Developing early warning systems to predict water lead levels in tap water for private systems.

Lead is a chemical contaminant that threatens public health, and high levels of lead have been identified in drinking water at locations across the globe. Under-served populations that use private systems for drinking water supplies may be at an elevated level of risk because utilities and governing agencies are not responsible for ensuring that lead levels meet the Lead and Copper Rule at these systems. Predictive models that can be used by residents to assess water quality threats in their households can create awareness of water lead levels (WLLs).

Compatibility of the Drawover Vaporizer With Military Field Ventilators.

For far-forward resuscitative care for combat trauma casualties, the field anesthesia machine best suited is the Universal Portable Anesthesia Complete (UPAC, Datex Ohmeda, GE Healthcare). However, no provision was made for mechanical ventilation. Historically the Impact Uni-Vent 754 ventilator (Impact Instrumentation, Zoll Medical Corp) was used to provide hands-free ventilation but has limitations.

Developing a framework for classifying water lead levels at private drinking water systems: A Bayesian Belief Network approach.

The presence of lead in drinking water creates a public health crisis, as lead causes neurological damage at low levels of exposure. The objective of this research is to explore modeling approaches to predict the risk of lead at private drinking water systems. This research uses Bayesian Network approaches to explore interactions among household characteristics, geological parameters, observations of tap water, and laboratory tests of water quality parameters.

Effectiveness of transcutaneous electrical nerve stimulation for postoperative pain control in adult surgical patients: an umbrella review protocol.

Objective: The objective of this review is to evaluate the effectiveness of transcutaneous electrical nerve stimulators for postoperative pain in comparison to current opioid-centric standard of care in adult surgical patients.

Introduction: In recent years, opioid pain medications have presented two major problems: national shortages triggering a pain management crisis and an increase in opioid related deaths. Opioids also have a variety of untoward side effects, complicating pain management in postoperative individuals.

Risk-based decision making to evaluate pollutant reduction scenarios.

A total maximum daily load (TMDL) is required for water bodies in the U.S. that do not meet applicable water quality standards.

Effectiveness of non-opioid pharmacological adjuncts for adult surgical patients: an umbrella review protocol.

Objective: The objective of this review is to determine the effectiveness of non-opioid pharmacological adjuncts for decreasing perioperative morphine equivalents and acute postoperative pain scores in adult surgical patients.

Introduction: Opioids are commonly administered during anesthesia to dull the senses, relieve pain and induce sleep. However, there are significant adverse effects associated with intraoperative opioid use.

Scale-dependent impacts of urban and agricultural land use on nutrients, sediment, and runoff.

We coupled a spatially-explicit land use/land cover (LULC) change model, Dinamica EGO, (Environment for Geoprocessing Objects), with the Chesapeake Bay Watershed Model (CBWM) to project the impact of future LULC change on loading of total nitrogen (TN), total phosphorous (TP) and total suspended solids (TSS) as well as runoff volume in the watersheds surrounding Virginia's Shenandoah National Park in the eastern United States. We allowed for the dynamic transition of four LULC classes, Developed, Forest, Grasses (including both pasture and hayfields) and Crops. Using 2011 as a baseline scenario and observed differences in LULC between 2001 and 2011, we estimated the temporal and spatial patterns of LULC change as influenced by physiographic and socio-economic drivers 50 years in the future (2061).

Evaluating Geologic Sources of Arsenic in Well Water in Virginia (USA).

We investigated if geologic factors are linked to elevated arsenic (As) concentrations above 5 μg/L in well water in the state of Virginia, USA. Using geologic unit data mapped within GIS and two datasets of measured As concentrations in well water (one from public wells, the other from private wells), we evaluated occurrences of elevated As (above 5 μg/L) based on geologic unit. We also constructed a logistic regression model to examine statistical relationships between elevated As and geologic units.

Effects of humerus intraosseous versus intravenous amiodarone administration in a hypovolemic porcine model.

Objective: To compare the effects of amiodarone administration by humerus intraosseous (HIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to maximum concentration (Tmax), maximum plasma drug concentration (Cmax), time to ROSC, and mean concentrations over time in a hypovolemic cardiac arrest model.

Design: Prospective, between subjects, randomized experimental design.

Setting: TriService Research Facility.

Tattoos and administration of regional anesthesia: a comprehensive systematic review protocol.

