An atlas of cells in the human tonsil.

Palatine tonsils are secondary lymphoid organs (SLOs) representing the first line of immunological defense against inhaled or ingested pathogens. We generated an atlas of the human tonsil composed of >556,000 cells profiled across five different data modalities, including single-cell transcriptome, epigenome, proteome, and immune repertoire sequencing, as well as spatial transcriptomics. This census identified 121 cell types and states, defined developmental trajectories, and enabled an understanding of the functional units of the tonsil. Exemplarily, we stratified myeloid slan-like subtypes, established a BCL6 enhancer as locally active in follicle-associated T and B cells, and identified SIX5 as putative transcriptional regulator of plasma cell maturation. Analyses of a validation cohort confirmed the presence, annotation, and markers of tonsillar cell types and provided evidence of age-related compositional shifts. We demonstrate the value of this resource by annotating cells from B cell-derived mantle cell lymphomas, linking transcriptional heterogeneity to normal B cell differentiation states of the human tonsil.

Neighborhood ethnic density and disparities in proximal blood donation opportunities.

BACKGROUND: Despite being the largest racial/ethnic minority group in the United States, Hispanic/Latinos (H/L) are significantly underrepresented among blood donors. A lack of proximal blood donation opportunities may be one factor contributing to these disparities. However, few studies have investigated this possibility. STUDY DESIGN AND METHODS: Proprietary data on mobile blood collections in Maricopa County, Arizona, were gathered for the period of January 01, 2022 to April 30, 2022 and paired with census tract information using ArcGIS. Maricopa County encompasses the city of Phoenix with a total population of approximately 4.5 million people, including 1.5 million H/L residents. Blood drive count was regressed on H/L ethnic density and total population, and model estimates were exponentiated to obtain odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: During the specified period, approximately 27,000 red blood cell units were collected through mobile drives. Consistent with expectations, when controlling for total neighborhood population, each 10% increase in H/L ethnic density lowered the odds of having a blood drive in the corresponding neighborhood by 12% (OR = 0.88, 95% CI (0.83, 0.92), p < .001). DISCUSSION: These findings provide initial evidence of fewer proximal donation opportunities in areas with greater H/L population density which may contribute to H/L underrepresentation in blood donation and the need for more inclusive collection efforts. Improved access to blood collection is modifiable and could help to increase the overall blood supply, enhance the ability to successfully match specific blood antigen needs of an increasingly diverse population, and bring about a more resilient blood system.

Experiences of using the MINDSET Self-Management mobile health app among Hispanic Patients:Results of a qualitative study.

BACKGROUND: Interventions focusing on epilepsy self-management (ESM) are vital for promoting the health of people living with epilepsy. E-technology and mobile health (mHealth) tools are becoming increasingly integrated into practice to promote self-management strategies for chronic diseases, enhance care delivery, and reduce health disparities. Management Information and Decision Support Epilepsy Tool (MINDSET), a bilingual decision support tool (available in English and Spanish), was found to be both feasible and effective in facilitating goal-based ESM in the clinic. PURPOSE: To assess the experience of using MINDSET as an ESM intervention among Hispanic patients with epilepsy to inform future interventional studies. METHODS: This study used a Qualitative Descriptive (QD) framework to provide a rich and straightforward description of patients' subjective experiences using MINDSET. Participants were enrolled in the intervention group of a larger parent study (RCT) to assess the efficacy of MINDSET among Hispanic People with Epilepsy (PWE). The purposive, convenient, criterion-based sample for this qualitative analysis comprised of 42 patients who agreed to participate in a semi-structured interview at the end of the larger RCT. This RCT was conducted between August 2017 and January 2019. Spanish and English-speaking Hispanic adult patients (n = 94) with epilepsy in Arizona (n = 53) and Texas (n = 41) were randomly assigned within 6 neurology clinics to treatment (MINDSET plus Usual Care, hereafter referred to as MINDSET; n = 46) and comparison (Usual Care Only; n = 48) conditions. RESULTS: Patient demographics, epilepsy conditions, and ESM behavioral characteristics were representative of the intervention group. Study participants were Hispanic, mainly of Mexican descent (94 %), with a mean age of 39 years, mostly female (53 %), and most of the participants reported having had one or more seizures per month (54 %). The MINDSET intervention revealed five ESM themes: (1) Awareness and Realization of Epilepsy Self-Management, (2) Communication and Partnership with Health Care Providers HCP, (3) Epilepsy Self-Management and Quality of Life, (4) Seizure Control, and (5) Optimism and Agency. CONCLUSION: The participants who used MINDSET as a self-management intervention reported an overall positive experience. Qualitative data in this study show that MINDSET is a valuable ESM tool for Hispanic patients with epilepsy. Findings from this qualitative study were consistent with results from a larger parent study that recognized MINDSET as an effective platform for improving epilepsy self-management adherence.

