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The continuing loss of urban wetlands due to an expanding human population and urban development pressures makes restoration or creation of urban wetlands a high priority. However, urban wetland restorations are particularly challenging due to altered hydrologic patterns, a high proportion of impervious surface and stormwater runoff, degraded urban soils, historic contamination, and competitive pressure from non-native species. Urban wetland projects must also consider human-desired socio-economic benefits. We argue that using current wetland restoration approaches and existing regulatory “success” criteria, such as meeting restoration targets for vegetation structure based on reference sites in non-urban locations, will result in “failed” urban restorations. Using three wetland Case Studies in highly urbanized locations, we describe geophysical tools, stormwater management methods, and design approaches useful in addressing urban challenges and in supporting “successful” urban rehabilitation outcomes. We suggest that in human-dominated landscapes, the current paradigm of “restoration” to a previous state must shift to a paradigm of “rehabilitation”, which prioritizes wetland functions and values rather than vegetation structure in order to provide increased ecological benefits and much needed urban open space amenities.

The New York African Burial Ground (NYABG) is the country’s oldest and largest burial site of free and enslaved Africans. Re-discovered in 1991, this site provided evidence of the biological and cultural existence of a 17th and 18th Century historic population viewing their skeletal remains. However, the skeletal remains were reburied in October 2003 and are unavailable for further investigation. The analysis of grave soil samples with modern technology allows for the assessment of trace metal presence. Portable X-ray fluorescence (pXRF) spectrometry provides a semi-quantitative and non-destructive method to identify trace metals of this population and in the surrounding environment. Sixty-five NYABG soil samples were analyzed on a handheld Bruker Tracer III- SD XRF with 40 kV of voltage and a 30μA current. Presence of As, Cu, and Zn can potentially decipher the influence of the local 18th Century pottery factories. Elevated levels of Sr validate the assumed heavy vegetative diets of poor and enslaved Africans of the time. Decreased levels of Ca may be due in part to the proximity of the Collect Pond, the existing water table until the early 19th Century, and Manhattan’s rising sea level causing an elevated water table washing away the leached Ca from human remains. These data help us reconstruct the lives of these early Americans in what became New York City.

In cities, the strong heterogeneity of soils, added to the lack of standardized assessment methods, serves as a barrier to the estimation of their soil organic carbon content (SOC), soil organic carbon stocks (SOCS; kgC m(-2)) and soil organic carbon citywide totals (SOCCT; kgC). Are urban soils, even the subsoils and sealed soils, contributing to the global stock of C? To address this question, the SOCS and SOCCT of two cities, New York City (NYC) and Paris, were compared. In NYC, soil samples were collected with a pedological standardized method to 1 m depth. The bulk density (D-b) was measured; SOC and SOCS were calculated for 0-30 cm and 30-100 cm depths in open (unsealed) soils and sealed soils. In Paris, the samples were collected for 0-30 cm depth in open soils and sealed soils by different sampling methods. If SOC was measured, Db had to be estimated using pedotransfer functions (PTFs) refitted from the literature on NYC data; hence, SOCS was estimated. Globally, SOCS for open soils were not significantly different between both cities (11.3 +/- 11.5 kgC m(-2) in NYC; 9.9 +/- 3.9 kgC m(-2) in Paris). Nevertheless, SOCS was lower in sealed soils (2.9 +/- 2.6 kgC m(-2) in NYC and 3.4 +/- 1.2 kgC m(-2) in Paris). The SOCCT was similar between both cities for 0-30 cm (3.8 TgC in NYC and 3.5 TgC in Paris) and was also significant for the 30-100 cm layer in NYC (5.8 TgC). A comparison with estimated SOCCT in agricultural and forest soils demonstrated that the city's open soils represent important pools of organic carbon (respectively 110.4% and 44.5% more C in NYC and Paris than in agricultural soils, for 0-30 cm depth). That was mainly observable for the 1 m depth (146.6% more C in NYC than in agricultural soils). The methodology to assess urban SOCS was also discussed. (c) 2018 Elsevier B.V. All rights reserved.