The review question is what is the impact of tattoos on the administration of regional anesthesia?The quantitative objective is to identify and quantify the risks to a patient when advancing a needle through tattooed skin for the purpose of administering a regional anesthetic.The qualitative objective is to investigate anesthesia providers' perceptions and experiences when presented with a patient and/or a surgeon requests for a regional anesthetic that would require needle trespass through tattooed skin. An additional qualitative objective is to identify the thoughts, opinions and biases related to the administration of a regional anesthetic through tattooed skin from the perspective of the patient, anesthesia provider, surgeon or other affected parties (e.

The effectiveness of tools used to evaluate successful critical decision making skills for applicants to healthcare graduate educational programs: a systematic review.

Background: Students leave healthcare academic programs for a variety of reasons. When they attrite, it is disappointing for the student as well as their faculty. Advanced practice nursing and other healthcare professions require not only extensive academic preparation, but also the ability to critically evaluate patient care situations.

Profiling Private Water Systems to Identify Patterns of Waterborne Lead Exposure.

Although extensive literature documents corrosion in municipal water systems, only minimal data is available describing corrosion in private water systems (e.g., wells), which serve as a primary source of drinking water for approximately 47 million Americans.

Incidence of waterborne lead in private drinking water systems in Virginia.

Although recent studies suggest contamination by bacteria and nitrate in private drinking water systems is of increasing concern, data describing contaminants associated with the corrosion of onsite plumbing are scarce. This study reports on the analysis of 2,146 samples submitted by private system homeowners. Almost 20% of first draw samples submitted contained lead concentrations above the United States Environmental Protection Agency action level of 15 μg/L, suggesting that corrosion may be a significant public health problem.

Enhanced nitrate and phosphate removal in a denitrifying bioreactor with biochar.

Denitrifying bioreactors (DNBRs) are an emerging technology used to remove nitrate-nitrogen (NO) from enriched waters by supporting denitrifying microorganisms with organic carbon in an anaerobic environment. Field-scale investigations have established successful removal of NO from agricultural drainage, but the potential for DNBRs to remediate excess phosphorus (P) exported from agricultural systems has not been addressed. We hypothesized that biochar addition to traditional woodchip DNBRs would enhance NO and P removal and reduce nitrous oxide (NO) emissions based on previous research demonstrating reduced leaching of NO and P and lower greenhouse gas production associated with biochar amendment of agricultural soils.

Associations between fecal indicator bacteria prevalence and demographic data in private water supplies in Virginia.

Over 1.7 million Virginians rely on private water sources to provide household water. The heaviest reliance on these systems occurs in rural areas, which are often underserved with respect to available financial resources and access to environmental health education.

Development of total maximum daily loads for bacteria impaired watershed using the comprehensive hydrology and water quality simulation model.

The objective of this study was to develop bacteria total maximum daily loads (TMDLs) for the Hardware River watershed in the Commonwealth of Virginia, USA. The TMDL program is an integrated watershed management approach required by the Clean Water Act. The TMDLs were developed to meet Virginia's water quality standard for bacteria at the time, which stated that the calendar-month geometric mean concentration of Escherichia coli should not exceed 126 cfu/100 mL, and that no single sample should exceed a concentration of 235 cfu/100 mL.

Quantitative analysis of microbial contamination in private drinking water supply systems.

Over one million households rely on private water supplies (e.g. well, spring, cistern) in the Commonwealth of Virginia, USA.

Modeling and assessing the impact of reclaimed wastewater irrigation on the nutrient loads from an agricultural watershed containing rice paddy fields.

Two models were used in concert to predict nutrient loads in a waterbody receiving irrigation return flows from a rice paddy production system. Two irrigation scenarios were simulated, one using reclaimed wastewater as the irrigation water source, the other using water from a surface reservoir designed to supply irrigation water. Total nitrogen (TN) and total phosphorus (TP) loads in irrigation return flows from the rice paddy fields were simulated using the field-scale water quality model Chemical, Runoff and Erosion from Agricultural Management System model for rice paddy fields (CREAMS-PADDY).

Development of bacteria and benthic total maximum daily loads: a case study, Linville Creek, Virginia.

Two total maximum daily load (TMDL) studies were performed for Linville Creek in Rockingham County, Virginia, to address bacterial and benthic impairments. The TMDL program is an integrated watershed management approach required by the Clean Water Act. This paper describes the procedures used by the Center for TMDL and Watershed Studies at Virginia Tech to develop the Linville Creek TMDLs and discusses the key lessons learned from and the ramifications of the procedures used in these and other similar TMDL studies.