Persistent Pain Among Older Adults Discharged Home From the Emergency Department After Motor Vehicle Crash: A Prospective Cohort Study

Motor vehicle collisions (MVCs) are the second most common form of trauma among older adults. We sought to describe the incidence, risk factors, and consequences of persistent pain among older adults evaluated in the emergency department (ED) after an MVC

Biomass offsets little or none of permafrost carbon release from soils, streams, and wildfire : an expert assessment

As the permafrost region warms, its large organic carbon pool will be increasingly vulnerable to decomposition, combustion, and hydrologic export. Models predict that some portion of this release will be offset by increased production of Arctic and boreal biomass; however, the lack of robust estimates of net carbon balance increases the risk of further overshooting international emissions targets. Precise empirical or model-based assessments of the critical factors driving carbon balance are unlikely in the near future, so to address this gap, we present estimates from 98 permafrost-region experts of the response of biomass, wildfire, and hydrologic carbon flux to climate change. Results suggest that contrary to model projections, total permafrost-region biomass could decrease due to water stress and disturbance, factors that are not adequately incorporated in current models. Assessments indicate that end-of-the-century organic carbon release from Arctic rivers and collapsing coastlines could increase by 75% while carbon loss via burning could increase four-fold. Experts identified water balance, shifts in vegetation community, and permafrost degradation as the key sources of uncertainty in predicting future system response. In combination with previous findings, results suggest the permafrost region will become a carbon source to the atmosphere by 2100 regardless of warming scenario but that 65%-85% of permafrost carbon release can still be avoided if human emissions are actively reduced.Peer reviewe

The spatially varying influence of humans on fire probability in North America

Humans affect fire regimes by providing ignition sources in some cases, suppressing wildfires in others, and altering natural vegetation in ways that may either promote or limit fire. In North America, several studies have evaluated the effects of society on fire activity; however, most studies have been regional or subcontinental in scope and used different data and methods, thereby making continent-wide comparisons difficult. We circumvent these challenges by investigating the broad-scale impact of humans on fire activity using parallel statistical models of fire probability from 1984 to 2014 as a function of climate, enduring features (topography and percent nonfuel), lightning, and three indices of human activity (population density, an integrated metric of human activity [Human Footprint Index], and a measure of remoteness [roadless volume]) across equally spaced regions of the United States and Canada. Through a statistical control approach, whereby we account for the effect of other explanatory variables, we found evidence of non-negligible human–wildfire association across the entire continent, even in the most sparsely populated areas. A surprisingly coherent negative relationship between fire activity and humans was observed across the United States and Canada: fire probability generally diminishes with increasing human influence. Intriguing exceptions to this relationship are the continent’s least disturbed areas, where fewer humans equate to less fire. These remote areas, however, also often have lower lightning densities, leading us to believe that they may be ignition limited at the spatiotemporal scale of the study. Our results suggest that there are few purely natural fire regimes in North America today. Consequently, projections of future fire activity should consider human impacts on fire regimes to ensure sound adaptation and mitigation measures in fire-prone areas

Appendix A. The annual percent area burned for the period 1980–2005 at spatial scales of 102, 103, 104, and 105 km2.

The annual percent area burned for the period 1980–2005 at spatial scales of 102, 103, 104, and 105 km2

Appendix D. The relationship between the observed values used in the boosted regression trees and those predicted by the models.

The relationship between the observed values used in the boosted regression trees and those predicted by the models

Appendix F. Maps of selected explanatory variables (top map of each pair) and the corresponding maps of partial dependence of area burned (bottom map of each pair) for the 104-km2 spatial scale for the variables not presented in Fig. 5.

Maps of selected explanatory variables (top map of each pair) and the corresponding maps of partial dependence of area burned (bottom map of each pair) for the 104-km2 spatial scale for the variables not presented in Fig. 5

Appendix E. Partial-dependence plots showing variation of the response in area burned (y-axis) as a function of the seven explanatory variables not shown in Fig. 4 at each spatial scale of study.

Partial-dependence plots showing variation of the response in area burned (y-axis) as a function of the seven explanatory variables not shown in Fig. 4 at each spatial scale of study

Appendix C. The minimum, mean, median, maximum, and standard deviation of each variable by spatial scale.

The minimum, mean, median, maximum, and standard deviation of each variable by spatial scale

Appendix A. Maps of the dependent variable (annual area burned) and the 14 explanatory variables computed from the annual means for the 1980–2010 time period.

Maps of the dependent variable (annual area burned) and the 14 explanatory variables computed from the annual means for the 1980–2010 time period

Appendix C. Flowchart of the general construction of the annual and averaged models.

Flowchart of the general construction of the annual and averaged models