HEALTHINESS Participant Information Sheet V2.0 (10.07.2024)

Title of Study HEALTHINESS (Health Inequalities in Diabetes Mellitus) Study Researchers Chief Investigator: Prof John Dillon Principal Investigator: Dr Rachael Barrett We are inviting you to take part in a study You are being invited to participate in the HEALTHINESS research study. The study takes the form of a questionnaire, and your responses will be linked to some of your medical information such as blood test results. Before you choose whether or not to take part, we want you to understand why we are doing the study. We also want to tell you what it will involve if you agree to take part. Please take time to read this information carefully. You can ask us any questions you have and talk to other people about it if you want (such as with friends and family). We will do our best to answer your questions and provide you with any more information you ask for. You do not have to decide straight away. Why are we doing this study? We are testing a new way of organising diabetes treatment in NHS Tayside. This is called iDiabetes, and uses information such as a person’s blood test results, height and weight and medical history to automatically make recommendations to their doctor or nurse on the best treatment option for them. The patients will also be able to see these recommendations on an app, called MyDiabetesMyWay. As part of the overall testing of the iDiabetes system, some GP surgeries will provide the same care that they have always done, and others will use the new iDiabetes system, so that these two groups can be compared. However, it will be important to make sure that not only does iDiabetes improve diabetes care but improves diabetes outcomes for everyone. Many researchers have found that “social determinants of health” impact on the likelihood of having type 2 diabetes, and on blood sugar control and the risk of complications in both type 1 and type 2 diabetes. Social determinants of health mean the conditions and environment where people are born, grow, live, work and age. These circumstances are often a result of distribution of resources at a worldwide, national, or local level and beyond an individual's control. This can result in “health inequalities” which is when people (with the same conditions) have different health outcomes due to certain characteristics such as sex, ethnicity, income level, education level and many more. We are performing the HEALTHINESS survey study alongside, but separately, to iDiabetes so we can see how social determinants of health are related to diabetes outcomes in NHS Tayside. We will then use the responses to make sure iDiabetes benefits all people with diabetes and to ensure it does not have less benefit in particular groups of people who may have less money, lower education level or certain ethnic groups. Why have I been contacted? We are contacting potential participants in NHS Tayside who have diabetes mellitus (any subtype). You may have been contacted because you are registered with either SHARE (The Scottish Health Research Register and Biobank) or the NRS (NHS Research Scotland) Diabetes Register and have indicated you are happy to be contacted to participate in research studies. You may also have been asked to take part during an iDiabetes study visit, diabetes clinic appointment or inpatient stay. You may have also heard about the study from posters or the iDiabetes website. We have deliberately made lots of options because we are looking to speak to as many different people as possible including people who may not normally use or receive emails. Do I have to take part? No. It is up to you to choose, taking part in this study is entirely up to you. You can choose to take part or choose not to take part. If you choose not to take part, then simply don’t complete the survey. You do not have to give a reason for not taking part. If you do not want to take part or want to stop the study the medical care you receive and your relationship with the medical or nursing staff looking after you will not be affected. What will happen if I take part? The study is a survey made up of two sets of questions. After finishing reading this information sheet you will be asked to review and agree to some statements making sure you understand and are happy to take part in the HEALTHINESS study. What if I’m unable to complete an online survey? We wish to hear from people who are not able, or do not have the facilities to complete this survey online. If this is the case for you, please contact the study team (contact details at the bottom of this sheet) and we will happily provide a paper copy or go through the survey with you over the telephone. The survey information below will be the same, just in paper format or over the telephone. What does the survey involve? If you take part, you will be transferred to an electronic survey page. You will be asked questions about your circumstances, quality of life, access to the internet and health literacy (how you find, read and understand health information in order to make decisions about your health). Your responses will be collected via our survey partner Jisc. When we have enough responses, the information will be downloaded to the NHS Tayside server. Your DOB (date of birth), name and postcode will be used to find your community health index number (CHI) to allow us to link your responses to your medical information. At this point we will anonymise your responses, by giving your responses a code (sometimes called a unique identifier). Your name, date of birth and CHI number will be removed