On 12 March 2020 the UK entered the 'delay phase' of the COVID-19 pandemic response. The Public Health England Emergency Department Syndromic Surveillance System (EDSSS) carries out daily (near ...real-time) public health surveillance of emergency department (ED) attendances across England. This retrospective observational analysis of EDSSS data aimed to describe changes in ED attendances during March-April 2020, and identify the attendance types with the largest impact. Type 1 ED attendances were selected from 109 EDs that reported data to EDSSS for the period 1 January 2019 to 26 April 2020. The daily numbers of attendances were plotted by age group and acuity of presentation. The 2020 'COVID-19' period (12 March 2020 to 26 April 2020) attendances were compared with the equivalent 2019 'pre-COVID-19' period (14 March 2019 to 28 April 2019): in total; by hour and day of the week; age group(<1, 1-4, 15-14, 15-44, 45-64 and 65+ years); gender; acuity; and for selected syndromic indicators(acute respiratory infection, gastroenteritis, myocardial ischaemia). Daily ED attendances up to 11 March 2020 showed regular trends, highest on a Monday and reduced in children during school holidays. From 12 March 2020 ED attendances decreased across all age groups, all acuity levels, on all days and times. Across age groups the greatest percentage reductions were seen in school age children (5-14 years). By acuity, the greatest reduction occurred in the less severe presentations. Syndromic indicators showed that the greatest reductions were in non-respiratory indicators, which fell by 44-67% during 2020 COVID-19, while acute respiratory infection was reduced by -4.4% (95% CI -9.5% to 0.6%). ED attendances in England have been particularly affected during the COVID-19 pandemic due to changes in healthcare seeking behaviour. EDSSS has enabled real-time daily monitoring of these changes, which are made publicly available to facilitate action. The EDSSS provides valuable surveillance of ED attendances in England. The flexibility of EDSSS allowed rapid development of new indicators (including COVID-19-like) and reporting methods.
Rotavirus infection is a common cause of gastroenteritis in children worldwide, with a high mortality burden in developing countries, particularly during the first two years of life. Rotavirus ...vaccination was introduced into the United Kingdom childhood vaccination schedule in July 2013, with high coverage (>90%) achieved by June 2016. We used an emergency department (ED) syndromic surveillance system to assess the impact of the rotavirus vaccination programme, specifically through the demonstration of any immediate and continuing impact on ED gastroenteritis visits in England. This retrospective, observational study used syndromic surveillance data collected from 3 EDs in the two years before (July 2011-June 2013) and 3 years post (July 2013-June 2016) introduction of rotavirus vaccination. The weekly levels of ED visits for gastroenteritis (by age group and in total) during the period before rotavirus vaccination was first described alongside the findings of laboratory surveillance of rotavirus during the same period. An interrupted time-series analysis was then performed to demonstrate the impact of rotavirus vaccination introduction on gastroenteritis ED visit levels. During the two years before vaccine introduction ED visits for gastroenteritis in total and for the 0-4 years age group were seen to rise and fall in line with the seasonal rotavirus increases reported by laboratory surveillance. ED gastroenteritis visits by young children were lower in the three years following introduction of rotavirus vaccination (reduced from 8% of visits to 6% of visits). These attendance levels in young children (0-4years) remained higher than in older age groups, however the previously large seasonal increases in children were greatly reduced, from peaks of 16% to 3-10% of ED visits per week. ED syndromic surveillance demonstrated a reduction in gastroenteritis visits following rotavirus vaccine introduction. This work establishes ED syndromic surveillance as a platform for rapid impact assessment of future vaccine programmes.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
Since the end of January 2020, the coronavirus (COVID-19) pandemic has been responsible for a global health crisis. In England a number of non-pharmaceutical interventions have ...been introduced throughout the pandemic, including guidelines on healthcare attendance (for example, promoting remote consultations), increased handwashing and social distancing. These interventions are likely to have impacted the incidence of non–COVID-19 conditions as well as healthcare seeking behaviour. Syndromic Surveillance Systems offer the ability to monitor trends in healthcare usage over time.
Methods
This study describes the indirect impact of COVID-19 on healthcare utilisation using a range of syndromic indicators including eye conditions, mumps, fractures, herpes zoster and cardiac conditions. Data from the syndromic surveillance systems monitored by Public Health England were used to describe the number of contacts with NHS 111, general practitioner (GP) In Hours (GPIH) and Out-of-Hours (GPOOH), Ambulance and Emergency Department (ED) services over comparable periods before and during the pandemic.
Results
The peak pandemic period in 2020 (weeks 13–20), compared to the same period in 2019, displayed on average a 12% increase in NHS 111 calls, an 11% decrease in GPOOH consultations, and a 49% decrease in ED attendances. In the GP In Hours system, conjunctivitis consultations decreased by 64% and mumps consultations by 31%. There was a 49% reduction in attendance at EDs for fractures, and there was no longer any weekend increase in ED fracture attendances, with similar attendance patterns observed across each day of the week. There was a decrease in the number of ED attendances with diagnoses of myocardial ischaemia.
