Objective: Characterization of the severity of injury should account for both mortality and disability. The objective of this study was to develop a disability metric for thoracic injuries in motor vehicle crashes (MVCs) and compare the functional outcomes between the pediatric and adult populations.
Methods: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank for the most frequently occurring Abbreviated Injury Scale (AIS) 2–5 thoracic injuries. Occupants with thoracic injury were classified as disabled or not disabled based on the FIM scale, and comparisons were made between the following age groups: pediatric, adult, middle-aged, and older occupants (ages 7–18, 19–45, 46–65, and 66+, respectively). For each age group, DR was calculated by dividing the number of patients who were disabled and sustained a given injury by the number of patients who sustained a given injury. To account for the effect of higher severity co-injuries, a maximum AIS adjusted DR (DRMAIS) was also calculated for each injury. DR and DRMAIS could range from 0 to 100% disability risk.
Results: The mean DRMAIS for MVC thoracic injuries was 20% for pediatric occupants, 22% for adults, 29% for middle-aged adults, and 43% for older adults. Older adults possessed higher DRMAIS values for diaphragm laceration/rupture, heart laceration, hemo/pneumothorax, lung contusion/laceration, and rib and sternum fracture compared to the other age groups. The pediatric population possessed a higher DRMAIS value for flail chest compared to the other age groups.
Conclusion: Older adults had significantly greater overall disability than each of the other age groups for thoracic injuries. The developed disability metrics are important in quantifying the significant burden of injuries and loss of quality life years. Such metrics can be used to better characterize severity of injury and further the understanding of age-related differences in injury outcomes, which can influence future age-specific modifications to AIS. 相似文献
Excessively high soil P can increase P loss with surface runoff. This study used indoor rainfall simulations to characterize soil and runoff P relationships for five Midwest soils (Argiudoll, Calciaquaoll, Hapludalf, and two Hapludolls). Topsoil (15-cm depth, 241-289 g clay kg(-1) and pH 6.0-8.0) was incubated with five NH4H2PO4 rates (0-600 mg P kg(-1)) for 30 d. Total soil P (TPS) and soil-test P (STP) measured with Bray-P1 (BP), Mehlich-3 (M3P), Olsen (OP), Fe-oxide-impregnated paper (FeP), and water (WP) tests were 370 to 1360, 3 to 530, 10 to 675, 4 to 640, 7 to 507, and 2 to 568 mg P kg(-1), respectively. Degree of soil P saturation (DPS) was estimated by indices based on P sorption index (PSI) and STP (DPSSTP) and P, Fe, and Al extracted by ammonium oxalate (DPSox) or Mehlich-3 (DPSM3). Soil was packed to 1.1 g cm(-3) bulk density in triplicate boxes set at 4% slope. Surface runoff was collected during 75 min of 6.5 cm h(-1) rain. Runoff bioavailable P (BAP) and dissolved reactive P (DRP) increased linearly with increased P rate, STP, DPSox, and DPSM3 but curvilinearly with DPSSTP. Correlations between DRP or BAP and soil tests or saturation indices across soils were greatest (r > or = 0.95) for FeP, OP, and WP and poorest for BP and TPS (r = 0.83-0.88). Excluding the calcareous soil (Calciaquoll) significantly improved correlations only for BP. Differences in relationships between runoff P and the soil tests were small or nonexistent among the noncalcareous soils. Routine soil P tests can estimate relationships between runoff P concentration and P application or soil P, although estimates would be improved by separate calibrations for calcareous and noncalcareous soils. 相似文献
Little is known about the impact of agricultural legacy on subsurface biogeochemical processes in the years following restoration of riparian wetlands (WLs). More knowledge is also needed on the relative importance of seasons, precipitation events, and inputs of water and nutrients driving nitrogen (N), phosphorus (P), sulfur (S), and greenhouse gas (GHG) (N2O, CO2, CH4) dynamics in these systems. This investigation of a riparian zone comprising a restored WL area and a nonrestored well‐drained alluvium (AL) area in the United States Midwest revealed that despite successful hydrological restoration a decade earlier, biogeochemical conditions in the WL area remained less anoxic than in natural WLs, and not significantly different from those in the AL area. No significant differences in N, P, S, and C compound concentrations or fluxes were observed between the AL and WL areas. Over the duration of the study, nitrate (NO3?) and soluble reactive phosphorus appeared to be primarily driven by hillslope contributions. Ammonium (NH4+), sulfate (SO42?), and CO2 responded strongly to seasonal changes in biogeochemical conditions in the riparian zone, while N2O and CH4 fluxes were most influenced by large rewetting events. Overall, our results challenge overly simplistic assumptions derived from direct interpretation of redox thermodynamics, and show complex patterns of solutes and GHGs at the riparian zone scale. 相似文献
