Energy Sources for the Surgical Treatment of Atrial Fibrillation.

The surgical treatment of atrial fibrillation has evolved over the past 2 decades due to the advent of ablation technology, and the introduction of less invasive surgical approaches. Current devices produce ablation lines that aim to replace the incisions of traditional surgical ablation strategies, such as the Cox-Maze procedure. This has helped to simplify and shorten surgical ablation procedures and has allowed for the development of minimally invasive surgical techniques. This review discusses surgical ablation energy sources and devices, providing background on device characteristics, mechanism of tissue injury, and success in creating transmural lesions.

Dynamics of antibiotic resistance genes in microbial fuel cell-coupled constructed wetlands treating antibiotic-polluted water.

Microbial fuel cell-coupled constructed wetlands (CW-MFCs) use electrochemical, biological, and ecological functions to treat wastewater. However, few studies have investigated the risks of antibiotic resistance genes (ARGs) when using such systems to remove antibiotics. Therefore, three CW-MFCs were designed to assess the dynamics of ARGs in filler biofilm and effluent over 5000 h of operation. The experimental results indicated that relatively high steady voltages of 605.8 mV, 613.7 mV, and 541.4 mV were obtained at total influent antibiotic concentrations of 400, 1,000, and 1600 µg L-1, respectively. The 16S rRNA gene level in the cathode layer was higher than those in the anode and two middle layers, but the opposite trend was observed for the sul and tet genes. The relative abundance of the three tested sul genes were in the order sulI > sulII > sulIII, and those of the five tet genes were in the order tetA > tetC > tetW > tetO > tetQ. The levels of sul and tet genes in the media biofilm showed an increase over the treatment period. The effluent water had relatively low abundances of sul and tet genes compared with the filler biofilm. No increases were observed for most ARGs over the treatment period, and no significant correlations were observed between the ARGs and 16S rRNA gene copy numbers, except for sulI and tetW in the effluent. However, significant correlations were observed among most of the ARG copy numbers.

Agricultural anaerobic digestion power plants in Ireland and Germany: policy and practice.

The process of anaerobic digestion (AD) is valued as a carbon-neutral energy source, while simultaneously treating organic waste, making it safer for disposal or use as a fertilizer on agricultural land. The AD process in many European nations, such as Germany, has grown from use of small, localized digesters to the operation of large-scale treatment facilities, which contribute significantly to national renewable energy quotas. However, these large AD plants are costly to run and demand intensive farming of energy crops for feedstock. Current policy in Germany has transitioned to support funding for smaller digesters, while also limiting the use of energy crops. AD within Ireland, as a new technology, is affected by ambiguous governmental policies concerning waste and energy. A clear governmental strategy supporting on-site AD processing of agricultural waste will significantly reduce Ireland's carbon footprint, improve the safety and bioavailability of agricultural waste, and provide an indigenous renewable energy source. © 2016 Society of Chemical Industry.

The environmental sustainability of anaerobic digestion as a biomass valorization technology.

This paper studies the environmental sustainability of anaerobic digestion from three perspectives. First, reference electricity is compared to electricity production from domestic organic waste and energy crop digestion. Second, different digester feed possibilities in an agricultural context are studied. Third, the influence of applying digestate as fertilizer is investigated. Results highlight that biomass is converted at a rational exergy (energy) efficiency ranging from 15.3% (22.6) to 33.3% (36.0). From a life cycle perspective, a saving of over 90% resources is achieved in most categories when comparing biobased electricity to conventional electricity. However, operation without heat valorization results in 32% loss of this performance while using organic waste (domestic and agricultural residues) as feedstock avoids land resources. The use of digestate as a fertilizer is beneficial from a resource perspective, but causes increased nitrogen and methane emissions, which can be reduced by 50%, making anaerobic digestion an environmentally competitive bioenergy technology.

Looking for alternative energy sources.

With unrest in oil-exporting countries, backlashes against biofuels and photovoltaics, and a nuclear incident in Japan, the year 2011 rattled confidence in future energy supplies. The search for alternatives is all the more urgent, but some of the solutions investigated hark back to fossil fuels that we can't afford to burn.

In vivo performance of a muscle-powered drive system for implantable blood pumps.

