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The loss of carbon and nitrogen from broiler litter limits nutrient recycling and is damaging to the environment. This study investigated lignite, a low-rank brown coal, as an amendment to reduce the loss of carbon and nitrogen from broiler litter over 3 consecutive grow-out cycles, November 2021 to May 2022, at a commercially operated farm in Victoria, Australia. Lignite-treated litter contained significantly more carbon and nitrogen, with an increase of 70.1 g/bird and 12.6 g/bird for carbon and nitrogen, respectively. Lignite also reduced aerobic microbial respiration, with a 46.0% reduction in CO2 flux recorded in week 7 of the study, resulting in reduced mass loss. It is expected that this is a key mechanism responsible for nutrient retention in litter following treatment with lignite. Furthermore, lignite treatment lowered litter moisture content by 7, 6 and 3 percentage points for grow-out 1, 2 and 3, respectively. These findings present lignite as a beneficial litter amendment for increasing the nutrient value of waste and reducing carbon dioxide emissions. The study highlights the potential of lignite to reduce the environmental impact of poultry production and presents an alternative use for lignite as an existing resource.

OBJECTIVES: We aimed to quantify the burden of exercise intolerance in systemic sclerosis (SSc) and explore the disease features that contribute to impaired exercise capacity (measured as peak oxygen uptake, peak VO2) to provide novel mechanistic insights into the causes of physical disability in SSc. METHODS: Thirty-three SSc patients with no history of cardiac disease and no active myositis underwent cardiac and skeletal muscle MRI, transthoracic echocardiography, pulmonary function tests and cardiopulmonary exercise testing (CPET). CPET results were compared to an age-, sex-, and weight-matched controls with no overt cardiopulmonary disease. Native T1 and T2-mapping sequences were used to quantify diffuse fibroinflammatory myocardial disease and qualitative assessment of skeletal muscle oedema was performed. The associations between parameters of cardiorespiratory function and skeletal muscle abnormalities and peak VO2 were evaluated with linear regression analysis. RESULTS: Exercise capacity was markedly impaired in SSc and significantly reduced when compared to control subjects (percent predicted peak VO2: 70% vs 98%, p < 0⋅01). Diffuse myocardial fibroinflammatory disease (p < 0⋅01) and skeletal muscle oedema (p = 0⋅01) were significantly associated with reduced exercise capacity. There was no association between impaired exercise capacity and left ventricular ejection fraction. CONCLUSION: SSc is associated with marked functional impairment that is not explained by commonly used parameters of cardiac function such as left ventricular ejection fraction. Rather, only more sensitive measures of organ involvement are associated with impaired exercise tolerance. Our results show diffuse interstitial changes of the myocardium and skeletal muscle affect oxygen uptake and are important contributors to functional limitation in SSc.

BACKGROUND: Skeletal muscle can be directly affected by systemic sclerosis (SSc); however, a significant burden of SSc-associated myopathy is undetected because clinical parameters such as weakness and creatine kinase (CK) are unreliable biomarkers of muscle involvement. This study presents qualitative and quantitative magnetic resonance imaging (MRI) findings that quantify the prevalence of myopathy and evaluate any association between skeletal and cardiac muscle involvement in SSc. METHODS: Thirty-two patients with SSc who fulfilled the 2013 American College of Rheumatology/European League Against Rheumatism classification criteria underwent skeletal muscle MRI in addition to cardiac MRI. Skeletal muscles were independently assessed by two musculoskeletal radiologists for evidence of oedema, fatty infiltration and atrophy. Skeletal muscle T2 mapping times and percentage fat fraction were calculated. Linear regression analysis was used to evaluate the clinical and myocardial associations with skeletal muscle oedema and fatty infiltration. Cardiac MRI was performed using post gadolinium contrast imaging and parametric mapping techniques to assess focal and diffuse myocardial fibrosis. RESULTS: Thirteen participants (40.6%) had MRI evidence of skeletal muscle oedema. Five (15.6%) participants had fatty infiltration. There was no association between skeletal muscle oedema and muscle strength, creatine kinase, inflammatory markers or fibroinflammatory myocardial disease. Patients with skeletal muscle oedema had higher T2-mapping times; there was a significant association between subjective assessments of muscle oedema and T2-mapping time (coef 2.46, p = 0.02) and percentage fat fraction (coef 3.41, p = 0.02). Diffuse myocardial fibrosis was a near-universal finding, and one third of patients had focal myocardial fibrosis. There was no association between skeletal myopathy detected by MRI and burden of myocardial disease. CONCLUSIONS: MRI is a sensitive measure of muscl