from the responses at this stage. We will keep your postcode to allow us to look up the Scottish Index of Multiple Deprivation code for where you live. After around one year we will invite you to repeat some parts of the survey to see if your understanding of healthcare or wellbeing has changed. How long will the study take? The survey should take around 10 minutes to complete, but may take slightly longer or slightly less time from person to person. The study will run until we have collected enough responses and have 1 year follow-up of participants’ medical records since enrolment in iDiabetes. Will taking part in the study affect my usual care? No, there will be no alteration to your usual care as a result of taking part in the study. The study is a survey only and we will not be making any changes to your medical care. What are the possible benefits of taking part? There are no direct health benefits to you from taking part. It is hoped that your responses will allow the study team to assess the impact of iDiabetes on health inequalities. Results gathered from this study may guide any alterations to the iDiabetes platform to ensure those from all backgrounds and circumstances can benefit. Results may also inform those making decisions about healthcare in Scotland to make health outcomes more equal across the whole population of Scotland. What are the possible disadvantages and risks of taking part? There are no disadvantages and risks of taking part as the study will not alter your usual medical care. Who is organising and funding this research? The study is being organised by the University of Dundee. It is being funded by the Chief Scientist’s Office. It is being organised by Prof John Dillon and team. How will my survey data be used? We will link the responses from your survey data to the medical data (such as blood test results, information on hospital admissions, prescription information) that is being collected as part of the iDiabetes study and some other routinely available medical data. We will use the information in your survey responses to see if there any patterns in those who have better diabetes control compared to those who have worse diabetes control. This will hopefully allow us to identify any groups of people who may require further help or assistance in getting the most out of iDiabetes and their diabetes care. Study results The results from the study will be made available through the development of reports, peer-reviewed research papers, and presentations. You will not be identifiable in any of the results or any of the publications. If you wish to receive details of how the study is progressing and research outputs, there will be an option to opt-in to this at the end of the study. How will my data be collected? Data will be collected via an online survey. If you wish to complete the survey over the telephone or paper, your answers will be entered into the online survey by the trial team. How will my survey response data be stored? Your study responses will initially be stored by the University of Dundee’s survey partner, Jisc. The Jisc security policy can be accessed here https://onlinesurveys.jisc.ac.uk/security/. Following completion of the survey, data will be downloaded to the NHS Tayside secure server to allow identification of your CHI number. The survey responses will then be stored within the University of Dundee’s, Health Informatics Centre (HIC) Trusted Research Environment (TRE). Your responses will only be accessible by the research team. How long will my survey response data be stored for? Data will be stored for 5 years after the study is completed. What measures are in place to protect the security and confidentiality of my data? Storage and usage of all data is governed by University of Dundee data protection policies, which are aligned to the General Data Protection Regulation (GDPR) and associated Standard Operation Procedures (SOP). Further information is available at: https://www.dundee.ac.uk/information-governance/data-protection. Will my data be anonymised? We will pseudo-anonymise your data which means you will be given a unique identifier (numerical code) which will be linked to your CHI. Your data will be stored with the unique identifier separately from your CHI, name and date of birth. Who will have access to my data? The research team and members of the NRS diabetes register team will have access to the survey responses. This is to allow linkage with your medical records and blood test results so we can analyse the results of the study. Will my data be archived for use in other research projects in the future? Your data may be used in some further analysis for the iDiabetes project but will not be used in any other projects. How will my data be destroyed? The survey data will be securely destroyed 5 years after the results of the HEALTHINESS study have been published. How will we use information about you? We will need to use information from your survey responses and from your medical records for this research project. This information will include your: • Name • Postcode • Community Health Index Number • Date of Birth We will use this information to link your survey responses with the information from your medical records. Your data will have a code number and your personal identifiers will be kept separately. We will ask you to enter your preferred contact details (email, telephone, address) at the end of the survey so we can contact you about the second set of questions after one year. We will also ask your consent to contact you to discuss participating in interviews we