%) were male. Referrals for additional necessary oral/medical care were made for 214 (50.1%) children; 45.9% of males and 53.3% of females (p= 0.287) had dental caries.Conclusion: Results from this study indicate that sex was not a statistically significant factor in school-based mobile dental facility attendance nor in current dental caries incidence among school-aged children in an underserved area of West Virginia.


Assuntos
Cárie Dentária , Criança , Assistência Odontológica , Instituições Odontológicas , Feminino , Humanos , Masculino , Saúde Bucal , West Virginia
13.
South Med J ; 113(5): 250-253, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358620

RESUMO

OBJECTIVES: This study describes the clinical problems and psychiatric diagnoses of college students who sought services at a student counseling clinic and were subsequently referred for evaluation by a psychiatrist. Several important psychiatric problems present before leaving for college that could mandate the selection of a college with psychiatric services at the university or nearby community. This study confirms the importance of having psychiatric consultation available in addition to the range of counseling services found in a campus mental health clinic. METHODS: We conducted a retrospective chart review of 150 patients who were referred for psychiatric care from an on-campus mental health clinic at an Appalachian university (Marshall University). Demographic and clinical data were collected, entered into SPSS version 24, and analyzed. RESULTS: The most common diagnosis was that of a depressive disorder (76.7%). The next most common was an anxiety disorder (60.7%). In addition, 43.3% of students had suicidal ideation within 1 month preceding their appointment with the psychiatrist, 24% had attempted suicide at least once in their life, and 36% had a history of nonsuicidal self-harm. Almost 81% had prior psychiatric diagnoses, and of those, 22% had a history of inpatient psychiatric care. CONCLUSIONS: These results indicate that this student sample referred for psychiatric treatment has significant psychiatric illness. Our findings also confirm the need for the availability of psychiatric consultation as a part of college mental health services. Those students most in need of psychiatric consultation had almost all received psychiatric treatment and almost half had suicidal ideation in the month preceding the appointment with the psychiatrist. The specific problems that may lead a student applying to college to take into consideration the availability of psychiatric services include a previous psychiatric hospitalization, previous suicidal ideation that had already come to the attention of a mental health professional, or a previous diagnosis of depressive disorder or anxiety disorder.


Assuntos
Transtornos Mentais/epidemiologia , Serviços de Saúde Mental , Psiquiatria , Encaminhamento e Consulta , Serviços de Saúde para Estudantes , Estudantes , Adolescente , Adulto , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Aconselhamento , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Transtornos Mentais/psicologia , Estudos Retrospectivos , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , West Virginia , Adulto Jovem
14.
Environ Sci Pollut Res Int ; 27(23): 29464-29474, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32440881

RESUMO

Dissolved organic carbon (DOC) and iron (Fe) have been observed to be the important contributors to surface water brownification. Additionally, the DOC quality influences water color by forming Fe-DOC complexes that provide additive effects and is influenced by dominant land use type within watersheds. However, the influence of quantity and quality of DOC on Fe and water color is poorly understood in headwater streams. The aim of this study was to investigate the effects of DOC and Fe on water color in forest (FC) and pasture (GFC) fine-scale watersheds to remove the confounding effects of climate and soil parent material. Significant differences of DOC, Fe, and water absorbance at 420 nm (a420) between FC and GFC were found (p < 0.05). A dominant contribution to water color was from DOC (95.5 - 63.7%) with a decreasing trend when Fe increased from 0.011 to 0.258 mg L-1. There were no significant interactions between FC and GFC and Fe on either a420/DOC (p = 0.06) or specific ultraviolet absorbance at 254 nm (SUVA254) (p = 0.30). Increasing values of a420/DOC and SUVA254 were significantly associated with increasing Fe concentration (p < 0.01). Significant interactions were found between FC and GFC and Fe on spectral slope ratio (S ratio) (p < 0.01). The response rate of S ratio with increasing Fe per unit was 0.235 for GFC while it was - 11.043 for FC. These differences indicate that land use may change the quality of DOC, influence Fe-DOC interactions, and thus affect water color. Linking the effects of soil Fe and DOC and headwater Fe and DOC may help identify optimal management practice to mitigate surface water brownification.


