Torsade de pointes induced by intravenous amiodarone therapy accompanied by marked augmentation of the transmural dispersion of repolarization in a patient with tachycardia-induced-cardiomyopathy.

We report a 77-year-old human on renal dialysis for end-stage renal disease with heart failure and atrial fibrillation (AF) complicated by a high ventricular frequency. The underlying disease was thought as tachycardia-induced-cardiomyopathy. Intravenous infusion of amiodarone was initiated, and direct current cardioversion succeeded in converting AF to sinus rhythm. Then, excessive increases in the QT and Tpeak-Tend (Tp-e) intervals were seen and hypokalemia induced by hemodialysis led to the development of numerous episodes of torsades de pointes (TdP). Magnesium repletion was effective in preventing TdP, while Tp-e intervals returned to the previous values 2 days after the discontinuation of amiodarone.

Environmental impacts of a rice-beef-biogas integrated system in the Mekong Delta, Vietnam evaluated by life cycle assessment.

It is essential to increase the production of foods to meet the increasing future food demand, but this should be done in an environmentally sustainable manner. Integrated crop-livestock systems have been suggested to balance the reduction of environmental impacts and the increase in food production. Here we assessed and compared the environmental impacts of specialized (SPC) and integrated (ITG) rice and beef production systems in the Mekong Delta, Vietnam, using a life-cycle assessment (LCA). The productions of rice and beef are separated in the SPC, whereas they are integrated in the ITG: cattle manure is treated by a biodigester for biogas production, its digestate is applied to rice paddy fields as fertilizer, and part of the rice straw is used as cattle feed. We developed an LCA model based on data collected by site investigations of rice and beef farms and the relevant literature and LCA databases. Our evaluation of the ITG and SPC rice-beef production systems using the LCA revealed that among the four environmental impact categories investigated herein, the ITG had less environmental impacts on climate change (22%), energy consumption (22%), and eutrophication (14%) compared to the SPC. With the ITG, the reduction of methane emissions from paddy fields, the avoided energy consumption by the biogas produced, and the lower ammonia, nitrate, and phosphorous emissions from cattle manure and no eutrophying pollutant emissions from grassland were the main contributors to the lower greenhouse gas emissions, energy consumption, and eutrophication potential of this system, respectively. A sensitivity analysis showed that the use of cover for digestate storage resulted in lower environmental impacts of the ITG system compared to SPC system in all of the impact categories investigated here. These results provide helpful information to develop a circular and resource-efficient rice and beef production system that balances increasing productivity with environmental sustainability in rice-producing countries, particularly in Asia.

Effects of Italian ryegrass silage supplementation on feed intake and behavior of pregnant sows.

This study aimed to assess the behavior and stress status of pregnant sows following supplementation with Italian ryegrass silage (IRS) and the impact of feeding the IRS on feeding costs. Six sows with an initial body weight (BW) of 238.6 ± 5.9 kg were allotted to a 6 × 3 Latin square design with a 5-day acclimatization period followed by a 5-day data collection period. A commercial diet was replaced by IRS on a dry matter (DM) basis up to 0%, 9%, and 13% in the control treatment and the two test treatments, respectively. Apart from collecting data on daily feed intake and BW, urine was collected, and video footage was recorded for the last day of each treatment for analysis of urinary cortisol and behavior. There were no leftovers with all diets and nutrient uptake was unaffected (p > 0.05), while BW gain decreased (p < 0.05) to be a limited range from 1% to 3%, with increased inclusion of IRS. Both the behavior of sows and cortisol concentration were unaffected (p > 0.05). Furthermore, it was estimated that feeding 13% DM of IRS would reduce feed costs by 17%. IRS would be acceptable in replacing up to 13% of the commercial diet and cutting feeding costs.

Paradigm Shift for Catheter Ablation of Atypical Atrioventricular Nodal Re-Entrant Tachycardia: 3-Dimensional Mapping-Based Ablation.