are planning in the future. This is entirely optional. We will keep all information about you safe and secure. Once we have finished the study, we will keep some of the data so we can check the results. We will write our reports in a way that no-one can work out that you took part in the study. What are your choices about how your information is used? • You can stop being part of the study at any time, without giving a reason. We will keep information about you that we already have but will not ask you to complete any further surveys. • If you choose to stop taking part in the study, we would like to continue collecting information about your health from central NHS records. If you do not want this to happen, tell us and we will stop. • We need to manage your records in specific ways for the research to be reliable. This means that we won’t be able to let you see or change the data we hold about you. Where can you find out more about how your information is used? You can find out more about how we use your information at https://www.hra.nhs.uk/information-about-patients/ or by asking one of the research team by sending an email to [email protected]. What if I am unhappy or there is a problem? If you are unhappy, or if there is a problem, please feel free to let us know by contacting us. Principal Investigator, Dr Rachael Barrett ([email protected]) and we will try to help. If you are not satisfied, you can make a formal complaint to a senior member of the research team or to the Complaints Officer for NHS Tayside. Patient Experience Team NHS Tayside Ninewells Hospital Dundee DD1 9SY Freephone: 0800 027 5507 Email: [email protected] If you think you have come to harm due to taking part in the study there are no automatic arrangements to get financial compensation.   Insurance The University of Dundee is Sponsoring the study. The University of Dundee holds Clinical Trials indemnity cover which covers the University’s legal liability for harm caused to patients/participants. Who has reviewed this trial/study? This trial/study has been reviewed and approved by Brent Research Ethics Committee who are responsible for reviewing research which is conducted in humans. The Research Ethics committee does not have any objections to this study going ahead. Contact details for further information. Principal Investigator Dr Rachael Barrett Ninewells Hospital and Medical School Dundee DD2 1SY Phone: 01382 383017 Email: [email protected] Thank you for taking time to read this information and for considering taking part in this study.  Information Governance – Data Protection How we use your information If you choose to provide personal data in response to any of our questions, you should understand that we will hold and process that information in the dataset we generate from the survey responses. We will retain the raw data from the survey responses until 5 years after the end of the study. We will retain our analysis and reporting. You are under no obligation to complete this survey. Personal data Personal data is explicitly asked for in this survey. Should you provide personal data in response to any of our questions, please consider whether your responses reveal circumstances which may identify you and whether you wish to include them. Any disclosure of personal data is at your own discretion. You should restrict your answers to the matter at hand and avoid disclosing the personal data of others. Special categories of personal data This survey will ask for special categories of personal data in the completion of this survey. These are required for they analysis of the results due to the nature of the study. Data controller Should you provide personal data in response to this survey the University of Dundee would be the data controller for this information. This data may be processed by the University’s nominated agents such as software or service providers. Data will be processed using the University’s business systems. These include Microsoft 365 and Microsoft OneDrive. The University uses an online survey run by JISC to collect this information. For information on how this service secures your data please see https://www.jisc.ac.uk/online-surveys. Lawful processing If you choose to provide personal data in response to our questions, it will be processed by the University on the basis that it is lawful for it to process your personal data, as the processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the University as data controller. Your rights The University respects your rights and preferences in relation to you. If you wish to update, access, erase, or limit the use of your information please let us know by emailing: Dr Rachael Barrett: [email protected]. If you wish to complain about the University’s use of your information, please contact the University’s Data Protection Officer in the first instance by emailing [email protected]. You may also wish to contact the Information Commissioner’s Office

HEALTHINESS Participant Information Sheet V2.0 (10.07.2024)

