Spatial and temporal characteristics of ambient atmospheric hydrocarbons in an active shale gas region in North Texas.

Over the past decade, significant development in shale gas extraction technologies has led to a massive increase in oil and gas production within the Barnett Shale region in North Texas. This region abuts a fast-growing Dallas-Fort Worth urban area with increasing air quality concerns. Air quality information for 2011-2015 from two urban and three non-urban monitoring sites within the Barnett Shale region were analyzed to identify the spatial and temporal trends of volatile organic compounds (VOC) concentrations. The non-urban sites had higher mean concentrations of total non-methane organic compounds (TNMOC) at 123.6 ppb-C than 77.06 ppb-C at the urban sites. Alkanes, which includes ethane, propane and n-butane, were the dominant VOC group at all five monitoring sites, with 88% of TNMOC at urban sites and 95% at the non-urban sites. Alkenes, alkynes and aromatics composition at urban sites accounted for 3.96%, 0.72% and 4.72% of TNMOC, and at the non-urban sites these were 1.55%, 0.43% and 1.94%, respectively. Seasonal variations were noted in the VOC profiles with high concentrations during the winter months and low during summer months. The alkane/TNMOC ratio also showed a similar seasonal pattern, with a median value of 0.8 at the urban sites and 0.9 at non-urban sites. Alkene/TNMOC ratios were highest during the summer months, while alkyne/TNMOC ratios were highest during spring and low in winter, due to the influence of localized urban emissions. Higher concentrations of isoprene were measured at one of the urban sites as a result of biogenic emissions from nearby urban forests. Spatial and temporal analysis of measured VOC concentrations at ambient air monitoring stations in North Texas revealed strong influence of source regions with high oil and gas activities in close proximity.

Disseminated cerebral toxoplasmosis in a patient with chronic lymphocytic leukemia.

Infections are one of the most common causes of mortality in immunocompromised patients. In patients diagnosed with hematologic malignancies, treatment with stem cell transplants (SCT) or T-cell suppressing chemotherapy increases the risk of central nervous system (CNS) infections, of which toxoplasmosis is the most common. We report the case of a 63 year-old woman with chronic lymphocytic leukemia (CLL) that presented with gait instability and visual changes. Intracranial lesions were noted on initial neuro-imaging. A rapid decline in the patient's mental status warranted an urgent biopsy of the lesions that revealed tachyzoites consistent with toxoplasmosis. In the presence of diffuse brain lesions that lack a metastatic pattern or contrast enhancement, a common approach is to perform biopsy only after a battery of non-invasive testing. This diagnostic delay may take several days, exposing the patient to a rapidly fatal infection. This report illustrates the utility of early brain biopsy in high-risk patients with hematologic malignancies and CNS lesions.

Hemifacial spasm due to vertebrobasilar dolichoectasia: a case report.

Hemifacial spasm (HFS) happens because of vascular compression of the facial nerve at the root exit zone. Vertebrobasilar dolichoectasia (VBD) is a very rare cause of HFS. VBD is diagnosed by computed tomography angiography and magnetic resonance imaging. Here, we report a case of 65-year-old female patient with HFS due to VBD. We discuss the complications and the treatment options for the case.

Statistical evaluation of the impact of shale gas activities on ozone pollution in North Texas.

Over the past decade, substantial growth in shale gas exploration and production across the US has changed the country's energy outlook. Beyond its economic benefits, the negative impacts of shale gas development on air and water are less well known. In this study the relationship between shale gas activities and ground-level ozone pollution was statistically evaluated. The Dallas-Fort Worth (DFW) area in north-central Texas was selected as the study region. The Barnett Shale, which is one the most productive and fastest growing shale gas fields in the US, is located in the western half of DFW. Hourly meteorological and ozone data were acquired for fourteen years from monitoring stations established and operated by the Texas Commission on Environmental Quality (TCEQ). The area was divided into two regions, the shale gas region (SGR) and the non-shale gas (NSGR) region, according to the number of gas wells in close proximity to each monitoring site. The study period was also divided into 2000-2006 and 2007-2013 because the western half of DFW has experienced significant growth in shale gas activities since 2007. An evaluation of the raw ozone data showed that, while the overall trend in the ozone concentration was down over the entire region, the monitoring sites in the NSGR showed an additional reduction of 4% in the annual number of ozone exceedance days than those in the SGR. Directional analysis of ozone showed that the winds blowing from areas with high shale gas activities contributed to higher ozone downwind. KZ-filtering method and linear regression techniques were used to remove the effects of meteorological variations on ozone and to construct long-term and short-term meteorologically adjusted (M.A.) ozone time series. The mean value of all M.A. ozone components was 8% higher in the sites located within the SGR than in the NSGR. These findings may be useful for understanding the overall impact of shale gas activities on the local and regional ozone pollution.