Environmental and structural factors associated with bacterial diversity in household dust across the Arizona-Sonora border.

We previously reported that asthma prevalence was higher in the United States (US) compared to Mexico (MX) (25.8% vs. 8.4%). This investigation assessed differences in microbial dust composition in relation to demographic and housing characteristics on both sides of the US-MX Border. Forty homes were recruited in the US and MX. Home visits collected floor dust and documented occupants' demographics, asthma prevalence, housing structure, and use characteristics. US households were more likely to have inhabitants who reported asthma when compared with MX households (30% vs. 5%) and had significantly different flooring types. The percentage of households on paved roads, with flushing toilets, with piped water and with air conditioning was higher in the US, while dust load was higher in MX. Significant differences exist between countries in the microbial composition of the floor dust. Dust from Mexican homes was enriched with Alishewanella, Paracoccus, Rheinheimera genera and Intrasporangiaceae family. A predictive metagenomics analysis identified 68 significantly differentially abundant functional pathways between US and MX. This study documented multiple structural, environmental, and demographic differences between homes in the US and MX that may contribute to significantly different microbial composition of dust observed in these two countries.

Health status of southern Arizona border counties: a Healthy Border 2010 midterm review / Situación de salud de los condados de la frontera sur de Arizona: examen a mitad de período del programa "Frontera saludable 2010"

OBJECTIVE: The region on the United States (US) side of the US-Mexico border consists of 44 counties in four states; populations on both sides of the border have similar health problems. Healthy Border 2010: An Agenda for Improving Health on the US-Mexico Border (HB 2010) is a binational agenda of health promotion and disease prevention for individuals in the region. This study reports on the health status of the four southern Arizona border counties. METHODS: Data on health indicators for Cochise, Pima, Santa Cruz, and Yuma Counties were collected from the Arizona Department of Health Services Vital Records and Statistics. Progress was calculated as a percentage made toward or away from the 2010 target. Comparisons were made between the border counties and Arizona. RESULTS: Progress toward the HB 2010 targets varied among the border counties. All border counties made progress toward the targets with the cervical cancer, hepatitis A, and teenage birthrate objectives. Most border counties moved toward the goals for breast cancer, diabetes mortality, tuberculosis, motor vehicle crashes, infant mortality from congenital abnormalities, and prenatal care. Border counties moved away from the target with the human immunodeficiency virus and infant mortality objectives. CONCLUSIONS: Assessment of the HB 2010 objectives provided a comprehensive description of the health status of the population. Although the southern Arizona border counties have shown improvement in some areas, monitoring is still needed to identify the disparities that remain.

OBJETIVO: La región estadounidense de la frontera entre México y los Estados Unidos consta de 48 condados distribuidos en cuatro estados, y las poblaciones que viven a uno y otro lado de la frontera tienen problemas de salud similares. El programa binacional "Frontera saludable 2010" está destinado a las poblaciones de la región y se propone mejorar la situación sanitaria en la frontera entre México y los Estados Unidos mediante actividades de promoción de la salud y prevención de enfermedades. Este estudio es un informe sobre la situación sanitaria de los cuatro condados de la frontera sur de Arizona. MÉTODOS. Los datos acerca de los indicadores de salud de los condados de Cochise, Pima, Santa Cruz y Yuma se obtuvieron del registro civil y estadísticas del Departamento de Servicios de Salud de Arizona. Se calculó el progreso mediante un porcentaje que refleja la cercanía o la lejanía del objetivo propuesto para el año 2010. Se compararon los datos correspondientes a los condados fronterizos con los del estado de Arizona. RESULTADOS: El progreso hacia los objetivos del programa "Frontera saludable 2010" no fue uniforme en los distintos condados fronterizos. Los cuatro condados lograron avances hacia los objetivos propuestos en materia de cáncer cervicouterino, hepatitis A y tasa de natalidad entre las adolescentes. La mayoría de los condados fronterizos están más próximos a cumplir con los objetivos en materia de cáncer de mama, mortalidad por diabetes, tuberculosis, colisiones de vehículos automotores, mortalidad infantil por anomalías congénitas y atención prenatal. Sin embargo, ninguno de los cuatro condados se está acercando al objetivo propuesto en cuanto al virus de la inmunodeficiencia humana y la mortalidad infantil. CONCLUSIONES: La evaluación de los objetivos del programa "Frontera saludable 2010" brindó una descripción integral de la situación de salud de la población. Aunque los condados de la frontera sur de Arizona han logrado avances en algunos aspectos, sigue siendo necesario mantener la vigilancia con el fin de detectar las disparidades aún presentes.

