Core Ideas Improving soil aggregation may promote infiltration. Soil aggregation properties differ by land use. Grassland and forest restoration may improve groundwater recharge. Improving soil aggregate stability, thus improving infiltration and reducing surface runoff and soil erosion, may lead to multiple environmental benefits in the Lower Mississippi River Valley (LMRV). The objective of this study was to evaluate the effects of common landuses (i.e., native prairie, deciduous forest, coniferous forest, Conservation Reserve Program [CRP] grassland, and conventional‐tillage [CT] and no‐tillage [NT] agriculture), aggregate‐size class, and soil depth on aggregate‐stability‐related properties on fine‐textured, loessial and alluvial soils in the Arkansas Delta region of the LMRV. Total water‐stable aggregate (TWSA) concentrations in the top 10 cm in the native prairie, CRP, and coniferous forest were similar (p > 0.05) to each other, averaging 806 g kg−1, and were 35% greater (p < 0.05) than that of the NT and CT agroecosystems, which did not differ and averaged 605 g kg−1. The mean weight diameter (MWD) in the top 10 cm in the native prairie, CRP, and coniferous forest was similar (p > 0.05) to each other, averaging 2.1 mm, and were 70% greater (p < 0.05) than that in the NT and CT agroecosystems, which did not differ and averaged 1.3 mm. In the top 5 cm, the MWD and TWSA concentration were 17 and 8% greater (p < 0.05), respectively, than that in the 5‐ to 10‐cm depth interval. Grassland and forest restoration, specifically of highly erodible agricultural land, should be considered to contribute to improvements in soil structural stability and the future sustainability of soil and water resources in the LMRV.

Introduction: Studies have demonstrated safety and efficacy of dexmedetomidine infusions at doses up to 1.5 mcg/kg/hr. Data evaluating doses greater than 1.5 mcg/kg/hr is limited; however, up to 2.5 mcg/kg/hr has been utilized. It is uncertain whether higher doses provide additional benefit but may result in more adverse events. The purpose of this study was to compare the safety and efficacy of dexmedetomidine at high doses (greater than 1.5 mcg/kg/hr) versus standard doses (0.2 to 1.5 mcg/kg/hr). Methods:A retrospective cohort study was conducted in critically ill, mechanically ventilated patients receiving dexmedetomidine for at least 24 hours. Standard dose dexmedetomidine (SD-DEX) was defined as less than or equal to 1.5 mcg/kg/ hr and high dose (HD-DEX) as greater than 1.5 mcg/kg/hr. Patients were assigned to SD-DEX group if maximum dose of dexmedetomidine received was between 0.2 and 1.5 mcg/kg/hr. Conversely, patients were assigned to HD-DEX group if maximum dose of dexmedetomidine received was greater than 1.5 mcg/kg/hr. Composite incidence of bradycardia or hypotension and proportion of time within target sedation were assessed.Results: A total of 799 patients were screened for inclusion with 120 included: 69 in the HD-DEX group and 51 in the SD-DEX group. Composite incidence of bradycardia or hypotension was not statistically different. A significantly larger proportion of time was spent within target sedation in the SD-DEX group. More patients in the HD-DEX group required sedatives and antipsychotics than the SD-DEX group and tended to receive higher daily doses of concomitant medications. Conclusion:Dexmedetomidine doses greater than 1.5 mcg/kg/hr may be as safe as standard doses; however, no additional benefit in maintaining target sedation level was found.

BackgroundRecognition of delirium in the intensive care unit (ICU) and its impact on hospitalization, short-term and long-term outcomes has gained increased awareness in the past decade [1]. The management of delirium is more complicated in patients with traumatic brain injuries (TBI) due to the injury-associated increased risk for neurobehavioral sequelae, including agitation, aggression, and disinhibition [2].Early recognition and management of delirium is necessary due to the associated morbidity and mortality. It is important to use an agent that is safe for the management of agitation and delirium in the ICU. Haloperidol is a commonly used neuroleptic agent for the management of agitation and delirium in critically ill patients. Haloperidol inhibits dopamine receptors (D2) in the mesolimbic system, which regulates feelings of reward, motivation, and reinforcement [3]. There is concern with the use of haloperidol in TBI patients due to its adverse event profile including neuroleptic

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A health care system instituted measures to enhance the safety of using an elastomeric infusion system for pain management.