Implantation of a novel insertable cardiac monitor: preliminary multicenter experience in Europe.

BACKGROUND: The LUX-Dx™ is a novel insertable cardiac monitor (ICM) introduced into the European market since October 2022. PURPOSE: The aim of this investigation was to provide a comprehensive description of the ICM implantation experience in Europe during its initial year of commercial use. METHODS: The system comprises an incision tool and a single-piece insertion tool pre-loaded with the small ICM. The implantation procedure involves incision, creation of a device pocket, insertion of the ICM, verification of sensing, and incision closure. Patients receive a mobile device with a preloaded App, connecting to their ICM and transmitting data to the management system. Data collected at European centers were analyzed at the time of implantation and before patient discharge. RESULTS: A total of 368 implantation procedures were conducted across 23 centers. Syncope (235, 64%) and cryptogenic stroke (34, 9%) were the most frequent indications for ICM. Most procedures (338, 92%) were performed in electrophysiology laboratories. All ICMs were successfully implanted in the left parasternal region, oriented at 45° in 323 (88%) patients. Repositioning was necessary after sensing verification in 9 (2%) patients. No procedural complications were reported, with a median time from skin incision to suture of 4 min (25th-75th percentiles 2-7). At implantation, the mean R-wave amplitude was 0.39 ± 0.30 mV and the P-wave visibility was 91 ± 20%. Sensing parameters remained stable until pre-discharge and were not influenced by patient characteristics or indications. Procedural times were fast, exhibited consistency across patient groups, and improved after an initial experience with the system. Operator Operator feedback on the system was positive. Patients reported very good ease of use of the App and low levels of discomfort after implantation. CONCLUSIONS: LUX-Dx™ implantation appears efficient and straightforward, with favorable post-implantation sensing values and associated with positive feedback from operators and patients.

Local adaptation of reproductive performance during thermal stress.

Considerable evidence exists for local adaptation of critical thermal limits in ectotherms following adult temperature stress, but fewer studies have tested for local adaptation of sublethal heat stress effects across life-history stages. In organisms with complex life cycles, such as holometabolous insects, heat stress during juvenile stages may severely impact gametogenesis, having downstream consequences on reproductive performance that may be mediated by local adaptation, although this is rarely studied. Here, we tested how exposure to either benign or heat stress temperature during juvenile and adult stages, either independently or combined, influences egg-to-adult viability, adult sperm motility and fertility in high- and low-latitude populations of Drosophila subobscura. We found both population- and temperature-specific effects on survival and sperm motility; juvenile heat stress decreased survival and subsequent sperm motility and each trait was lower in the northern population. We found an interaction between population and temperature on fertility following application of juvenile heat stress; although fertility was negatively impacted in both populations, the southern population was less affected. When the adult stage was also subject to heat stress, the southern population exhibited positive carry-over effects whereas the northern population's fertility remained low. Thus, the northern population is more susceptible to sublethal reproductive consequences following exposure to juvenile heat stress. This may be common in other organisms with complex life cycles and current models predicting population responses to climate change, which do not take into account the impact of juvenile heat stress on reproductive performance, may be too conservative.

Comparative study of chemical and physical methods for distinguishing between passive and metabolically active mechanisms of water contaminant removal by biofilms.

In this study, physical and chemical approaches were employed to distinguish between passive and active mechanisms in biofilms removing contaminants in waste waters and their relative merits were assessed. Respiration, post-exposure recovery and scanning electron microscopic analysis demonstrated that both ultraviolet (UV) treatment (300 mJ/cm(2)) and sodium azide (10 mM) completely inhibited metabolic activity at 5 and 24 h exposure, respectively, whilst not damaging the integrity of the biofilms. Amongst the commonly used chemical inhibitors, only sodium azide showed complete inhibition after 24 h incubation with only about 10% (±4%) of biofilm carbon released into the bulk solution, compared to 33-41% (±8%) when exposed to 5 mM and 10 mM 2,4-dinitrophenol (DNP) and 69-80% (±5%) when exposed to 2% and 5% w/v formalin, respectively. Biofilm inhibition with UV and sodium azide was found to be equally effective at inhibiting biofilms for treatment of triethanolamine (TEA) and benzotriazole (BTA): the results confirming that the dominant removal mechanism was biodegradation. However, the rates of glucose removal by sodium azide-inhibited biofilms were similar to controls, suggesting that chemical inhibitors were not effective for distinguishing the removal mechanisms of simple sugars. Statistically similar amounts of metal were removed by biofilms treated with UV and sodium azide in zinc, copper and cadmium single-systems: the results indicated that the removal mechanism is predominantly a passive biosorption process.

The environmental genomics of metazoan thermal adaptation.

Continued and accelerating change in the thermal environment places an ever-greater priority on understanding how organisms are going to respond. The paradigm of 'move, adapt or die', regarding ways in which organisms can respond to environmental stressors, stimulates intense efforts to predict the future of biodiversity. Assuming that extinction is an unpalatable outcome, researchers have focussed attention on how organisms can shift in their distribution to stay in the same thermal conditions or can stay in the same place by adapting to a changing thermal environment. How likely these respective outcomes might be depends on the answer to a fundamental evolutionary question, namely what genetic changes underpin adaptation to the thermal environment. The increasing access to and decreasing costs of next-generation sequencing (NGS) technologies, which can be applied to both model and non-model systems, provide a much-needed tool for understanding thermal adaptation. Here we consider broadly what is already known from non-NGS studies about thermal adaptation, then discuss the benefits and challenges of different NGS methodologies to add to this knowledge base. We then review published NGS genomics and transcriptomics studies of thermal adaptation to heat stress in metazoans and compare these results with previous non-NGS patterns. We conclude by summarising emerging patterns of genetic response and discussing future directions using these increasingly common techniques.

Hypothyroidism in patients with thalassemia syndromes.

Sixty transfusion-dependent thalassemic patients were studied by simultaneous measurement of circulating thyroid hormones, basal thyroid-stimulating hormone (TSH) and TSH response to thyrotropin-releasing hormone with the aim of evaluating the frequency of hypothyroidism in such patients, and the relationship between hypothyroidism and compliance with treatment and iron overload. Thyroid failure was present in 31 of the 60 patients. A correlation was found between impairment of thyroid functions, duration of chronic hypoxia and the activities of various transaminases. The results of this study emphasize the importance of early evaluation of thyroid function in thalassemic patients and suggest that anemia and hypoxia may potentiate the toxicity of iron deposition in endocrine glands.

Interferences in the spectrophotometric S-diphenylcarbazide determination of environmental hexavalent chromium in a chromium and zinc plating plant.

A study on the determination of environmental hexavalent chromium [Cr(VI)] was carried out in a chromium and zinc plating plant. The atmospheric particulate was collected both on glass wool filters and with an electrostatic sampler; Cr(VI) was determined by the S-diphenylcarbazide method. The filtered and electrostatically collected Cr(VI) was extracted with both 1.4% sulfuric acid and 7% sodium carbonate. Strong interference was observed when extraction was carried out with the acid medium. Alkaline extraction permits 95 +/- 6 (+/- SD)% recovery of the total chromium and has been shown to be suitable in releasing Cr(VI). The analyses of the alkaline samples were carried out with the standard addition method to compensate for a depressive interference of 26 +/- 8 (+/- SD)%. The absorbance decrease of the Cr-S-diphenylcarbazide complex is a time function, and it should be measured within a few minutes of the reagent addition.