ASSIGN score and cancer risk in the Scottish Heart Health Extended Cohort (SHHEC) study

BackgroundThe aim of this work was to determine whether the ASSIGN cardiovascular disease (CVD) score, a 10-year CVD risk score used in primary care in Scotland, could additionally detect cancer risk.Methods18,107 participants were recruited to the Scottish Heart Health Extended Cohort (SHHEC) study between 1982 and 1995. Information on health and lifestyle were collected, along with blood and urine, and participants were followed up via record linkage to 2017. Cox proportional hazards were used to estimate HRs (95% CIs) for time to cancer diagnosis.ResultsA total of 5046 cases of cancer were reported during the follow up period. ASSIGN was significantly associated with a diagnosis of cancer, with a 2.3–3.4% increase in risk of cancer per 1-point increase of ASSIGN. The components of ASSIGN predominantly associated with the risk of cancer were age (HR 1.52; 95% CI 1.48–1.56, cholesterol level (HR 1.11; 95% CI 1.08–1.13), diabetes status (HR 1.24; 95% CI 1.01–1.53), and systolic blood pressure (HR 1.16; 95% CI 1.13–1.19).ConclusionASSIGN could be used not only to predict CVD, but also to predict cancer risk in patients. This needs to be validated in further cohorts

Respiratory admissions linked to air pollution in a medium sized city of the UK:A case-crossover study

This study, from the Tayside Pollution Research Programme (TPRP), aims to investigate the effects of air pollution on respiratory hospital admissions in adults and children &lt; 16 y of age, over a 14-year period, in Dundee, Scotland (population circa 148,270). We conducted a case-crossover study using routinely collected healthcare records from Ninewells Hospital, Dundee, Scotland from 2004 to 2017. Respiratory hospitalisation events were linked to daily nitric oxide gases (NOx, NO2, NO) extracted from publicly available data over this period. We used distributed lag models to allow for delayed effects of air pollutants up to 14 days. A total of 34,192 hospital admissions for a respiratory condition were included in this study (children = 9,501; adults = 24,691). Respiratory admissions in children were significantly associated with cumulative 14-day exposure to NOx (RR for a 10 µg m–3 increase in concentration 1.020; 95% confidence interval 1.010–1.031), NO2 (RR 1.086; 95% CI 1.036–1.139) and NO (RR 1.033; 95% CI 1.016–1.052). Similar estimates were observed for acute respiratory infection categories in children. Effects appeared to be somewhat delayed, with the largest estimates mostly observed around lag 6. No significant association was seen for respiratory admissions in adults. This study shows that both NO and NO2 are associated with increased respiratory hospital admissions in children &lt; 16 y of age, and that much more should be done to improve and enforce the established legal NOx pollution limits in cities for the sake of our children’s health.</p

An 18 year data-linkage study on the association between air pollution and acute limb ischaemia

&lt;jats:p&gt; Summary: Background: There is limited information regarding the effects of air pollutants, such as nitrogen oxides (NO&lt;jats:sub&gt;x&lt;/jats:sub&gt;), nitric oxide (NO&lt;jats:sub&gt;2&lt;/jats:sub&gt;), nitrous oxide (NO) and particulate matter with a diameter smaller than 10 μm (PM10), on acute limb ischaemia (ALI), a peripheral arterial disease (PAD) often with a poor clinical outcome. Patients and methods: We conducted an 18-year retrospective cohort study using routinely collected healthcare records from Ninewells Hospital, Dundee, and Perth Royal Infirmary, in Tayside, Scotland, UK from 2000 to 2017. ALI hospitalisation events and deaths were linked to daily NO&lt;jats:sub&gt;x&lt;/jats:sub&gt;, NO&lt;jats:sub&gt;2&lt;/jats:sub&gt;, NO and PM10 levels extracted from publicly available data over this same time period. Distributed lag models were used to estimate risk ratios for ALI hospitalisation and for ALI mortality, adjusting for temperature, humidity, day of the week, month and public holiday. Results: 5,608 hospital admissions in 2,697 patients were identified over the study period (mean age 71.2 years, ±11.1). NO&lt;jats:sub&gt;x&lt;/jats:sub&gt; and NO were associated with an increase of ALI hospital admissions on days of exposure to pollutant (p=.018), while PM10 was associated with a cumulative (lag 0–9 days) increase (p=.027) of ALI hospital admissions in our study. There was no increase of ALI mortality associated with pollution levels. Conclusions: ALI hospital admissions were positively associated with ambient NO&lt;jats:sub&gt;x&lt;/jats:sub&gt; and NO on day of high measured pollution levels and a cumulative effect was seen with PM10. &lt;/jats:p&gt

Dielectric Replica Measurement : A New Technique for Obtaining the Complex Permittivity of Irregularly Shaped Objects

Dielectric measurements provide valuable information about the properties of materials, and could be used to classify and identify the source of objects in fields such as archaeology. Current methods of identification are all partly destructive, so an innovative electromagnetic method developed by the authors, based on resonant cavity perturbation (RCP), provides an attractive, non-destructive alternative. A problem with traditional RCP is that the changes in frequency and Q-factor vary with the object's shape; however, we overcome this by creating a replica of the object, from a material whose dielectric properties are known. Then, by combining three separate perturbations with orthogonal field directions, due firstly to the object and then to its replica, we eliminate the shape dependency, and thus determine the object's dielectric constant and loss factor. After developing the theory of this novel DRM technique, we demonstrate the principle using a set of geometric shapes made in both polytetrafluoroethylene and a 3D printed material. Further measurements then enable second-order terms to be included in the model, improving its accuracy. Finally, DRM is shown to be capable of distinguishing two irregularly shaped objects of different materials. Potential applications of DRM include determining the provenance of pottery, glasses and flints, and distinguishing ivory from bone. These would be of interest to customs and environmental agencies, as well as museum curators and archaeologists

