Cardiac Screening of Young Athletes: a Practical Approach to Sudden Cardiac Death Prevention.

PURPOSE OF REVIEW: We aim to report on the current status of cardiovascular screening of athletes worldwide and review the up-to-date evidence for its efficacy in reducing sudden cardiac death in young athletes. RECENT FINDINGS: A large proportion of sudden cardiac death in young individuals and athletes occurs during rest with sudden arrhythmic death syndrome being recognised as the leading cause. The international recommendations for ECG interpretation have reduced the false-positive ECG rate to 3% and reduced the cost of screening by 25% without compromising the sensitivity to identify serious disease. There are some quality control issues that have been recently identified including the necessity for further training to guide physicians involved in screening young athletes. Improvements in our understanding of young sudden cardiac death and ECG interpretation guideline modification to further differentiate physiological ECG patterns from those that may represent underlying disease have significantly improved the efficacy of screening to levels that may make screening more attractive and feasible to sporting organisations as a complementary strategy to increased availability of automated external defibrillators to reduce the overall burden of young sudden cardiac death

A small area analysis of mortality inequalities in Scotland, 1980-2001

This thesis examines the changing patterns of mortality in Scotland, with particular emphasis on whether there are widening mortality inequalities among small areas in Scotland. The annual number of deaths in Scotland has decreased steadily since the 1950s, yet mortality rates in Scotland are amongst the highest in Europe for many causes. Furthermore, mortality from some causes, such as suicide, has been increasing over time, particularly among young adults. Evidence suggests that inequalities in mortality have widened over time in Scotland, despite substantial investment in policies aimed at reducing inequalities. Therefore, it is important to seek geographical clues that might help explain what causes these high mortality rates. The changing patterns in Scottish mortality between 1980 and 2001 were examined for small areas, created by the author, known as Consistent Areas Through Time (CATTs). These areas have the same boundaries for each census, so that direct comparisons over time are possible. In this study, CATTs have been used to investigate three aspects of the mortality gap in Scotland. First, the widening mortality gaps between 1980-1982 and 1999-2001 are examined for the total population and for premature mortality (<65 years). Second, the influence that geographic scale and deprivation have on the relationship between population change and premature mortality are assessed. Third, suicide inequalities are examined for the younger (15-44 years), older (45+) and total population, using mortality ratios and statistical modelling. The research found that inequalities in premature mortality (<65) have widened for all causes of death studied, particularly for suicide. The negative association between mortality and population change was affected by geographic scale, but this relationship could not be fully explained by deprivation. Small area analyses found that the Highlands and Islands had higher suicide rates than elsewhere in Scotland for males, but not females, when social variables were controlled for

Communication, Collaboration and Enhancing the Learning Experience: Developing a Collaborative Virtual Enquiry Service in University Libraries in the North of England

This paper uses the case study of developing a collaborative ‘out of hours’ virtual enquiry service by members of the Northern Collaboration Group of academic libraries in the north of England to explore the importance of communication and collaboration between academic library services in enhancing student learning. Set within the context of a rapidly changing UK higher education sector the paper considers the benefits and challenges of collaboration and the contribution of library services to the student experience. The project demonstrated clear benefits to student learning and evidence of value for money to individual institutions as well as showing commitment to national shared services agendas. Effective communication with students, with colleagues and stakeholders in our own and other Northern Collaboration member institutions, and with OCLC, our partner organisation, was a critical success factor in the development, promotion and uptake of the new service

Measuring area-level disadvantage in Australia : Development of a locally sensitive indicator

Background In Australia, the Socio-Economic Indexes for Areas (SEIFA), which includes the Index of Relative Socioeconomic Disadvantage (IRSD), captures the socioeconomic characteristics of areas. Because SEIFA rankings are relative to the country or state, the decile categorisations may not reflect an area’s socioeconomic standing relative to areas nearby. Aims The aim of the research was to explore whether IRSD rankings could be re-ranked to become locally sensitive. Data and methods Using existing SEIFA data to redistribute the membership of current decile IRSD groups, we tested three methods to re-rank all SA1 areas relative to the nearest areas capped at: (1) the nearest 99 neighbours, (2) a population threshold of 50,000 (3) a distance threshold of 10 km. Results The reclassification of SEIFA IRSD deciles was largest (up to 8 decile points of change) when comparing the nearest neighbour and population threshold local methods to current state-based rankings. Moreover, compared to using current national and state SEIFA IRSD rankings, the use of local rankings resulted in more evenly distributed deciles between cities, regional, and remote areas. Conclusions Because SEIFA IRSD rankings are used to allocate resources and health services, we encourage the combined use of a state and local ranking to refine areas considered the most disadvantaged