A unique biomechanical implant has been developed to convert muscle power into hydraulic energy for the purpose of driving an implanted blood pump. This device, called a muscle energy converter (MEC), is designed to attach to the humeral insertion of the latissimus dorsi (LD) muscle, so that stimulated contractions cause a rotary cam to compress a fluid-filled bellows. Here we report results from the latest in a series of canine implant trials where the MEC was connected to an adjustable pressure load to measure power output and assess long-term function. Full-length (2 cm) actuator strokes were maintained for a period of 1 month with no discernable discomfort to the animal. Load conditions were cycled periodically to measure stroke work capacity and pressure production. The peak driveline pressure recorded in this experiment was 1743 mm Hg. Steady state power generation was measured to 478 +/- 21 mJ/stroke (mean +/- SD) with stroke work levels reaching 785 mJ in one test. Normal left and right ventricular stroke work levels in dogs this size (35 kg) are 700 and 150 mJ, respectively. These data confirm that MEC/LD power levels--maintained in tandem with an appropriate cardiac assist device--are sufficient to provide significant long-term circulatory support. Further testing, however, is still needed to demonstrate the long-term stability of this drive system.

Biodiesel exhaust: the need for health effects research.

BACKGROUND: Biodiesel is a diesel fuel alternative that has shown potential of becoming a commercially accepted part of the United States' energy infrastructure. In November 2004, the signing of the Jobs Creation Bill HR 4520 marked an important turning point for the future production of biodiesel in the United States because it offers a federal excise tax credit. By the end of 2005, industry production was 75 million gallons, a 300% increase in 1 year. Current industry capacity, however, stands at just over 300 million gallons/year, and current expansion and new plant construction could double the industry's capacity within a few years. Biodiesel exhaust emission has been extensively characterized under field and laboratory conditions, but there have been limited cytotoxicity and mutagenicity studies on the effects of biodiesel exhaust in biologic systems. OBJECTIVES: We reviewed pertinent medical literature and addressed recommendations on testing specific research needs in the field of biodiesel toxicity. DISCUSSION: Employment of biodiesel fuel is favorably viewed, and there are suggestions that its exhaust emissions are less likely to present any risk to human health relative to petroleum diesel emissions. CONCLUSION: The speculative nature of a reduction in health effects based on chemical composition of biodiesel exhaust needs to be followed up with investigations in biologic systems.

Ethanol production: energy, economic, and environmental losses.

The prime focus of ethanol production from corn is to replace the imported oil used in American vehicles, without expending more fossil energy in ethanol production than is produced as ethanol energy. In a thorough and up-to-date evaluation of all the fossil energy costs of ethanol production from corn, every step in the production and conversion process must be included. In this study, 14 energy inputs in average U.S. corn production are included. Then, in the fermentation/distillation operation, 9 more identified fossil fuel inputs are included. Some energy and economic credits are given for the by-products, including dried distillers grains (DDG). Based on all the fossil energy inputs, a total of 1.43 kcal fossil energy is expended to produced 1 kcal ethanol. When the energy value of the DDG, based on the feed value of the DDG as compared to that of soybean meal, is considered, the energy cost of ethanol production is reduced slightly, to 1.28 kcal fossil energy input per 1 kcal ethanol produced. Several proethanol investigators have overlooked various energy inputs in U.S. corn production, including farm machinery, processing machinery, and the use of hybrid corn. In other studies, unrealistic, low energy costs were attributed to such inputs as nitrogen fertilizer, insecticides, and herbicides. Controversy continues concerning the energy and economic credits that should be assigned to the by-products. The U.S. Department of Energy reports that 17.0 billion L ethanol was produced in 2005. This represents only less than 1% of total oil use in the U.S. These yields are based on using about 18% of total U.S. corn production and 18% of cornland. Because the production of ethanol requires large inputs of both oil and natural gas in production, the U.S. is importing both oil and natural gas to produce ethanol. Furthermore, the U.S. Government is spending about dollar 3 billion annually to subsidize ethanol production, a subsidy of dollar 0.79/L ethanol produced. With the subsidy, plus the cost of production, the cost of ethanol is calculated to be dollar 1.21/L. The subsidy for a liter of ethanol is 45-times greater than the subsidy per liter of gasoline. The environmental costs associated with producing ethanol are significant but have been ignored by most investigators in terms of energy and economics. The negative environmental impacts on cropland, and freshwater, as well as air pollution and public health, have yet to be carefully assessed. These environmental costs in terms of energy and economics should be calculated and included in future ethanol analyses. General concern has been expressed about taking 18% of U.S. corn, and more in the future, to produce ethanol for burning in automobiles instead of using the corn as food for the many malnourished people in the world. The World Health Organization reports that more than 3.7 billion humans are currently malnourished in the world--the largest number ever in history.

Daily average exposures to respirable particulate matter from combustion of biomass fuels in rural households of southern India.

