Injury Severity Score alone predicts mortality when compared to EMS scene time and transport time for motor vehicle trauma patients who arrive alive to hospital

ABSTRACT

Objective: This study aims to identify the association, if any, between prehospital scene time, prehospital transport time, and Injury Severity Score (ISS) with in-hospital mortality.

Methods: A retrospective analysis was performed on patients at least 18 years of age who arrived to the hospital alive via emergency medical services (EMS) after a motor vehicle collision (MVC) between 1992 and 2016. These patients were divided into groups based on minutes spent at the scene and in transport. The ISS of the in-hospital mortalities, as well as the entire patient sample for each time frame, was collected. Patients without documented scene time, transport time, or ISS were excluded.

Results: Four thousand one hundred ninety-four patients were captured when analyzing scene time, though only 3,980 met inclusion criteria. In addition, 4,177 patients were captured when analyzing transport time, though only 3,979 met inclusion criteria. Scene time and transport time were not statistically significant predictors of in-hospital mortality (P = .31 and P = .458, respectively). ISS was found to be a statistically significant predictor of in-hospital mortality (P < .001).

Conclusions: ISS predicts mortality independent of scene time or transport time for patients who arrive to the hospital alive following an MVC at Guthrie Robert Packer Hospital. Limitations of our study include inability to capture prehospital deaths and inability to correlate ISS with prehospital injury severity scores.     

A Wind Tunnel Study to Design Large,Open-top Chambers for Whole-tree Pollutant Exposure Experiments

A wind tunnel study was conducted to determine the optimal design features of a large, open-top chamber, as needed for pollution exposure studies on mature trees. An optimally-designed, open-top chamber must minimize the incursion of ambient air through its opening and maintain a uniform treatment concentration throughout the chamber. The design features of interest are the diameter and height of the chamber and the deflection angle and opening size of any frustum that may be mounted on top of a model chamber.

Design specifications depend on the turbulence regime about the chamber, which is influenced by the nature of the surrounding vegetation. Consequently, our investigation was performed on scale-model, open-top chambers in a wind tunnel populated with a model coniferous forest. Turbulence measurements demonstrated the similarity between the turbulence regime of the model and a natural forest. A hydrocarbon tracer was injected into the wind tunnel flow to characterize chamber performance.

The main design features of open-top chambers are the velocity of air exiting through the top and the relationship between the length scale of the turbulence and the diameter of the chamber opening. As exit velocities increase, the proportion of eddies with sufficient force to penetrate into the chamber decrease. Therefore, for equal volumetric air flows, smaller opening sizes increase the exit velocities and reduce the number and extent of ambient air incursions. Almost total exclusion of ambient air is achieved as the exit velocity of the air exceeds the magnitude of one standard deviation of the vertical wind velocity measured at the chamber top. The incursion of ambient air is also reduced when the diameter of the chamber opening is smaller than the characteristic length scale of the turbulence, a measure of mean eddy size.

Frusta deflect air flow over the chamber. Three prototypes, with 30?, 45? and 60-degree angles were tested. A 30-degree frustum slightly improves the performance of the chamber and is more effective in preventing ambient air from entraining into the chamber opening than frusta with either a 45? or 60-degree angle. A flatter frustum allows for a smoother transition in the wind velocity streamline and is less apt to cause wake turbulence, as is the case with steeper frusta.

Knowledge of the turbulence characteristics of plant canopies are readily available in the literature and can aid scientists and engineers in designing the optimal chamber and frusta dimensions for their particular application. Therefore, the empirical approach to chamber design can be avoided, and substantial savings can be realized.     

Spatial Variability of Different Fractions of Particulate Matter within an Urban Environment and between Urban and Rural Sites

ABSTRACT

The spatial variability of different fractions of particulate matter (PM) was investigated in the city of Basel, Switzerland, based on measurements performed throughout 1997 with a mobile monitoring station at six sites and permanently recorded measurements from a fixed site. Additionally, PM₁₀ measurements from the following year, which were concurrently recorded at two urban and two rural sites, were compared.

Generally, the spatial variability of PM₄, PM₁₀, and total suspended particulates (TSP) within this Swiss urban environment (area = 36 km²) was rather limited. With the exception of one site in a street canyon next to a traffic light, traffic density had only a weak tendency to increase the levels of PM. Mean PM₁₀ concentration at six sites with different traffic densities was in the range of less than ±10% of the mean urban PM₁₀ level. However, comparing the mean PM levels on workdays to that on weekends indicated that the impact of human activities, including traffic, on ambient PM levels may be considerable.

Differences in the daily PM₁₀ concentrations between urban and more elevated rural sites were strongly influenced by the stability of the atmosphere. In summer, when no persistent surface inversions exist, differences between urban and rural sites were rather small. It can therefore be concluded that spatial variability of annual mean PM concentration between urban and rural sites in the Basel area may more likely be caused by varying altitude than by distance to the city center.     

