Committing to genomic answers for all kids: Evaluating inequity in genomic research enrollment

PurposePersistent inequities in genomic medicine and research contribute to health disparities. This analysis uses a context-specific and equity-focused strategy to evaluate enrollment patterns for Genomic Answers for Kids (GA4K), a large, metropolitan-wide genomic study on children.MethodsElectronic health records for 2247 GA4K study participants were used to evaluate the distribution of individuals by demographics (race, ethnicity, and payor type) and location (residential address). Addresses were geocoded to produce point density and 3-digit zip code maps showing local and regional enrollment patterns. Health system reports and census data were used to compare participant characteristics with reference populations at different spatial scales.ResultsRacial and ethnic minoritized and populations with low-income were underrepresented in the GA4K study cohort. Geographic variation demonstrates inequity in enrollment and participation among children from historically segregated and socially disadvantaged communities.ConclusionOur findings illustrate inequity in enrollment related to both GA4K study design and structural inequalities, which we suspect may exist for similar US-based studies. Our methods provide a scalable framework for continually evaluating and improving study design to ensure equitable participation in and benefits from genomic research and medicine. The use of high-resolution, place-based data represents a novel and practical means of identifying and characterizing inequities and targeting community engagement.     

Heterogeneity of Na+/K+-ATPase from rectal gland of Squalus acanthias is not due to α isoform diversity

 Purified Na⁺/K⁺-ATPase (EC 3.6.1.37) isolated from the rectal gland of Squalus acanthias was characterized in ouabain-binding studies and with respect to isoform(s) of the α peptide. To avoid enzyme inactivation [³H]ouabain equilibrium binding was carried out at 20°C. The heterogeneity of Na⁺/K⁺-ATPase isolated from shark rectal gland was similar in [³H]ouabain binding as previously seen in hydrolytic studies. The binding isotherms were compatible with the existence of a high-affinity (K _dis 0.69 nM) and a low-affinity (K _dis 42 nM) component of 1.46 and 0.79 nmol^.(mg protein)^–1, respectively. In Western blots the α peptide of the enzyme hybridized with an isoform-specific polyclonal antibody raised to an α₃-specific region of the large intracellular domain of rat Na⁺/K⁺-ATPase, but not with the supposed α₃-specific monoclonal antibody MA3-915 with its epitope near the N-terminus. Semi-quantitative analysis of the reaction of the α₃-specific polyclonal antibody with the α peptide from the shark enzyme compared to the reaction with α peptide from rat brain enzyme indicated that this region is not exactly the same in the two species. The α peptide of shark enzyme was not recognized by α₁- or α₂-specific polyclonal antibodies, or by the α₁-specific monoclonal antibodies 3B and F6. The large intracellular domain of Na⁺/K⁺-ATPase from shark rectal gland thus seems to be α₃-like and no α isoform heterogeneity seems able to account for the heterogeneity seen in ouabain binding. Received: 7 August 1998 / Accepted: 6 November 1998     

Ⅳ型胶原,纤维连接蛋白和层粘连蛋白在舌癌中的表达和意义

探讨Ⅳ型胶原,纤维连接蛋白（ＦＮ）,层粘蛋白（ＬＮ）与舌鳞形细胞癌（ＴＳＣＣ）的关系,应用免疫组化ＳＰ法检测ＴＳＣＣ３０例中Ｃｏｌ Ⅳ,ＦＮ和ＬＮ的表达情况。结果：ＣｏｌⅣ、ＦＮ和ＬＮ表达一致,癌旁原位癌基底膜呈线状,偶见局部染色模糊或中断,浸润癌癌巢周围表达阳性２１例,阳性９例,阳性率在分化好,无颈淋巴结转移组明显高于分化差,颈淋巴结转移组;癌巢呈团块型者,癌团呈较完整线状表达,染色强度深浓,细     

Compliance and adverse drug reactions: a prospective study with ethinylestradiol using continuous compliance monitoring