Although more than 600,000 coronary stents are implanted during percutaneous coronary interventions (PCIs) annually in the United States, no real-world surveillance system exists to monitor their safety, so claims data are often used for this purpose. We used deterministic matching to link patients

Reconstitution of coronary flow in aortic root replacement has generally been accomplished by (1) the Bentall (inclusion) technique, (2) the Cabrol (graft) technique, or (3) the direct reimplantation of coronary artery buttons (button technique). The inclusion and graft techniques have at times required supplementation by a Cabrol fistula from the peri-graft space to the right atrium for control of bleeding. Our experience over an 8-year period comprises 33 composite graft replacements of the aortic root (24 male, 9 female, ages 16–79). Twenty-seven patients had aneurysm (annuloaortic ectasia), 5 had acute dissection, and 1 had advanced endocarditis. The Bentall technique was used in 7 patients, the graft technique in 7, and the button technique in 19. Five were reoperations and in an additional 5 patients, therapeutic coronary bypass or valve replacement needed to be performed. Hospital mortality was 4/33 (12.1%). Actuarial overall survival 1 year after the operation was 84.8%. Complications related to aortic root replacement occurred only in patients not operated with the button technique and included persistence of the Cabrol fistula requiring reexploration in a patient done by the graft technique, saphenous vein graft stenosis in a patient done by the graft technique, and postoperative bleeding in 3 patients done with the Bentall (2 patients) and the graft (1 patient) technique. In late follow-up, survival free of complications related to the aortic replacement was 94.7% in patients done with the button technique and 57.1% in patients done with the other techniques (p

Objectives: To determine the incidence, impact, etiology, and methods for prevention of stroke after surgery of the thoracic aorta. Methods: A total of 317 thoracic aortic operations on 303 patients (194 male, 109 female) aged 13 to 87 years (mean 61 years) were reviewed. There were 218 procedures on the ascending aorta and arch and 99 on the descending aorta. Of the 218 procedures on the ascending aorta and arch, 86 involved cardiopulmonary bypass, 122 involved deep hypothermic circulatory arrest, 2 involved antegrade cerebral perfusion, and 8 involved "clamp and sew" or left heart bypass. Of the 99 procedures on the descending aorta, 20 involved "clamp and sew," 69 involved left heart or full bypass, and 10 involved deep hypothermic circulatory arrest. A total of 206 cases were elective and 97 were emergency operations. Results: Twenty-three (7.3%) of 317 patients had a stroke. Fifteen strokes occurred in operations on the ascending aorta and 8 in operations on the descending aorta (6.9% vs 8.1%; P =.703). Stroke occurred in 16 (16.5%) of 97 emergency operations and 7 (3.4%) of 206 elective operations ( P =.001). In the 300 patients surviving the operation, stroke was a significant predictor of postoperative death (9/23 [39.1%] vs 23/277 [8.3%]; P =.001). Analysis of operative reports, brain images, and neurologic consultations revealed 15 of the 23 strokes were embolic, 3 were ischemic, 3 hemorrhagic, and 2 indeterminate. Patients with stroke had longer intensive care unit stays (18.4 vs 6.8 days; P =.0001), longer times to extubation (12.7 vs 3.8 days; P ||.0012), longer postoperative stays (31.4 vs 14.3 days; P =.001), and decreased age-adjusted survival (relative risk 2.775; P =.0013). After implementation of a rigorous antiembolic regimen, both strokes and mortality trended downward. Conclusions: (1) Stroke complicates surgery of both the ascending and descending thoracic aorta and warrants consideration in decision making. (2) Strokes are largely embolic. (3) Antiembolic measures for particles and air are essential, including gentle aortic manipulation, thorough debridement, transesophageal echocardiography to identify aortic atheromas, carbon dioxide flooding of the field, and (in descending cases) proximal clamp application before initiating femoral perfusion. J Thorac Cardiovasc Surg 2001;122:935-45