OBJECTIVES: Cardiac complications of SSc are a leading cause of SSc-associated death. Cardiac imaging for identifying substrate abnormality may be useful in predicting risk of cardiac arrhythmias or future cardiac failure. The aim of this study was to quantify the burden of asymptomatic fibro-inflammatory myocardial disease using cardiac magnetic resonance imaging (CMR) and assess the relationship between asymptomatic myocardial fibrosis and cardiac arrhythmias in SSc. METHODS: Thirty-two patients with SSc with no documented history of pulmonary vascular or heart disease underwent CMR with gadolinium and 24-h ambulatory ECG. Focal myocardial fibrosis was assessed using post-gadolinium imaging and diffuse fibro-inflammatory myocardial disease quantified using T1- and T2-mapping. CMR results were compared with an age- and sex-matched control group. RESULTS: Post-gadolinium focal fibrosis was prevalent in SSc but not controls (30% vs 0%, p < 0.01).. T1-mapping values (as a marker of diffuse fibrosis) were greater in SSc than controls [saturated recovery single-shot acquisition (SASHA): 1584 ms vs 1515 ms, P < 0.001; shortened Modified look locker sequence (ShMOLLI): 1218 ms vs 1138 ms, p < 0.001]. More than one-fifth (22.6%) of the participants had ventricular arrhythmias on ambulatory ECG, but no associations between focal or diffuse myocardial fibrosis and arrhythmias were evident. CONCLUSION: In SSc patients without evidence of overt cardiac disease, a high burden of myocardial fibrosis and arrhythmias was identified. However, there was no clear association between focal or diffuse myocardial fibrosis and arrhythmias, suggesting CMR may have limited use as a screening tool to identify SSc patients at risk of future significant arrhythmias.

Background: Patients with chronic kidney disease (CKD) have a higher risk of cardiovascular morbidity and mortality compared to the healthy populous. The mechanisms are complex but involve cardiac fibrosis (CFib) and related dysfunction. Cardiac magnetic resonance imaging (cMRI) allows evaluation of both, and we explored CFib in patients with CKD compared to healthy volunteers (HV) with normal kidney function. Method(s): Cardiac function, morphology and tissue characterization were compared between 10 patients with CKD Stages 3-5, 12 patients on maintenance haemodialysis (HD) and 26 HV. Cardiac function and native T1 mapping time (nT1mt), using saturation recovery single-shot acquisition (SASHA) and shortened modified look-locker inversion recovery (ShMOLLI) to measure CFib, were compared across groups using analysis of variance (ANOVA) and post-hoc comparison. Result(s): Left ventricular (LV) ejection fraction was 62 +/- 5%, 62 +/- 8%, and 64 +/- 10% (p = 0.692), and LV mass was 111 +/- 34 g/m2, 136 +/- 32 g/m2, and 137 +/- 34 g/m2 (p = 0.056) in HV, CKD and HD groups, respectively. The nT1mt (SASHA) were 1485 +/- 42 ms, 1547 +/- 45 ms and 1600 +/- 105 ms (p < 0.001), and (ShMOLLI) 1157 +/- 63 ms, 1186 +/- 36 ms and 1219 +/- 47 ms (p < 0.001), respectively. In post hoc comparisons, nT1mt were significantly lower in HV than CKD (p = 0.034 for SASHA, p < 0.01 for ShMOLLI) or HD (p < 0.01 for both), but not different between CKD and HD (p = 0.152 for SASHA, p = 0.255 for ShMOLLI). Conclusion(s): Despite similar LV ejection fraction and LV mass, cMRI detected increased CFib in patients with CKD and HD. Thus, CFib appears early in CKD and may help identify CKD patients at higher risk of adverse cardiac outcomes.

