Nutritional Optimization for Brain Health in Contact Sports: A Systematic Review and Meta-Analysis on Long-Chain ω-3 Fatty Acids and Neurofilament Light.

Background: Accumulating evidence has highlighted the acute and chronic impact of repetitive subconcussive head impacts (rSHIs) in contact sports. Neurofilament-light (Nf-L), a brain-derived biomarker of neuroaxonal injury, elevates in concert with rSHI. Recently, long-chain ω-3 polyunsaturated fatty acids (LC ω-3 PUFAs) supplementation has been suggested to mitigate brain injury from rSHI as reflected by attenuation of Nf-L concentrations within contact sport athletes.

Omega-3 Status Evaluation in Australian Female Rugby League Athletes: Ad Libitum Fish Oil Provision Results in a Varied Omega-3 Index.

Optimal omega-3 status, influenced by increased intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is vital for physiological health. This study investigated the impact of ad libitum fish oil supplementation on the omega-3 status of female athletes in a professional rugby league team during a competitive season. Twenty-four (n = 24) athletes participated, and their omega-3 status was assessed using the Omega-3 Index (O3I) and arachidonic acid (AA) to EPA ratio through finger-prick blood samples taken at the start and end of the season.

A conceptual model for chronic hepatitis B and content validity of the Hepatitis B Quality of Life (HBQOL) instrument.

Background: There is increased emphasis on incorporating patient perspectives and patient-relevant endpoints in drug development. We developed a conceptual model of the impact of chronic hepatitis B (CHB) on patients' lives and evaluated the content validity of the Hepatitis B Quality of Life (HBQOL) instrument, a patient-reported outcome tool for use in clinical studies, as a patient-relevant endpoint to measure health-related quality of life in patients with CHB.

Methods: A literature review of qualitative studies of patient experience with CHB and concept elicitation telephone interviews with patients with CHB in the United Kingdom were used to develop a conceptual model of the experience and impact of living with CHB.

The Murray-Darling Medical Schools Network Research Collaboration: protocol for a longitudinal, multi-university program of work to explore the effect of rurally based medical school programs in the Murray-Darling region.

Introduction: There is now strong evidence to support the positive impact of place-based medical education on the recruitment and retention of the rural health workforce in Australia. Much of this work, however, has been undertaken in the context of 'extended rural clinical placement' - students undertaking part of their medical degree in a rural location. Until recently, there were only a few places in Australia in which students could undertake the entirety of their medical degree in a rural area.

The utility of heart rate and heart rate variability to identify limits of tolerance to moderate-intensity work in the heat: a secondary analysis.

We investigated the utility of heart rate (HR) and heart rate variability (HRV) for identifying individuals who may terminate work early due to excessive heat strain. Forty-eight men and women (median = 36 years; Q1 = 20 years; Q3 = 54 years) attempted 180 min of moderate-intensity work at a fixed metabolic rate (∼200 W/m; ∼3.5 METs) in a hot environment (wet-bulb globe temperature: 32 °C).

A 20-year population study of peripartum cardiomyopathy.

Background And Aims: The epidemiology of peripartum cardiomyopathy (PPCM) in Europe is poorly understood and data on long-term outcomes are lacking. A retrospective, observational, population-level study of validated cases of PPCM in Scotland from 1998 to 2017 was conducted.

Methods: Women hospitalized with presumed de novo left ventricular systolic dysfunction around the time of pregnancy and no clear alternative cause were included.

Burden of respiratory syncytial virus in adults in the United Kingdom: A systematic literature review and gap analysis.

Despite the growing recognition of a potentially significant respiratory syncytial virus (RSV) disease burden in adults, relevant evidence in the United Kingdom (UK) is limited. This systematic literature review (SLR) aimed to identify the disease burden of RSV in UK adults, including certain high-risk subgroups and existing evidence gaps. Published studies (2011 onwards) reporting epidemiological, economic and clinical burden outcomes in UK adults (≥15 years) with RSV were identified from indexed databases, including MEDLINE, Embase and the Cochrane library.

A Six Year Experience of a National Leadership Fellowship in Northern Ireland: Achieve, Develop, Explore Programme for Trainees (ADEPT).

Introduction: The Achieve, Develop, Explore Programme for Trainees (ADEPT) Clinical Leadership Fellowship Programme was established in response to growing recommendations to underpin healthcare reconfiguration in Northern Ireland with a collective leadership strategy. The fellowship combines a leadership development programme with a project carried out within a host organisation. With the fellowship now in its sixth year, a need was identified to assess its impact on the fellows' leadership skills, career choices, achievements, and views on both the fellowship and how to develop future leaders.