Background —Cardiopulmonary bypass (CPB) induces a systemic inflammatory response that causes substantial clinical morbidity. Activation of complement during CPB contributes significantly to this inflammatory process. We examined the capability of a novel therapeutic complement inhibitor to prevent pathological complement activation and tissue injury in patients undergoing CPB. Methods and Results —A humanized, recombinant, single-chain antibody specific for human C5, h5G1.1-scFv, was intravenously administered in 1 of 4 doses ranging from 0.2 to 2.0 mg/kg before CPB. h5G1.1-scFv was found to be safe and well tolerated. Pharmacokinetic analysis revealed a sustained half-life from 7.0 to 14.5 hours. Pharmacodynamic analysis demonstrated significant dose-dependent inhibition of complement hemolytic activity for up to 14 hours at 2 mg/kg. The generation of proinflammatory complement byproducts (sC5b-9) was effectively inhibited in a dose-dependent fashion. Leukocyte activation, as measured by surface expression of CD11b, was reduced ( P P =0.05) in patients who received 2 mg/kg. Sequential Mini-Mental State Examinations (MMSE) demonstrated an 80% reduction in new cognitive deficits ( P P Conclusions —A single-chain antibody specific for human C5 is a safe and effective inhibitor of pathological complement activation in patients undergoing CPB. In addition to significantly reducing sC5b-9 formation and leukocyte CD11b expression, C5 inhibition significantly attenuates postoperative myocardial injury, cognitive deficits, and blood loss. These data suggest that C5 inhibition may represent a novel therapeutic strategy for preventing complement-mediated inflammation and tissue injury.

A long history of urbanization and industrialization has affected trace elements in New York City (NYC) soils. Selected NYC pedons were analyzed by aqua regia microwave digestion and sequential chemical extraction as follows: water soluble (WS); exchangeable (EX); specifically sorbed/carbonate bound (SS/CAR); oxide-bound (OX); organic/sulfide bound (OM/S). Soils showed a range in properties (e.g., pH 3.9 to 7.4). Sum of total extractable (SUMTE) trace elements was higher in NYC parks compared to Bronx River watershed sites. NYC surface horizons showed higher total extractable (TE) levels compared to US non-anthropogenic soils. TE levels increased over 10 year in some of the relatively undisturbed and mostly wooded park sites. Surface horizons of park sites with long-term anthropogenic inputs showed elevated TE levels vs. subsurface horizons. Conversely, some Bronx River watershed soils showed increased concentrations with depth, reflective of their formation in a thick mantle of construction debris increasing with depth and intermingled with anthrotransported soil materials. Short-range variability was evident in primary pedons and satellite samples (e.g., Pb 253 ± 143 mg/kg). Long-range variability was indicated by PbTE (348 versus 156 mg/kg) and HgTE (1 versus 0.3 mg/kg) concentrations varying several-fold in the same soil but in different geographic locations. Relative predominance of fractions: RES (37 %) > SS/CAR (22 %) > OX (20 %) > OM/S (10 %) > EX (7 %) > WS (4 %). WS and EX fractions were greatest for Hg (7 %) and Cd (14 %), respectively. RES was predominant fraction for Co, Cr, Ni, and Zn (41 to 51 %); SS/CAR for Cd and Pb (40 and 63 %); OM/S for Cu and Hg (36 and 37 %); and OX for As (59 %).

