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Nutrient loading from conventional row-crop production systems impairs surface waterbodies in the mid-southern United States. This study was conducted to determine whether minimum tillage and winter cover crops can decrease nutrient loading in surface runoff from conventionally tilled row-crop fields. The effects of winter cover crops and minimum tillage on N and P loading from a corn (Zea mays L.)-soybean [Glycine max (L.) Merr.] rotation system were investigated on production fields in northwestern Mississippi using a split-field approach. As measured at the edge of the field, minimum tillage with cover crops had no effect on surface runoff from production fields regarding N or P loading (p .10 for all nutrient loads), discharge (p .10), or loss of suspended solids (p .10). Minimum tillage and cover crops decreased sediment and nutrient concentrations in runoff for total N (p = .05) and total P (p = .09) but had no effect on other nutrients of interest. Although these practices decreased total N concentration by 36% in surface runoff to receiving waters, this reduction was only seen when aboveground cover crop biomass was present (p = .07). Regardless of the time of year, minimum tillage with cover crops decreased total P concentration in surface runoff by 27% (p = .09). These data indicate that it is unlikely that minimum tillage and cover crops will affect N and P loading while transitioning to a conservation production system in the mid-southern United States.

This chapter presents the findings of an ongoing digital project of the Helsinki Computational History Group at Helsinki Centre for Digital Humanities (HELDIG) focused on the history of eighteenth-century book publication. The authors have created a historical-biographical database based onThe English Short-Title Catalogue(ESTC), a standard source for analytical bibliographic research, and extracted a data-driven canon which considers changes over time, subject-topics, top-works, authors, publishers, publication place, and materiality. This chapter provides both methodological and historical insights into the development of print and demonstrates the huge analytical potential of harmonized metadata catalogs. While quantitative analyses of the book trade were attempted before, they did not engage with the complex process of canon formation at such a large scale. The authors’ work highlights the formative role played by publishers in this process and the epistemological shift started at the end of the seventeenth century, when religious works were increasingly replaced by literary works. As the authors argue, this shift in the production and consumption of print allowed for a reinvention of the canon during the eighteenth century.

This article engages with the longstanding debate over the authorship of the Scottish Militia pamphlet Sister Peg (1761). While previous evidence is born out of rigorous historical research, a debate remains between whether Adam Ferguson or David Hume was the author. This article uses computational stylometry to statistically investigate this question, with the aim of complementing existing historical evidence rather than overturning it. In doing this it concludes that the work was not written solely by David Hume and, instead, Adam Ferguson is likely to be the sole author or there was a more complicated history of co-authorship.

Background Candidates for repeat kidney transplant (KT) have increased. While graft and patient survival are inferior to primary KT, second and third KTs improve patient survival over dialysis. Little is known about the outcomes after fourth KTs. Methods We retrospectively compared characteristics of third and fourth KTs in the SRTR. Factors associated with graft survival in third vs fourth KT and patient survival of fourth KT vs patients waitlisted for a 4th KT were assessed by Cox regression and multivariable linear regression analysis. Results There were 3055 third- and fourth-time KTs performed in the United States. Fourth-time graft survival was not significantly different from third-time transplants (HR 1.06, P = .653). Patients who received a fourth KT have a significant survival advantage compared with patients who remained on the waitlist for a fourth KT (HR = 0.53, P = .006). Conclusions Graft and patient survival of fourth KTs are comparable to third KTs, but inferior to first and second KTs in terms of graft and patient survival. Recipients of fourth KT have had an increased life expectancy compared with patients waitlisted for a fourth KT.

A debate between virtuous self-interest and social morality emerged in the seventeenth and eighteenth centuries. The historical narrative of these ideas has been touched on by others – such as Albert O. Hirschman, Pierre Force, and Eric MacGilvray – with nuance and detail, but broadly one can recognize two camps: those who saw public utility in self-interest through the positive externalities of commerce, and those who had serious concerns over the political outcomes of the entanglement of commerce and virtue. This chapter follows these studies and attempts to locate Rousseau (primarily) and Smith (secondarily) within this debate. By looking at how their particular moral philosophies interact with their political thought it is argued that Rousseau is distinct from Smith in an important, but often confused, way: while some have argued that Rousseau is a moralist and Smith a philosopher of the political and social value of self-interest, it will be argued here that the opposite may be true. That is, despite Rousseau's “general will” and Smith's “impartial spectator” having been identified as similar moral tools used to overcome the negative aspects of self-interest through externalized self-reflection, it is argued that Rousseau is a moral rationalist who is skeptical of reason as a moral motivator, and thus dismisses the general will as a tool which can encourage personal moral action, while Smith is a moral realist, but a particularly soft one in regard to the motivational force of morality, and instead turns to rationality – through the impartial spectator – as a source of moral action. The upshot of this distinction being, Rousseau does not deny the power of commerce and self-interest as motivational forces, simply their social utility; social institutions like English coffeehouses – centres of politeness and doux commerce – should exist, and self-interest should motivate, but both need to be cleansed of the vice of commerce. That is, this chapter argues that Smith is moral realist who relies on reason – specifically that one must be a spectator who can impartially and rationally reflect on situations in order to will moral ends – and Rousseau is a moral rationalist who relies on sentiment – one must have an interest in situations if they are to be a moral actor.