Objectives: This study sought to determine the long-term outcomes of restoring sinus rhythm with catheter ablation (CA). Background(s): The CAMERA-MRI (Catheter Ablation Versus Medical Rate Control in Atrial Fibrillation and Heart Failure-An MRI-Guided Multicenter Randomized Controlled Trial) study demonstrated that restoration of sinus rhythm with CA significantly improved left ventricular ejection fraction (LVEF) compared with medical rate control (MRC) at 6 months in persistent atrial fibrillation and otherwise unexplained systolic heart failure. However, the long-term outcomes have not been reported. Method(s): Patients enrolled in the CAMERA-MRI study were followed for 4 years with echocardiogram and cardiac magnetic resonance. CA involved pulmonary vein isolation and posterior left atrial wall isolation in 94%. Patients crossed over to CA after 6-month study duration. Arrhythmia burden was determined with implanted cardiac monitors or cardiac devices. Result(s): Sixty-six patients (age 62 +/- 10 years, atrial fibrillation duration of 22 +/- 16 months, and LVEF 33 +/- 9%) were randomized 1:1 to CA versus MRC. Eighteen of 33 patients crossed over from MRC group to CA group. At 4.0 +/- 0.9 years, atrial fibrillation recurred in 27 patients (57%) in the CA group with a mean burden of 10.6 +/- 21.2% after 1.4 +/- 0.6 procedures. There was an absolute increase in LVEF with CA of 16.4 +/- 13.3% compared with 8.6 +/- 7.6% in MRC (p = 0.001). In the CA group, the absence of ventricular late gadolinium enhancement was associated with a greater improvement in absolute LVEF (19 +/- 13% vs. 10 +/- 11% in the late gadolinium enhancement-positive group; p = 0.04) and LVEF normalization in 19 patients (58%) versus 4 patients (18%) in the late gadolinium enhancement-positive group (p = 0.008) at 4.0 +/- 0.9 years follow-up. Conclusion(s): CA is superior to MRC in improving LVEF in the long term in patients with atrial fibrillation and systolic heart failure. The greatest recov

Cancer therapy related cardiac dysfunction (CTRCD) is an area of increasing focus, particularly during the survivorship period, for paediatric, adolescent and adult cancer survivors. With the advent of immunotherapy and targeted therapy, there is a new set of mechanisms from which paediatric and young adult patients with cancer may suffer cardiovascular injury. Furthermore, cardiovascular disease is the leading cause of morbidity and mortality in the survivorship period. The recently established Australian Cardio-Oncology Registry is the largest and only population-based cardiotoxicity database of paediatric and adolescent and young adult oncology patients in the world, and the first paediatric registry that will document cardiotoxicity caused by chemotherapy and novel targeted therapies using a prospective approach. The database is designed for comprehensive data collection and evaluation of the Australian practice in terms of diagnosis and management of CTRCD. Using the Australian Cardio-Oncology Registry critical clinical information will be collected regarding predisposing factors for the development of CTRCD, the rate of subclinical left ventricular dysfunction and transition to overt heart failure, further research into protectant molecules against cardiac dysfunction and aid in the discovery of which genetic variants predispose to CTRCD. A health economic arm of the study will assess the cost/benefit of both the registry and cardio-oncology clinical implementation. Finally, an imaging arm will establish if exercise cardiac magnetic resonance imaging and VO2 max testing is a more sensitive predictor of cardiac reserve in paediatric and adolescent and young adult oncology patients exposed to cardiac toxic therapies.Copyright © 2019 Royal Australasian College of Physicians

