What is a covid dashboard?

 

Public Health Reporting has a long history (text here suddenly missing!)There is a long tradition of Public Health Reporting to support knowledge during public health crises. The Covid-19 pandemic has seen the unprecedented rapid demand for Public Health Reporting. The size, speed and scale of the pandemic led to governments, public health professionals, the media and citizens asking for up-to-date, accurate and accessible information and intelligence. One way that these demands were answered were through the creation and publication of Covid-19 dashboards to communicate to diverse audiences. Health Information Professionals were required to make significant decisions quickly. Which indicators to select? Which audiences to develop dashboards for? Which technologies to deploy? Decisions that would normally take a considerable length of time were abbreviated. There were no international standards and a variability of requirements for different commissioners of dashboards. Furthermore the public spotlight and ‘democratisation' of health information created additional pressure and a lack of situational control. Some of the choices made will have a consequential impact for shared Health Service and Population Health Research as the pandemic continues.

 

The purpose of this presentation is to

Discuss the need for rapid health reporting as a result of the Covid-19 pandemic

Examine some of the choices faced by health information professionals in creating and sustaining public Covid-19 dashboards during the pandemic.

Illustrate a variety of solutions that emerged internationally that were broadly trying to address the same need.

Orthogonal Comparison of Molecular Signatures of Kidney Transplants With Subclinical and Clinical Acute Rejection: Equivalent Performance Is Agnostic to Both Technology and Platform

We performed orthogonal technology comparisons of concurrent peripheral blood and biopsy tissue samples from 69 kidney transplant recipients who underwent comprehensive algorithm-driven clinical phenotyping. The sample cohort included patients with normal protocol biopsies and stable transplant (sTx) function (n = 25), subclinical acute rejection (subAR, n = 23), and clinical acute rejection (cAR, n = 21). Comparisons between microarray and RNA sequencing (RNA-seq) signatures were performed and demonstrated a strong correlation between the blood and tissue compartments for both technology platforms. A number of shared differentially expressed genes and pathways between subAR and cAR in both platforms strongly suggest that these two clinical phenotypes form a continuum of alloimmune activation. SubAR is associated with fewer or less expressed genes than cAR in blood, whereas in biopsy tissues, this clinical phenotype demonstrates a more robust molecular signature for both platforms. The discovery work done in this study confirms a clear ability to detect gene expression profiles for sTx, subAR, and cAR in both blood and biopsy tissue, yielding equivalent predictive performance that is agnostic to both technology and platform. Our data also provide strong biological insights into the molecular mechanisms underlying these signatures, underscoring their logistical potential as molecular diagnostics to improve clinical outcomes following kidney transplantation.

Parapharyngeal abscess in an insulin dependant diabetic patient following an elective tonsillectomy

OBJECTIVES

To demonstrate a potentially life-threatening complication following tonsillectomy in a diabetic patient and discuss the possible pathogenesis.

METHODS

Case report and review of the world literature concerning parapharyngeal abscess post-tonsillectomy.

CASE REPORT

A 20-year-old female patient underwent an uneventful tonsillectomy following a history of recurrent tonsillitis. She re-presented 14 days post-surgery with a large erythematous tender right mid cervical neck swelling. Clinical and radiological evaluation confirmed a parapharyngeal abscess. She proceeded to have an incision and drainage of the abscess through a horizontal skin crease incision and subsequent intravenous antibiotic therapy. She was discharged home well three days post-surgery.

CONCLUSION

Diabetes mellitus is a well-recognised systemic disease that may leave an individual more susceptible to infection. We report the first case in a young healthy diabetic patient and highlight a potential serious complication following a routine tonsillectomy.

The mechanism of cytokeratin aggresome formation: the role of mutant ubiquitin (UBB+1)

Aggresome formation in cells involves the failure of the ubiquitin-proteasome pathway to dispose of proteins destined for degradation by the 26S proteasome. UBB(+1) is present in Mallory bodies in alcoholic liver disease and in aggresomes formed in Alzheimer's desease. The present investigation focuses on the role that UBB(+1) plays in cytokeratin aggresome formation in Mallory bodies (MBs) in vitro. Immunoprecipitation with a monoclonal antibody to cytokeratin-8 (CK-8) was used. The immunoprecipitate was incubated for 24 h in the presence of different constituents involved in aggresome formation including ubiquitin, UBB(+1), the proteasome inhibitor PS341, an ATP generating energy source, a deubiquitinating enzyme inhibitor, a purified proteasome fraction, and an E(1-3) conjugating enzyme fraction. MB-like protein aggregates formed in the presence of ubiquitin, plus UBB(+1) or PS341. These aggregates stained positively for CK-8. UBB(+1), and a proteasome subunit Tbp7, as demonstrated on Western blots. A second approach was used to form MBs in vitro in cultured hepatocytes transfected with UBB(+1) protein using Chariot. The cells were double stained using CK-8 and ubiquitin antibodies. The two proteins colocalized in MB-like aggregates. The results support the possibility that aggresome formation is a complex multifactor process, which is favored by inhibition of the proteasome and by the presence of UBB(+1).

