Biased sampling of methane release from northern lakes: A problem for extrapolation

Methane emissions from lakes are widely thought to be highly irregular and difficult to quantify with anything other than numerous distributed measurement stations and long-term sampling campaigns. In spite of this, a large majority of the study sites north of 50 degrees N have been measured over surprisingly short time periods of only one to a few days. Using long-term data from three intensively studied small subarctic lakes, we recommend that measurements of diffusive methane flux and ebullition should be made over at least 11 and 39days scattered throughout the ice-free season using depth-stratified sampling at 3 and 11 or more locations, respectively. We further show that low temporal and spatial resolutions are unlikely to cause overestimates. Therefore, we argue that most sites measured previously are likely underestimated in terms of emission potential. Avoiding these biases seen in much of the contemporary data is crucial to further constrain large-scale methane emissions from northern lakes and ponds.Funding Agencies|Swedish Research Council [2007-4547]; Nordic Center of Excellence DEFROST under Nordic Top-Level Research Initiative</p

Pain Management Considerations in Patients With Opioid Use Disorder Requiring Critical Care

The opioid epidemic has resulted in increased opioid-related critical care admissions, presenting challenges in acute pain management. Limited guidance exists in the management of critically ill patients with opioid use disorder (OUD). This narrative review provides the intensive care unit clinician with guidance and treatment options, including nonopioid analgesia, for patients receiving medications for OUD and for patients actively misusing opioids. Verification and continuation of the patient\u27s outpatient medications for OUD regimen, specifically buprenorphine and methadone formulations; assessment of pain and opioid withdrawal; and treatment of acute pain with nonopioid analgesia, nonpharmacologic strategies, and short-acting opioids as needed, are all essential to adequate management of acute pain in patients with OUD. A multidisciplinary approach to treatment and discharge planning in patients with OUD may be beneficial to engage patients with OUD early in their hospital stay to prevent withdrawal, stabilize their OUD, and reduce the risk of unplanned discharge and other associated morbidity