Indoor air pollution resulting from combustion of biomass fuels in rural households of developing countries is now recognized as a major contributor to the global burden of disease. Accurate estimation of health risks has been hampered by a paucity of quantitative exposure information. In this study we quantified exposures to respirable particulate matter from biomass-fuel combustion in 436 rural homes selected through stratified random sampling from four districts of Tamil Nadu, India. The study households are a subset of a larger sample of 5,028 households from the same districts in which socioeconomic and health information has been collected. Results of measurements for personal exposures to respirable particulate matter during cooking were reported earlier. This has been extended to calculation of 24-hr exposures with the aid of additional measurements during noncooking times and the collection of time-activity records. Concentrations of respirable particulate matter ranged from 500 to 2,000 micro g/m(3) during cooking in biomass-using households, and average 24-hr exposures ranged from 90 +/- 21 micro g/m(3) for those not involved in cooking to 231 +/- 109 micro g/m(3) for those who cooked. The 24-hr exposures were around 82 +/- 39 micro g/m(3) for those in households using clean fuels (with similar exposures across household subgroups). Fuel type, type and location of the kitchen, and the time spent near the kitchen while cooking were the most important determinants of exposure across these households among other parameters examined, including stove type, cooking duration, and smoke from neighborhood cooking. These estimates could be used to build a regional exposure database and facilitate health risk assessments.

The origin, fate, and health effects of combustion by-products: a research framework.

Incomplete combustion processes can emit organic pollutants, metals, and fine particles. Combustion by-products represent global human and environmental health challenges that are relevant not only in heavily industrialized nations, but also in developing nations where up to 90% of rural households rely on unprocessed biomass fuels for cooking, warmth, and light. These issues were addressed at the Seventh International Congress on Combustion By-Products, which convened 4-6 June 2001 in Research Triangle Park, North Carolina. This congress included a diverse group of multidisciplinary researchers and practitioners who discussed recent developments and future goals in the control of combustion by-products and their effects of exposure on human and ecologic health. Participants recommended that interdisciplinary, coordinated research efforts should be focused to capitalize on the important potential synergisms between efforts to reduce the adverse human health effects linked to exposures to combustion by-products and broader efforts to reduce greenhouse gas emissions and save energy through efficiency. In this article we summarize the principal findings and recommendations for research focus and direction.

Myopotential inhibition of unipolar pacing in children.

Myopotential inhibition of unipolar demand pacing systems has been shown to be a frequent occurrence in adults with transvenous pacing systems in which the pulse generators are implanted adjacent to the pectoralis muscle. To evaluate this problem in children, most of whom have epimyocardial systems and abdominal wall generator implants, 50 patients underwent electrocardiographically monitored exercise and 24-hour ambulatory electrocardiograph monitoring. Patients' ages at the time of study ranged from less than one year to 18 years, and weights ranged from less than 5 kg to 63 kg. Sixteen different models of pulse generators from five manufacturers were involved. Pacing modes were VVI, DVI, AAI, VDD, and DDD. Forty-seven patients had epimyocardial systems. None of the patients was symptomatic as a result of myopotential inhibition. Only three patients (6%) had any evidence of myopotential inhibition and all three demonstrated this inhibition on both monitored exercise and ambulatory electrocardiograph. The inhibition was eliminated by reprogramming the sensitivity levels of the three generators without compromising R-wave sensing. Thirteen of the remaining 35 patients with multiprogrammable generators had induction of myopotential inhibition when exercised after temporary programming to maximal sensitivity settings. Myopotential inhibition of unipolar demand pacing appears to be less frequent and less problematic in the pediatric population, even though they are physically quite active. It is not clear whether this is a function of patient size or the abdominal wall position of the pulse generator.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical experience with the Mentor bladder stimulator. III. Patients with urinary vesical hypotonia.

The Mentor bladder stimulator has been implanted in 5 patients with vesical hypotonia. Of these patients 3 empty the bladder with low residua and sterile urine postoperatively. Pain is the primary side effect in patients with incomplete lower motor neuron lesions or vesical hypotonia of unknown etiology.

Runaway pacemaker in seven patients: a persisting problem.

Runaway pacemaker has been encountered in 7 patients during the past 7 years at the Texas Heart Institute. In this series, 4 patients with fixed-rate pacemakers experienced pacemaker arrhythmias because of battery depletion, and 3 had arrhythmias because of component failure. Battery deterioration was heralded by an increase in cardiac rate. Ventricular tachycardia, rapidly followed by ventricular fibrillation, occurred in 2 patients. Prompt surgical exteriorization of the failing pulse generator and connection to an external pacemaker resulted in prompt recovery in all patients. Elective generator change should be performed routinely after 24 to 30 months unless reliable serial observations of ventricular rates can be attained. This at least will reduce the lethal complications attributed to battery exhaustion. Increasing developments in the design of generators and sources of power, as well as data from pacemaker clinic follow-up and telephone pulse transmittal, are expected to decrease the frequency of this complication.