Next Generation Sequencing Detects Premeiotic Errors in Human Oocytes

Autosomal aneuploidy is the leading cause of embryonic and foetal death in humans. This arises mainly from errors in meiosis I or II of oogenesis. A largely ignored source of error stems from germinal mosaicism, which leads to premeiotic aneuploidy. Molecular cytogenetic studies employing metaphase fluorescence in situ hybridization and comparative genomic hybridisation suggest that premeiotic aneuploidy may affect 10–20% of oocytes overall. Such studies have been criticised on technical grounds. We report here an independent study carried out on unmanipulated oocytes that have been analysed using next generation sequencing (NGS). This study confirms that the incidence of premeiotic aneuploidy in an unselected series of oocytes exceeds 10%. A total of 140 oocytes donated by 42 women gave conclusive results; of these, 124 (88.5%) were euploid. Sixteen out of 140 (11.4%) provided evidence of premeiotic aneuploidy. Of the 140, 112 oocytes were immature (germinal vesicle or metaphase I), of which 10 were aneuploid (8.93%); the remaining 28 were intact metaphase II-first polar body complexes, and six of these were aneuploid (21.4%). Of the 16 aneuploid cells, half contained simple errors (one or two abnormal chromosomes) and half contained complex errors. We conclude that germinal mosaicism leading to premeiotic aneuploidy is a consistent finding affecting at least 10% of unselected oocytes from women undergoing egg collection for a variety of reasons. The importance of premeiotic aneuploidy lies in the fact that, for individual oocytes, it greatly increases the risk of an aneuploid mature oocyte irrespective of maternal age. As such, this may account for some cases of aneuploid conceptions in very young women

A comparison of conventional and 137 Cs-based estimates of soil erosion rates on arable and grassland across lowland England and Wales

Soils deliver a range of ecosystem services and underpin conventional global food production which must increase to feed the projected growth in human population. Although soil erosion by water and subsequent sediment delivery to rivers are natural processes, anthropogenic pressures, including modern farming practices and management, have accelerated soil erosion rates on both arable and grassland. A range of approaches can be used to assess and document soil erosion rates and, in the case of the UK, these mainly comprise the 137Cs-based approach, conventional surveys using volumetric measurements, integration of information on suspended sediment flux, fine sediment source apportionment and landscape sediment retention and traditional bounded hydrological monitoring at edge-of-field using experimental platforms. We compare the erosion rates for arable and grassland in lowland England assessed by these different techniques. Rates assessed by volumetric measurements are similar to those generated by integrating information on suspended sediment flux, sources and landscape retention, but are much less than those estimated by the 137Cs-based approach; of the order of one magnitude less for arable land. The 137Cs approach assumes an initial distribution of 137Cs uniformly spread across the landscape and relates the sampled distribution to erosion, but other (transport) processes are also involved and their representation in the calibration procedures remains problematic. We suggest that the 137Cs technique needs to be validated more rigorously and conversion models re-calibrated. As things stand, rates of erosion based on the distribution of 137Cs may well overstate the severity of the problem in lowland Britain and, therefore, are not a reliable indicator of water erosion rates

High resolution biologging of breaching by the world's second largest shark species

This is the final version. Available on open access from Nature Research via the DOI in this recordData availability: the datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.Basking sharks, the world’s second largest fish, are endangered globally following two centuries of large-scale exploitation for their oily livers. In the northeast Atlantic, they seasonally gather in key sites, including the western Scottish Isles, where they feed on plankton, but their breeding grounds are currently completely unknown. Using high36 resolution three-axis accelerometry and depth logging, we present the first direct records of breaching by basking sharks over 41 days. We show that basking sharks breach both during the night and day, starting at approximately 20 metres depth and can breach multiple times in short succession. We also present early evidence of potential lateralisation in basking sharks. Given the energetic nature of breaching, it should have an important biological function, but this remains unclear.Scottish Natural HeritageNatureSco

Functional analysis of two PLA2G2A variants associated with secretory phospholipase A2-IIA levels.

Secretory phospholipase A2 group IIA (sPLA2-IIA) has been identified as a biomarker of atherosclerosis in observational and animal studies. The protein is encoded by the PLA2G2A gene and the aim of this study was to test the functionality of two PLA2G2A non-coding SNPs, rs11573156 C>G and rs3767221 T>G where the rare alleles have been previously associated with higher and lower sPLA2-IIA levels respectively