New Methodology for an Expert-Designed Map From International Classification of Diseases (ICD) to Abbreviated Injury Scale (AIS) 3+ Severity Injury

Objective: There has been a longstanding desire for a map to convert International Classification of Diseases (ICD) injury codes to Abbreviated Injury Scale (AIS) codes to reflect the severity of those diagnoses. The Association for the Advancement of Automotive Medicine (AAAM) was tasked by European Union representatives to create a categorical map classifying diagnoses codes as serious injury (Abbreviated Injury Scale [AIS] 3+), minor/moderate injury (AIS 1/2), or indeterminate. This study's objective was to map injury-related ICD-9-CM (clinical modification) and ICD-10-CM codes to these severity categories.

Methods: Approximately 19,000 ICD codes were mapped, including injuries from the following categories: amputations, blood vessel injury, burns, crushing injury, dislocations/sprains/strains, foreign body, fractures, internal organ, nerve/spinal cord injury, intracranial, laceration, open wounds, and superficial injury/contusion. Two parallel activities were completed to create the maps: (1) An in-person expert panel and (2) an electronic survey. The panel consisted of expert users of AIS and ICD from North America, the United Kingdom, and Australia. The panel met in person for 5 days, with follow-up virtual meetings to create and revise the maps. Additional qualitative data were documented to resolve potential discrepancies in mapping. The electronic survey was completed by 95 injury coding professionals from North America, Spain, Australia, and New Zealand over 12 weeks. ICD-to-AIS maps were created for: ICD-9-CM and ICD-10-CM. Both maps indicated whether the corresponding AIS 2005/Update 2008 severity score for each ICD code was AIS 3+, 1/2, or indeterminable. Though some ICD codes could be mapped to multiple AIS codes, the maximum severity of all potentially mapped injuries determined the final severity categorization.

Results: The in-person panel consisted of 13 experts, with 11 Certified AIS specialists (CAISS) with a median of 8 years and an average of 15 years of coding experience. Consensus was reached for AIS severity categorization for all injury-related ICD codes. There were 95 survey respondents, with a median of 8 years of injury coding experience. Approximately 15 survey responses were collected per ICD code. Results from the 2 activities were compared, and any discrepancies were resolved using additional qualitative and quantitative data from the in-person panel and survey results, respectively.

Conclusions: Robust maps of ICD-9-CM and ICD-10-CM injury codes to AIS severity categories (3+ versus <3) were successfully created from an in-person panel discussion and electronic survey. These maps provide a link between the common ICD diagnostic lexicons and the AIS severity coding system and are of value to injury researchers, public health scientists, and epidemiologists using large databases without available AIS coding.     

Spatial variation of soil phosphorus within a drainage ditch network

Agricultural drainage ditches serve as P transport pathways from fields to surface waters. Little is known about the spatial variation of P at the soil-water interface within ditch networks. We quantified the spatial variation of surficial (0-5 cm) soil P within vegetated agricultural ditches on a farm in Princess Anne, MD with an approximately 30-yr history of poultry litter application. Ditch soils from 10 ditches were sampled at 10-m intervals and analyzed for acid ammonium oxalate-extractable P, Fe, Al (P(ox), Fe(ox), Al(ox)), and pH. These variables were spatially autocorrelated. Oxalate-P (min = 135 mg kg(-1), max = 6919 mg kg(-1), mean = 700 mg kg(-1)) exhibited a high standard deviation across the study area (overall 580 mg kg(-1)) and within individual ditches (maximum 1383 mg kg(-1)). Several ditches contained distinct areas of high P(ox), which were associated with either point- or nonpoint-P sources. Phosphorus was correlated with Al(ox) or Fe(ox) within specific ditches. Across all ditches, Al(ox) (r = 0.80; p < 0.001) was better correlated with P(ox) than was Fe(ox) (r = 0.44; p < 0.001). The high level of spatial variation of soil P observed in this ditch network suggests that spatially distributed sampling may be necessary to target best management practices and to model P transport and fate in ditch networks.     

Principles and processes for effecting change in environmental management in New Zealand

In New Zealand environmental management is essentially the responsibility of land managers. Management decisions affect both production/productivity and the environment. However, responsibility for ensuring positive environmental outcomes falls on both local (Regional) and Central Government, and both they and international agencies such as the OECD would wish to monitor and report on changes. In terms of policy, strong links have been established via Central and Regional Government to land managers. Consumers in the market place are also, increasingly, requiring responsibility for positive environmental outcomes of those who purchase and process primary products. Strong links for responsibility have been established between our international markets and processing businesses and there is a noticeable strengthening of the links from the processors to the land manager/producer. In New Zealand a range of initiatives has been developed and implemented over recent times, whereby land managers are taking increasing responsibility for accounting for the environmental outcomes of their production activities. The range covers the spectrum from voluntary to compulsory (e.g., in order to meet market requirements) and from those initiated by customers to processor and/or producer initiatives. This paper follows the evolution of the principles that drove the predominant activities of the period and the processes that initiated the changes in environmental management. As the focus of agriculturalists changed from pioneering in a new world, to establishing a production base, to economic reality, and finally to environmental responsibility, the processes of extension adapted to meet the new challenge.     