Richards, R. Peter, Ibrahim Alameddine, J. David Allan, David B. Baker, Nathan S. Bosch, Remegio Confesor, Joseph V. DePinto, David M. Dolan, Jeffrey M. Reutter, and Donald Scavia, 2012. Discussion –“Nutrient Inputs to the Laurentian Great Lakes by Source and Watershed Estimated Using SPARROW Watershed Models” by Dale M. Robertson and David A. Saad. Journal of the American Water Resources Association (JAWRA) 1‐10. DOI: 10.1111/jawr.12006 Abstract: Results from the Upper Midwest Major River Basin (MRB3) SPARROW model and underlying Fluxmaster load estimates were compared with detailed data available in the Lake Erie and Ohio River watersheds. Fluxmaster and SPARROW estimates of tributary loads tend to be biased low for total phosphorus and high for total nitrogen. These and other limitations of the application led to an overestimation of the relative contribution of point sources vs. nonpoint sources of phosphorus to eutrophication conditions in Lake Erie, when compared with direct estimates for data‐rich Ohio tributaries. These limitations include the use of a decade‐old reference point (2002), lack of modeling of dissolved phosphorus, lack of inclusion of inputs from the Canadian Lake Erie watersheds and from Lake Huron, and the choice to summarize results for the entire United States Lake Erie watershed, as opposed to the key Western and Central Basin watersheds that drive Lake Erie’s eutrophication processes. Although the MRB3 SPARROW model helps to meet a critical need by modeling unmonitored watersheds and ranking rivers by their estimated relative contributions, we recommend caution in use of the MRB3 SPARRROW model for Lake Erie management, and argue that the management of agricultural nonpoint sources should continue to be the primary focus for the Western and Central Basins of Lake Erie. 相似文献
The potential impacts of climate change are varied and highly uncertain, and pose a significant challenge to agencies charged with managing environmental risks. This paper presents a comprehensive and structured Mental Modeling approach to elicit, organize and present relevant information from experts and stakeholders about the factors influencing environmental risk management in the face of climate change. We present and review an initiative undertaken by the United States Army Corps of Engineers (USACE) to characterize climate change challenges to USACE environmental risk management activities, and to identify gaps with respect to science, engineering, and organizational processes for addressing these challenges. By employing Mental Modeling, the research has characterized the influences of climate change on USACE environmental risk management, and aggregating recommendations from 28 experts. In addition, the study identifies the most important opportunities to improve organizational response to climate change, ranging from focused research and development of technical capabilities to broad paradigm shifts and systemic organizational improvements within the USACE environmental risk management programs. This study demonstrates that Mental Modeling is a useful tool for understanding complex problems, identifying gaps, and formulating strategies, and can be used by a multitude of organizations and agencies. 相似文献
The gametogenic periodicity of the cold seep mussel “Bathymodiolus” childressi was analysed from a time series of samples from depths of ∼ 650 m surrounding the Brine Pool cold seep on the continental
slope of the northern Gulf of Mexico. Occasional samples were retrieved from Bush Hill and GC 234 for comparison. At the Brine
Pool, both females and males showed strong reproductive periodicity with the initiation of gametogenesis from December to
March, followed by a period of gamete growth or proliferation and spawning from October to February. Gametogenesis was synchronized
at all three sites. Gametogenic periodicity appears to be correlated with surface production that peaks during the winter
months. Downward flux of detritus during this period may provide food for the planktotrophic larvae and also supplementary
nutrition for the adult, which has chemosynthetic bacterial symbionts but is also capable of filter feeding. Individuals in
all three populations carried parasites and these were especially common at Bush Hill and GC234, where it is suggested they
have a major impact on reproductive output. 相似文献