Distribution of livestock sectors in Canada: Implications for manureshed management

Canada's livestock production and human populations are concentrated in southern regions. Understanding spatial and temporal distributions of animals and excreted nutrients is key to optimizing manure resources and minimizing impact of livestock. Here, we identify manureshed concerns and opportunities by reconciling nitrogen supply and demand on a regional and national scale. Data based on national statistics and farm surveys were allocated to homogeneous soil polygons (Soil Landscapes of Canada [SLC]) to quantify changes in nutrient distribution and ammonia (NH₃ ) emissions across Canada (1981-2018). Livestock sectors tied to domestic consumption, dairy and poultry, were stable over time and well dispersed. Export driven beef production has moved west since 1981, whereas pig production was prominent in Manitoba, Quebec, and Ontario. Per ha manure N excretion across livestock sectors in 2018 was generally low with 58% and 6% of the SLCs averaging <25 and >100 kg N ha^-1 , respectively. Although only 3% of SLCs had average NH₃ emissions reaching 16-200 kg ha^-1 , most of these were located near cities and emissions spiked in spring when more people might be exposed. The greatest concentrations of nutrients and livestock occurred around the three largest metropolitan areas: Toronto, Montreal-Quebec City, and Vancouver, posing challenges for nutrient recycling and public health. This study shows that as Canadian cities and livestock agriculture grow in southern Canada, so will challenges around food production, human health, and managing nutrients. Livestock and land use strategies are needed to reconcile changing animal sectors and growing populations.

One size does not fit all: Toward regional conservation practice guidance to reduce phosphorus loss risk in the Lake Erie watershed

Agricultural phosphorus (P) losses to surface water bodies remain a global eutrophication concern, despite the application of conservation practices on farm fields. Although it is generally agreed upon that the use of multiple conservation practices ("stacking") will lead to greater improvements to water quality, this may not be cost effective to farmers, reducing the likelihood of adoption. At present, wholesale recommendations of conservation practices are given; however, the application of specific conservation practices in certain environments (e.g., no-till with surface application, cover crops) may not be effective and can even lead to unintended consequences. In this paper, we present the Lake Erie watershed as a case study. The Lake Erie watershed contains regions with unique physical geographies that include differences in climate, soil, topography, and land use, which have implications for both P transport from agricultural fields and the efficacy of conservation practices in mitigating P losses. We define major regions within the Lake Erie watershed where common strategies for conservation practice implementation are appropriate, and we propose a five-step plan for bringing regionally tailored, adaptive, and cost-conscious conservation practice into watershed planning. Although this paper is specific to the Lake Erie watershed, our framework can be transferred across broader geographic regions to provide guidance for watershed planning.

Celebrating the 350th Anniversary of Phosphorus Discovery: A Conundrum of Deficiency and Excess

2019 will be the 350th anniversary of the discovery of phosphorus (P) by the alchemist Henning Brandt. This perspective traces the historical threads that P has weaved through the fabric of our society and identifies challenges to improve P stewardship in the future and for our future. A century after Brandt's discovery, P was identified in bone ash, which became the primary source of P until guano and ultimately rock P was mined to provide the various mineral formulations used today. Owing to limited supplies, a strategic shift in resource management ethics-from exploiting to conserving P resources-is needed. In agriculture, remedial strategies should consider when conservation practices can transition from P sinks to sources; however, a broader, long-term strategy for P stewardship is needed. This must include educing P loss in food and other wastes, ecovering P from waste streams, eusing P generated beneficial by-products, and estructuring production systems. A key action to enact such changes will be collaboration across all sectors of society and the supply chain, from field to fork and beyond. As this will likely increase the cost of food, fiber, and feed production, it will require an innovative mix of public and private initiatives.

