Leeds City Council

NaV (voltage-gated sodium) channels drive cardiac excitability. Although NaV1.5 is the primary cardiac isoform, the composition and functional contributions of non-NaV1.5 isoforms in the heart remain unclear. Here, we developed a chemical-genetic mouse model (NaV1.5GX/GX) in which NaV1.5 can be selectively and reversibly inhibited by acyl- and aryl-sulfonamide compounds (GX [acyl- and aryl-sulfonamide compounds typically denoted by the name GX-### and associated items] drugs). Cardiac activity was assessed by electrocardiograms in vivo, and optical mapping was used for imaging of ex vivo hearts. Whole-cell voltage-clamp in tandem with validated toxins and isoform-selective inhibitors were used to examine sodium current composition. NaV1.5GX/GX mice exhibited normal cardiac function at baseline, but acute GX drug administration caused profound conduction defects and arrhythmias. Whole-heart optical mapping revealed dose-dependent chamber-specific sensitivity to NaV1.5 inhibition, with the right ventricle being the most sensitive, followed by the left ventricle, left atrium, and right atrium. Patch-clamp recordings of isolated cardiomyocytes with application of NaV isoform-selective inhibitors showed that NaV1.5 contributed 93% of sodium current in the left ventricle, 79% in the right ventricle, and 78% in the atria. Non-NaV1.5 isoforms were differentially enriched across chambers: NaV1.8 in the left ventricle, NaV1.1/1.3 in the right ventricle, and NaV1.2/1.6/1.7 in the atria. These results reveal a surprising chamber-specific isoform landscape of cardiac sodium currents, which may underlie the right ventricular predominant phenotype of Brugada syndrome. These data highlight non-NaV1.5 isoforms as potential mediators of chamber-specific cardiac pathologies and as pharmacological targets.

These data describe the distribution of risk factors for liver disease in Leeds, a large city in the UK. Anonymised, unlinked data were aggregated to lower super output areas by the Leeds GP data extraction programme for deprivation, obesity, diabetes and alcohol use. Incident liver disease was quantified from coding of hospital admissions. Alcohol use, deprivation and obesity were associated with LD. Risk factors clustered together geographically. Liver blood tests were more frequently done in areas of low-disease prevalence. These results illustrate health inequalities and support public health policies to reduce incident liver disease.

In the UK, place-based food initiatives, herein “food hubs,” offer a range of economic, social, and/or environmental benefits via the programs, activities and support they offer. Examples of food hubs include food banks, food pantries, social supermarkets, community farms and gardens, and community cafes. Identifying, monitoring, and communicating the benefits of and areas of improvement for food hubs are important in ena­bling these organizations to access funding, scale up and/or out, and support their ambitions to enhance community development and promote community-based circular food systems (C-B CFS). However, due to constraints in time, funding, and resources, evaluation of the work of food hubs across the UK is limited to date and does not cap­ture the multidimensional benefits they provide or the impacts they have to achieve a C-B CFS. This paper presents the co-production and application of an impact evaluation tool aiming to support food hubs to capture evidence of the benefits they provide, and areas where additional benefits can be achieved across four domains: (a) sustainability and resilience; (b) health and wellbeing; (c) access and demand for healthy, local food; and (d) food secu­rity and economy. The tool, available freely online, was implemented at 10 diverse food hubs in Leeds, UK, to capture their activities and impact. Partici­pating food hubs agreed that the tool offers a comprehensive yet practical method of evidencing the impact of their activities. The evidence cap­tured using the tool could strengthen both indivi­dual PBFIs and the wider community food sector. By demonstrating their contributions to national and global priorities in health, food security, and sustainability, this evidence supports advocacy for greater policy recognition and funding. After assessing the implementation of the too across multiple PBFIs, we found how structured impact monitoring could enhance operational resilience, inform strategic planning, and reinforce the case for systemic support of C-B CFS.

Effective collaboration between health and social service providers is critical for delivering holistic, patient-centered care, yet fragmented communication remains a persistent challenge. Digital communication platforms, including secure messaging systems, teleconferencing tools, and integrated electronic health record portals, offer significant potential to enhance information flow, coordination, and decision-making across multidisciplinary teams. However, the absence of standardized policies governing digital communication can undermine transparency, accountability, and trust, leading to errors, delays, and suboptimal care outcomes. This study proposes a comprehensive digital communication policy framework designed to address these challenges by establishing clear guidelines, roles, and protocols that facilitate secure, timely, and accountable information exchange. The framework emphasizes transparency by promoting clear documentation of communication channels, decisions, and actions across care pathways. Open reporting mechanisms allow stakeholders to track interventions, report delays or errors, and ensure that information is consistently shared with all relevant parties. Accountability is reinforced through defined responsibilities for clinicians, social workers, administrators, and IT personnel, combined with monitoring systems that track adherence to communication protocols and document outcomes. Privacy and confidentiality are prioritized through compliance with relevant data protection regulations, secure storage and transmission of sensitive information, and protocols for informed consent and access control. Additionally, the framework incorporates equity and accessibility, ensuring that patients, caregivers, and providers have access to digital communication tools, and addressing barriers related to digital literacy, technological access, or cognitive and language differences. Implementation of this framework is expected to enhance collaborative decision-making, reduce miscommunication, and improve care continuity across health and social service networks. By integrating policy guidance with secure digital tools, organizations can foster trust among stakeholders, optimize resource use, and strengthen accountability mechanisms. Furthermore, continuous monitoring and evaluation allow iterative improvements, ensuring that communication practices remain effective, inclusive, and responsive to emerging challenges. In summary, a structured digital communication policy framework provides a strategic foundation for achieving transparent, accountable, and efficient collaboration in complex, multidisciplinary care environments.

IntroductionLiver-related deaths are increasingly common in the UK and are particularly frequent amongst people of working age. Understanding the risk factors for liver disease and their distribution is necessary to allow for targeted public health and hepatology interventions to improve health. We aimed to describe the distribution of population-level risk factors for liver disease and current practice regarding liver testing in a large UK city.MethodsLeeds is a large city of approximately 900,000 people in England with a single hospital provider, which also provides laboratory services to primary care. Lower super output areas (LSOA), geographical units of approximately 1500 people, were used as the unit of analysis. Severe liver disease (LD) was quantified from clinical coding of hospital admissions with liver disease over a two year period from January 2018 to December 2019. The number of liver blood tests (LBT) over the same period were quantified for each LSOA. Publically available data regarding deprivation, obesity, diabetes, and alcohol use for each LSOA were collated and compared to the incidence of liver disease. The relationship between the various public health measures, LBT and LD was analysed with linear regression. Distribution of disease and risk factors was visualised with maps and panel plots.ResultsIncidence of severe liver disease was not uniform across Leeds but showed significant variation across LSOA ranging between 1 – 199 admissions over the study period. Hazardous alcohol use (AUDIT score ≥ 16) (OR 2.80, p=0.037), severity of deprivation (OR 1.76 p<0.001) and obesity (odds ratio (OR) 1.13, p<0.001) were independent predictors of the incidence of severe liver disease. These risk factors clustered together geographically. Testing for liver disease with LBT was not associated with the incidence of liver disease or with the risk factors for liver disease and in fact was more frequent in areas of low disease prevalence.DiscussionDeprivation, obesity and alcohol use, measured at a population level are associated with liver disease and tend to occur together. These findings underline the need for robust public-health solutions to reduce the prevalence of liver disease and suggest that case-finding undiagnosed liver disease could be targeted to areas of high prevalence.

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