Resolution of Crohn's disease and complex regional pain syndrome following treatment of paratuberculosis.

A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis (MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP IgG in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans.

Spinal subdural abscess following epidural steroid injection.

The authors report the case of a 58-year-old man who presented with a cervicothoracolumbosacral spinal subdural abscess about a month after receiving an epidural steroid injection for management of low-back pain due to L5-S1 disc herniation. Although he presented with symptoms concerning for a spinal etiology, the subdural empyema was not evident on the initial MRI study and was observed on imaging 5 days later. This patient was successfully managed with surgical intervention and antibiotic treatment, and he is doing well more than 21 months after the operation. It is possible that a prior history of disc herniation or other spinal abnormality may increase a patient's risk of developing spinal subdural empyema. This case illustrates the risk of infection following spinal epidural steroid injections and the importance of early recognition and intervention to successfully treat an extensive subdural abscess.

Roadside measurements of ultrafine particles at a busy urban intersection.

A field sampling campaign on ultrafine particles (UFPs, diameter <100 nm) was conducted at a busy traffic intersection from December 2006 to June 2007 in Corpus Christi, TX. This traffic intersection consisted of South Padre Island Drive (SPID, Highway 358) and Staples Street. Traffic densities on SPID were 9102/hr and 7880/hr for weekdays and weekends, respectively. Staples Street traffic densities were 2795/hr and 2572/hr, respectively. There were approximately 3.7% heavy-duty diesel vehicles (HDDVs) on both roadways. Peak traffic flows occurred early in the morning and late in the evening during weekdays and around noon on weekends. The average UFP total number concentration collected by a condensation particle counter (CPC 3785; TSI) was 66 x 10(3) cm(-3). A direct relationship between the UFP number concentration and traffic density was observed, but the HDDV traffic density was found to be a better estimator of the UFP number concentration than total traffic density. A scanning mobility particle sizer (SMPS 3936 with DMA 3081 and CPC 3785, TSI) measuring the particle size distribution from 7 to 290 nm was rotated among four corners of the intersection. The upwind and downwind size distributions were both bimodal in shape, exhibiting a nucleation mode at 10-30 nm and a secondary mode at 50-70 nm. The highest and lowest particle concentrations were observed on the downwind and upwind sides of both roadways, respectively, indicating the importance of wind direction. Wind speed also played an important role in overall particle concentrations; UFP concentrations were inversely proportional to wind speed. A negative correlation was observed between particle number concentrations and ambient temperature. The particle number concentration was 3.5 times greater when traffic was idling at a red light than moving at a green light.

Source characterization of volatile organic compounds affecting the air quality in a coastal urban area of South Texas.

Selected Volatile Organic Compounds (VOC) emitted from various anthropogenic sources including industries and motor vehicles act as primary precursors of ozone, while some VOC are classified as air toxic compounds. Significantly large VOC emission sources impact the air quality in Corpus Christi, Texas. This urban area is located in a semi-arid region of South Texas and is home to several large petrochemical refineries and industrial facilities along a busy ship-channel. The Texas Commission on Environmental Quality has setup two continuous ambient monitoring stations (CAMS 633 and 634) along the ship channel to monitor VOC concentrations in the urban atmosphere. The hourly concentrations of 46 VOC compounds were acquired from TCEQ for a comprehensive source apportionment study. The primary objective of this study was to identify and quantify the sources affecting the ambient air quality within this urban airshed. Principal Component Analysis/Absolute Principal Component Scores (PCA/APCS) was applied to the dataset. PCA identified five possible sources accounting for 69% of the total variance affecting the VOC levels measured at CAMS 633 and six possible sources affecting CAMS 634 accounting for 75% of the total variance. APCS identified natural gas emissions to be the major source contributor at CAMS 633 and it accounted for 70% of the measured VOC concentrations. The other major sources identified at CAMS 633 included flare emissions (12%), fugitive gasoline emissions (9%), refinery operations (7%), and vehicle exhaust (2%). At CAMS 634, natural gas sources were identified as the major source category contributing to 31% of the observed VOC. The other sources affecting this site included: refinery operations (24%), flare emissions (22%), secondary industrial processes (12%), fugitive gasoline emissions (8%) and vehicle exhaust (3%).

Characterization of fine particulate matter in Ohio: indoor, outdoor, and personal exposures.