Evaluation of Phosphorus Site Assessment Tools: Lessons from the USA

Critical source area identification through phosphorus (P) site assessment is a fundamental part of modern nutrient management planning in the United States, yet there has been only sparse testing of the many versions of the P Index that now exist. Each P site assessment tool was developed to be applicable across a range of field conditions found in a given geographic area, making evaluation extremely difficult. In general, evaluation with in-field monitoring data has been limited, focusing primarily on corroborating manure and fertilizer "source" factors. Thus, a multiregional effort (Chesapeake Bay, Heartland, and Southern States) was undertaken to evaluate P Indices using a combination of limited field data, as well as output from simulation models (i.e., Agricultural Policy Environmental eXtender, Annual P Loss Estimator, Soil and Water Assessment Tool [SWAT], and Texas Best Management Practice Evaluation Tool [TBET]) to compare against P Index ratings. These comparisons show promise for advancing the weighting and formulation of qualitative P Index components but require careful vetting of the simulation models. Differences among regional conclusions highlight model strengths and weaknesses. For example, the Southern States region found that, although models could simulate the effects of nutrient management on P runoff, they often more accurately predicted hydrology than total P loads. Furthermore, SWAT and TBET overpredicted particulate P and underpredicted dissolved P, resulting in correct total P predictions but for the wrong reasons. Experience in the United States supports expanded regional approaches to P site assessment, assuming closely coordinated efforts that engage science, policy, and implementation communities, but limited scientific validity exists for uniform national P site assessment tools at the present time.

Phosphorus legacy: overcoming the effects of past management practices to mitigate future water quality impairment

The water quality response to implementation of conservation measures across watersheds has been slower and smaller than expected. This has led many to question the efficacy of these measures and to call for stricter land and nutrient management strategies. In many cases, this limited response has been due to the legacies of past management activities, where sinks and stores of P along the land-freshwater continuum mask the effects of reductions in edge-of-field losses of P. Accounting for legacy P along this continuum is important to correctly apportion sources and to develop successful watershed remediation. In this study, we examined the drivers of legacy P at the watershed scale, specifically in relation to the physical cascades and biogeochemical spirals of P along the continuum from soils to rivers and lakes and via surface and subsurface flow pathways. Terrestrial P legacies encompass prior nutrient and land management activities that have built up soil P to levels that exceed crop requirements and modified the connectivity between terrestrial P sources and fluvial transport. River and lake P legacies encompass a range of processes that control retention and remobilization of P, and these are linked to water and sediment residence times. We provide case studies that highlight the major processes and varying timescales across which legacy P continues to contribute P to receiving waters and undermine restoration efforts, and we discuss how these P legacies could be managed in future conservation programs.

Selection of a water-extractable phosphorus test for manures and biosolids as an indicator of runoff loss potential

The correlation of runoff phosphorus (P) with water-extractable phosphorus (WEP) in land-applied manures and biosolids has spurred wide use of WEP as a water quality indicator. Land managers, planners, and researchers need a common WEP protocol to consistently use WEP in nutrient management. Our objectives were to (i) identify a common WEP protocol with sufficient accuracy and precision to be adopted by commercial testing laboratories and (ii) confirm that the common protocol is a reliable index of runoff P. Ten laboratories across North America evaluated alternative protocols with an array of manure and biosolids samples. A single laboratory analyzed all samples and conducted a separate runoff study with the manures and biosolids. Extraction ratio (solution:solids) was the most important factor affecting WEP, with WEP increasing from 10:1 to 100:1 and increasing from 100:1 to 200:1. When WEP was measured by a single laboratory, correlations with runoff P from packed soil boxes amended with manure and biosolids ranged from 0.79 to 0.92 across all protocol combinations (extraction ratio, filtration method, and P determination method). Correlations with P in runoff were slightly lower but significant when WEP was measured by the 10 labs (r=0.56-0.86). Based on laboratory repeatability and water quality evaluation criteria, we recommend the following common protocol: 100:1 extraction ratio; 1-h shaking and centrifuge 10 min at 1500xg (filter with Whatman #1 paper if necessary); and determining P by inductively coupled plasma-atomic emission spectrometry or colorimetric methods.

Effect of rainfall simulator and plot scale on overland flow and phosphorus transport