Cancer therapy related cardiac dysfunction (CTRCD) is an area of increasing focus, particularly during the survivorship period, for paediatric, adolescent and adult cancer survivors. With the advent of immunotherapy and targeted therapy, there is a new set of mechanisms from which paediatric and young adult patients with cancer may suffer cardiovascular injury. Furthermore, cardiovascular disease is the leading cause of morbidity and mortality in the survivorship period. The recently established Australian Cardio-Oncology Registry is the largest and only population-based cardiotoxicity database of paediatric and adolescent and young adult oncology patients in the world, and the first paediatric registry that will document cardiotoxicity caused by chemotherapy and novel targeted therapies using a prospective approach. The database is designed for comprehensive data collection and evaluation of the Australian practice in terms of diagnosis and management of CTRCD. Using the Australian Cardio-Oncology Registry critical clinical information will be collected regarding predisposing factors for the development of CTRCD, the rate of subclinical left ventricular dysfunction and transition to overt heart failure, further research into protectant molecules against cardiac dysfunction and aid in the discovery of which genetic variants predispose to CTRCD. A health economic arm of the study will assess the cost/benefit of both the registry and cardio-oncology clinical implementation. Finally, an imaging arm will establish if exercise cardiac magnetic resonance imaging and VO2 max testing is a more sensitive predictor of cardiac reserve in paediatric and adolescent and young adult oncology patients exposed to cardiac toxic therapies.

BACKGROUND: Indigenous Australians experience a greater burden of AF. Whether this is in-part due to differences in arrhythmogenic structures that appear to contribute to AF differences amongst other ethnicities is not known. METHODS: We studied forty individuals matched for ethnicity and other AF risk factors. Computed tomography imaging was used to characterise left atrial (LA), pulmonary vein (PV), and left atrial appendage (LAA) anatomy. RESULTS: There were no significant differences in LA diameters or volumes between Indigenous and non-Indigenous Australians. Similarly, we could not detect any consistent differences in PV number, morphology, diameters, or ostial characteristics according to ethnicity. LAA analyses suggested that Indigenous Australians may have a greater proportion of non chickenwing LAA type, and a tendency for eccentric, oval-shaped LAA ostia; however, there were no other differences seen with regards to LAA volume or depth. Indexed values for LA, PV and LAA anatomy corrected for body size were broadly similar. CONCLUSIONS: In a cohort of individuals matched for AF risk factors, we could find no strong evidence of ethnic differences in LA, PV, and LAA characteristics that may explain a predisposition of Indigenous Australians for atrial arrhythmogenesis. These findings, in conjunction with our previous data showing highly prevalent cardiometabolic risk factors in Indigenous Australians with AF, suggest that it is these conditions that are more likely responsible for the AF substrate in these individuals. Continued efforts should therefore be directed towards risk factor management in an attempt to prevent and minimise the effects of AF in Indigenous Australians.

Subsurface soil acidity is a serious constraint to crop production and is inherently difficult to correct through conventional application of lime. Thus, new approaches to ameliorate subsurface soil acidity are needed. A column leaching experiment was established to determine whether the plant residues, when combined with lime, could facilitate lime dissolution and alkalinity movement down soil columns (10 cm in diameter × 45 cm long) to ameliorate acid subsurface soil layers. Five plant residues from canola (Brassica nappus L.), field pea (Pisum sativum L.), lucerne (Medicago sativa L.), oats (Avena sativa L.) and vetch (Vicia villosa L.) (C/N ratios of 52, 13, 16, 53 and 12, respectively) were mixed with soil (18 g dry matter kg⁻¹) in the top of soil columns (0–10 cm) either limed (target pH 7 in CaCl₂) or non‐limed and incubated for 3 months at 25°C. Soil columns were leached six times over the 3‐month incubation period and destructively sampled at 1 and 3 months for chemical analysis. The soil amended with plant residues created favourable pH gradients and facilitated downward movement of alkalinity when lime was added. However, net increases in pH in the 10–12‐cm layer after 3 months were only observed in two non‐legume residue‐amended treatments (canola and oat residues, 0.22–0.43 pH unit increase), but not in three legume residue‐amended treatments (field pea, lucerne and vetch residues), although those treatments had the greatest pH increase in the short term (1 month). In conclusion, surface incorporation of lime in combination with plant residues accelerated the amelioration of subsurface acidity in the immediate zone (10–12 cm) below the amended layer. Canola and oat residues were superior in terms of increased soil pH over a longer term (3 months), possibly due to their higher C/N ratios. HIGHLIGHTS: Can plant residues, combined with lime, facilitate alkalinity movement down soil columns? Few studies have examined leaching, alkalinity movement and pH gra