Geographic and Population Distributions of Human Immunodeficiency Virus (HIV)-1 and HIV-2 Circulating Subtypes: A Systematic Literature Review and Meta-analysis (2010-2021).

Background: HIV poses significant challenges for vaccine development due to its high genetic mutation and recombination rates. Understanding the distribution of HIV subtypes (clades) across regions and populations is crucial. In this study, a systematic review of the past decade was conducted to characterize HIV-1/HIV-2 subtypes.

Declining risk of heart failure hospitalization following first acute myocardial infarction in Scotland between 1991-2016.

Aim: Mortality from acute myocardial infarction (AMI) has declined, increasing the pool of survivors at risk of later development of heart failure (HF). However, coronary reperfusion limits infarct size and secondary prevention therapies have improved. In light of these competing influences, we examined long-term trends in the risk of HF hospitalization (HFH) following a first AMI occurring in Scotland over 25 years.

A review and evaluation of study design considerations for omega-3 fatty acid supplementation trials in physically trained participants.

Long-chain omega-3 polyunsaturated fatty acid (LC -3 PUFA) supplements, rich in eicosapentaenoic acid and/or docosahexaenoic acid, are increasingly being recommended within athletic institutions. However, the wide range of doses, durations and study designs implemented across trials makes it difficult to provide clear recommendations. The importance of study design characteristics in LC -3 PUFA trials has been detailed in cardiovascular disease research, and these considerations may guide LC -3 PUFA study design in healthy cohorts.

Overnight sleeping heart rate variability of Army recruits during a 12-week basic military training course.

Purpose: This study aimed to quantify sleeping heart rate (HR) and HR variability (HRV) alongside circulating tumor necrosis factor alpha (TNFα) concentrations during 12-week Basic Military Training (BMT). We hypothesised that, despite a high allostatic load, BMT would increase cardiorespiratory fitness and HRV, while lowering both sleeping HR and TNFα in young healthy recruits.

Methods: Sixty-three recruits (18-43 years) undertook ≥ 2 overnight cardiac frequency recordings in weeks 1, 8 and 12 of BMT with 4 h of beat-to-beat HR collected between 00:00 and 06:00 h on each night.

Effects of sex and wet-bulb globe temperature on heart rate variability during prolonged moderate-intensity exercise: a secondary analysis.

Sex differences in heart rate (HR) and heart rate variability (HRV), a surrogate of cardiac autonomic modulation, are evident during rest and exercise in young healthy individuals. However, it remains unclear whether sex impacts HRV during prolonged exercise at differing levels of environmental heat stress. Therefore, we completed a secondary analysis upon the effects of sex and wet-bulb globe temperature (WBGT) on HR and HRV during prolonged exercise.

The impact of age, type 2 diabetes and hypertension on heart rate variability during rest and exercise at increasing levels of heat stress.

Purpose: In older adults with type 2 diabetes (T2D) and hypertension (HTN), cardiac autonomic modulation is markedly attenuated during exercise-heat stress. However, the extent to which this impairment is evident under increasing levels of heat stress remains unknown.

Methods: We examined heart rate variability (HRV), a surrogate of cardiac autonomic modulation, during incremental exercise-heat stress exposures in young (20-30 years) and middle-aged-to-older individuals (50-70 years) without and with T2D and HTN.

DHA-Rich Fish Oil Increases the Omega-3 Index in Healthy Adults and Slows Resting Heart Rate without Altering Cardiac Autonomic Reflex Modulation.

Regular fish consumption, a rich source of long-chain omega-3 (ω-3) docosahexaenoic acid (DHA), modifies cardiac electrophysiology. However, human studies investigating fish oil and cardiac electrophysiology have predominantly supplemented therapeutic (high) doses of fish oil (often ω-3 eicosapentaenoic acid (EPA) rich sources). This study examined whether non-therapeutic doses of DHA-rich fish oil modulate cardiac electrophysiology at rest and during cardiovascular reflex challenges to the same extent, if at all, in young healthy adults.

Cardiac contractile dysfunction, during and following ischaemia, is attenuated by low-dose dietary fish oil in rats.

Aims: Supplementing animal diets with high-dose fish oil, rich in long chain omega-3 (ω-3) docosahexaenoic acid (DHA), enhances cardiac contractile efficiency and attenuates dysfunction, attributable to ischaemia. However, it remains unclear whether smaller doses, equivalent to what is achievable via regular fish consumption in the human diet, offer similar protection.