Oral low-carbohydrate alcohol liquid diet induces experimental steatohepatitis in the rat

The intragastric tube feeding model of alcoholic liver disease in the rat induces significant liver histopathology, including steatohepatitis and fibrosis. The question is, if the same low-carbohydrate diet is fed ad lib, will the same pathology develop? Rats were fed a liquid diet with ethanol ad lib that was low in calories derived from carbohydrates for 2 months. The urinary ethanol levels (UALs) were monitored at hourly, daily, and weekly intervals, and the growth of the rats was charted. The liver histopathology and blood transaminase levels were determined. Rats fed ethanol grew 1 g/day, which was 2 g/day less than when they were fed the same diet intragastrically. UALs varied hourly between 150 and 500 mg%, daily between 120 and 360 mg%, and weekly between 0 and 500 mg%. Individual rat UALs showed no predictable pattern. The pair-fed controls ate all of their daily ration within 12 h, then fasted until the next day. The histopathology and blood alanine aminotransferase were similar to those seen with the intragastric tube feeding of the same diet, except that necrosis, inflammation, and fibrosis did not develop. The conclusion was that the oral feeding of a low-carbohydrate diet produces less liver injury than that produced by the same diet fed intragastrically. The UALs varied hourly, daily, and weekly in individual rats, making it difficult to synchronize UALs at the time of sacrifice.

An investigation into the quality of life of individuals after laryngectomy

BACKGROUND

Little longitudinal data are available on the general physical, psychological, and social problems experienced as a result of laryngectomy or on the preoperative status of patients in regard to these aspects. In particular, prospective longitudinal data gathered from the same group of subjects over time and examining a variety of such outcomes is rare. This descriptive study addresses these issues.

METHODS

The study investigates the progress of a group of 34 laryngectomees from the preoperative stage up to 6 months after surgery. Medical complications, communication, swallowing, diet, physical, and psychosocial adjustment were measured using both the Short-Form Health Survey (SF-36) and original outcome tools.

RESULTS

A large percentage of subjects demonstrated significant and persistent communication and swallowing problems throughout the period studied. Low preoperative and postoperative scores on the SF-36 demonstrate that this group had a poorer state of general health in many respects than those with serious medical conditions previously documented.

CONCLUSIONS

The results suggest that communication and swallowing difficulties persist for many laryngectomees up to 6 months after surgery and still require further investigation. Poor preoperative and postoperative general health scores indicate that this group may require more long-term social support than is currently being offered to adjust to the laryngectomy.

Long-term results of vestibular nerve section

Records are available on 27 patients who had vestibular nerve section between 1975 and 1987 giving a follow-up time of 10 to 22 years with a mean of 16 years. Episodic vertigo was fully controlled in 26 patients, one needing a labyrinthectomy 18 months later. In addition to the patient who had labyrinthectomy, one patient had immediate post-operative profound hearing loss so that long-term follow-up of hearing was possible in 25 patients. After six months there was an overall average improvement in hearing of 1 dB. Thereafter there were average deterioration of 7 dB at two years, 15 dB at 10 years, 23 dB at 15 years and 29 dB at 20 years. This deterioration was more marked in those who had better hearing at the time of surgery, with all 10 whose hearing was classified as good deteriorating to poor by 15 years. At 10 years hearing deteriorated by 25 dB in those with good hearing and by 7 dB in those with poor hearing. In 20 per cent of patients there was audiological evidence of eventual involvement of the other ear. Tinnitus became worse in five patients but was a major problem in only one patient. One patient suffered a facial paralysis with partial recovery and, in addition, in one the frontal branch was divided in the incision.

Acute oesophageal obstruction 18 months after an abdominal shotgun wound

A 32-year-old man presented to the otolaryngology department with acute dysphagia after vomiting. Radiological investigation suggested a piece of meat lodged in the lower oesophagus and rigid oesophagoscopy was performed. However, a plastic shotgun cartridge was found and removed. This had gained access to the stomach when the patient had been shot at point-blank range 18 months previously, and appeared to have been forced into the oesophagus by the vomiting, where it caused obstruction.

An unusual cause of otalgia--an ossified stylohyoid ligament

Otalgia is often related to pathology in areas of the head and neck apart from the ear. This is due to the rich innervation of the ear via the fifth, seventh, ninth and tenth cranial nerves and the cervical plexus. It is estimated that 50% of ear pain is referred from non-otologic sites. A case is reported where otalgia was due to the presence of a bone in place of a ligament in the neck and was relieved by its removal.

Neurotoxicities and behavioral changes in a 12-year-old male exposed to dicofol, an organochloride pesticide

The case of a 12-yr-old male exposed to a substantial amount of dicofol, a DDT analog, is presented. The patient was still contaminated 3 wk after exposure. Blood and fat analysis documented the presence of dicofol. The patient demonstrated subjective and objective evidence of neurological injury, which resolved. Other organ injury was not present. Cognitive and emotional difficulties persisted over an 18-mo period.

Insulin regulates the paracellular permeability of cultured intestinal epithelial cell monolayers

The T84 human colonic epithelial cell line retains the ability to produce secretagogue-responsive monolayer cultures with high transepithelial resistance when grown and maintained on collagen-coated permeable supports in media supplemented with 5% newborn calf serum. The addition of highly purified insulin to the basolateral but not the apical membrane side of established monolayers caused the transepithelial resistance to decline more than eightfold over a 3-4-d period. By comparing the transepithelial flux of 22Na with that of the extracellular space marker, [3H]mannitol, the decline in electrical resistance was shown to be due solely to an effect on tight junction-mediated paracellular permeability. The effect of insulin was dose dependent with a half-maximal effect at 3.9 ng/ml (approximately 0.7 nM) and fully reversible over a 10-d time course. Simultaneous addition of 2 microM cycloheximide prevented the insulin-induced decline in resistance; in fact, this combination caused a significant increase in electrical resistance. There was no effect on the short-circuit current response of insulin-treated monolayers to secretagogues so long as media was changed daily. While no gross morphological changes were apparent, there did appear to be a subtle condensation of the perijunctional actin ring as visualized using rhodamine-labeled phalloidin. These results demonstrate that insulin modulates the permeability of the occluding junction in T84 cell monolayers through a receptor mediated process which probably involves changes in protein synthesis and cytoskeletal structure. Insulin was also shown to produce similar effects on two other intestinal epithelial cell lines.