What's begin used at home: a household pesticide survey

Objetivos. Dado que se sabe muy poco acerca de los efectos del uso doméstico de pesticidas sobre la salud de los niños, los autores realizaron una encuesta con el fin de identificar los pesticidas usados en los hogares y averiguar dónde se usan y almacenan, y cuales son los métodos utilizados para su eliminación. Métodos. En la primavera de 1999 se realizó una encuesta en una comunidad del estado de Arizona, Estados Unidos de América, fronteriza con México. Para poder participar en la encuesta, en los hogares se tenía que haber usado un pesticida en los 6 meses anteriores y tenía que residir al menos un niño menor de 10 años. Se obtuvo información general sobre el uso, almacenamiento y eliminación de pesticidas, además de información específica sobre cada uno de los pesticidas que se estaban usando o almacenando actualmente en la casa. Resultados. en los 107 hogares encuestados se encontraron 148 productos pesticidas (media de 1,4 por hogar) La mitad de los pesticidas se guardaban a menos de 1,22 m del suelo, al alcance de los niños, y 70 por ciento se guardaban dentro de la casa, sobre todo en la cocina. La cocina era también el lugar donde mas se usaban los pesticidas(69 por ciento de los encuestados decían haber usado al menos un pesticida). Conclusiones. Se concluye que es importante seguir investigando todas las vías de exposición de los pesticidas para poder analizar la exposición infantil, proceso al que contribuirán el conocimiento sobre el uso doméstico de los pesticidas y el desarrollo de un modelo de exposición. Las caracteristicas del uso, almacenamiento y eliminación de los pesticidas también servirán de guía para el desarrollo de programas comunitarios eficaces de educación y prevención de las intoxicaciones por estos productos

What's begin used at home: a household pesticide survey / Encuesta sobre el uso de pesticidas en el hogar

Objetivos. Dado que se sabe muy poco acerca de los efectos del uso doméstico de pesticidas sobre la salud de los niños, los autores realizaron una encuesta con el fin de identificar los pesticidas usados en los hogares y averiguar dónde se usan y almacenan, y cuales son los métodos utilizados para su eliminación. Métodos. En la primavera de 1999 se realizó una encuesta en una comunidad del estado de Arizona, Estados Unidos de América, fronteriza con México. Para poder participar en la encuesta, en los hogares se tenía que haber usado un pesticida en los 6 meses anteriores y tenía que residir al menos un niño menor de 10 años. Se obtuvo información general sobre el uso, almacenamiento y eliminación de pesticidas, además de información específica sobre cada uno de los pesticidas que se estaban usando o almacenando actualmente en la casa. Resultados. en los 107 hogares encuestados se encontraron 148 productos pesticidas (media de 1,4 por hogar) La mitad de los pesticidas se guardaban a menos de 1,22 m del suelo, al alcance de los niños, y 70 por ciento se guardaban dentro de la casa, sobre todo en la cocina. La cocina era también el lugar donde mas se usaban los pesticidas(69 por ciento de los encuestados decían haber usado al menos un pesticida). Conclusiones. Se concluye que es importante seguir investigando todas las vías de exposición de los pesticidas para poder analizar la exposición infantil, proceso al que contribuirán el conocimiento sobre el uso doméstico de los pesticidas y el desarrollo de un modelo de exposición. Las caracteristicas del uso, almacenamiento y eliminación de los pesticidas también servirán de guía para el desarrollo de programas comunitarios eficaces de educación y prevención de las intoxicaciones por estos productos

Objective. Since very little is known about the health effects that household pesticides have on children, we conducted this survey to identify what pesticides are being used in the home, where they are being used and stored, and what methods are used for their disposal. Methods. In the spring of 1999 we conducted a survey in a community in the state of Arizona, in the United States of America, on the border with Mexico. To be eligible to participate in the survey, households had to have used a pesticide in the 6 mo prior to the survey and to have at least one child under the age of 10 years. We gathered general information on pesticide usage, storage, and disposal, in addition to specific information about each of the pesticides currently being used and/or stored in the home. Results. In the 107 households surveyed, we found 148 pesticide products, for a mean of 1.4 per household. Half of the pesticides were stored less than 4 feet (1.22 m) from the ground, at a level a child could reach. Seventy percent of all the pesticides were stored inside the home, with the kitchen being the storage room most often mentioned. The kitchen was also the room where most of the pesticides were used, with 69% of the respondents saying they had used at least one pesticide there. Conclusions. From our research we conclude that it will be important to continue to investigate all avenues of pesticide exposure in order to fully evaluate childhood exposures. Understanding household pesticide use and developing a model of exposure will help in this process. Profiles of the use, storage, and disposal of products will also guide the development of effective education and poison prevention programs in the community