Overview of the relationship between organizational and workplace factors and injury rates

This paper summarizes data from ten studies examining the relationship between organizational and workplace factors and injury rates. The studies were identified from a systematic literature search, as well as from other sources, and were included if they reported comparisons among at least 20 workplaces. Factors that were examined in at least two studies were identified. Their relationship with injury rates was determined. It was not possible to make quantitative comparisons between studies. We looked for ‘consistency’ or ‘contradiction’ in the relationships. Among the variables ‘consistency’ associated with lower injury rates were: empowerment of the workforce (in general matters); delegation of safety activities; and an active role (in health and safety) of top management. Among the ‘contradictory’ variables were the level and use of discipline for safety violations; and several others that were contradictory only in subgroups of the same study. We discuss the limitations of synthesizing results from the diverse studies.     

Detection of scale-specific community dynamics using wavelets

The response of ecological communities to anthropogenic disturbance is of both scientific and practical interest. Communities where all species respond to disturbance in a similar fashion (synchrony) will exhibit large fluctuations in total biomass and dramatic changes in ecosystem function. Communities where some species increase in abundance while others decrease after disturbance (compensation) can maintain total biomass and ecosystem function in the face of anthropogenic change. We examined dynamics of the Little Rock Lake (Wisconsin, USA) zooplankton community in the context of an experimental pH manipulation conducted in one basin of the lake. A novel application of wavelets was used to partition patterns of synchrony and compensation by time scale. We find interestingly that some time series show both patterns of synchrony and compensation depending on the scale of analysis. Within the unmanipulated basin, we found subtle patterns of synchrony and compensation within the community, largely at a one-year time scale corresponding to seasonal variation. Within the acidified lake basin, dynamics shifted to longer time scales corresponding to the pattern of pH manipulation. Comparisons between pairs of species in different functional groups showed both strong compensatory and synchronous responses to disturbance. The strongest compensatory signal was observed for two species of Daphnia whose life history traits lead to synchrony at annual time scales, but whose differential sensitivity to acidification led to compensation at multiannual time scales. The separation of time scales inherent in the wavelet method greatly facilitated interpretation as patterns resulting from seasonal drivers could be separated from patterns driven by pH manipulation.     

Trajectories of zooplankton recovery in the Little Rock Lake whole-lake acidification experiment.

Understanding the factors that affect biological recovery from environmental stressors such as acidification is an important challenge in ecology. Here we report on zooplankton community recovery following the experimental acidification of Little Rock Lake, Wisconsin, USA. One decade following cessation of acid additions to the northern basin of Little Rock Lake (LRL), recovery of the zooplankton community was complete. Approximately 40% of zooplankton species in the lake exhibited a recovery lag in which biological recovery to reference basin levels was delayed by 1-6 yr after pH recovered to the level at which the species originally responded. Delays in recovery such as those we observed in LRL may be attributable to "biological resistance" wherein establishment of viable populations of key acid-sensitive species following water quality improvements is prevented by other components of the community that thrived during acidification. Indeed, we observed that the recovery of species that thrived during acidification tended to precede recovery of species that declined during acidification. In addition, correspondence analysis indicated that the zooplankton community followed different pathways during acidification and recovery, suggesting that there is substantial hysteresis in zooplankton recovery from acidification. By providing an example of a relatively rapid recovery from short-term acidification, zooplankton community recovery from experimental acidification in LRL generally reinforces the positive outlook for recovery reported for other acidified lakes.     

Toxicity and repellency of hot pepper extracts to spider mite, Tetranychus urticae Koch

Increasing concern about persistence and environmental impact of synthetic pesticide residues require development of biodegradable and environmentally safe alternatives. The potential of using fruit extracts of hot pepper as alternatives to synthetic acaricides for controlling the two-spotted spider mite, Tetranychus urticae Koch, is explored in this study. Twenty-four Capsicum accessions (Solanaceae) were screened for their toxicity and repellency to the spider mites. Crude extracts from fruits of C. chinense, C. frutescens, C. baccatum, C. annuum, and C. pubescens were prepared in methanol and tested for their acaricidal properties. Spider mite mortality was greatest (45%) when fruit extract of accession Grif-9169 (C. annuum) was used. Results from diving board bioassays indicated that mites avoided filter paper strips treated with hot pepper extracts from accessions PI-596057 (C. baccatum), PI-195299 (C. annuum), and Grif- 9270 (C. annuum). This investigation suggests that methanolic extracts of these three accessions may have a great potential for repelling spider mites and should be field-tested on a large-scale to assess their value in managing populations of spider mites, which could reduce reliance on synthetic acaricides. An attempt was made to correlate repellency with chemical constituents of fruit extracts of the most repellent accessions to identify chemical sources of repellency. Capsaicin and dihydrocapsaicin, the pungent components of pepper fruit, were not correlated with toxicity or repellency, indicating that these are not likely related to the toxicity or repellency of the pepper fruit extracts. Other, unidentified chemicals are likely responsible for toxicity and repellency to the two-spotted spider mite.