In utero antihypertensive medication exposure and neonatal outcomes : A data linkage cohort study

We acknowledge the support from the Farr Institute @ Scotland. The Farr Institute @ Scotland is supported by a 10-funder consortium: Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government), the Chief Scientist Office (Scottish Government Health Directorates), the Wellcome Trust, (MRC grant number MR/K007017/1).Peer reviewedPublisher PD

Tayside Screening For Cardiac Events (TASCFORCE) study : a prospective cardiovascular risk screening study

This study was funded by Chest Heart and Stroke (Scotland) and the Souter Foundation.Purpose: Risk factor-based models struggle to accurately predict the development of cardiovascular disease (CVD) at the level of the individual. Ways of identifying people with low predicted risk who will develop CVD would allow stratified advice and support informed treatment decisions about the initiation or adjustment of preventive medication, and this is the aim of this prospective cohort study. Participants: The Tayside Screening for Cardiac Events (TASCFORCE) study recruited men and women aged≥40 years, free from known CVD, with a predicted 10-year risk of coronary heart disease<20%. If B-type natriuretic peptide (BNP) was greater than their gender median, participants were offered a whole-body contrast-enhanced MRI (WBCE-MRI) scan (cardiac imaging, whole-body angiography to determine left ventricular parameters, delayed gadolinium enhancement, atheroma burden). Blood, including DNA, was stored for future biomarker assays. Participants are being followed up using electronic record-linkage cardiovascular outcomes. Findings to date: 4423 (1740, 39.3% men) were recruited. Mean age was 52.3 years with a median BNP of 7.50 ng/L and 15.30 ng/L for men and women, respectively. 602 had a predicted 10-year risk of 10%-19.9%, with the remainder<10%. Age, female sex, ex-smoking status, lower heart rate, higher high-density lipoprotein and lower total cholesterol were independently associated with higher log10 BNP levels. Mean left ventricular mass was 129.2 g and 87.0 g in men and women, respectively. Future plans: The TASCFORCE study is investigating the ability of a screening programme, using BNP and WBCE-MRI, at the time of enrolment, to evaluate prediction of CVD in a population at low/intermediate risk. Blood stored for future biomarker analyses will allow testing/development of novel biomarkers. We believe this could be a new UK Framingham study allowing study for many years to come. Clinical Trial Registration: ISRCTN38976321.Publisher PDFPeer reviewe

Educational and health outcomes of children and adolescents receiving antidepressant medication : Scotland-wide retrospective record linkage cohort study of 766 237 schoolchildren

Funding Health Data Research UK (grant reference number MR/S003800/1). Acknowledgements The study was sponsored by Health Data Research UK (www.hdruk.ac.uk), which is a joint investment led by the Medical Research Council, together with the National Institute for Health Research (England), the Chief Scientist Office (Scotland), Health and Care Research Wales, Health and Social Care Research and Development Division (Public Health Agency, Northern Ireland), the Engineering and Physical Sciences Research Council, the Economic and Social Research Council, the British Heart Foundation and Wellcome (grant reference number MR/S003800/1). The sponsor and funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication. This study formed part of a wider PhD thesis undertaken by the lead author within the University of Glasgow and was published in 2017. Certain sections of this paper appear in the thesis, which is accessible and downloadable from the following link: http://theses.gla.ac.uk/8594/1/2017flemingphd.pdf. Author Contributions J.P.P. had the original concept. All authors agreed the study design. D.C. and A.K. provided data and undertook record linkage. M.F. and D.F.M. undertook the statistical analyses. All authors interpreted the results. M.F. and J.P.P. drafted the manuscript and all other authors contributed revisions. All authors reviewed and approved the final version of the manuscript. M.F. is guarantor for the study. Approvals The authors applied for permission to access, link and analyse these data and undertook mandatory training in data protection, IT security and information governance. Therefore, the datasets generated and analysed during the study are not publicly available. The study was approved by the National Health Service Privacy Advisory Committee and covered by a data-processing agreement between Glasgow University and ISD, and a data-sharing agreement between Glasgow University and ScotXed. All data were linked by the Electronic Data Research and Innovation Service (eDRIS), part of NHS National Services Scotland. Ethics The NHS West of Scotland Research Ethics Service confirmed that formal NHS ethics approval was not required, since the study involved anonymized extracts of routinely collected data with an acceptably negligible risk of identification. Conflict of interest: None declaredPeer reviewedPublisher PD

Educational and health outcomes of children and adolescents receiving antiepileptic medication : Scotland-wide record linkage study of 766 244 schoolchildren

Acknowledgements The study was sponsored by Health Data Research UK (www.hdruk.ac.uk) which is a joint investment led by the Medical Research Council, together with the National Institute for Health Research (England), the Chief Scientist Office (Scotland), Health and Care Research Wales, Health and Social Care Research and Development Division (Public Health Agency, Northern Ireland), the Engineering and Physical Sciences Research Council, the Economic and Social Research Council, the British Heart Foundation and Wellcome. This study formed part of a wider PhD thesis undertaken by the lead author within the University of Glasgow, which was published in 2017. Therefore, certain sections of this paper appear in the thesis, which is accessible and downloadable from the following link: http://theses.gla.ac.uk/8594/1/2017flemingphd.pdf. Funding The study was sponsored by Health Data Research UK. The sponsor and funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review or approval of the manuscript, or decision to submit the manuscript for publication. Availability of data and materials The authors applied for permission to access, link and analyse these data and undertook mandatory training in data protection, IT security and information governance. Therefore, the datasets generated and analysed during the study are not publicly available.Peer reviewedPublisher PD