FishPhyloMaker: An R package to generate phylogenies for ray-finned fishes

Phylogenies summarize information for evolutionary and ecological studies. They allow investigating hypotheses from trait evolution to the relationship between evolutionary diversity and ecosystem functioning. However, obtaining a phylogenetic hypothesis for local fish assemblages can be difficult, hindering studies involving this group. We developed the FishPhyloMaker R package to facilitate the obtention of phylogenetic information for ray-finned fishes. FishPhyloMaker automates the insertion procedure of species in the most comprehensive phylogeny of ray-finned fishes following their taxonomic positions. The main functions of the FishPhyloMaker package, FishTaxaMaker() and FishPhyloMaker(), assess the validity of species names and generate dated phylogenies for a local pool of species, respectively. FishPhyloMaker facilitates the generation of phylogenetic trees through a reliable and reproducible way for the most diversified group of vertebrates. The package adopts well-known rules of insertion, which will expand the range of evolutionary and ecological questions that can be addressed using ray-finned fishes as study models.

Real-world experience with the insertion of a new implantable cardiac monitor

Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Biotronik SE & Co.KG OnBehalf BIO|CONCEPT.BIOMONITOR III study group, BIO|MASTER.BIOMONITOR III study group, BIO|STREAM-ICM study group Background Implantable Cardiac Monitors (ICM) provide continuous long-term heart rhythm monitoring. The new ICM BIOMONITOR III / IIIm (BM III) is provided with a single-step insertion tool. Purpose To report on the insertion procedure of the BM III in a large real-world patient population. Methods The BM III combines a low cross-section (4.5 x 8.5 mm) with an extended ICM length (77 mm, including flexible antenna). It is inserted into subcutaneous tissue with an ‘injection’ tool that forms the pocket and delivers the device in a single step. We report results of the insertion procedure from a pooled data set from the BIO|CONCEPT BM III (completed) and the BIO|MASTER BM III and BIO|STREAM-ICM (ongoing) studies. Results From 54 investigational sites in 11 countries, 455 insertions were reported (including 39 BM IIIm). The patients were 63 ± 16 years old, had a BMI of 27.6 ± 5.4, and 43% were women. The indications were syncope or pre-syncope (57%), cryptogenic stroke (23%), management of AF (11%) or other (9%). Insertions took 1.7 ± 1.8 minutes until removal of the insertion tool, 4.7 ± 3.4 minutes until wound closure, and 7.1 ± 5.6 minutes including wound cleaning. The wound was sutured (79%) or closed with staples (10%) or adhesive strips (10%). General anaesthesia was used in 8% of the patients and antibiotic prophylaxis in 50% (44% systemic and 6% local). Insertions took place in the catheter laboratory (62%), operating theatre (22%) or in a consultation room (16%) without specific precautional equipment. The insertion site was parallel to the heart"s long axis (56%), parasternal (39%), in the 2nd/3rd intercostal space (3.5%), axillary (0.9%) or at the clavicula (0.7%). The device was repositioned in one case (0.2%). 13 adverse events were reported in connection to the insertion procedure. 5 cases of device pocket bleeding or hematoma occurred. In 5 further cases, the device migrated, posing the risk of extrusion, or actually extruded. Three of these cases used only adhesive strips or no wound closure at all. In two cases, an incorrect usage of the incision tool and substantial subcutaneous fatty tissue may have contributed. One device was damaged by a 200 J defibrillation shock with a shock electrode placed over the device. One patient suffered from dyspnoea, possibly due to psychogenic hyperventilation. One patient had a vasovagal syncope due to pain after an insertion with insufficient local anaesthesia. No infections were reported until the day of analysis, which was more than 30 days after insertion in 92% of all cases. Conclusion The new BM III was inserted in typically less than 5 minutes until wound closure. A relevant number of insertions took place in a consultation room. Prophylactic antibiotics may be unnecessary, because no pocket infections were reported, although no antibiotic prophylaxis was used in one half of all cases (N = 229). In summary, the insertion with the new tool is fast and has a low risk of complications.

Approach to the synthesis of variable data insertion procedures in structure-independent databases

The aim of developing an approach to the synthesis of variable data insertion procedures in structure-independent databases is to identify and analyze heterogeneities in the existing construction process. Two types of heterogeneities were identified associated with various forms of representing the minimum structural units for constructing the process of constructing the data insertion procedure, as well as semantic heterogeneities associated with the use of elements that are semantically heterogeneous to structural elements of a structure-independent database. To eliminate them, you need to use an approach based on the action designer. It allows to use actions as minimal structural units in the synthesis process, to reveal the meanings of characteristics, presenting them in the form of an action structure. The result of the article is a formulated approach to the synthesis of variable data insertion procedures in structure-independent databases.

Central venous catheters and arrhythmia: Two unusual cases

Jugular Tesio lines (TesioCaths; MedCOMP, Harleysville, PA, USA) are frequently used as permanent vascular accesses in haemodialysis patients. During the insertion procedure, arrhythmias are a relatively common complication, usually related to an excessively advanced catheter tip, without major consequences. We present two cases of life-threatening arrhythmias triggered by the Tesio catheter eccentric high-velocity jet of blood resolved after reposition of the catheter without further episodes, despite both lines being inserted under real-time ultrasound and fluoroscopic guidance. We believe dialysis lines should be checked for tip position even when long-standing to prevent relevant complications due to catheter sliding.