Methods: Male Sprague-Dawley (12-15w) rats were fed isoenergetic diets (ad libitum) containing 10% fat by weight (22% energy) for 4-5w.

The Influence of Long-Chain Omega-3 Fatty Acids on Eccentric Exercise-Induced Delayed Muscle Soreness: Reported Outcomes Are Compromised by Study Design Issues.

Delayed onset muscle soreness (DOMS) following eccentric exercise is associated with increased inflammation which can be debilitating. Incorporation of long-chain omega-3 polyunsaturated fatty acids (LC n-3 PUFA), eicosapentaenoic acid, and docosahexaenoic acid into membrane phospholipids provides anti-inflammatory, proresolving, and analgesic effects. This systematic review aims to examine both the quality of studies and the evidence for LC n-3 PUFA in the attenuation of DOMS and inflammation following eccentric exercise, both which of course are empirically linked.

Effect of exercise-heat acclimation on cardiac autonomic modulation in type 2 diabetes: a pilot study.

The effects of exercise-heat acclimation on heart rate variability (HRV) in individuals with type 2 diabetes (T2D) remains unclear. We assessed electrocardiogram recordings during exercise-heat stress in middle-aged-to-older individuals (50-70 years) with ( = 6) and without (control;  = 8;) T2D, before and after 7 days of exercise-heat acclimation. Exercising heart rate was reduced (control, -9 ± 5 bpm; T2D, -14 ± 9 bpm) yet HRV was not significantly different.

Heart rate variability during cardiovascular reflex testing: the importance of underlying heart rate.

Objectives: Heart rate variability (HRV) is often measured during clinical and experimental cardiovascular reflex tests (CRT), as a reflection of cardiac autonomic modulation, despite limited characterization of the rapid responses that occur. Therefore, we evaluated the responsiveness of HRV indices in 20 healthy young adults (age, 27 ± 6 y; mass, 76.9 ± 16.

Cardiac Arrhythmia Prevention in Ischemia and Reperfusion by Low-Dose Dietary Fish Oil Supplementation in Rats.

Background: Supplementing animal diets with fish oil increases myocardial omega-3 polyunsaturated fatty acids [ω-3 (n-3) PUFA], lowers heart rate, and prevents malignant cardiac arrhythmias. In contrast to epidemiological reports, results of some human clinical trials and of unphysiologically high doses employed in animal studies call into question the application of dietary ω-3 PUFA for cardioprotection.

Objective: This study tested the hypothesis that low ω-3 PUFA dietary thresholds for myocardial incorporation in rats, equivalent in dose to what humans derive from eating fish, can reduce heart rate and arrhythmia vulnerability.

Heart rate variability in older workers during work under the Threshold Limit Values for heat exposure.

Background: The Threshold Limit Values (TLV) of the American Conference of Governmental and Industrial Hygienists indicate the levels of heat stress that all workers may be repeatedly exposed to without adverse health effects. In this study, we evaluated heart rate variability (HRV) during moderate-to-heavy work performed continuously or according to different TLV work-rest (WR) allocations in healthy physically active older workers.

Methods: Nine healthy older (58 ± 5 years) males performed three different 120-minute conditions in accordance with TLV guidelines for moderate-to-heavy intensity work (360 W fixed rate of heat production) in different wet-bulb globe temperatures (WBGT): continuous cycling at 28°C WBGT (CON), as well as intermitted work performed at WR of 3:1 in 29°C WBGT (WR3:1), and at WR of 1:1 at 30°C (WR1:1).

Heart rate variability in older men on the day following prolonged work in the heat.

Susceptibility to heat illness during physically demanding work in hot environments is greater on the second of two consecutive workdays. While it has been demonstrated that heat storage is exacerbated on the second compared to first workday in older workers (50-65 yr), the effects on heart rate variability (HRV), an established surrogate of cardiac autonomic modulation, remain unclear. This study evaluated HRV in older workers on the day following prolonged work in the heat.

Cardiac autonomic modulation in type 1 diabetes during exercise-heat stress.

Aims: Cardiac autonomic modulation, as assessed by heart rate variability (HRV), is independently attenuated by both type 1 diabetes (T1D) and exercise-heat stress, although their combined effects remain unclear. We therefore assessed HRV during exercise-heat stress in young individuals (18-37 years) with (n = 14) and without type 1 diabetes (n = 14).

Methods: Participants completed 30-min seated rest and three, 30-min bouts of semi-recumbent cycling at light, moderate, and vigorous metabolic heat productions (200, 250, 300 W/m, respectively), each followed by 30-min recovery.