Conclusion
The COVID-19 pandemic drastically impacted healthcare utilisation for non-COVID-19 conditions, due to a combination of a probable decrease in incidence of certain conditions and changes in healthcare seeking behaviour. Syndromic surveillance has a valuable role in describing and understanding these trends.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Bioprinting for the Biologist Daly, Andrew C.; Prendergast, Margaret E.; Hughes, Alex J. ...
Cell,
01/2021, Letnik:
184, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Building tissues from scratch to explore entirely new cell configurations could revolutionize fundamental understanding in biology. Bioprinting is an emerging technology to do this. Although ...typically applied to engineer tissues for therapeutic tissue repair or drug screening, there are many opportunities for bioprinting within biology, such as for exploring cellular crosstalk or cellular morphogenesis. The overall goals of this Primer are to provide an overview of bioprinting with the biologist in mind, outline the steps in extrusion bioprinting (the most widely used and accessible technology), and discuss alternative bioprinting technologies and future opportunities for bioprinting in biology.
An exploration of the kinds of biological questions bioprinting can be used to address is paired with practical steps to getting started and recent technological advances.
Microfluidic Western blotting Hughes, Alex J.; Herr, Amy E.
Proceedings of the National Academy of Sciences - PNAS,
12/2012, Letnik:
109, Številka:
52
Journal Article
Recenzirano
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Rapid, quantitative Western blotting is a long-sought bioanalytical goal in the life sciences. To this end, we describe a Western blotting assay conducted in a single glass microchannel under purely ...electronic control. The μWestern blot is comprised of multiple steps: sample enrichment, protein sizing, protein immobilization (blotting), and in situ antibody probing. To validate the microfluidic assay, we apply the μWestern blot to analyses of human sera (HIV immunoreactivity) and cell lysate (NFκB). Analytical performance advances are achieved, including: short durations of 10–60 min, multiplexed analyte detection, mass sensitivity at the femtogram level, high-sensitivity 50-pM detection limits, and quantitation capability over a 3.6-log dynamic range. Performance gains are attributed to favorable transport and reaction conditions on the microscale. The multistep assay design relies on a photopatternable (blue light) and photoreactive (UV light) polyacrylamide gel. This hydrophilic polymer constitutes both a separation matrix for protein sizing and, after brief UV exposure, a protein immobilization scaffold for subsequent antibody probing of immobilized protein bands. We observe protein capture efficiencies exceeding 75% under sizing conditions. This compact microfluidic design supports demonstration of a 48-plex μWestern blot in a standard microscope slide form factor. Taken together, the μWestern blot establishes a foundation for rapid, targeted proteomics by merging exceptional specificity with the throughput advantages of multiplexing, as is relevant to a broad range of biological inquiry.
Major sporting events may influence attendance levels at hospital emergency departments (ED). Previous research has focussed on the impact of single games, or wins/losses for specific ...teams/countries, limiting wider generalisations. Here we explore the impact of the Euro 2016 football championships on ED attendances across four participating nations (England, France, Northern Ireland, Wales), using a single methodology. Match days were found to have no significant impact upon daily ED attendances levels. Focussing upon hourly attendances, ED attendances across all countries in the four hour pre-match period were statistically significantly lower than would be expected (OR 0.97, 95% CI 0.94-0.99) and further reduced during matches (OR 0.94, 95% CI 0.91-0.97). In the 4 hour post-match period there was no significant increase in attendances (OR 1.01, 95% CI 0.99-1.04). However, these impacts were highly variable between individual matches: for example in the 4 hour period following the final, involving France, the number of ED attendances in France increased significantly (OR 1.27, 95% CI 1.13-1.42). Overall our results indicate relatively small impacts of major sporting events upon ED attendances. The heterogeneity observed makes it difficult for health providers to predict how major sporting events may affect ED attendances but supports the future development of compatible systems in different countries to support cross-border public health surveillance.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Seasonal epidemics of respiratory syncytial virus (RSV) cause a clinically significant burden of disease among young children. Non-pharmaceutical interventions targeted at SARS-CoV-2 have affected ...the activity of other respiratory pathogens. We describe changes in the epidemiology of RSV among children younger than 5 years in England since 2020.
Surveillance data on RSV infections, comprising laboratory-confirmed cases, proportion of positive tests, hospital admissions for RSV-attributable illness, and syndromic indicators for RSV-associated disease (emergency department attendances for acute bronchitis or bronchiolitis, non-emergency health advice telephone service NHS 111 calls for cough, general practitioner GP in-hours consultations for respiratory tract infections, and GP out-of-hours contacts for acute bronchitis or bronchiolitis) were analysed from Dec 29, 2014 to March 13, 2022, for children younger than 5 years. Data were extracted from national laboratory, clinical, and syndromic surveillance systems. Time-series analyses using generalised linear models were used to estimate the effect of non-pharmaceutical interventions targeting SARS-CoV-2 on RSV indicators, with absolute and relative changes calculated by comparing observed and predicted values.