Title of Study HEALTHINESS (Health Inequalities in Diabetes Mellitus) Study Researchers Chief Investigator: Prof John Dillon Principal Investigator: Dr Rachael Barrett We are inviting you to take part in a study You are being invited to participate in the HEALTHINESS research study. The study takes the form of a questionnaire, and your responses will be linked to some of your medical information such as blood test results. Before you choose whether or not to take part, we want you to understand why we are doing the study. We also want to tell you what it will involve if you agree to take part. Please take time to read this information carefully. You can ask us any questions you have and talk to other people about it if you want (such as with friends and family). We will do our best to answer your questions and provide you with any more information you ask for. You do not have to decide straight away. Why are we doing this study? We are testing a new way of organising diabetes treatment in NHS Tayside. This is called iDiabetes, and uses information such as a person’s blood test results, height and weight and medical history to automatically make recommendations to their doctor or nurse on the best treatment option for them. The patients will also be able to see these recommendations on an app, called MyDiabetesMyWay. As part of the overall testing of the iDiabetes system, some GP surgeries will provide the same care that they have always done, and others will use the new iDiabetes system, so that these two groups can be compared. However, it will be important to make sure that not only does iDiabetes improve diabetes care but improves diabetes outcomes for everyone. Many researchers have found that “social determinants of health” impact on the likelihood of having type 2 diabetes, and on blood sugar control and the risk of complications in both type 1 and type 2 diabetes. Social determinants of health mean the conditions and environment where people are born, grow, live, work and age. These circumstances are often a result of distribution of resources at a worldwide, national, or local level and beyond an individual's control. This can result in “health inequalities” which is when people (with the same conditions) have different health outcomes due to certain characteristics such as sex, ethnicity, income level, education level and many more. We are performing the HEALTHINESS survey study alongside, but separately, to iDiabetes so we can see how social determinants of health are related to diabetes outcomes in NHS Tayside. We will then use the responses to make sure iDiabetes benefits all people with diabetes and to ensure it does not have less benefit in particular groups of people who may have less money, lower education level or certain ethnic groups. Why have I been contacted? We are contacting potential participants in NHS Tayside who have diabetes mellitus (any subtype). You may have been contacted because you are registered with either SHARE (The Scottish Health Research Register and Biobank) or the NRS (NHS Research Scotland) Diabetes Register and have indicated you are happy to be contacted to participate in research studies. You may also have been asked to take part during an iDiabetes study visit, diabetes clinic appointment or inpatient stay. You may have also heard about the study from posters or the iDiabetes website. We have deliberately made lots of options because we are looking to speak to as many different people as possible including people who may not normally use or receive emails. Do I have to take part? No. It is up to you to choose, taking part in this study is entirely up to you. You can choose to take part or choose not to take part. If you choose not to take part, then simply don’t complete the survey. You do not have to give a reason for not taking part. If you do not want to take part or want to stop the study the medical care you receive and your relationship with the medical or nursing staff looking after you will not be affected. What will happen if I take part? The study is a survey made up of two sets of questions. After finishing reading this information sheet you will be asked to review and agree to some statements making sure you understand and are happy to take part in the HEALTHINESS study. What if I’m unable to complete an online survey? We wish to hear from people who are not able, or do not have the facilities to complete this survey online. If this is the case for you, please contact the study team (contact details at the bottom of this sheet) and we will happily provide a paper copy or go through the survey with you over the telephone. The survey information below will be the same, just in paper format or over the telephone. What does the survey involve? If you take part, you will be transferred to an electronic survey page. You will be asked questions about your circumstances, quality of life, access to the internet and health literacy (how you find, read and understand health information in order to make decisions about your health). Your responses will be collected via our survey partner Jisc. When we have enough responses, the information will be downloaded to the NHS Tayside server. Your DOB (date of birth), name and postcode will be used to find your community health index number (CHI) to allow us to link your responses to your medical information. At this point we will anonymise your responses, by giving your responses a code (sometimes called a unique identifier). Your name, date of birth and CHI number will be removed from the responses at this stage. We will keep your postcode to allow us to look up the Scottish Index of Multiple Deprivation code for where you live. After around one year we will invite you to repeat some parts of the survey to see if your understanding of healthcare or wellbeing has changed. How long will the study take? The survey should take around 10 minutes to complete, but may take slightly longer or slightly less time from person to person. The study will run until we have collected enough responses and have 1 year follow-up of participants’ medical records since enrolment in iDiabetes. Will taking part in the study affect my usual