Rainfall simulation experiments are widely used to study erosion and contaminant transport in overland flow. We investigated the use of two rainfall simulators designed to rain on 2-m-long (2-m2) and 10.7-m-long (32.6-m2) plots to estimate overland flow and phosphorus (P) transport in comparison with watershed-scale data. Simulated rainfall (75 mm h(-1)) generated more overland flow from 2-m-long (20 L m2) than from 10.7-m-long (10 L m2) plots established in grass, no-till corn (Zea mays L.), and recently tilled fields, because a relatively greater area of the smaller plots became saturated (>75% of area) during rainfall compared with large plots (<75% area). Although average concentrations of dissolved reactive phosphorus (DRP) in overland flow were greater from 2-m-long (0.50 mg L(-1)) than 10.7-m-long (0.35 mg L(-1)) plots, the relationship between DRP and Mehlich-3 soil P (as defined by regression slope) was similar for both plots and for published watershed data (0.0022 for grassed, 0.0036 for no-till, and 0.0112 for tilled sites). Conversely, sediment, particulate phosphorus (PP), and total phosphorus (TP) concentrations and selective transport of soil fines (<2 microm) were significantly lower from 2- than 10.7-m-long plots. However, slopes of the logarithmic regression between P enrichment ratio and sediment discharge were similar (0.281-0.301) for 2- and 10.7-m-long plots, and published watershed data. While concentrations and loads of P change with plot scales, processes governing DRP and PP transport in overland flow are consistent, supporting the limited use of small plots and rainfall simulators to assess the relationship between soil P and overland flow P as a function of soil type and management.

[Early treatment of biliary lithiasis in biliary pancreatitis]

Since 1982, 38 consecutive patients with biliary pancreatitis were treated prospectively in order to prevent recurrent migration of gallstones. Removal of the stones was achieved by "early surgery" i. e. within the first week after admission or by endoscopic sphincterotomy in patients with severe pancreatitis. Gallstones were visualized by ultrasonography in 31 patients (82 p. 100). Microlithiasis was present in 14 (37 p. 100) and was missed at ultrasonography in 7 patients. According to Ranson's prognostic signs, only 4 patients had 4 or more signs. These 4 patients and 2 additional patients aged more than 85 underwent urgent retrograde cholangiography and endoscopic sphincterotomy. No complications could be attributed to this technique. Among the 4 patients with severe pancreatitis, 3 developed an abscess which required delayed surgery without further complications. The 32 other patients underwent a biliary operation within the first week after admission. Common bile duct calculi were present in 14 patients being discovered by cholangioscopy in 6. One patient died after operation and one was reoperated on for a pseudocyst on day 40. No recurrent attack of pancreatitis was observed in either group. Our study suggests that slightly delayed biliary operation with cholangioscopy during the same hospitalization can be performed safety in patients with mild pancreatitis. In patients with severe attack and/or poor general condition, endoscopic sphincterotomy is a safe technique and deserves wider consideration in the management of severe acute pancreatitis for which delayed drainage of pancreatic necrosis may occasionally be required.

The anatomical basis for retrorenal extensions of pancreatic effusions: the role of the renal fasciae

Retrorenal extension of pancreatic inflammatory processes are considered to involve invasion of the posterior pararenal space. Analysis of computed tomographic (CT) images demonstrates preservation of posterior pararenal fat in most patients, implicating some other mechanism. We have examined the anatomical basis for these retrorenal extensions in static and functional studies of 12 cadavers using CT imaging, dissection and histological techniques. We observed that the posterior renal fascia was thicker than the anterior, that it could be easily separated into two layers by manual dissection and injections of liquid latex, that the inner (anterior) layer of the posterior fascia was continuous with the anterior fascia and the outer layer continuous with the lateroconal fascia. The point at which the two layers of the posterior fascia separated laterally and the medial extent of the posterior fascia varied considerably in CT scans of 100 patients. These data are interpreted to mean that pancreatic effusions extend posterior to the kidney by separating the two layers of the posterior renal fascia.

Predicting WAIS-R scores from the Revised Beta for low functioning minority group offenders

Investigated the use of the Revised Beta for predicting WAIS-R scores of low functioning minority group criminal offenders. Ninety black and Hispanic offenders who scored below 80 on the Beta were administered the WAIS-R. For the entire group, mean scores on the two measures were correlated only moderately and were not interchangeable. Offenders scored significantly lower on the Beta than on the WAIS-R. Subgroup analyses of blacks (N = 67) and Hispanics (N = 23) revealed that the Beta scores for the Hispanic offenders were not related significantly to either their WAIS-R Verbal or Full Scale scores.