Ambient, indoor, and personal PM2.5 concentrations were assessed based on an exhaustive study of PM2.5 performed in Ohio from 1999 to 2000. Locations in Columbus, one in an urban corridor and the other in a suburban area were involved. A third rural location in Athens, Ohio, was also established. At all three locations, elementary schools were utilized to determine outdoor, indoor, and personal PM2.5 concentrations for fourth and fifth grade students using filter-based measurements. Three groups of 30 students each were used for personal sampling at each school. Continuous ambient PM2.5 mass concentrations were also measured with tapered element oscillating microbalances (TEOMs). At all three sites, personal and indoor PM2.5 concentrations exceeded outdoor levels. This trend is consistent on all week days and most evident in the spring as compared to fall and winter. The ambient PM2.5 concentrations were similar among the three sites, suggesting the existence of a common regional source influence. At all the three sites, larger variations were found in personal and indoor PM2.5 than ambient levels. The strongest correlations were found between indoor and personal concentrations, indicating that personal PM2.5 exposures were significantly affected by indoor PM2.5 than by ambient PM2.5. This was further confirmed by the indoor to outdoor (I/O) ratios of PM2.5 concentrations, which were greater when school was in session than non-school days when the students were absent.

Brain death: a challenging diagnosis in trauma patients.

Brain death is a catastrophic consequence of trauma, and diagnosing it can be a challenging for physicians because it presents in numerous ways. Since existing recommendations are not applicable to all hospitals because of the requirement of special equipment and highly-trained personnel, a committee of health care professionals at Charleston Area Medical Center in Charleston decided to review the available literature and create a new set of protocols regarding brain death. This article summarizes the findings of the committee and provides recommendations for physicians working with trauma patients.

Analysis of trace elements and ions in ambient fine particulate matter at three elementary schools in Ohio.

The results from a chemical characterization study of fine particulate matter (PM2.5) measured at three elementary schools in Central and Southeast Ohio is presented here. PM2.5 aerosol samples were collected from outdoor monitors and indoor samplers at each monitoring location during the period of February 1, 1999, through August 31, 2000. The locations included a rural elementary school in Athens, OH, and two urban schools within Columbus, OH. The trace metal and ionic concentrations in the collected samples were analyzed using an X-ray fluorescence spectrophotometer and ion chromatography unit, respectively. Sulfate ion was found to be the largest component present in the samples at all three of the sites. Other abundant components included nitrate, chloride, ammonium, and sodium ions, as well as calcium, silicon, and iron. The average PM2.5 concentrations showed similar temporal variations among the three sites within the study region. PM2.5 and its major component, sulfate ion, showed strong seasonal variations with maximum concentrations observed during the summer at all three of the sites. The indoor environment was found to be more contaminated during the spring months (March through May) at New Albany (a suburb of Columbus, OH) and East Athens (rural Ohio area). Potential source contribution function analysis showed that particulate matter levels at the monitoring sites were affected by transport from adjoining urban areas and industrial complexes located along the Ohio River Valley. A preliminary outdoor source apportionment using the principal component analysis (PCA) technique was performed. The results from the PCA suggest that the study region was primarily impacted by industrial, fossil fuel combustion, and geological sources. The 2002 emissions inventory data for PM2.5 compiled by Ohio Environmental Protection Agency also showed impacts of similar source types, and this was used to validate the PCA analysis.

The regional nature of PM2.5 episodes in the upper Ohio River Valley.

From October 1999 through September 2000, particulate matter (PM) with aerodynamic diameter > or =2.5 microm (PM2.5) mass and composition were measured at the National Energy Technology Laboratory Pittsburgh site, with a particle concentrator Brigham Young University-organic sampling system and a tapered element oscillating microbalance (TEOM) monitor. PM2.5 measurements had also been obtained with TEOM monitors located in the Pittsburgh, PA, area, and at sites in Ohio, including Steubenville, Columbus, and Athens. The PM data from all these sites were analyzed on high PM days; PM2.5 TEOM particulate mass at all sites was generally associated with transitions from locally high barometric pressure to lower pressure. Elevated concentrations occurred with transport of PM from outside the local region in advance of frontal passages as the local pressure decreased. During high-pressure periods, concentrations at the study sites were generally low throughout the study region. Further details related to this transport were obtained from surface weather maps and estimated back-trajectories using the hybrid single-particle Lagrangian integrated trajectory model associated with these time periods. These analyses indicated that transport of pollutants to the Pittsburgh site was generally from the west to the southwest. These results suggest that the Ohio River Valley and possible regions beyond act as a significant source of PM and its precursors in the Pittsburgh area and at the other regional sites included in this study.