care? No, there will be no alteration to your usual care as a result of taking part in the study. The study is a survey only and we will not be making any changes to your medical care. What are the possible benefits of taking part? There are no direct health benefits to you from taking part. It is hoped that your responses will allow the study team to assess the impact of iDiabetes on health inequalities. Results gathered from this study may guide any alterations to the iDiabetes platform to ensure those from all backgrounds and circumstances can benefit. Results may also inform those making decisions about healthcare in Scotland to make health outcomes more equal across the whole population of Scotland. What are the possible disadvantages and risks of taking part? There are no disadvantages and risks of taking part as the study will not alter your usual medical care. Who is organising and funding this research? The study is being organised by the University of Dundee. It is being funded by the Chief Scientist’s Office. It is being organised by Prof John Dillon and team. How will my survey data be used? We will link the responses from your survey data to the medical data (such as blood test results, information on hospital admissions, prescription information) that is being collected as part of the iDiabetes study and some other routinely available medical data. We will use the information in your survey responses to see if there any patterns in those who have better diabetes control compared to those who have worse diabetes control. This will hopefully allow us to identify any groups of people who may require further help or assistance in getting the most out of iDiabetes and their diabetes care. Study results The results from the study will be made available through the development of reports, peer-reviewed research papers, and presentations. You will not be identifiable in any of the results or any of the publications. If you wish to receive details of how the study is progressing and research outputs, there will be an option to opt-in to this at the end of the study. How will my data be collected? Data will be collected via an online survey. If you wish to complete the survey over the telephone or paper, your answers will be entered into the online survey by the trial team. How will my survey response data be stored? Your study responses will initially be stored by the University of Dundee’s survey partner, Jisc. The Jisc security policy can be accessed here https://onlinesurveys.jisc.ac.uk/security/. Following completion of the survey, data will be downloaded to the NHS Tayside secure server to allow identification of your CHI number. The survey responses will then be stored within the University of Dundee’s, Health Informatics Centre (HIC) Trusted Research Environment (TRE). Your responses will only be accessible by the research team. How long will my survey response data be stored for? Data will be stored for 5 years after the study is completed. What measures are in place to protect the security and confidentiality of my data? Storage and usage of all data is governed by University of Dundee data protection policies, which are aligned to the General Data Protection Regulation (GDPR) and associated Standard Operation Procedures (SOP). Further information is available at: https://www.dundee.ac.uk/information-governance/data-protection. Will my data be anonymised? We will pseudo-anonymise your data which means you will be given a unique identifier (numerical code) which will be linked to your CHI. Your data will be stored with the unique identifier separately from your CHI, name and date of birth. Who will have access to my data? The research team and members of the NRS diabetes register team will have access to the survey responses. This is to allow linkage with your medical records and blood test results so we can analyse the results of the study. Will my data be archived for use in other research projects in the future? Your data may be used in some further analysis for the iDiabetes project but will not be used in any other projects. How will my data be destroyed? The survey data will be securely destroyed 5 years after the results of the HEALTHINESS study have been published. How will we use information about you? We will need to use information from your survey responses and from your medical records for this research project. This information will include your: • Name • Postcode • Community Health Index Number • Date of Birth We will use this information to link your survey responses with the information from your medical records. Your data will have a code number and your personal identifiers will be kept separately. We will ask you to enter your preferred contact details (email, telephone, address) at the end of the survey so we can contact you about the second set of questions after one year. We will also ask your consent to contact you to discuss participating in interviews we are planning in the future. This is entirely optional. We will keep all information about you safe and secure. Once we have finished the study, we will keep some of the data so we can check the results. We will write our reports in a way that no-one can work out that you took part in the study. What are your choices about how your information is used? • You can stop being part of the study at any time, without giving a reason. We will keep information about you that we already have but will not ask you to complete any further surveys. • If you choose to stop taking part in the study, we would like to continue collecting information about your