BACKGROUND: In current practice, the ablation target of atypical atrioventricular nodal re-entrant tachycardia (AVNRT) is the earliest atrial activation site in the coronary sinus (CS) or conventional slow pathway region. OBJECTIVES: The purposes of this study were to map the site of earliest retrograde atrial activation using electroanatomic three-dimensional mapping during atypical AVNRT and to evaluate successful ablation sites. METHODS: A total of 42 patients with a total of 49 AVNRTs (slow/fast: 30; fast/slow: 15; slow/slow: 4) underwent electrophysiological study and ablation. Among them there were 14 patients (10 women; 60 ± 19 years of age) in whom 19 atypical AVNRT (fast/slow: 15; slow/slow: 4) were induced. RESULTS: The intracardiac electrocardiograms or three-dimensional mapping of the exit site during tachycardia revealed that 7 patients had exit sites solely inside the CS (left inferior extension [LIE]), 3 solely in the right postero-septal tricuspid annulus (TA; right inferior extension [RIE]), and 4 had both LIE and RIE exits. The distance from the CS ostium to LIE exits was 14 ± 6 mm. RIE exits were located on the TA posterior to the CS ostium (between 5 and 6 o'clock in the left anterior oblique projection). Ablation targeting these exits or conventional slow pathway succeeded in long-term elimination of AVNRT in 13 of the 14 patients (93%). There were no complications. CONCLUSIONS: Catheter ablation targeting the exit sites of LIE or RIE mapped at the CS or TA holds promise as an effective and safe alternative approach to the current targets of ablation for atypical AVNRT cases.

Orthodromic AVRT With 2 Different Wide QRS Complexes Caused by Bilateral Bystander Nodoventricular Pathways.

We present a case of orthodromic atrioventricular re-entrant tachycardia exhibiting both right and left bundle branch block pattern wide QRS morphologies caused by bilateral bystander nodoventricular (NV) accessory pathways. These wide QRS morphologies came from pre-excitation accompanied by delta waves. In the context of NV accessory pathways, left-sided manifest NV accessory pathways are rare.

Life cycle assessment of animal feeds prepared from liquid food residues: a case study of rice-washing water.

Life cycle assessment (LCA) was used to compare the greenhouse gas (GHG) emissions and energy consumption of three methods used to produce animal feed from concentrated rice-washing water (CRW) and disposing of the rice-washing water through wastewater treatment. Four scenarios were compared using LCA: (i) producing concentrated liquid feed by centrifugation (CC) of CRW with wastewater treatment and discharge of the supernatant, (ii) producing concentrated liquid feed by heating evaporation (HC) of CRW, (iii) producing dehydrated feed by dehydration (DH) of CRW, and (iv) wastewater treatment and discharge of nonconcentrated rice-washing water (WT). The functional unit (FU) was defined as 1 metric ton of rice washed for cooking or processing. Our results suggested that the energy consumptions of CC, HC, DH, and WT were 108, 322, 739, and 242 MJ per FU, respectively, and the amounts of GHG emissions from CC, HC, DH, and WT were 6.4, 15.8, 45.5, and 22.5 kg of CO equivalents per FU, respectively. When the produced feed prepared from CRW was assumed to be transported 200 km to farms, CC and HC still emitted smaller GHGs than the other scenarios, and CC consumed the smallest amount of energy among the scenarios. The present study indicates that liquid feed production from CRW by centrifugation has a remarkably reduced environmental impact compared with the wastewater treatment and discharge of rice-washing water.

Effect of feeding Bacillus subtilis on rumen fermentation, blood metabolites, nutrient digestibility, and energy and nitrogen balances in non-lactating crossbred cows.

The purpose of this study was to investigate the effects of feeding Bacillus subtilis on rumen fermentation, blood metabolites, nutrient digestibility, and energy and nitrogen balances in non-lactating crossbred (Holstein-Friesian × Bos indicus) cows. Four cows were assigned to the control and B. subtilis diets in a crossover design, and respiratory and metabolic experiments were conducted. For the B. subtilis diet, B. subtilis DSM15544 spores were added at the rate of 1.0 × 1010  CFU/head/day to the control diet. At 4 hr after feeding, cows fed the B. subtilis diet had increased levels of i-butyric acid in the rumen fluid and tended to have lower concentrations of plasma non-esterified fatty acids when compared with cows fed the control diet. This suggests that feeding B. subtilis could improve energy efficiency. However, there was no effect on energy retention in this study. Although there were no effects on nutrient digestibility, nitrogen balance, or methane production, heat production was significantly higher in cows fed the B. subtilis diet than in those fed the control diet.