Strong links between metal contamination, habitat modification and estuarine larval fish distributions

Changes to larval fish assemblages may have far reaching ecological impacts. Correlations between habitat modification, contamination and marine larval fish communities have rarely been assessed in situ. We investigated links between the large-scale distribution of stressors and larval fish assemblages in estuarine environments. Larval fish communities were sampled using a benthic sled within the inner and outer zones of three heavily modified and three relatively unmodified estuaries. Larval abundances were significantly greater in modified estuaries, and there were trends towards greater diversity in these systems. Differences in larval community composition were strongly related to sediment metal levels and reduced seagrass cover. The differences observed were driven by two abundant species, Paedogobius kimurai and Ambassis jacksoniensis, which occurred in large numbers almost exclusively in highly contaminated and pristine locations respectively. These findings suggest that contamination and habitat alteration manifest in substantial differences in the composition of estuarine larval fish assemblages.     

Quantifying dry NH3 deposition to an ombrotrophic bog from an automated NH3 field release system

Providing an accurate estimate of the dry component of N deposition to low N background, semi-natural habitats, such as bogs and upland moors dominated by Calluna vulgaris is difficult, but essential to relate nitrogen deposition to effects in these communities. To quantify the effects of NH₃ inputs to moorland vegetation growing on a bog at a field scale, a field release NH₃ fumigation system was established at Whim Moss (Scottish Borders) in 2002. Gaseous NH₃ from a line source was released along of a 60 m transect, when meteorological conditions (wind speed >2.5 m s^–1 and wind direction in the sector 180–215°) were met, thereby providing a profile of decreasing NH₃ concentration with distance from the source. In a complementary study, using a NH₃ flux chamber system, the relationships between NH₃ concentrations and cuticular resistances were quantified for a range of NH₃ concentrations and micrometeorological conditions for moorland vegetation. Cuticular resistances increased with NH₃ concentration from 11 s m^–1 at 3.0 g m^–3 to 30 s m^–1 at 30 g m^–3. The NH₃ concentration data and the concentration-dependent canopy resistance are used to calculate NH₃ deposition taking into account leaf surface wetness. The implications of using an NH₃ concentration-dependent cuticular resistance and the importance for refining critical loads are discussed.     

ON‐FARM WATER CONSERVATION PRACTICES IN SOUTHERN ALBERTA1

ABSTRACT: In southern Alberta, as elsewhere, pressures on limited water supplies are increasing. Not surprisingly, a great deal of attention has been focused on irrigated agriculture, which accounts for the largest share of water consumed in the region. In order to meet broadly accepted water conservation goals, some commentators have suggested that irrigation water use should be metered and that irrigators should be charged based on the amount of water used. An alternative proposal would have water management authorities rely upon the perceived adaptability of irrigators. This paper offers a perspective on the willingness of irrigators to conserve water. Based on a survey of 183 irrigation farmers conducted over the summer and early fall of 1998, we found that irrigators are generally aware of the need to conserve water and soil moisture, and that a variety of water conserving strategies were being employed. Water saving technologies specific to irrigation agriculture were less widely adopted. The findings suggest that there is considerable potential to reduce the amount of water consumed by the irrigation sector through increased efficiency, but that change will be limited if current economic circumstances and institutional arrangements persist.     

Integrated Measures of Anthropogenic Stress in the U.S. Great Lakes Basin

Integrated, quantitative expressions of anthropogenic stress over large geographic regions can be valuable tools in environmental research and management. Despite the fundamental appeal of a regional approach, development of regional stress measures remains one of the most important current challenges in environmental science. Using publicly available, pre-existing spatial datasets, we developed a geographic information system database of 86 variables related to five classes of anthropogenic stress in the U.S. Great Lakes basin: agriculture, atmospheric deposition, human population, land cover, and point source pollution. The original variables were quantified by a variety of data types over a broad range of spatial and classification resolutions. We summarized the original data for 762 watershed-based units that comprise the U.S. portion of the basin and then used principal components analysis to develop overall stress measures within each stress category. We developed a cumulative stress index by combining the first principal component from each of the five stress categories. Maps of the stress measures illustrate strong spatial patterns across the basin, with the greatest amount of stress occurring on the western shore of Lake Michigan, southwest Lake Erie, and southeastern Lake Ontario. We found strong relationships between the stress measures and characteristics of bird communities, fish communities, and water chemistry measurements from the coastal region. The stress measures are taken to represent the major threats to coastal ecosystems in the U.S. Great Lakes. Such regional-scale efforts are critical for understanding relationships between human disturbance and ecosystem response, and can be used to guide environmental decision-making at both regional and local scales.     

A biomonitor as a measure of an ecologically-significant fraction of metals in an industrialized harbour

Biomonitors are commonly used to assess levels of bioavailable contaminants in the environment, however the relationships between biomonitor tissue concentrations and ecological effects are rarely assessed. The present study investigated metal contamination within a highly industrialised harbour and ecological effects on sessile invertebrates. The native oyster Saccostrea glomerata was deployed as a biomonitor across twenty-six sites to test for correlations between metal levels in their tissues and the recruitment of hard-substrate invertebrates. Concentrations of lead and copper in oyster tissues were negatively correlated with densities of the dominant barnacle, Amphibalanus variegatus, and positively correlated with densities of the dominant polychaete, Hydroides elegans, and the two native encrusting bryozoans Celloporaria nodulosa and Arachnopusia unicornis. Results suggest that highly localised events drive contaminant availability and that these events pose a significant risk to fauna. Biomonitoring studies may be enhanced by running concurrent ecological surveys.