Law in Colonial America: The Reassessment of Early American Legal History

A Review of Law and Society in Puritan Massachusetts: Essex County, 1629-1692 by David Thomas Konig, and Dispute and Conflict Resolution in Plymouth County, Massachusetts, 1725-1825 by William E. Nelson, and Faithful Magistrates and Republican Lawyers: Creators of Virginia Legal Culture, 1680-1810 by A.G. Roebe

Cracking Silent Codes: Critical race theory and education organizing

Critical race theory (CRT) has moved beyond legal scholarship to critique the ways in which “colorblind” laws and policies perpetuate existing racial inequalities in education policy. While criticisms of CRT have focused on the pessimism and lack of remedies presented, CRT scholars have begun to address issues of praxis. Specifically, communities of color must challenge the dominant narratives of mainstream institutions with alternative visions of pedagogy and school reform, and community organizing plays an important role in helping communities of color to articulate these alternative counter-narratives. Yet, many in education organizing disagree with CRT\u27s critique of colorblindness. Drawing on five case study organizations working towards school reform in the South Bronx neighborhoods of New York City, this article traces the difficulty of implementing anti-racist practices in education organizing groups. It also analyzes specific practices that may help such groups to transform race-consciousness into positive political action

Quality-of-life outcomes in older patients with early-stage rectal cancer receiving organ-preserving treatment with hypofractionated short-course radiotherapy followed by transanal endoscopic microsurgery (TREC): non-randomised registry of patients unsuitable for total mesorectal excision

Background Older patients with early-stage rectal cancer are under-represented in clinical trials and, therefore, little high-quality data are available to guide treatment in this patient population. The TREC trial was a randomised, open-label feasibility study conducted at 21 centres across the UK that compared organ preservation through short-course radiotherapy (SCRT; 25 Gy in five fractions) plus transanal endoscopic microsurgery (TEM) with standard total mesorectal excision in adults with stage T1–2 rectal adenocarcinoma (maximum diameter ≤30 mm) and no lymph node involvement or metastasis. TREC incorporated a non-randomised registry offering organ preservation to patients who were considered unsuitable for total mesorectal excision by the local colorectal cancer multidisciplinary team. Organ preservation was achieved in 56 (92%) of 61 non-randomised registry patients with local recurrence-free survival of 91% (95% CI 84–99) at 3 years. Here, we report acute and long-term patient-reported outcomes from this non-randomised registry group. Methods Patients considered by the local colorectal cancer multidisciplinary team to be at high risk of complications from total mesorectal excision on the basis of frailty, comorbidities, and older age were included in a non-randomised registry to receive organ-preserving treatment. These patients were invited to complete questionnaires on patient-reported outcomes (the European Organisation for Research and Treatment of Cancer Quality of Life [EORTC-QLQ] questionnaire core module [QLQ-C30] and colorectal cancer module [QLQ-CR29], the Colorectal Functional Outcome [COREFO] questionnaire, and EuroQol-5 Dimensions-3 Level [EQ-5D-3L]) at baseline and at months 3, 6, 12, 24, and 36 postoperatively. To aid interpretation, data from patients in the non-randomised registry were compared with data from those patients in the TREC trial who had been randomly assigned to organ-preserving therapy, and an additional reference cohort of aged-matched controls from the UK general population. This study is registered with the ISRCTN registry, ISRCTN14422743, and is closed. Findings Between July 21, 2011, and July 15, 2015, 88 patients were enrolled onto the TREC study to undergo organ preservation, of whom 27 (31%) were randomly allocated to organ-preserving therapy and 61 (69%) were added to the non-randomised registry for organ-preserving therapy. Non-randomised patients were older than randomised patients (median age 74 years [IQR 67–80] vs 65 years [61–71]). Organ-preserving treatment was well tolerated among patients in the non-randomised registry, with mild worsening of fatigue; quality of life; physical, social, and role functioning; and bowel function 3 months postoperatively compared with baseline values. By 6–12 months, most scores had returned to baseline values, and were indistinguishable from data from the reference cohort. Only mild symptoms of faecal incontinence and urgency, equivalent to less than one episode per week, persisted at 36 months among patients in both groups. Interpretation The SCRT and TEM organ-preservation approach was well tolerated in older and frailer patients, showed good rates of organ preservation, and was associated with low rates of acute and long-term toxicity, with minimal effects on quality of life and functional status. Our findings support the adoption of this approach for patients considered to be at high risk from radical surgery. Funding Cancer Research UK

