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Search Results: 1 - 10 of 200836 matches for " Garcia-Tsao G "
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Patterns and predictors of treatment initiation and completion in patients with chronic hepatitis C virus infection
Clark BT, Garcia-Tsao G, Fraenkel L
Patient Preference and Adherence , 2012, DOI: http://dx.doi.org/10.2147/PPA.S30111
Abstract: tterns and predictors of treatment initiation and completion in patients with chronic hepatitis C virus infection Original Research (2160) Total Article Views Authors: Clark BT, Garcia-Tsao G, Fraenkel L Published Date April 2012 Volume 2012:6 Pages 285 - 295 DOI: http://dx.doi.org/10.2147/PPA.S30111 Received: 22 January 2012 Accepted: 07 February 2012 Published: 04 April 2012 Brian T Clark1,2, Guadalupe Garcia-Tsao1,2, Liana Fraenkel1,2 1Veterans Administration, Connecticut Healthcare System, West Haven, 2Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA Objectives: Guidelines for hepatitis C (HCV) strongly recommend antiviral treatment for patients with more severe liver disease given their increased risk of developing cirrhosis and other liver-related complications. Despite the proven benefits of therapy, 70%–88% of patients chronically infected with HCV do not undergo treatment. The goal of this paper is to describe patterns of treatment initiation among patients with both mild and severe disease and to assess the factors that are associated with treatment initiation and completion. Methods: Subjects completed previously validated questionnaires to ascertain sociodemographic characteristics, choice predisposition, and clinical characteristics prior to meeting with the hepatologist to discuss treatment initiation and were followed for 12 months. We examined the association between patient characteristics and treatment patterns controlling for liver disease severity. Results: Of the 148 eligible subjects entered into our study, 55 (37%) initiated treatment during the 12-month follow-up period. Of the 86 subjects with severe liver disease, 43 (50%) initiated treatment. Financial barriers and geographic access to care were the most common reasons for treatment deferral. Of the 55 patients initiating treatment, 24 (44%) discontinued treatment, with intolerance of side effects being the most common reason for discontinuation. After adjusting for liver disease severity, patient choice predisposition (prior to discussion with their provider) was strongly associated with initiation of treatment, while sociodemographic characteristics were not. Conclusion: Treatment initiation did align with current recommendations (patients with severe disease were more likely to initiate treatment), however, rates of treatment initiation and completion were low. Patient choice predisposition is the strongest predictor of treatment initiation, independent of disease severity. Improving individualized treatment outcomes for patients with chronic HCV requires efforts at identifying patients’ choice predisposition, and improving access for those wishing to initiate therapy.
Patterns and predictors of treatment initiation and completion in patients with chronic hepatitis C virus infection
Clark BT,Garcia-Tsao G,Fraenkel L
Patient Preference and Adherence , 2012,
Abstract: Brian T Clark1,2, Guadalupe Garcia-Tsao1,2, Liana Fraenkel1,21Veterans Administration, Connecticut Healthcare System, West Haven, 2Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USAObjectives: Guidelines for hepatitis C (HCV) strongly recommend antiviral treatment for patients with more severe liver disease given their increased risk of developing cirrhosis and other liver-related complications. Despite the proven benefits of therapy, 70%–88% of patients chronically infected with HCV do not undergo treatment. The goal of this paper is to describe patterns of treatment initiation among patients with both mild and severe disease and to assess the factors that are associated with treatment initiation and completion.Methods: Subjects completed previously validated questionnaires to ascertain sociodemographic characteristics, choice predisposition, and clinical characteristics prior to meeting with the hepatologist to discuss treatment initiation and were followed for 12 months. We examined the association between patient characteristics and treatment patterns controlling for liver disease severity.Results: Of the 148 eligible subjects entered into our study, 55 (37%) initiated treatment during the 12-month follow-up period. Of the 86 subjects with severe liver disease, 43 (50%) initiated treatment. Financial barriers and geographic access to care were the most common reasons for treatment deferral. Of the 55 patients initiating treatment, 24 (44%) discontinued treatment, with intolerance of side effects being the most common reason for discontinuation. After adjusting for liver disease severity, patient choice predisposition (prior to discussion with their provider) was strongly associated with initiation of treatment, while sociodemographic characteristics were not.Conclusion: Treatment initiation did align with current recommendations (patients with severe disease were more likely to initiate treatment), however, rates of treatment initiation and completion were low. Patient choice predisposition is the strongest predictor of treatment initiation, independent of disease severity. Improving individualized treatment outcomes for patients with chronic HCV requires efforts at identifying patients’ choice predisposition, and improving access for those wishing to initiate therapy.Keywords: barriers, access, preferences, utilization, adverse events
Treatment of portal hypertension
Khurram Bari,Guadalupe Garcia-Tsao
World Journal of Gastroenterology , 2012, DOI: 10.3748/wjg.v18.i11.1166
Abstract: Portal hypertension is the main complication of cirrhosis and is defined as an hepatic venous pressure gradient (HVPG) of more than 5 mmHg. Clinically significant portal hypertension is defined as HVPG of 10 mmHg or more. Development of gastroesophageal varices and variceal hemorrhage are the most direct consequence of portal hypertension. Over the last decades significant advancements in the field have led to standard treatment options. These clinical recommendations have evolved mostly as a result of randomized controlled trials and consensus conferences among experts where existing evidence has been reviewed and future goals for research and practice guidelines have been proposed. Management of varices/variceal hemorrhage is based on the clinical stage of portal hypertension. No specific treatment has shown to prevent the formation of varices. Prevention of first variceal hemorrhage depends on the size/characteristics of varices. In patients with small varices and high risk of bleeding, non-selective β-blockers are recommended, while patients with medium/large varices can be treated with either β-blockers or esophageal band ligation. Standard of care for acute variceal hemorrhage consists of vasoactive drugs, endoscopic band ligation and antibiotics prophylaxis. Transjugular intrahepatic portosystemic shunt (TIPS) is reserved for those who fail standard of care or for patients who are likely to fail (“early TIPS”). Prevention of recurrent variceal hemorrhage consists of the combination of β-blockers and endoscopic band ligation.
