A multi-organ map of the human immune system across age, sex and ethnicity.

Understanding tissue biology's heterogeneity is crucial for advancing precision medicine. Despite the centrality of the immune system in tissue homeostasis, a detailed and comprehensive map of immune cell distribution and interactions across human tissues and demographics remains elusive. To fill this gap, we harmonised data from 12,981 single-cell RNA sequencing samples and curated 29 million cells from 45 anatomical sites to create a comprehensive compositional and transcriptional healthy map of the healthy immune system. We used this resource and a novel multilevel modelling approach to track immune ageing and test differences across sex and ethnicity. We uncovered conserved and tissue-specific immune-ageing programs, resolved sex-dependent differential ageing and identified ethnic diversity in clinically critical immune checkpoints. This study provides a quantitative baseline of the immune system, facilitating advances in precision medicine. By sharing our immune map, we hope to catalyse further breakthroughs in cancer, infectious disease, immunology and precision medicine.

An ocular biomechanic model for dynamic simulation of different eye movements.

Simulating and analysing eye movement is useful for assessing visual system contribution to discomfort with respect to body movements, especially in virtual environments where simulation sickness might occur. It can also be used in the design of eye prosthesis or humanoid robot eye. In this paper, we present two biomechanic ocular models that are easily integrated into the available musculoskeletal models. The model was previously used to simulate eye-head coordination. The models are used to simulate and analyse eye movements. The proposed models are based on physiological and kinematic properties of the human eye. They incorporate an eye-globe, orbital suspension tissues and six muscles with their connective tissues (pulleys). Pulleys were incorporated in rectus and inferior oblique muscles. The two proposed models are the passive pulleys and the active pulleys models. Dynamic simulations of different eye movements, including fixation, saccade and smooth pursuit, are performed to validate both models. The resultant force-length curves of the models were similar to the experimental data. The simulation results show that the proposed models are suitable to generate eye movement simulations with results comparable to other musculoskeletal models. The maximum kinematic root mean square error (RMSE) is 5.68° and 4.35° for the passive and active pulley models, respectively. The analysis of the muscle forces showed realistic muscle activation with increased muscle synergy in the active pulley model.

Emergency department patient knowledge of medications.

Therapeutic decisions made by Emergency Physicians are often influenced by which prescribed medications are being taken by patients. We sought to assess Emergency Department (ED) patients' knowledge of their medications by using a survey. A convenience sample of adult ED patients was surveyed verbally by a research assistant. Two-hundred patients were enrolled. Only 48% of patients could recall or produce a list or the actual bottles of all of their medications, 39% knew the times they take their medications, and only 24% knew all the dosages. Seventeen percent brought a list or the actual medication bottles with them to the ED. Patients who had a primary care physician knew all their medications 51% of the time, compared to 43% who did not have a physician. Fifty-one percent of insured patients compared to 38% of non-insured patients could identify all of their medications. Although knowledge of medications is often critical for decision making in the ED, a significant number of patients are unable to provide this information.

Inactivated influenza vaccine (IIV) in children <2 years of age: examination of selected adverse events reported to the Vaccine Adverse Event Reporting System (VAERS) after thimerosal-free or thimerosal-containing vaccine.

Thimerosal as a preservative (in all but trace amounts) was removed from vaccines used in infants starting in the late 1990s, though the preservative-including inactivated influenza vaccine is still available for use in individuals >or=6 months of age. We compared the proportion of injection site reactions, rash, and infections reported to the Vaccine Adverse Event Reporting System (VAERS) after preservative-free (PFV), preservative-including (PIV), and preservative unknown (PUV) vaccines in reports from 7/1/2004 to 1/4/2006. There were 145, 175, and 216 reports after vaccination with PFV, PIV, and PUV, respectively. The most frequently reported coding terms (fever, rash, and urticaria) were seen in similar proportions in the PFV, PIV, and PUV groups. No difference was detected in the proportion of injection site reactions (ISR), rash, or infections in the PIV, PFV, and PUV reports. Keeping in mind the inherent limitations of VAERS, including underreporting and potential reporting biases, we conclude that there were no substantial differences in the proportion of rash, ISR, and infection reports in the PIV, PFV and PUV reports in infants.

Norwalk virus-associated gastroenteritis traced to ice consumption aboard a cruise ship in Hawaii: comparison and application of molecular method-based assays.

Investigation of an outbreak of acute nonbacterial gastroenteritis on a cruise ship provided an opportunity to assess new molecular method-based diagnostic methods for Norwalk virus (NV) and the antibody response to NV infection. The outbreak began within 36 h of embarkation and affected 30% of 672 passengers and crew. No single meal, seating, or food item was implicated in the transmission of NV, but a passenger's risk of illness was associated with the amount of ice (but not water) consumed (chi-square for trend, P = 0.009). Of 19 fecal specimens examined, 7 were found to contain 27-nm NV-like particles by electron microscopy and 16 were positive by PCR with very sensitive NV-specific primers, but only 5 were positive by a new highly specific antigen enzyme immunoassay for NV. Ten of 12 serum specimen pairs demonstrated a fourfold or greater rise in antibody titer to recombinant baculovirus-expressed NV antigen. The amplified PCR band shared only 81% nucleotide sequence homology with the reference NV strain, which may explain the lack of utility of the fecal specimen enzyme immunoassay. This report, the first to document the use of these molecular method-based assays for investigation of an outbreak, demonstrates the importance of highly sensitive viral diagnostics such as PCR and serodiagnosis for the epidemiologic investigation of NV gastroenteritis.