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Law in Colonial America: The Reassessment of Early American Legal History

A Review of Law and Society in Puritan Massachusetts: Essex County, 1629-1692 by David Thomas Konig, and Dispute and Conflict Resolution in Plymouth County, Massachusetts, 1725-1825 by William E. Nelson, and Faithful Magistrates and Republican Lawyers: Creators of Virginia Legal Culture, 1680-1810 by A.G. Roebe

Sir William Berkeley\u27s \u3ci\u3eDiscourse and View of Virginia\u3c/i\u3e: A Note on Its Authorship

Sir William Berkeley (1605-1677), long-time governor of Virginia is known to history mainly for his part in Bacon\u27s Rebellion, an episode that forever stained an otherwise noteworthy reputation. Of a West Country family, he took degrees at the University of Oxford before making a tour of the Continent and finding a place at the court of Charles I. He remained a courtier until lack of advancement led him to seek a fresh start somewhere else, and he used his connections to win appointment as governor of Virginia in 1641. Save for the eight years of the Interregnum (1652-1660), he was Virginia\u27s leading politician and planter throughout the three decades he lived in the colony. Foremost among his landholdings was Green Spring plantation, the site of his private residence. Eventually he turned the house into the largest of early Anglo-American stately mansions, whereas he used the acreage to conduct numerous agricultural trials as he searched for marketable substitutes for tobacco. Twice married, his second wife was the redoubtable Frances Culpeper Stephens Berkeley (1635-1695?), who dominated his last years as governor. Disagreements between the aging Berkeley and Nathaniel Bacon, his cousin by marriage, over Indian policy ripened into Bacon\u27s Rebellion in 1676, which ruined him politically. He returned to England in 1677 to defend himself and died in disgrace far from the place he called home. More Virginian than cavalier, his like as governor would not be seen in the Old Dominion ever again. A gifted man, deeply inclined to the betterment of his adopted homeland, Berkeley devoted much of his life there to diversifying its economy. He successfully produced various exotic staples-silk, potash, wine, rice, flax, dye stuffs, citrus fruits-as substitutes for tobacco, and he pushed his fellow Virginians to emulate him. Likewise, he sought the backing of the crown, and at the behest of the General Assembly, he returned to England in 1661 to lobby for his schemes. While in London, he wrote A Discourse and View of Virginia, which is one of his few surviving printed works

\u3ci\u3eCardinal Principles, Historical and Archival\u3c/i\u3e

This first convention of our associtation invites observations on the present state of documentary editing. As a branch of learning, documentary editing has come of age, for underlying its practice are principles and values that make it as distinctive a field of inquiry as say quantitative history or literary criticism. That it has matured is due in no small measure to scholars like our president and president-elect, who rank among the pioneers of modern editorial methods. Documentary editing has gained in popularity, as witness the growth of this organization in just its first year of existence or the increasing number of graduate programs in which editing is a part of their course offerings. For example, the second edition of the American Historical Association\u27s Guide to Departments of History, published in 1977, listed 19 graduate departments that offered classes in editing, whereas the 1979 edition numbers a total of 24 departments. This change represents an increase of 20 percent in just two years. One probable import of these statistics is their reflection of efforts by history departments to prepare their graduate students with skills that will enhance their attractiveness in a declining job market. The figures may also indicate a trend toward the day when graduate schools become the chief breeding ground for future documentary editors. Whatever their portent, they certainly argue the advisability of having working editors periodically examine the manner in which future practitioners are trained. Because this association is committed to encouraging excellence in documentary editing, it can be the ideal vehicle for making such examinations. The membership can take a leading part in establishing standards to guide those of us who instruct young scholars in the mysteries of our craft. To do that, though, we ought to have a clear understanding as to how we wish to train future editors, especially the solo practitioner who is the most numerous of the genus documentary editor