Evaluating microvascular obstruction after acute myocardial infarction using cardiac magnetic resonance imaging and 201-thallium and 99m-technetium pyrophosphate scintigraphy.

BACKGROUND: Few studies have compared the ability of cardiac magnetic resonance (CMR) with that of scintigraphy using 201-thallium (201-Tl) and 99m-technetium pyrophosphate (99m-Tc PYP) to evaluate microvascular obstructions (MOs). In the present study the relationship between the scintigraphic and CMR characteristics of MOs after acute myocardial infarction (MI) was examined. METHODS AND RESULTS: The 14 patients (age 69±8 years, 11 males) underwent 201-Tl/99m-Tc PYP SPECT 7±3 days, initial CMR 16±12 days, and follow-up CMR 193±20 days after a reperfused first acute MI. Each image was analyzed using a 17-segment model. Segmental extent of delayed enhancement (DE), wall motion (WM) and degree of 201-Tl uptake were scored in 238 segments. Of 91 MI segments, MO was recognized in 22 (25%) segments on CMR. WM was significantly better in proportion to 201-Tl uptake (P=0.01) in MO segments. All 8 MO segments with WM improvement at follow-up had 99m-Tc PYP uptake, although only 3 (21%) of 14 MO segments that did not show WM improvement at follow-up had 99m-Tc PYP uptake (P=0.001). CONCLUSIONS: 99m-Tc PYP and 201-Tl scintigraphy have the potential to predict WM status and improvement of the MO region after reperfused acute MI.

Fermented liquid feed enhances bacterial diversity in piglet intestine.

Because of limitations imposed on the antibiotic use in animal industry, there is a need for alternatives to maintain the efficiency of production. One of them may be the use of fermented liquid feed (FLF) but how it affects gut ecology is poorly understood. We investigated the effect of three diets, standard dry feed (control), dry feed supplemented with antibiotics, and fermented liquid feed (FLF, fermented with Lactobacillus plantarum), on gut bacterial diversity in piglets. The structure of the ileal and caecal communities was estimated by sequencing the SSU rRNA gene libraries. Antibiotic-supplemented feed slightly increased bacterial diversity in the ileum but reduced it in the caecum while in FLF-fed animals bacterial diversity was elevated. The majority of bacterial sequences in the ileum of all three groups belonged to lactobacilli (92-98%). In the caecum the lactobacilli were still dominant in control and antibiotic-fed animals (59% and 64% of total bacterial sequences, respectively) but in FLF-fed animals they fell to 31% with the concomitant increase in the Firmicutes diversity represented by the Dorea, Coprococcus, Roseburia and Faecalibacterium genera. Thus FLF affects the gut ecology in a different way than antibiotics and contributes to the enhanced bacterial diversity in the gastrointestinal tract.

Coronary Arterial Vasospasm: A Rare Complication of Vein of Marshall Ethanol Infusion for Atrial Fibrillation.

A 75-year-old man was admitted for repeat ablation of atrial fibrillation. At 30 min after infusion of 3.5 ml of ethanol into the vein of Marshall, inferior ST-segment elevation with coronary arterial vasospasm was observed. This is the first report of coronary vasospasm after chemical ablation of the vein of Marshall. (Level of Difficulty: Intermediate.).

Low coronary flow velocity and shear stress predict restenosis after sirolimus-eluting stent implantation.

OBJECTIVES: This study sought to assess predictive values of coronary flow velocity and an index of shear stress throughout the vessel for angiographic restenosis after sirolimus-eluting stent implantation. DESIGN: The study patients underwent successful implantation of a sirolimus-eluting stent for de novo lesions located in native coronary vessels and underwent follow-up angiography 6-9 months later. The TIMI frame count method and quantitative digital angiographic analysis were performed based on the post-stenting angiogram. Coronary flow velocity and Reynolds number, an index of shear stress, were measured. RESULTS: Post-stenting digital angiograms from 267 patients were analyzed. We divided the study patients into two groups: a Restenosis group with 21 patients and a Non-Restenosis group with 246 patients. The Restenosis group indicated significantly lower coronary flow velocity (137.7+/-35.6 mm/sec versus 241.1+/-72.9 mm/sec, p = 0.0001) and lower Reynolds number (107.0+/-35.8 versus 199.2+/-67.1, p = 0.0001) than did the Non-Restenosis group. CONCLUSIONS: Lowered coronary flow velocity and shear stress after sirolimus-eluting stenting may predict the risk of restenosis.