To focus on rhythms within the lived relations between humans and technology is to focus on unfolding processes, dynamic temporality, and patterns of change and continuity. Rhythms infuse the political, the social, the personal and the technological. Through anticipation and expectation rhythms also point towards the future and its tendencies. Drawing inspiration from Rhythmanalysis, Somaesthetic Design and Entanglement HCI this paper explores methods for analysing rhythm within HCI and discusses the challenges of recording the ephemeral, articulating experience and understanding the non-human. Like rhythm, the methods outlined involve process, temporality and diference. There are the embodied practices of developing sensitivity, paying attention and thinking by doing. Then there are the representational practices of revealing through sound, working with moving images, shifting temporal scales and expressing dynamics graphically. These methods are presented as suggestions and tentative principles for ways of thinking with and through rhythm and aim to inspire further exploration.

Dasatinib has shown superiority over imatinib in achieving molecular responses (MRs) in chronic phase chronic myeloid leukemia but with a different toxicity profile, which may impact its overall benefit. Reported toxicities include pleural effusions and pulmonary hypertension, and although the incidence of these events is well described, response to therapy and impact of dose modifications on toxicity has not been comprehensively characterized in a real-world setting. We retrospectively reviewed the incidence of dasatinib adverse events in 212 chronic phase chronic myeloid leukemia patients at 17 Australian institutions. Adverse events were reported in 116 patients (55%), most commonly pleural effusions (53 patients, 25%), which was the predominant cause of permanent drug cessation. Age and dose were risk factors for pleural effusion (P < .01 and .047, respectively). Recurrence rates were higher in those who remained on 100 mg compared with those who dose reduced (P = .041); however, recurrence still occurred at 50 mg. Patients who developed pleural effusions were more likely to have achieved MR4.5 after 6 months of dasatinib than those without effusions (P = .008). Pulmonary hypertension occurred in 5% of patients, frequently in association with pleural effusion, and was reversible upon dasatinib cessation in 6 of 7 patients. Dose reductions and temporary cessations had minimal impact on MR rates. Our observations suggest that by using the lowest effective dose in older patients to minimize the effusion risk, dose modification for cytopenias, and care with concomitant antiplatelet therapy, the necessity for permanent dasatinib cessation due to toxicity is likely to be minimal in immunologically competent patients.

Background: Patients with chronic kidney disease (CKD) are at increased risk for cardiovascular complications, and dialysis patients often receive iron supplementation. Cardiac magnetic resonance (CMR) allows evaluation of cardiac function, fibrosis and iron deposition. We used CMR to explore mechanistic links between cardiac iron and abnormal myocardial substrate in patients with CKD. Method(s): Cardiac function and morphology, tissue characterisation and iron deposition were compared in 24 healthy controls,10 patients with CKD stage 3-5, and 30 patients dialysed for >1 year. Result(s): There were no between group differences in left ventricular (LV) ejection fraction (65+/-5 v 62+/-7 v 61+/-10%, p=0.908), end diastolic volume (84+/-16 v 69+/-13 v 76+/-22 ml/m2, p=0.532) or left atrial size (21+/-5 v 22+/-4 v 23+/-7m2, p=0.473). LV mass (58+/-13 v 66+/-9 v 76+/-27 g/m2, p=0.005) and global longitudinal strain (-22+/-3 v -20+/-4 v -14+/-4%, p<0.001) were abnormal in the dialysis group, but not the CKD group. Native T1 and T2 times were increased in both CKD and dialysis patients (ShMOLLI 1127+/-43 v 1189+/-37 v 1223+/-61ms, p<0.001; and T2 FLASH 35+/-2 v42+/-4 v 39+/-2ms, p<0.001). No group had significant iron deposition by T2-star. Conclusion(s): Despite no significant myocardial iron deposition, CMR detects abnormal myocardial structure and function across the spectrum of CKD, with abnormal global longitudinal strain seen only in dialysis patients. CMR may aid in identifying CKD patients at higher risk of adverse cardiac outcomes.Copyright © 2020

