Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial

Aims: Atrial fibrillation (AF) is a preventable cause of ischaemic stroke but it is often undiagnosed and undertreated. The utility of smartphone electrocardiogram (ECG) for the detection of AF after ischaemic stroke is unknown. The aim of this study is to determine the diagnostic yield of 30-day smartphone ECG recording compared with 24-h Holter monitoring for detecting AF ≥30 s. Methods and results: In this multicentre, open-label study, we randomly assigned 203 participants to undergo one additional 24-h Holter monitoring (control group, n = 98) vs. 30-day smartphone ECG monitoring (intervention group, n = 105) using KardiaMobile (AliveCor®, Mountain View, CA, USA). Major inclusion criteria included age ≥55 years old, without known AF, and ischaemic stroke or transient ischaemic attack (TIA) within the preceding 12 months. Baseline characteristics were similar between the two groups. The index event was ischaemic stroke in 88.5% in the intervention group and 88.8% in the control group (P = 0.852). AF lasting ≥30 s was detected in 10 of 105 patients in the intervention group and 2 of 98 patients in the control group (9.5% vs. 2.0%; absolute difference 7.5%; P = 0.024). The number needed to screen to detect one AF was 13. After the 30-day smartphone monitoring, there was a significantly higher proportion of patients on oral anticoagulation therapy at 3 months compared with baseline in the intervention group (9.5% vs. 0%, P = 0.002). Conclusions: Among patients ≥55 years of age with a recent cryptogenic stroke or TIA, 30-day smartphone ECG recording significantly improved the detection of AF when compared with the standard repeat 24-h Holter monitoring. Keywords: Anticoagulation; Atrial fibrillation; Cryptogenic stroke; Digital health; Smartphone electrocardiogram.

Determining the Exposure Pathway and Impacts of Microcystis on Threadfin Shad, Dorosoma petenense, in San Francisco Estuary

Blooms of the cyanobacterium Microcystis spp. could affect fish health through the ingestion of colonies as well as exposure to dissolved microcystins in the water column. The goal of the present study was to evaluate the dietary exposure pathway through which Microcystis spp. blooms may affect liver function and nutritional status using a novel approach involving multiple analytical methods to assess the potential risk. Our study was conducted using threadfin shad, Dorosoma petenense, which is a pelagic fish commonly exposed to Microcystis spp. blooms in the upper San Francisco Estuary. The approach incorporated published and optimized methods that offer multiple lines of evidence including in situ hybridization, immunohistochemistry, histopathology, condition factor indices, and nutritional profiles. Measurements of threadfin shad health and tissue condition were conducted at sites where Microcystis was present or absent during the 2007 bloom season. The results showed that dietary exposure to fish from Microcystis blooms resulted in the accumulation of microcystin in the gut and liver tissues of threadfin shad collected from the sites with blooms. Although toxicity endpoints were likely confounded by antecedent conditions, our findings demonstrate dietary exposure of Microcystis toxins to fish using a novel approach with multiple lines of evidence. Environ Toxicol Chem 2020;39:787-798. © 2020 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of SETAC

Anthropogenic debris in seafood: Plastic debris and fibers from textiles in fish and bivalves sold for human consumption.

The ubiquity of anthropogenic debris in hundreds of species of wildlife and the toxicity of chemicals associated with it has begun to raise concerns regarding the presence of anthropogenic debris in seafood. We assessed the presence of anthropogenic debris in fishes and shellfish on sale for human consumption. We sampled from markets in Makassar, Indonesia, and from California, USA. All fish and shellfish were identified to species where possible. Anthropogenic debris was extracted from the digestive tracts of fish and whole shellfish using a 10% KOH solution and quantified under a dissecting microscope. In Indonesia, anthropogenic debris was found in 28% of individual fish and in 55% of all species. Similarly, in the USA, anthropogenic debris was found in 25% of individual fish and in 67% of all species. Anthropogenic debris was also found in 33% of individual shellfish sampled. All of the anthropogenic debris recovered from fish in Indonesia was plastic, whereas anthropogenic debris recovered from fish in the USA was primarily fibers. Variations in debris types likely reflect different sources and waste management strategies between countries. We report some of the first findings of plastic debris in fishes directly sold for human consumption raising concerns regarding human health