Assuntos
Carbono/análise , Água , Região dos Apalaches , Florestas , Ferro , West Virginia
15.
Environ Sci Technol ; 54(12): 7175-7184, 2020 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-32458687

RESUMO

Perfluorooctanoic acid (PFOA) was used as a fluoropolymer manufacturing aid at a fluoropolymer production facility in Parkersburg, WV from 1951 to 2013. The manufacturer introduced a replacement surfactant hexafluoropropylene oxide dimer acid (HFPO-DA) that has been in use at this site since 2013. Historical releases of PFOA and related epidemiological work in this area has been primarily focused on communities downstream. To provide an update on the ongoing impacts from this plant, 94 surface water samples and 13 soil samples were collected mainly upstream and downwind of this facility. PFOA was detected in every surface water sample with concentrations exceeding 1000 ng/L at 13 sample sites within an 8 km radius of the plant. HFPO-DA was also found to be widespread with the highest levels (>100 ng/L) found in surface water up to 6.4 km north of the plant. One sample site, 28 km north of the plant, had PFOA at 143 ng/L and HFPO-DA at 42 ng/L. Sites adjacent to landfills containing fluorochemical waste had PFOA concentrations ranging up to >1000 ng/L. These data indicate that downwind atmospheric transport of both compounds has occurred and that the boundaries of the impact zone have yet to be fully delineated.


Assuntos
Fluorcarbonetos , Poluentes Químicos da Água , Caprilatos , Monitoramento Ambiental , Fluorcarbonetos/análise , Ohio , Óxidos , Solo , Água , Poluentes Químicos da Água/análise , West Virginia
16.
Environ Sci Process Impacts ; 22(5): 1224-1232, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32322852

RESUMO

While development of the Utica/Point Pleasant Shale (UPP) is extensive in Ohio (U.S.) and increasing in Pennsylvania and West Virginia, few studies report the chemistry of produced waters from UPP wells. These data have important implications for developing best management practices for handling and waste disposal, or identifying the fluid in the event of accidental spill events. Here, we evaluated the elemental and isotope chemistry of UPP produced waters from 26 wells throughout Ohio, Pennsylvania, and West Virginia to determine any unique fluid chemistries that could be used for forensic studies. Compared to the Marcellus, UPP produced waters contain higher activities of total radium (226Ra + 228Ra) and higher 228Ra/226Ra ratios. As with the Marcellus Shale, elemental ratios (Sr/Ca) and isotope ratios (87Sr/86Sr) can distinguish UPP produced waters from many conventional oil and gas formations. Sr/Ca and 87Sr/86Sr ratios can fingerprint small fractions (∼0.1%) of UPP produced water in freshwater. However, because Marcellus and UPP produced waters display similar major elemental chemistry (i.e., Na, Ca, and Cl) and overlapping ratios of Sr/Ca and 87Sr/86Sr, 228Ra/226Ra ratios may be the best tracer to distinguish these waters.


Assuntos
Isótopos , Poluentes Químicos da Água , Região dos Apalaches , Gás Natural , Ohio , Campos de Petróleo e Gás , Pennsylvania , Águas Residuárias , West Virginia
20.
South Med J ; 113(3): 140-145, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32123930

RESUMO

OBJECTIVES: To explore temporal trends and geographic variations in mortality from prescription opioids from 1999 to 2016. METHODS: Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death files were used to calculate age-adjusted rates and 95% confidence intervals (CIs) and create spatial cluster maps. RESULTS: From 1999 to 2016, counties in West Virginia experienced the highest overall mortality rates in the United States from prescription opioids. Specifically, from 1999 to 2004, the highest rate in West Virginia of 24.87/100,000 (95% CI 17.84-33.73) was the fourth highest in the United States. From 2005 to 2009, West Virginia experienced the highest rate in the United States, 60.72/100,000 (95% CI 47.33-76.71). From 2010 to 2016, West Virginia also experienced the highest rate in the United States, which was 90.24/100,000 (95% CI 73.11-107.36). As such, overall, West Virginia experienced the highest rates in the United States and the largest increases overall of ~3.6-fold between 1999 and 2004 and 2010 and 2016. From 1999 to 2004, Florida had no "hot spots," but from 2006 to 2010 they did appear, and from 2011 to 2016, they disappeared. CONCLUSIONS: These data show markedly divergent temporal trends and geographic variations in mortality rates from prescription opioids, especially in the southern United States. Specifically, although initial rates were high and continued to increase alarmingly in West Virginia, they increased but then decreased in Florida. These descriptive data generate hypotheses requiring testing in analytic epidemiological studies. Understanding the divergent patterns of prescription opioid-related deaths, especially in West Virginia and Florida, may have important clinical and policy implications.


Assuntos
Analgésicos Opioides/efeitos adversos , Mapeamento Geográfico , Mortalidade/tendências , Transtornos Relacionados ao Uso de Opioides/mortalidade , Fatores de Tempo , Adulto , Analgésicos Opioides/uso terapêutico , Florida/epidemiologia , Humanos , Transtornos Relacionados ao Uso de Opioides/epidemiologia , West Virginia/epidemiologia
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