Effects of physically effective fiber in diets based on rice straw and cassava pulp on chewing activity, ruminal fermentation, milk production, and digestibility in dairy cows.

The objective of this study was to evaluate the effects of physically effective neutral detergent fiber (peNDF) in rice straw and cassava pulp diets on the chewing activity, ruminal fermentation, milk production, and digestibility in low-producing dairy cows. Eight lactating Holstein crossbred cows were randomly divided into two groups in a crossover design with two dietary treatments over two 21-day periods. The difference in peNDF contents was achieved by balancing the ratio of rice straw, cassava pulp, and concentrate. The high cassava pulp diet had 15.5% peNDF and the low cassava pulp diet had 20.2% peNDF. The results showed that feeding the low cassava pulp diet increased the concentrations of milk protein, milk fat, solids-not-fat, and total solids in the milk. In contrast, the dry matter intake, milk yield, lactose content, chewing activity, nutrient digestibility, ruminal fermentation, and pH were not affected by treatments.

Impact of first documented rhythm on cost-effectiveness of extracorporeal cardiopulmonary resuscitation.

OBJECTIVES: Recommendations for extracorporeal cardiopulmonary resuscitation (ECPR) state that appropriate patient selection is important for the sake of efficacy and cost-effectiveness of ECPR. It is not known whether first documented rhythm plays a prominent role in economic outcomes of patients with cardiac arrest who received ECPR. METHODS AND RESULTS: We reviewed the medical records of 120 consecutive patients who received extracorporeal membrane oxygenation (ECMO) assisted CPR due to refractory circulatory collapse between 2008 and 2016 in Urasoe General Hospital. The patients presented with ventricular fibrillation or pulseless ventricular tachycardia (VF/VT; n = 59, 49.2%) or with asystole or pulseless electric activity (ASY/PEA; n = 61, 50.8%) as the first documented rhythm. Multivariate logistic regression analysis identified shorter duration from collapse to ECMO initiation (odds ratio, 1.95 per 10 min; 95% confidence interval, 1.32-2.89, p = 0.001), bystander CPR (odds ratio, 5.53; 95% confidence interval, 1.36-22.5, p = 0.017), and first documented rhythm of VF/VT (odds ratio, 3.93; 95% confidence interval, 1.30-11.8, p = 0.015) as clinical predictors for neurologically intact survival. Total hospital cost per life saved by ECPR for ASY/PEA was approximately twice that for VF/VT ($213,656 vs. $101,669). ECPR yielded Quality adjusted life years (QALYs) of 3.32 at a mean total cost of $39,634 for VF/VT and QALYs of 1.17 at a mean cost of $35,609 for ASY/PEA. The cost per QALYs was $11,081 for VF/VT and $29,447 for ASY/PEA. The incremental cost-effectiveness ratio of ECPR vs. conventional CPR was estimated to be $ 16,246 per QALY gained. CONCLUSION: ECPR for patients presenting with VF/VT was found to be highly cost-effective and ECPR for patients presenting with ASY/PEA was borderline cost-effective.

Reduction of chlortetracycline-resistant Escherichia coli in weaned piglets fed fermented liquid feed.