Background and Objectives Study objectives, included determination of: (i) associations between radiologic and pathologic responses of colorectal cancer liver metastases (CRCLM) to chemotherapy; and (ii) whether CRCLM histopathology is associated with recurrence free survival (RFS) after resection among patients not treated with pre-operative chemotherapy (untreated). Methods Demographics, clinicopathologic characteristics, and outcomes among patients who underwent CRCLM resection from 2007 to 2014 were reviewed. Tumor regression grade (TRG) of 1–2 and 4–5 depict low and high proportions of viable tumor relative to fibrosis, respectively. Results Of 138 patients, 84 (60.9%) were treated with pre-operative chemotherapy. In these patients, there was no difference in proportions with TRG 1–2 among those with verses without radiologic response (26.9% vs. 18.8%, P = 0.393). TRG 1–2 was associated with superior RFS on univariable (median 15 vs. 6 months, P

Much has been made of the digital humanities, yet it remains an underexplored field in relation to intellectual history. This paper aims to add to the little literature which does exist by offering a survey of the ideas and issues facing would-be practitioners. This includes: an overview of what the digital humanities are; reflections on what they offer intellectual history and how they may be problematic in regard to, first, accessing texts, and second, analysing source material; and a conclusion with three reflections on future best practices – to be sceptical of digital sources, to be reflective of methodologies and how they may need to be modified when engaging with the digital humanities, and to embrace more directly the methodological, statistical, and technical aspects behind digital humanities. The aim is not to provide all the answers – at this stage that is impossible – but to be part of an emerging and ongoing discussion.

BACKGROUND: Donor designation refers to the laws and processes for documentation of an individual’s wishes regarding organ donation should that person become eligible for donation at death. All 50 states have laws supporting donor designation. Donor-family conflict arises when a designated donor’s family attempts to rescind the donor’s authorization to donate. Little guidance exists in the current literature to address these situations. METHODS: Hospital public relations offices and organ procurement organization (OPO) records were queried to assess the incidence of legal action and adverse media coverage. Public legal records were searched for civil actions involving the hospitals at which these conflicts occurred. RESULTS: Fourteen cases of donor-family conflict were identified. Organ procurement proceeded in 9 (64%) of 14. A total of 38 organs were transplanted from these 9 donors. For those nine cases, median follow-up time was 57 months (interquartile range, 52Y77 months; range, 38Y114 months). The identified reasons for conflict include a belief by the family that they were given a choice in the decision about whether to proceed with donation; misunderstanding and lack of acceptance of the brain death diagnosis; disagreement among family members; concerns about timing/length of the donation process and desire to withdraw ventilator support; next-of-kin anger over cause of death when cause of death was suicide; and challenges to the validity of donor document and stated donor intent. No adverse news items were reported, and no lawsuits were filed in cases of donor-family conflict where organ donation proceeded. In addition, we found no mention of lawsuits brought against hospitals for failure to proceed with organ donation when donor was designated and eligible. CONCLUSION: The 2006 Anatomical Gift Act compels hospitals and OPOs to pursue donation regardless of family wishes in cases of brain death in designated donors. When a donor’s family attempts to rescind the donor’s authorization, the donor’s wishes, not the families, should be honored. Fears of legal action and adverse media coverage are unfounded. Clinicians, OPO staff, and hospital administrators should strive to understand state donor designation law and create a plan for managing this conflict should it arise. ( JT rauma Acute Care Surg. 2014;77: 555Y558. Copyright * 2014 by Lippincott Williams & Wilkins) LEVEL OF EVIDENCE: Therapeutic/care management study, level V.