Dynamic cholecystosonography of the contracted gallbladder: the double-arc-shadow sign

In 41 of 55 patients in whom the gallbladder lumen was not identified by static sonography, a specific image was observed with dynamic scanning. This consisted of two parallel arcuate echogenic lines separated by a thin anechoic space with distal acoustic shadowing: the "double-arc-shadow" sign. The proximal arc represents the near wall of the gallbladder, the anechoic space is bile in the gallbladder lumen, and the distal arc represents the gallstone(s) responsible for the acoustic shadowing. Of the two additional sonographic patterns observed, the "'echo-shadow" pattern, which was seen with static scanning in 44 and with dynamic scanning in eight patients was an accurate, indirect indicator for cholelithiasis. On the other hand, "nonvisualization" was an unreliable sign. Of 11 such patients scanned with static and six with dynamic scanning, four proved to have a normal gallbladder. Comparing static with dynamic cholecystosonography in patients with nonphysiologically contracted gallbladders, the accuracy rate for cholelithiasis increased from 86.3% (44 of 51 patients) to 96% (49 of 51). In 41 of these patients (80%) the double-arc-shadow pattern positively identified the gallbladder lumen, increasing the confidence of the examiner. Furthermore, these images can be produced in a fraction of the time required for complete evaluation with static scanning.

Comparison of real-time and gray-scale static ultrasonic cholecystography

The authors compared the diagnostic accuracy of gray-scale static scanning and high-resolution real-time ultrasonography in the evaluation of gallbladder disease in 339 patients. With real-time scanning, the gallbladder was seen in 97.6% of cases and gallstones were unequivocally demonstrated in 94.5% of patients with cholelithiasis, compared to 89.5% and 78.8%, respectively, with static scanning. Real-time scanning is more accurate because it can show the contracted, stone-filled gallbladder. It is also faster and more convenient to both patient and examiner, making it the procedure of choice in the primary evaluation of gallbladder disease.

Suicide attempt by pacemaker system abuse: a case report with comments on the psychological adaptation of pacemaker patients

Thirty patients selected at random from a pacemaker clinic were interviewed to gain an understanding of how psychological symptoms in these patients related to their cardiac condition. In 20% veiled depression or even a wish to die was elicited. Joking, fantasies, and denial were common psychological mechanisms used to adapt to their illness and the pacemaker itself. A dramatic example of attempted suicide in which the patient tried to cut the subcutaneously implanted pacemaker leads is presented and illustrated.

Juvenile ankylosing spondylitis

The clinical histories and radiographs of 28 patients with ankylosing spondylitis were reviewed. Symptoms developed before the age of 17 in all cases. Juvenile ankylosing spondylitis affected youths in their early teens, who presented most commonly with appendicular joint complaints rather than low back pain. The disease was progressive, with the characteristic changes of ankylosing spondylitis eventually occurring in the spine and sacroiliac joints, frequently accompanied by widespread and severe changes in the appendolar joints. HLA B 27 antigen was present in 8 of the 9 patients tested. Thorough clinical, radiographic, and laboratory examination should prevent confusion with juvenile rheumatoid arthritis.

Necroqizing enterocolitis with pneumatosis intestinalis in systemic lupus erythematosus and polyarteritis

Pneumatosis intestinalis was encountered in association with fatal necrotizing enterocolitis in systemic lupus erythematosus (SLE) and polyarteritis nodosa. The radiologic identification of mottled, bubbly, and linear collections of intramural intestinal gas distinguish this ominous complication from benign pneumatosis cystoides intestinalis. In the setting of intestinal vasculitis due to SLE or polyarteritis nodosa, these characteristic radiologic features indicate necrotizing enterocolitis. Since corticosteroids may mask clinical progression of the intestinal lesion, radiologic evaluation is essential in the overall management of the patient with intestinal vasculitis.

Sulfatide cholecystosis

Polypoid masses metachromatic sulfatides have been found at autopsy in the gallbladder of patients with metachromatic leucodystrophy. In a 10-year-old girl with this disease oral cholecystrography demonstrated a filling defect, which was felt to represent a polyp. In the proper clinical setting, sulfatide cholecystosis should be considered in the differential diagnosis of polypoid lesions of the gallbladder.

Pseudotumor of the nasal fossa secondary to mucoid impaction in choanal atresia

An intranasal mass was discovered during evaluation of unilateral choanal atresia. Radiologic investigation of the lobulated cystic mass showed no communication with the central nervous system or any other bony abnormalities. During surgery for the choanal atresia, the mass proved to be a mucous impaction. The case illustrates the need to utilize decongestants and aspiration prior to instillation of contrast agent.