We investigated the change in chlortetracycline resistance in 360 Escherichia coli strains separated from the feces of piglets fed fermented liquid feed (FLF) in comparison with those fed dry feed (control). The total amount of lactic acid bacteria in feces was 8.77 x 10(8) CFU/g DM at weaning, which increased to 1.23 x 10(12) CFU/g DM (FLF) at 28 days after weaning (P<0.001). As a result of the antibiotic susceptibility test, almost all isolates were chlortetracycline-resistant (CTCR) until 14 days after weaning both in the FLF and control groups. At 28 days, the CTCR E. coli decreased to 22.2% in the FLF group, while the proportion of resistant bacteria was 88.9% in the control group. In addition, as a result of the gene analysis, it was clarified that there is a relation between the decrease in the minimum inhibitory concentration values and the possession rate of the tetracycline-resistance gene tet(A), tet(B) and tet(D). These results show that FLF caused an increase in the number of lactic acid bacteria in the intestines, and suggested that the feeding of FLF can possibly reduce antibiotic-resistance bacteria.

Chemical composition and nutritive values of cassava pulp for cattle.

We evaluated the chemical compositions of cassava pulp samples produced by four cassava starch factories at different locations in northeast Thailand and the metabolizable energy (ME) of the cassava pulp for cattle. There were significant differences in the P (0.03% ± 0.02%) and K (0.36% ± 0.2%) contents of the samples from different factories (p < .05). Moreover, we found interactions between factory and season in the neutral detergent fiber (36.02% ± 8.8%) and nonfibrous carbohydrate contents (59.33% ± 9.1%) (p < .05). For the evaluation of ME, a crossover-design experiment with four cattle maintained in each of two groups was conducted. There were two dietary treatments at a maintenance level of 1.27% body weight: (1) a control diet, and (2) a cassava pulp diet, containing the control diet at 70.2% and cassava pulp at 29.8% (dry matter [DM] basis). Feeding cassava pulp did not affect energy intake, energy loss, heat production, energy utilization efficiency (except for the urine-to-gross energy ratio), methane production, fecal N, or nutrient digestibility (except for crude protein digestibility). The total digestible nutrients, digestible energy, and ME contents of cassava pulp were 74.4%, 12.9 MJ/kg DM, and 11.3 MJ/kg DM, respectively.

Prediction of enteric methane emission from beef cattle in Southeast Asia.

We conducted a meta-data analysis to develop prediction equations to estimate enteric methane (CH4 ) emission from beef cattle in Southeast Asia. The dataset was obtained from 25 studies, which included 332 individual observations on nutrient intakes, digestibilities, and CH4 emissions. Cattle were provided tropical forage or rice straw, with or without concentrates in individual pens equipped with indirect open-circuit head hood apparatus. The simplest and best equation to predict daily CH4 emission was CH4 (g/day) = 22.71 (±1.008) × dry matter intake (DMI, kg/day) + 8.91 (±10.896) [R2  = 0.77; root mean square error (RMSE) = 19.363 g/day]. The best equation to predict CH4 energy as a proportion of gross energy intake (CH4 -E/GEI, J/100 J) was obtained using DMI per body weight (DMIBW, kg/100 kg), content (g/100 g DM) of ether extract (EE) and crude protein (CP), and DM digestibility (DMD, g/100 g); CH4 -E/GEI = -0.782 (±0.2526) DMIBW - 0.436 (±0.0548) EE - 0.073 (±0.0218) CP + 0.049 (±0.0097) DMD + 8.654 (±0.6517) (R2  = 0.39; RMSE = 1.3479 J/100 J GEI). It was indicated that CH4 emissions from beef cattle in Southeast Asia are predictable using present developed models including simple indices.

Environmental impact evaluation of feeds prepared from food residues using life cycle assessment.

There is increasing concern about feeds prepared from food residues (FFR) from an environmental viewpoint; however, various forms of energy are consumed in the production of FFR. Environmental impacts of three scenarios were therefore investigated and compared using life cycle assessment (LCA): production of liquid FFR by sterilization with heat (LQ), production of dehydrated FFR by dehydration (DH), and disposal of food residues by incineration (IC). The functional unit was defined as 1 kg dry matter of produced feed standardized to a fixed energy content. The system boundaries included collection of food residues and production of feed from food residues. In IC, food residues are incinerated as waste, and thus the impacts of production and transportation of commercial concentrate feeds equivalent to the FFR in the other scenarios are included in the analysis. Our results suggested that the average amounts of greenhouse gas (GHG) emissions from LQ, DH, and IC were 268, 1073, and 1066 g of CO(2) equivalent, respectively. The amount of GHG emissions from LQ was remarkably small, indicating that LQ was effective for reducing the environmental impact of animal production. Although the average amount of GHG emissions from DH was nearly equal to that from IC, a large variation of GHG emissions was observed among the DH units. The energy consumption of the three scenarios followed a pattern similar to that of GHG emissions. The water consumption of the FFR-producing units was remarkably smaller than that of IC due to the large volumes of water consumed in forage crop production.