health from central NHS records. If you do not want this to happen, tell us and we will stop. • We need to manage your records in specific ways for the research to be reliable. This means that we won’t be able to let you see or change the data we hold about you. Where can you find out more about how your information is used? You can find out more about how we use your information at https://www.hra.nhs.uk/information-about-patients/ or by asking one of the research team by sending an email to [email protected]. What if I am unhappy or there is a problem? If you are unhappy, or if there is a problem, please feel free to let us know by contacting us. Principal Investigator, Dr Rachael Barrett ([email protected]) and we will try to help. If you are not satisfied, you can make a formal complaint to a senior member of the research team or to the Complaints Officer for NHS Tayside. Patient Experience Team NHS Tayside Ninewells Hospital Dundee DD1 9SY Freephone: 0800 027 5507 Email: [email protected] If you think you have come to harm due to taking part in the study there are no automatic arrangements to get financial compensation.   Insurance The University of Dundee is Sponsoring the study. The University of Dundee holds Clinical Trials indemnity cover which covers the University’s legal liability for harm caused to patients/participants. Who has reviewed this trial/study? This trial/study has been reviewed and approved by Brent Research Ethics Committee who are responsible for reviewing research which is conducted in humans. The Research Ethics committee does not have any objections to this study going ahead. Contact details for further information. Principal Investigator Dr Rachael Barrett Ninewells Hospital and Medical School Dundee DD2 1SY Phone: 01382 383017 Email: [email protected] Thank you for taking time to read this information and for considering taking part in this study.  Information Governance – Data Protection How we use your information If you choose to provide personal data in response to any of our questions, you should understand that we will hold and process that information in the dataset we generate from the survey responses. We will retain the raw data from the survey responses until 5 years after the end of the study. We will retain our analysis and reporting. You are under no obligation to complete this survey. Personal data Personal data is explicitly asked for in this survey. Should you provide personal data in response to any of our questions, please consider whether your responses reveal circumstances which may identify you and whether you wish to include them. Any disclosure of personal data is at your own discretion. You should restrict your answers to the matter at hand and avoid disclosing the personal data of others. Special categories of personal data This survey will ask for special categories of personal data in the completion of this survey. These are required for they analysis of the results due to the nature of the study. Data controller Should you provide personal data in response to this survey the University of Dundee would be the data controller for this information. This data may be processed by the University’s nominated agents such as software or service providers. Data will be processed using the University’s business systems. These include Microsoft 365 and Microsoft OneDrive. The University uses an online survey run by JISC to collect this information. For information on how this service secures your data please see https://www.jisc.ac.uk/online-surveys. Lawful processing If you choose to provide personal data in response to our questions, it will be processed by the University on the basis that it is lawful for it to process your personal data, as the processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the University as data controller. Your rights The University respects your rights and preferences in relation to you. If you wish to update, access, erase, or limit the use of your information please let us know by emailing: Dr Rachael Barrett: [email protected]. If you wish to complain about the University’s use of your information, please contact the University’s Data Protection Officer in the first instance by emailing [email protected]. You may also wish to contact the Information Commissioner’s Office

The consumption of protein-rich foods in older adults: An exploratory focus group study

Objective: Many older adults consume inadequate protein for their needs. This study explored the factors associated with the consumption of high-protein foods in older adults. Methods: Participants over the age of 65 years (n = 28) took part in 1 of 4 focus group discussions on meat, fish, eggs, dairy products, nuts, and pulses. Discussions were audio taped, transcribed, and analyzed using thematic analysis. Results: Numerous and various reasons for the consumption and non-consumption of high-protein foods were reported. Many of these reasons result from reductions in chemosensory, dental and physical abilities, and changes in living situation in the older population, and have impact specifically on high-protein foods because of their often hard, perishable and need-to-be-cooked nature, and high cost. Conclusions and Implications: Further work is required to establish the importance of each of thesereasons in relation to protein intakes, to prioritize those of likely greatest impact for increasing intakes. © 2013 Society for Nutrition Education and Behavior

Long QT syndrome-associated calmodulin variants disrupt the activity of the slowly activating delayed rectifier potassium channel.