Preoperative risk assessment of potential kidney transplant recipients often fails to adequately balance risk related to underlying comorbidities with the beneficial impact of kidney transplantation. We sought to develop a simple scoring system based on factors known at the time of patient assessment for placement on the waitlist to predict likelihood of severe adverse events 1 year post-transplant. The tool includes four components: age, cardiopulmonary factors, functional status, and metabolic factors. Pre-transplant factors strongly associated with severe adverse events include diabetic (OR: 3.76, P

Hughes MG Jr, Khan KM, Gruessner AC, Sharp H, Hill M, Jie T, Kandaswamy R, Humar A, Payne WD, Gruessner RWG. Long-term outcome in 42 pediatric liver transplant patients with alpha 1-antitrypsin deficiency: a single-center experience. Clin Transplant 2011: 25: 731–736. © 2010 John Wiley & Sons A/S. Abstract: Introduction: We examined the long-term outcome of transplantation for alpha 1-antitrypsin deficiency (A1ATD). Method: Data were reviewed on 42 transplants in 35 children with A1ATD over 42 yr and compared with 129 transplants in 116 children with biliary atresia (BA). Results: Over 50% of patients were followed up for >10 yr. A1ATD were older than BA at transplantation, median age, 6.0 vs. 1.0 yr (p

Partial graft liver recipients with graft weight/recipient weight (GW/RW) ratios0.8% are thought to have a higher incidence of postoperative complications, including small-for-size syndrome (SFSS). We analyzed a cohort of such recipients and compared those with GW/RW0.8% to those with GW/RWor= 0.8%. Between 1999 and 2008, 107 adult patients underwent partial graft liver transplants: 76 from live donors [living donor liver transplantation (LDLT)] and 31 from deceased donors [split liver transplantation (SLT)]. Of these, 22 had GW/RW0.8% (12 with LDLT and 10 with SLT), and 85 had GW/RWor= 0.8% (64 with LDLT and 21 with SLT). The baseline demographics and median length of follow-up were similar. SFSS developed in 3 recipients with GW/RW0.8% (13.6%) and in 8 recipients with GW/RWor= 0.8% (9.4%; P = not significant). Other early complications were similar between the 2 groups. Inflow modification with splenic artery occlusion was performed in 13 recipients: 7 with GW/RW0.8% and 6 with GW/RWor= 0.8%. Graft survival at 1 year post-transplant did not differ (91% versus 92%; P = not significant). In conclusion, GW/RW did not appear to be the only determinant of outcome after partial liver transplantation. Using techniques such as inflow modification may help to prevent some of the problems seen with smaller grafts.

We examined a group of SPK recipients that had early (

Study objectives, included determination of: (i) associations between radiologic and pathologic responses of colorectal cancer liver metastases (CRCLM) to chemotherapy; and (ii) whether CRCLM histopathology is associated with recurrence free survival (RFS) after resection among patients not treated with pre-operative chemotherapy (untreated).Demographics, clinicopathologic characteristics, and outcomes among patients who underwent CRCLM resection from 2007 to 2014 were reviewed. Tumor regression grade (TRG) of 1-2 and 4-5 depict low and high proportions of viable tumor relative to fibrosis, respectively.Of 138 patients, 84 (60.9%) were treated with pre-operative chemotherapy. In these patients, there was no difference in proportions with TRG 1-2 among those with verses without radiologic response (26.9% vs. 18.8%, P = 0.393). TRG 1-2 was associated with superior RFS on univariable (median 15 vs. 6 months, P 0.001) and multivariable (P = 0.005) analyses. Radiologic response was not associated with RFS. Among untreated patients (n = 54), TRG 4-5 was associated with poor RFS on univariable (median 44 vs. 15 months, P = 0.011) and multivariable (P = 0.012) analyses.High proportions of CRCLM fibrosis occur in 20% of patients without radiologic response to chemotherapy. Among untreated patients, high proportion of viable tumor relative to fibrosis is associated with poor RFS after resection. J. Surg. Oncol. 2016;113:456-462. © 2016 Wiley Periodicals, Inc.

A consensus surveillance protocol is lacking for non-cirrhotic patients with hypervascular liver lesions presumed to represent hepatocellular adenomas. Patients with hypervascular liver lesions

Background: Recently the Organ Injury Scaling Committee of the American Association for the Surgery of Trauma developed a Rectal Injury Scaling System (RISS). Little data exist regarding its clinical utility. Methods: We retrospectively reviewed 45 patients with rectal injuries to assess the impact of the RISS on patient management and outcome. We compared RISS grade I patients (group I, partial-thickness injury) with patients with grades 2, 3, and 4 injuries (group II, full-thickness injury). Results: Group II underwent distal rectal washout and repair of the injury twice as often and had a significantly higher rate of diversion of the fecal stream. This was associated with a 3-fold increase in complications. The only complications in group I were in patients managed with diversion of the fecal stream and distal rectal washout. Conclusions: Our data suggest that aggressive surgical management for RISS grade I injury may not be necessary. Implementation of therapy based on the RISS may improve outcomes of civilian rectal trauma. (Surgery 1999;126:693-700.)

