A Pesticide Decision Support Tool to guide the selection of less environmentally harmful pesticides for the sugar cane industry.

Pesticides applied to agricultural land have been shown to decrease the quality of water entering the Great Barrier Reef lagoon. This issue is addressed by the Reef 2050 Water Quality Improvement Plan which includes a pesticide reduction target. As part of a wider educational strategy, one method that could help meet the target is to provide stakeholders with information that assists in the selection and use of pesticide active ingredients (PAIs) that pose a lower risk to aquatic environments compared to those currently used. This study developed a Pesticide Decision Support Tool (PDST) in collaboration with stakeholders for the sugar cane industry. The PDST covers all PAIs registered and applied to sugar cane in Australia and four additional PAIs registered for use on crops grown in rotation with sugar cane. The PDST incorporates both the measure of mobility and persistence of a PAI and the measure of effect, which is based on the PAI application rate and ecotoxicity threshold value. The aquatic risk, which is the product of the measure of effect and the measure of mobility and persistence, is a measure of the likelihood that a PAI will reach the aquatic environment and cause harmful effects. Insecticide active ingredients (e.g., cadusafos, chlorpyrifos) posed the greatest aquatic risk, followed by herbicide active ingredients (e.g., MSMA, metolachlor), while fungicide AIs typically had a lower aquatic risk. An interactive spreadsheet allows characteristics, including application rate and tank mixes, to be considered when assessing the potential risk. While focusing on sugar cane, the results are equally appropriate to other crops that use the same PAIs provided the application rates are corrected to the new crop. In addition, the approach used in the PDST can be applied internationally and to any PAIs with sufficient toxicity, mobility, and persistence data.

Efficacy of intravenous magnesium for the management of non-post operative atrial fibrillation with rapid ventricular response: A systematic review and meta-analysis.

BACKGROUND: Intravenous magnesium (IV Mg), a commonly utilized therapeutic agent in the management of atrial fibrillation (AF) with rapid ventricular response, is thought to exert its influence via its effect on cellular automaticity and prolongation of atrial and atrioventricular nodal refractoriness thus reducing ventricular rate. We sought to undertake a systematic review and meta-analysis of the effectiveness of IV Mg versus placebo in addition to standard pharmacotherapy in the rate and rhythm control of AF in the nonpostoperative patient cohort given that randomized control trials (RCTs) have shown conflicting results. METHODS: Randomized controlled trials comparing IV Mg versus placebo in addition to standard of care were identified via electronic database searches. Nine RCTs were returned with a total of 1048 patients. Primary efficacy endpoints were study-defined rate control and rhythm control/reversion to sinus rhythm. The secondary endpoint was patient experienced side effects. RESULTS: Our analysis found IV Mg in addition to standard care was successful in achieving rate control (odd ratio [OR] 1.87, 95% confidence interval [CI] 1.13-3.11, p = .02) and rhythm control (OR 1.45, 95% CI 1.04-2.03, p = .03). Although not well reported among studies, there was no significant difference between groups regarding the likelihood of experiencing side effects. CONCLUSIONS: IV Mg, in addition to standard-of-care pharmacotherapy, increases the rates of successful rate and rhythm control in nonpostoperative patients with AF with rapid ventricular response and is well tolerated.

The collateral circulation of coronary chronic total occlusions.

AIMS: Despite advances in understanding the physiological role of collaterals in coronary chronic total occlusions (CTOs), collateral anatomy remains poorly defined. Our aim was to define the anatomy and interventional utility of collaterals within a large population of patients with CTOs. METHODS AND RESULTS: We studied the coronary angiograms of 481 patients with 519 CTOs at six centres in the U.K. over four years. Detailed angiographic analysis was performed by interventional cardiologists specialising in CTO percutaneous coronary intervention (PCI). All visible collaterals with a collateral connection (CC) grade ≥1 were recorded. A subgroup of CTOs (n=277) was assessed for interventional capability, defined as whether the collateral supply was able to facilitate retrograde access. We described 45 different collateral patterns: 20 in right coronary artery (RCA), 13 in left anterior descending (LAD), and 12 in circumflex artery CTOs. Septal collaterals from the LAD to the right posterior descending artery (RPDA), and from the posterior descending artery to the LAD were most common, and most often considered as having "interventional capability". CONCLUSIONS: This is the largest analysis of collateral circulation anatomy in a population of patients with CTOs. We anticipate that these data will be of significant benefit in angiographic analysis and procedure planning for CTO PCI.