Soils in urban, industrial, traffic, mining and military areas (SUITMA) is a working group of the International Union of Soil Sciences created in 1998 to increase and promote soil science in strongly anthropized areas (Morel and Heinrich 2008). Originally dedicated to basic soil science aimed at the description, analysis, classification, and mapping of soils developed in humantransformed environments, i.e., the SUITMAs, which exhibit contrasting features in comparison with natural soils, the SUITMA group interest has shifted towards the study of soil functions, their status and restoration, and their role in the functioning and evolution of urban ecosystems. Every 2 years, the SUITMA group organizes a conference (i.e., Essen, Nancy, Cairo, Nanjing, New York City, Marrakech) which gathers 100–150 scientists and professionals whose activities are centered in urban and peri-urban environments. The 2011 conference (SUITMA 6) was held in Marrakech, Morocco. It was co-organized by the Faculte des Sciences et Techniques of Marrakech and the GISFI (http://www.gisfi.fr). One hundred participants attended the conference and a total of 45 communications and 48 posters were presented in four sessions: session 1: SUITMA properties and diversity, contamination, and remediation; session 2: role of SUITMAs in global change and water quality; session 3: biodiversity in SUITMAs; and session 4: SUITMAs as buffer for human health and social stability. Eleven peer-reviewed papers are being published in this special issue of the Journal of Soils and Sediments, which focus on the properties, processes, evolution, and management of soils in urban and human-altered environments. Targets of study include soils with technic materials (Abakumov et al. 2013; El Khalil et al. 2013; Houben et al. 2013; Huot et al. 2013; Nehls et al. 2013; Schonsky et al. 2013), those with elevated metal contents (Aboudrar et al. 2013; Jean-Soro et al. 2013), soils in storm water infiltration basins (Coulon et al. 2013; El-Mufleh et al. 2013), and soils with landmines (Preetz et al. 2013). The conference was completed with a 2-day field trip in Marrakech and its vicinity to study the impacts of mining activities on soils, the consumption of agricultural soils by urbanization (e.g., the Palmeraie of Marrakech), the management of water in arid zones, and the creation of urban parks. During the meeting, Torun, Poland, was selected for the next conference (SUITMA 7, September 16–22, 2013; http://www.suitma7.umk.pl). SUITMA will also be present in 2014 at the 20th World Congress of Soil Science in Jeju, South Korea, with a symposium entitled “Urban soils—properties, functions, and evolution.” We look forward to welcoming new members and old friends at both events. N. Dickinson Department of Ecology, Lincoln University, PO Box 84, Lincoln, Canterbury 7647, New Zealand

Background Recently, surgeons have embraced axillary artery cannulation for type A aortic dissection repair out of concern for malperfusion phenomena with traditional femoral artery cannulation. My colleagues and I sought to determine whether these concerns are justified. Methods Records of 86 consecutive patients (51 men and 35 women; age, 30 to 86 years; mean, 62 years) undergoing surgical repair for acute type A dissection were reviewed. Cannulation site, specific operative repair, and complications related to cannulation were noted. Results Seventy-nine cannulations were performed in the femoral artery (47 left, 23 right, and 9 unspecified), 3 in the axillary artery (1 left and 2 right), and 4 in the ascending aorta or arch. Deep hypothermic arrest was used in 64 operations. Seven involved re-sternotomy. Seventy patients had supracoronary grafts (2 with valve replacement and 10 with valve resuspension), and 16 underwent aortic root replacement. Fourteen patients were in shock from cardiac tamponade. Eighty patients survived the operation, and 71 were hospital survivors. Malperfusion on initiation of cardiopulmonary bypass was noted in 3 patients. In 1, the original cannulation site was the ascending aorta, and the cannula was moved to the femoral artery for correction. In 2, the original cannulation site was the femoral artery, and the cannula was moved to the ascending aorta. Malperfusion on clamping of the aorta or on resumption of aortic flow was noted in no patient. Postoperative ischemia of any vascular bed was noted locally only in 3 (cannulated) lower extremities. Conclusions Straight femoral cannulation for all phases of type A dissection repair is appropriate and yields excellent clinical results. The anticipated malperfusion events are actually rare (2 of 79 with femoral artery cannulation, or 2.5%).