Calmodulin (CaM) is a highly conserved mediator of calcium (Ca2+ )-dependent signalling and modulates various cardiac ion channels. Genotyping has revealed several CaM mutations associated with long QT syndrome (LQTS). LQTS patients display prolonged ventricular recovery times (QT interval), increasing their risk of incurring life-threatening arrhythmic events. Loss-of-function mutations to Kv7.1 (which drives the slow delayed rectifier potassium current, IKs, a key ventricular repolarising current) are the largest contributor to congenital LQTS (>50% of cases). CaM modulates Kv7.1 to produce a Ca2+ -sensitive IKs, but little is known about the consequences of LQTS-associated CaM mutations on Kv7.1 function. Here, we present novel data characterising the biophysical and modulatory properties of three LQTS-associated CaM variants (D95V, N97I and D131H). We showed that mutations induced structural alterations in CaM and reduced affinity for Kv7.1, when compared with wild-type (WT). Using HEK293T cells expressing Kv7.1 channel subunits (KCNQ1/KCNE1) and patch-clamp electrophysiology, we demonstrated that LQTS-associated CaM variants reduced current density at systolic Ca2+ concentrations (1 μm), revealing a direct QT-prolonging modulatory effect. Our data highlight for the first time that LQTS-associated perturbations to CaM's structure impede complex formation with Kv7.1 and subsequently result in reduced IKs. This provides a novel mechanistic insight into how the perturbed structure-function relationship of CaM variants contributes to the LQTS phenotype. KEY POINTS: Calmodulin (CaM) is a ubiquitous, highly conserved calcium (Ca2+ ) sensor playing a key role in cardiac muscle contraction. Genotyping has revealed several CaM mutations associated with long QT syndrome (LQTS), a life-threatening cardiac arrhythmia syndrome. LQTS-associated CaM variants (D95V, N97I and D131H) induced structural alterations, altered binding to Kv7.1 and reduced IKs. Our data provide a novel mechanistic insight into how the perturbed structure-function relationship of CaM variants contributes to the LQTS phenotype

How is Europe positioned for a re-emergence of Schmallenberg virus?

The Schmallenberg virus (SBV) caused a large scale epidemic in Europe from 2011–2013 infecting ruminants and causing fetal deformities after infection of pregnant animals. The main impacts of the virus were financial losses due to animal, meat and semen trade restrictions. Even though effective vaccines were produced, their uptake was never high. This along with the subsequent decline in new SBV infections and natural replacement of previously exposed livestock has resulted in a drop in the number of protected animals. Recent surveillance has found a large population of naïve animals currently present in Europe and the virus circulating at a low level. These changes in animal status in combination with favourable conditions for the insect vectors may open the door to the re-emergence of the virus and another large-scale outbreak in Europe. This review details the potential and preparedness for SBV re-emergence in Europe, discusses possible co-ordinated sentinel monitoring programmes both for ruminant seroconversion and the presence of virus in the insect vectors and provides an overview of the economic impact associated with diagnosis, control and the effect of non-vaccination