Parenchymal markers were placed in the left caudal lobes of anesthetized dogs, and the three-dimensional positions of the markers were tracked by biplane videofluoroscopy during expiration from total lung capacity (TLC) to approximately 30% TLC at steady expiratory flows of 0.3-7% TLC/s. Regional volumes of samples of parenchyma with volumes at TLC of 1-5 cm3 were obtained by computing the volumes of tetrahedral defined by taking the markers, four at a time, as apices of the tetrahedra, Regional volume (Vr), as a fraction of volume at TLC, was plotted against average volume (VL), as a fraction of volume at TLC, and Vr was fit by a quadratic function of VL. The initial slopes of the plots, dVr/dVL at VL = 1, varied by +/- 26% from the mean slope of 1. The curvatures were highly correlated with the slopes, and the Vr vs. VL plots formed a nest of “onion skins”. The initial slopes were weakly correlated with the vertical position of the centroid of the tetrahedron, with the slope increasing by approximately 20%/cm, on average, in the dorsal direction in the supine dog. The vertical gradient in Vr accounted for approximately 30% of the total variability; small-scale heterogeneity contributed the remaining 70%. These results confirm earlier quasistatic measurements of nonuniform Vr and provide the first data on curvature of Vr trajectories. The mechanisms that cause the nongravitational component of Vr variability and the curvatures of the trajectories are unknown.

The parenchymal marker technique was used to measure regional tidal volumes of samples of lung parenchyma in four open-chest supine dogs. Radiopaque markers that had been implanted in the lower lobe were tracked by biplane video fluoroscopy during sinusoidal volume oscillations at tidal volumes of approximately 20% of total lung capacity and frequencies of 1-40 breaths/min before and after methacholine was administered by aerosol. The volumes of tetrahedrons with apexes at four markers were computed, and sine waves were fit to the data for volume vs. time for each tetrahedron. The ratio of mean regional volume to mean airway pressure decreased by 10-45% after exposure to methacholine. Dynamic lung elastance and resistance of the constricted lungs were larger than control, and both were frequency dependent. Regional elastance and resistance varied considerably among tetrahedrons, and these were also frequency dependent. The data were fit by a model in which tissue elastance was uniform and nearly equal to elastance in the control state, but small-airway resistance was high and variable. We conclude that the lung contracts under bronchoconstriction but that the increased dynamic elastance and resistance of the constricted lung may be primarily the result of nonuniform increased airway resistance at the level of the terminal bronchioles.

Background Calcineurin inhibitors (CNI) are the basis of contemporary immunosuppression in clinical pancreas transplantation (PT). Nevertheless, CNI toxicities, especially nephrotoxicity, have stimulated the search for CNI-sparing protocols. We performed a retrospective analysis of 25 PT patients with progressive CNI toxicities that were switched to a daclizumab (DAC)–based maintenance regimen. Methods From 2003 to 2007, 25 PT patients with progressive CNI toxicity (predominantly nephrotoxicity) were identified and switched from CNI to monthly DAC maintenance therapy. The DAC group was compared with matched control subjects (1:1) by transplant type and number, age, year of transplant, and duct management. Results and conclusions Results showed improved graft survival rates and decreased immunologic loss rates at 1, 3, and 5 years in the DAC group compared with the control group. There was no difference in patient survival rate between the 2 groups. Analysis demonstrates that DAC maintenance therapy is safe and effective for PT patients experiencing CNI toxicities. A randomized trial to compare DAC- and CNI-based regimens is needed in CNI-intolerant patients, with particular attention to the impact on renal function and patient morbidity (eg, infection rates).

Hill, Mark J., Theodore A. Wilson, and Rodney K. Lambert.Effects of surface tension and intraluminal fluid on the mechanics of small airways. J. Appl. Physiol.82(1): 233–239, 1997.—Airway constriction is accompanied by folding of the mucosa to form ridges that run axially along the inner surface of the airways. The muscosa has been modeled (R. K. Lambert. J. Appl. Physiol. 71: 666–673, 1991) as a thin elastic layer with a finite bending stiffness, and the contribution of its bending stiffness to airway elastance has been computed. In this study, we extend that work by including surface tension and intraluminal fluid in the model. With surface tension, the pressure on the inner surface of the elastic mucosa is modified by the pressure difference across the air-liquid interface. As folds form in the mucosa, intraluminal fluid collects in pools in the depressions formed by the folds, and the curvature of the air-liquid interface becomes nonuniform. If the amount of intraluminal fluid is small, 2%, the area of the air-liquid interface decreases as airway cross-sectional area decreases, and surface tension contributes to airway compression. The model predicts that surface tension plus intraluminal fluid can cause an instability in the area-pressure curve of small airways. This instability provides a mechanism for abrupt airway closure and abrupt reopening at a higher opening pressure.