BACKGROUND: Excessive alcohol consumption is associated with incident atrial fibrillation and adverse atrial remodeling; however, the effect of abstinence from alcohol on secondary prevention of atrial fibrillation is unclear. METHOD(S): We conducted a multicenter, prospective, open-label, randomized, controlled trial at six hospitals in Australia. Adults who consumed 10 or more standard drinks (with 1 standard drink containing approximately 12 g of pure alcohol) per week and who had paroxysmal or persistent atrial fibrillation in sinus rhythm at baseline were randomly assigned in a 1:1 ratio to either abstain from alcohol or continue their usual alcohol consumption. The two primary end points were freedom from recurrence of atrial fibrillation (after a 2-week "blanking period") and total atrial fibrillation burden (proportion of time in atrial fibrillation) during 6 months of follow-up. RESULT(S): Of 140 patients who underwent randomization (85% men; mean [+/-SD] age, 62+/-9 years), 70 were assigned to the abstinence group and 70 to the control group. Patients in the abstinence group reduced their alcohol intake from 16.8+/-7.7 to 2.1+/-3.7 standard drinks per week (a reduction of 87.5%), and patients in the control group reduced their alcohol intake from 16.4+/-6.9 to 13.2+/-6.5 drinks per week (a reduction of 19.5%). After a 2-week blanking period, atrial fibrillation recurred in 37 of 70 patients (53%) in the abstinence group and in 51 of 70 patients (73%) in the control group. The abstinence group had a longer period before recurrence of atrial fibrillation than the control group (hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.84; P=0.005). The atrial fibrillation burden over 6 months of follow-up was significantly lower in the abstinence group than in the control group (median percentage of time in atrial fibrillation, 0.5% [interquartile range, 0.0 to 3.0] vs. 1.2% [interquartile range, 0.0 to 10.3]; P=0.01). CONCLUSION(S): Abstinence from alcohol red

BACKGROUND Excessive alcohol consumption is associated with incident atrial fibrillation and adverse atrial remodeling; however, the effect of abstinence from alcohol on secondary prevention of atrial fibrillation is unclear. METHODS We conducted a multicenter, prospective, open-label, randomized, controlled trial at six hospitals in Australia. Adults who consumed 10 or more standard drinks (with 1 standard drink containing approximately 12 g of pure alcohol) per week and who had paroxysmal or persistent atrial fibrillation in sinus rhythm at baseline were randomly assigned in a 1:1 ratio to either abstain from alcohol or continue their usual alcohol consumption. The two primary end points were freedom from recurrence of atrial fibrillation (after a 2-week "blanking period") and total atrial fibrillation burden (proportion of time in atrial fibrillation) during 6 months of follow-up. RESULTS Of 140 patients who underwent randomization (85% men; mean [+/-SD] age, 62+/-9 years), 70 were assigned to the abstinence group and 70 to the control group. Patients in the abstinence group reduced their alcohol intake from 16.8+/-7.7 to 2.1+/-3.7 standard drinks per week (a reduction of 87.5%), and patients in the control group reduced their alcohol intake from 16.4+/-6.9 to 13.2+/-6.5 drinks per week (a reduction of 19.5%). After a 2-week blanking period, atrial fibrillation recurred in 37 of 70 patients (53%) in the abstinence group and in 51 of 70 patients (73%) in the control group. The abstinence group had a longer period before recurrence of atrial fibrillation than the control group (hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.84; P = 0.005). The atrial fibrillation burden over 6 months of follow-up was significantly lower in the abstinence group than in the control group (median percentage of time in atrial fibrillation, 0.5% [interquartile range, 0.0 to 3.0] vs. 1.2% [interquartile range, 0.0 to 10.3]; P = 0.01). CONCLUSIONS Abstinence from alcohol reduced a