RSV-associated activity was reduced for all RSV indicators during winter 2020–21 in England, with 10 280 (relative change –99·5% 95% prediction interval –100·0 to –99·1) fewer laboratory-confirmed cases, 22·2 (–99·6%) percentage points lower test positivity, 92 530 (–80·8% –80·9 to –80·8) fewer hospital admissions, 96 672 (–73·7% –73·7 to –73·7) fewer NHS 111 calls, 2924 (–88·8% –90·4 to –87·2) fewer out-of-hours GP contacts, 91 304 (–89·9% –90·0 to –89·9) in-hours GP consultations, and 27 486 (–85·3% –85·4 to –85·2) fewer emergency department attendances for children younger than 5 years compared with predicted values based on winter seasons before the COVID-19 pandemic. An unprecedented summer surge of RSV activity occurred in 2021, including 11 255 (1258·3% 1178·3 to 1345·8) extra laboratory-confirmed cases, 11·6 percentage points (527·3%) higher test positivity, 7604 (10·7% 10·7 to 10·8) additional hospital admissions, 84 425 (124·8% 124·7 to 124·9) more calls to NHS 111, 409 (39·0% 36·6 to 41·8) more out-of-hours GP contacts, and 9789 (84·9% 84·5 to 85·4) more emergency department attendances compared with the predicted values, although there were 21 805 (–34·1% –34·1 to –34·0) fewer in-hours GP consultations than expected. Most indicators were also lower than expected in winter 2021–22, although to a lesser extent than in winter 2020–21.
The extraordinary absence of RSV during winter 2020–21 probably resulted in a cohort of young children without natural immunity to RSV, thereby raising the potential for increased RSV incidence, out-of-season activity, and health-service pressures when measures to restrict SARS-CoV-2 transmission were relaxed.
None.
Single-cell western blotting Hughes, Alex J; Spelke, Dawn P; Xu, Zhuchen ...
Nature methods,
07/2014, Letnik:
11, Številka:
7
Journal Article
Recenzirano
Odprti dostop
To measure cell-to-cell variation in protein-mediated functions, we developed an approach to conduct ∼10(3) concurrent single-cell western blots (scWesterns) in ∼4 h. A microscope slide supporting a ...30-μm-thick photoactive polyacrylamide gel enables western blotting: settling of single cells into microwells, lysis in situ, gel electrophoresis, photoinitiated blotting to immobilize proteins and antibody probing. We applied this scWestern method to monitor single-cell differentiation of rat neural stem cells and responses to mitogen stimulation. The scWestern quantified target proteins even with off-target antibody binding, multiplexed to 11 protein targets per single cell with detection thresholds of <30,000 molecules, and supported analyses of low starting cell numbers (∼200) when integrated with FACS. The scWestern overcomes limitations of antibody fidelity and sensitivity in other single-cell protein analysis methods and constitutes a versatile tool for the study of complex cell populations at single-cell resolution.
Many tissues fold into complex shapes during development. Controlling this process in vitro would represent an important advance for tissue engineering. We use embryonic tissue explants, finite ...element modeling, and 3D cell-patterning techniques to show that mechanical compaction of the extracellular matrix during mesenchymal condensation is sufficient to drive tissue folding along programmed trajectories. The process requires cell contractility, generates strains at tissue interfaces, and causes patterns of collagen alignment around and between condensates. Aligned collagen fibers support elevated tensions that promote the folding of interfaces along paths that can be predicted by modeling. We demonstrate the robustness and versatility of this strategy for sculpting tissue interfaces by directing the morphogenesis of a variety of folded tissue forms from patterns of mesenchymal condensates. These studies provide insight into the active mechanical properties of the embryonic mesenchyme and establish engineering strategies for more robustly directing tissue morphogenesis ex vivo.
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•Mesenchymal condensation involves myosin II-dependent compaction of ECM•Reconstituted condensates compact ECM and drive curvature at tissue interfaces•Finite element modeling of condensation mechanics predicts tissue folding patterns•Arrays of condensates encode complex curvature profiles of reconstituted tissues
A key challenge for tissue engineering is to harness the organizational principles that generate complex tissue topography in vivo. Hughes et al. find that mesenchymal compaction processes are sufficient to generate curvature at tissue interfaces and develop a framework to engineer curvature trajectories of reconstituted tissues via patterns of mesenchymal condensates.
The physiological functions of several organs rely on branched epithelial tubule networks bearing specialized structures for secretion, gas exchange, or filtration. Little is known about conflicts in ...development between building enough tubules for adequate function and geometric constraints imposed by organ size. We show that the mouse embryonic kidney epithelium negotiates a physical packing conflict between increasing tubule tip numbers through branching and limited organ surface area. Through imaging of whole kidney explants, combined with computational and soft material modeling of tubule families, we identify six possible geometric packing phases, including two defective ones. Experiments in explants show that a radially oriented tension on tubule families is necessary and sufficient for them to switch to a vertical packing arrangement that increases surface tip density while avoiding defects. These results reveal developmental contingencies in response to physical limitations and create a framework for classifying congenital kidney defects.
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