Summary This study examined the relationship between adverse reactions and patient compliance with ethinylestradiol at 40 g twice daily versus 20 g four times daily. In a randomized study 61 female patients with primary- infertility were prescribed the drug twice daily (n = 31) or four times daily (n = 30). Ethinylestradiol was administered for 7 days before the sperm cervical mucus penetration-test was performed for hormonal standardization of the cervical mucus quality. Drug compliance was measured by continuous monitoring using the Medication Event Monitoring System. Two parameters were evaluated: percentage of prescribed doses taken (administration compliance) and adherence to the prescribed dose schedule (regimen compliance, number of days with two or four dosing events recorded). Adverse drug reactions were assessed using a standardized questionnaire. Fourty-four women experienced side effects, of which 81% were rated by patients as being mild. Patient compliance was higher with the twice daily than with the four times daily regimen: 85% versus 65% prescribed doses taken (P<0.05). There was no significant difference in compliance comparing patients with and without adverse reactions (82% versus 72%, respectively), but compliance was lower and more irregular with at least 3 versus one or two adverse reactions reported: 54% versus 84% in administration compliance and 31% versus 58% in regimen compliance (P<0.05). Compliance was also lower in patients with nausea and vomiting than in those without these symptoms, 59% versus 91% and 34% versus 66% (P<0.005), respectively, and lower with moderate or severe compared to mild side effects; 48% versus 85% and 25% versus 59% (P<0.005). Thus the mere occurrence of side effects was not associated with low compliance. However, the number and nature of symptoms and their intensity as perceived by patients may have considerably influenced drug use behavior.Abbreviations ADR adverse drug reactions - SCMPT sperm cervical mucus penetration-test Prof. Dr. E. Weber died 7 December 1992     

电子病历书写的质量管理与对策

目的 探讨和总结电子病历（Eleetronic Medical Record,EMR)使用中医生记录的质量控制方法。方法 对EMR中医生记录进行质量分析，找出存在的常见主观性和客观性错误，采用软件设计与建立管理制度的方法提高质量。结果 通过改进软件设计和建立健全规章制度可以达到EMR质量控制。     

舌癌的外科治疗

该文讨论舌癌切除术后的整复及颈淋巴结转移的处理 ,指出T1 病变切除后可直接缝合 ,而T2 以上病变则需用带蒂或游离皮瓣整复。认为颈淋巴结转移与T病变范围和浸润深度、组织病理分化和转移有关。NO 病变仅做肩胛舌骨上淋巴结清扫即可。T3、T4 病变强调术后放射治疗。随诊至少3年 ,3年内无复发则以后复发机会极少。     

高温对人舌癌细胞粘附性影响的实验研究

[目的]观察高温外理前、后的人舌癌细胞(Tca鄄8113)对层粘连蛋白(Ln)和纤维粘连蛋白(Fn)的粘附能力的影响,探寻高温治癌的机理。[方法]采用结晶紫染色法分别测定在37℃条件下培养24小时和在43℃条件下加热40分钟后继续培养24小时的Tca鄄8113细胞对Ln和Fn的粘附能力。[结果]加温后的人舌癌细胞粘附在包被了Fn和Ln孔板上的数量、密度明显减小;通过酶标仪测定光密度OD值,发现加温组的OD值均低于未加温组的OD值,两组相比,具有显著性差异(P<0.01)。[结论]高温能够降低人舌癌细胞对Fn、Ln的粘附能力,从而降低肿瘤细胞对基底膜的浸润、转移力,达到治疗肿瘤的目的。     

舌诊指导临床辨证论治初探

望舌能够测知体质禀赋强弱；察舌能够准确地进行临床辨证；舌诊可帮助鉴别诊断；望舌能够预测疾病的进退预后；舌诊还能够指导临床定治则、遣方药。如能将舌诊和其他诊法有机地结合起来，将进一步提高临床诊断准确率和治愈好转率。     

Base of tongue varices associated with portal hypertension

A symptomatic case of tongue base varices in a patient with portal hypertension secondary to liver cirrhosis is presented. There are no previously documented cases in the world literature. Oesophageal varices may not be the only source of expectorated blood in a patient with portal hypertension.     

舌诊与血液流变学的研究

对２６６例慢性病患者以血液的红细胞压积、全血粘度等７项检测为指标，按舌诊中舌体、舌质、舌苔分类，比较舌象与血液流变学的关系。结果，胖大舌红细胞压积明显升高而全血粘度无明显改变，瘦小舌红细胞压积明显降低而全血还原粘度、全血粘度明显升高。发现暗淡舌、暗红舌、暗紫舌红细胞压积值及全血粘度均有不同程度的升高；随舌质由淡、红、紫色的加深，全血粘度质呈递增趋势。血液流变学的指标测定对阐明舌体、舌质的形成原理具有一定价值；舌象可以反映人体血液流变学的一些变化，为中医舌诊辨证的科学性提供了有力证据