Controversy exists regarding the management of angiographically disease-free saphenous vein grafts at the time of redo coronary artery bypass grafting (CABG). Some authorities favor replacement of these disease-free grafts, arguing that occlusion is likely in the near future. Others believe that these grafts are "biologically privileged" and should not be replaced.One hundred thirty-two consecutive patients (113 men, 19 women, aged 46 to 88 years, mean 67 years) underwent redo revascularization with one or more angiographically disease-free saphenous vein grafts at the time of redo CABG. Thirty-six patients had the disease-free grafts replaced (R) and 96 did not (NR). The mean interval from the first CABG was 9.25 years.Surgical mortality was comparable in the NR and R groups (5 of 96 or 5.2% versus 3 of 36 or 8.3%, respectively; p0.5). Survival at 1 and 3 years was higher in the NR group than the R group (98% versus 80%, and 95% vs. 66% respectively; p0.0001). Late myocardial infarction was less common in the NR group than in the R group (12 of 91 or 12.9% versus 12 of 33 or 36.4%; p0.003). Recurrent angina was less common in the NR than in the R group (21 of 91 or 23.1% versus 15 of 33 or 45.5%; p0.015). Cardiac hospitalization was required less commonly in the NR than in the R group (11 of 91 or 12.1% versus 12 of 33 or 36.4%; p0.002). In nondiseased grafts undergoing angiographic evaluation late after redo CABG, rate of new stenosis was lower in NR grafts than in R grafts (2 of 12 or 16.7% versus 2 of 3 or 66.7%; p0.05).With a conservative approach that does not replace nondiseased saphenous vein grafts at redo CABG (1) there is no increase in operative mortality, (2) good late survival is obtained, (3) clinical ischemia related to the NR saphenous vein grafts is uncommon, and (4) NR grafts continue to be patent. We conclude that disease-free vein grafts may not require routine replacement at redo CABG. A randomized study is required for definitive resolution.

Three cases of primary malignant melanoma of the esophagus are presented with emphasis on the gross and histopathologic features. Grossly, the tumors tended to be polypoid with a smooth predominantly intact overlying mucosa. Microscopically a junctional lentiginous growth pattern was characteristic as well as a tendency to expand and fill the submucosa without invading the muscularis. A given tumor invariably was more extensive than grossly suspected and the lateral junctional spread was striking in two of the cases. Primary malignant melanoma should be included in the preoperative differential diagnosis of radiographically unusual esophageal tumors, particularly if the lesion is polypoid. Because of the potentially widespread intramucosal component, surgical treatment of esophageal melanoma required a radical procedure with a far greater margin than for the usual squamous cell carcinoma. Intracavitary radiotherapy may be a useful form of adjuvant therapy in selected patients.

The use of an automated system equipped with a microprocessor-based controller and data handler is presented for the analysis of soil extracts for P, K, Ca, and Mg. With the aid of drift, gain, and carryover correction features, the system has the potential to improve accuracy and precision of analytical results. Moreover, the system allows the use of faster sampling rates in its operation. Accuracy and precision are evaluated for P, K, Ca, and Mg analyses, determined in standard solutions with the automated system at 50, 85, 120 and 155 hourly sampling rates. Results of P, K, Ca, and Mg analyses in 3 extracts of 50 soil samples, determined with the new system at the 120 hourly sampling rate, are also presented. Analyses performed by the microprocessor- based automated system are compared with those obtained using different nonautomated techniques.

Thirty-seven quadriplegic patients with respiratory paralysis were treated by electrical stimulation of the phrenic nerves to pace the diaphragm. Full-time ventilatory support by diaphragm pacing was accomplished in 13 patients. At least half-time support was achieved in 10 others. There were two deaths unrelated to pacing in these two groups. Fourteen patients could not be paced satisfactorily, and 8 of these patients died, most of them from respiratory infections. The average time the 13 patients on total ventilatory support have had bilateral diaphragm pacemakers is 26 months. The longest is 60 months. Many of these patients are out of the hospital and several are in school or working. Injury to the phrenic nerves either by the initial trauma to the cervical cord or during operation for implantation of the nerve cuff was the most significant complication. Nerve damage from prolonged electrical stimulation has not been a problem thus far. A description of the pacemaker, the technique of its implantation, and the pacing schedule are reported.

THE rapid phosphorolytic cleavage of 5-bromodeoxy-uridine (BUdR) and 5-iododeoxyuridine (IUdR) in vivo1,2 greatly limits the clinical usefulness of these thymidine analogues as antineoplastic agents3, radiosensitizers4, systemic antiviral compounds5, or detectors of malignant tissue2. Investigations in man with halogen-labelled analogues have indicated that a greater amount of BUdR is probably retained by the body than is IUdR under non-loading conditions2. We have devised a rapid and convenient method which permits one to make a direct comparison of the rate and extent of degradation of thymidine and its analogues in the same subject, and to examine the effect of loading doses, depot administration6, and the influence of 5-fluorodeoxyuridine6, or agents designed to reduce nucleoside phosphorolysis7 on the degradation of the analogues.