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.     

A critical and empirical analysis of the national-local ‘gap’ in public responses to large-scale energy infrastructures

A national-local ‘gap’ is often used as the starting point for analyses of public responses to large scale energy infrastructures. We critique three assumptions found in that literature: the public's positive attitudes, without further examining other type of perceptions at a national level; that local perceptions are best examined through a siting rather than place-based approach; that a gap exists between national and local responses, despite a non-correspondence in how these are examined. Survey research conducted at national and local levels about electricity transmission lines in the UK confirm these criticisms. Results do not support a gap between national and local levels; instead, both differences and similarities were found. Results show the value of adopting a place-based approach and the role of surveys to inform policy making are discussed.     

An empirical model of soil chemical properties that regulate methane production in Japanese rice paddy soils

To understand which soil chemical properties are the best predictors of CH4 production in rice paddy soils, a model was developed with empirical data from nine types of rice soils collected around Japan and anaerobically incubated at 30 degrees C for 16 wk in laboratory conditions. After 1, 2, 4, 8, and 16 wk of incubation, CO2, CH4, and Fe(II) were measured to understand soil organic matter decomposition and iron (Fe) reduction. Available N (N ava) was also measured at the end of incubation. The results showed that decomposable C and reducible Fe are two key parameters that regulate soil CH(4) production (P CH4). There was a significant relationship between decomposable C and available N (N ava) (r2 = 0.975**). Except for a sandy soil sample, a significant relationship between total Fe (Fe total) and reducible Fe was found. From this experiment, a simple model of soil CH4 production was developed: P CH4 = 1.593N(ava) - 2.460Fe total/1000 (each unit was mg kg(-1) soil). After simulated CH4 production by two soil chemical properties as above, there was a significant consistency between model simulation and actual measurement (r2 = 0.831**).     

Gathering “wild” food in the city: rethinking the role of foraging in urban ecosystem planning and management

Recent “green” planning initiatives envision food production, including urban agriculture and livestock production, as desirable elements of sustainable cities. We use an integrated urban political ecology and human–plant geographies framework to explore how foraging for “wild” foods in cities, a subversive practice that challenges prevailing views about the roles of humans in urban green spaces, has potential to also support sustainability goals. Drawing on research from Baltimore, New York City, Philadelphia, and Seattle, we show that foraging is a vibrant and ongoing practice among diverse urban residents in the USA. At the same time, as reflected in regulations, planning practices, and attitudes of conservation practitioners, it is conceptualised as out of place in urban landscapes and an activity to be discouraged. We discuss how paying attention to urban foraging spaces and practices can strengthen green space planning and summarise opportunities for and challenges associated with including foragers and their concerns.     

In vivo endocrine effects of naphthenic acids in fish

Oil pollution from various sources, including exploration, production and transportation, is a growing global concern. The highest toxicity of hydrocarbon pollutants is associated with the water-soluble phase compounds, including naphthenic acids, a known component found in all hydrocarbon deposits. Recently, naphthenic acids (NAs) have shown estrogenic and anti-androgenic effects in vitro. For this reason we investigated the potential effects of two commercial mixtures of naphthenic acids on fish in vivo, using the three-spined stickleback (Gasterosteus aculeatus) as a model species.     

Species Distribution Models of Freshwater Stream Fishes in Maryland and Their Implications for Management

Species distribution models (SDMs) are often used in conservation planning, but their utility can be improved by assessing the relationships between environmental and species response variables. We constructed SDMs for 30 stream fishes of Maryland, USA, using watershed attributes as environmental variables and presence/absence as species responses. SDMs showed substantial agreement between observed and predicted values for 17 species. Most important variables were natural attributes (e.g., ecoregion, watershed area, latitude/longitude); land cover (e.g., %impervious, %row crop) was important for three species. Focused analyses on four representative species (central stoneroller, creek chub, largemouth bass, and white sucker) showed the probability of presence of each species increased non-linearly with watershed area. For these species, SDMs built to predict absent, low, and high densities were similar to presence/absence predictions but provided probable locations of high densities (e.g., probability of high-density creek chub decreased rapidly with watershed area). We applied SDMs to predict suitability of watersheds within the study area for each species. Maps of suitability and the environmental and species response relationships can help develop better management plans.     

Spectroscopic characterization of organic matter of a soil and vinasse mixture during aerobic or anaerobic incubation

Mineralization potentials are often used to classify organic wastes. These methods involve measuring CO₂ production during batch experiments, so variations in chemical compounds are not addressed. Moreover, the physicochemical conditions are not monitored during the reactions. The present study was designed to address these deficiencies. Incubations of a mixture of soil and waste (vinasse at 20% dry matter from a fermentation industry) were conducted in aerobic and anaerobic conditions, and liquid samples obtained by centrifugation were collected at 2 h, 1 d and 28 d. Dissolved organic carbon (DOC) patterns highlighted that: there was a “soil effect” which increased organic matter (OM) degradation in all conditions compared to vinasse incubated alone; and OM degradation was faster under aerobic conditions since 500 mg kg^?1 of C remained after aerobic incubation, as compared to 4000 mg kg^?1 at the end of the anaerobic incubation period. No changes were detected by Fourier transform infrared spectroscopy (FTIR) between 2 h and 1 d incubation. At 28 days incubation, the FTIR signal of the aerobic samples was deeply modified, thus confirming the high OM degradation. Under anaerobic conditions, the main polysaccharide contributions (ν(C–O)) disappeared at 1000 and 1200 cm^?1, as also confirmed by the ¹³C NMR findings. Under aerobic incubation, a 50% decrease in the polysaccharide proportion was observed. Under anaerobic conditions, significant chemical modifications of the organic fraction were detected, namely formation of low molecular weight organic acids.