An improved dry ash procedure for the detection of titanium dioxide in cattle feces.

We improved the dry ash procedure for detecting titanium dioxide (TiO2 ) in cattle feces containing chromium oxide [corrected] (Cr(2)O(3) ). First, the effect of amount of sodium sulfate (Na2 SO4 ) on the recovery of TiO2 from cattle feces that contained Cr2 O3 was evaluated. Average recovery of TiO2 at the 2.5 g Na2 SO4 level was significantly higher (P < 0.0001) than that at 0.75 g Na2 SO4 . Second, the effect of Cr2 O3 concentration on the recovery of TiO2 of cattle feces by using two levels of Na2 SO4 addition was examined. The recovery of TiO2 decreased with the increase in the amount of Cr2 O3 at the 0.75 g Na2 SO4 level but was consistently high at 2.5 g Na2 SO4 . Third, the recovery of Cr2 O3 from cattle feces was checked. The recoveries of TiO2 and Cr2 O3 were high enough at the 2.5 g Na2 SO4 level. Fourth, the improved dry ash procedure (5 mL of concentrated H2 SO4 and 2.5 g of Na2 SO4 were used for sample digestion) was compared to the wet ash procedure. Average recovery of TiO2 by the improved dry ash procedure was significantly higher (P = 0.0077) than that by the wet ash procedure. Thus, the improved dry ash procedure can be used for TiO2 analysis in cattle feces containing Cr2 O3 .

Impressions and purchasing intentions of Japanese consumers regarding pork produced by 'Ecofeed,' a trademark of food-waste or food co-product animal feed certified by the Japanese government.

Impressions and purchasing intentions of Japanese consumers regarding pork produced by 'Ecofeed', a trademark of food-waste or co-product animal feeds certified by the Japanese government, were investigated by a questionnaire on the Internet. 'Ecofeed' did not elicit specific impressions as compared to domestic, imported, Kurobuta (in Japan), and specific pathogen-free (SPF) pork. Purchasing intent for 'Ecofeed' pork was the second lowest of the five pork products. Knowledge and purchasing experience regarding 'Ecofeed' pork was the lowest of the five pork products. Respondents were classified into four categories according to their impressions of 'Ecofeed' pork. The largest category of respondents did not have any specific impression of 'Ecofeed' pork and had little knowledge of pork farming. A category that had a positive impression for 'Ecofeed' pork had high knowledge of the pork farming system. In order to establish 'Ecofeed' pork in Japan, our results suggest that information disclosure and education about 'Ecofeed', its certification system, environmental benefits and the current self-efficiency ratio of animal feed, are needed.

Effect of liquid whey feeding on fecal microbiota of mature and growing pigs.

The effect of liquid whey feeding on fecal bacteria and their metabolites was assessed in five pregnant sows and 66 growing pigs. Sows were fed a control diet for 4 weeks (control period) followed by the same diet but with whey feeding (5 L/day/pig) for 4 weeks (whey period). One group of growing pigs was given 267 L of whey per pig (whey group), while the other group was not (control group). In both cases, liquid whey was given separately from control diet. Sows in the whey period had feces showing lower pH, lower ammonia concentration, and larger population sizes of total bacteria, lactobacilli and bifidobacteria. The bacterial gene library analysis indicated that Mitsuokella and Megasphaera were more frequently detected, while Clostridium disporicum were detected less frequently in the whey period. Feces from whey-fed growing pigs showed lower pH than that from control pigs in the early stage of growing. Also, larger populations of total bacteria, lactobacilli and bifidobacteria were recorded in the whey group. From the bacterial gene library analysis, the detection frequency of Lactobacillus reuteri tended to be higher in the whey group. These results indicate that whey feeding influences the hindgut microbiota of pigs, possibly leading to a fermentation shift that is favorable for animal health.