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This article demonstrates the benefits of the Continuous Commissioning® process at a high school in Austin. The case study school was built in 2000. The HVAC system is operated by a full DDC system. The building continuous commissioning was started in August, 2005. All of the primary energy operation systems in the building were investigated to determine their current conditions and operations. The identified CC® measures for chiller, boiler, and AHU were implemented by Bes-Tech engineers. Utility bills before CC® were used to create baseline models of energy use. The accumulated savings is $41,916 from November, 2005, to November, 2006. On an annual base, the total cost savings is $38,691/yr, which represents 9.5 percent of baseline energy costs. [ABSTRACT FROM AUTHOR]

In the present study we used a mixed-method design to examine perceptions of legal status and their association with psychosocial experiences among undocumented Latino/a immigrants in the United States Participants were asked to compare their perceived social experiences with those of documented Latinos/as in order to determine whether differences in such perceptions might emerge and whether such perceptions might differentially impact well-being. A community sample of 140 self-reported undocumented Latino/a immigrants completed questionnaires measuring perceptions of legal status, well-being (global and psychological), perceived context of reception, and experiences of discrimination. Results indicated that individuals who perceived their experiences as different from those of documented Latinos/as due to an unauthorized legal status reported less social equality as evidenced by lower well-being, increased experiences of discrimination, and a more adverse context of reception. Moreover, individuals who perceived their social experiences as different from those of documented Latinos/as due to their legal status reported issues centering on 2 domains: limited opportunity/restricted social mobility and discrimination/unfair treatment. Theoretical and practical implications are discussed in terms of advancing theory and from a multicultural counseling perspective. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Background & Aims: We aimed to identify new serum biomarkers of esophageal adenocarcinoma (EAC)., Methods: We performed metabolomic analyses of serum samples from 2 sets of case-control pairs in the discovery phase, each consisting of 30 patients with histologically confirmed EAC (cases) from the University of Texas MD Anderson Cancer Center and 30 matched subjects without EAC (controls). We identified metabolites whose levels differed significantly between cases and controls and validated those with the greatest difference in an analysis of 321 EAC cases and 331 controls. We generated a metabolite risk score (MRS) for the metabolites., Results: The levels of 64 metabolites differed significantly between EAC cases and controls in the discovery phase. The metabolites with the greatest difference were amino acid L-proline (LP), ketone body 3-hydroxybutyrate (BHBA), and carbohydrate D-mannose (DM); these differences were confirmed in the validation set. Cases had lower mean levels of LP than controls (22.78 ± 6.79 μg/mL vs 28.24 ± 8.64 μg/mL; P < .001) and higher levels of BHBA (18.06 ± 17.84 μg/mL vs 7.73 ± 9.92 μg/mL; P < .001) and DM (9.87 ± 4.28 μg/mL vs 6.28 ± 3.61 μg/mL; P < .001). Levels of DM were significantly higher in patients with late-stage EAC than early-stage EAC (10.61 ± 4.79 μg/mL vs 8.97 ± 3.36 μg/mL; P = .005). Higher levels of LP were associated with significant decrease in risk of EAC (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.18-0.38). A significant increase in risk of EAC was associated with higher levels of BHBA (OR, 4.05; 95% CI, 2.84-5.78) and DM (OR, 7.04; 95% CI, 4.79-10.34). Levels of all 3 metabolites associated with EAC risk in a dose response manner; the level of risk conferred by the metabolites increased jointly with smoking status and body mass index. Individuals with high MRS had significant (7.76-fold) increase in risk of EAC vs those with low MRS. Smokers with high MRS had the greatest risk of EAC (OR, 23.40; 95% CI, 10.95-50.00), compared with never smokers with low MRS., Conclusions: On the basis of a case vs control metabolic profile analysis, levels of LP, BHBA, and DM are associated with risk of EAC. These markers might be used as risk and prognostic factors for patients with EAC., (Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Background: Readmissions in patients with chronic obstructive pulmonary disease (COPD) are common and costly. We examined the effect of early follow-up visit with patient's primary care physician (PCP) or pulmonologist following acute hospitalization on the 30-day risk of an emergency department (ER) visit and readmission., Methods: We conducted a retrospective cohort study of fee-for-service Medicare beneficiaries with an identifiable PCP who were hospitalized for COPD between 1996 and 2006. Three or more visits to a PCP in the year prior to the hospitalization established a PCP for a patient. We performed a Cox proportional hazard regression with time-dependent covariates to determine the risk of 30-day ER visit and readmission in patients with or without a follow-up visit to their PCP or pulmonologist., Results: Of the 62 746 patients admitted for COPD, 66.9% had a follow-up visit with their PCP or pulmonologist within 30 days of discharge. Factors associated with lower likelihood of outpatient follow-up visit were longer length of hospital stay, prior hospitalization for COPD, older age, black race, lower socioeconomic status, and emergency admission. Those receiving care at nonteaching, for-profit, and smaller-sized hospitals were more likely to have a follow-up visit. In a multivariate, time-dependent analysis, patients who had a follow-up visit had a significantly reduced risk of an ER visit (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.83-0.90) and readmission (HR, 0.91; 95% CI, 0.87-0.96)., Conclusion: Continuity with patient's PCP or pulmonologist after an acute hospitalization may lower rates of ER visits and readmission in patients with COPD.