Appetite Enhancement and Weight Gain by Peripheral Administration of TrkB Agonists in Non-Human Primates
John C. Lin, David Tsao, Paul Barras, Raul A. Bastarrachea, Bob Boyd, Joyce Chou, Rodnie Rosete, Hua Long, Alison Forgie, Yasmina Abdiche, Jeanette Dilley, Jennifer Stratton, Carlos Garcia, David L. Sloane, Anthony G. Comuzzie, Arnon Rosenthal
PLOS ONE , 2008, DOI: 10.1371/journal.pone.0001900
Abstract: Loss of function mutations in the receptor tyrosine kinase TrkB pathway resulted in hyperphagia and morbid obesity in human and rodents. Conversely, peripheral or central stimulation of TrkB by its natural ligands BDNF or NT4 reduced body weight and food intake in mice, supporting the idea that TrkB is a key anorexigenic signal downstream of the melanocortin-4 receptor (Mc4r) system. Here we show that in non-human primates TrkB agonists were anorexigenic when applied centrally, but surprisingly orexigenic, leading to gain in appetite, body weight, fat deposits and serum leptin levels, when given peripherally. The orexigenic and pro-obesity effects of peripherally administered TrkB agonists appear to be dose dependent, not associated with fluid retention nor with evidence of receptor down regulation. Our findings revealed that TrkB signaling exerts dual control on energy homeostasis in the primates that could be targeted for the treatment of either wasting disorders or obesity.
On the Spectrum of Asymptotic Expansions for an Asymptotic Normal Sequence  [PDF]
Min Tsao
Open Journal of Statistics (OJS) , 2012, DOI: 10.4236/ojs.2012.21010
Abstract: We present a family of formal expansions for the density function of a general one-dimensional asymptotic normal sequence Xn. Members of the family are indexed by a parameter τ with an interval domain which we refer to as the spectrum of the family. The spectrum provides a unified view of known expansions for the density of Xn. It also provides a means to explore for new expansions. We discuss such applications of the spectrum through that of a sample mean and a standardized mean. We also discuss a related expansion for the cumulative distribution function of Xn.
Neutrinos as Superluminal Particles  [PDF]
Tsao Chang
Journal of Modern Physics (JMP) , 2013, DOI: 10.4236/jmp.2013.412A1002
Abstract:

Based on parity violation in the weak interaction and evidences from neutrino oscillation, a natural choice is that neutrinos may be superluminal particles with tiny mass. To keep causality for Superluminal particles, a kinematic time under a non-standard form of the Lorentz transformation is introduced. A Dirac-type equation for Superluminal neutrinos is further investigated, and its solution is brief discussed. This equation can be written in two spinor equations coupled together via tiny mass while respecting maximum parity violation. As a consequence, parity violation implies that the principle of relativity is violated in the weak interaction.

An Experiment to Improve the Model of Lumped Element Circuit  [PDF]
Tsao Chang
Journal of Modern Physics (JMP) , 2018, DOI: 10.4236/jmp.2018.94041
Abstract: The model of lumped element circuit ignores the finite time of signals to propagate around a circuit. However, using modern oscilloscope, the time of nanoseconds in a circuit can be measured. Then the speed of alternating electricity can be obtained in a RL circuit. A typical RL circuit is formed by a power source, wire, resistance and inductance. The basic formula is: U(t)=I(t)R+LdI(t)/dt. It can be derived from the Ohm’s law and Kirchhoff laws. Based on our experimental results, this paper has discussed the new explanation of this equation in a RL circuit. As a result, the speed of alternating electricity is greater than light in a special RL circuit. The model of lumped element circuit can be improved when considering the finite time of signals.
Tissue attenuation coefficient estimation using bubble harmonics with frequency diversity  [PDF]
Sheng-Kai Tsao, Jenho Tsao
Journal of Biomedical Science and Engineering (JBiSE) , 2012, DOI: 10.4236/jbise.2012.55035
Abstract: In a previous work, we developed a consistent TAC (tissue attenuation coefficient) estimator using bubble echoes. Based on temporal averaging, we can improve the estimation precision of TAC for the tissue bounded between two vessels. In this paper, we extend it to use frequency diversity for saving interrogation time by transmit multiple narrowband signals in each pulse. At first, we analyze the deterministic and stochastic properties of the diversity signals. Then a multi-band maximum likelihood diversity combiner is developed. We also provide diversity gains of different diversity estimators for comparing their estimation efficiencies. In the experimental work, we design a simplified phantom for demonstrating the performance of the purposed estimator. It is shown that the TAC estimation rate can be improved by frequency diversity. The convergence rates of single-band and multi-band estimators are compared and it is shown that the multi-band estimator is more consistent than the single-band estimator.
Subsampling Method for Robust Estimation of Regression Models  [PDF]
Min Tsao, Xiao Ling
Open Journal of Statistics (OJS) , 2012, DOI: 10.4236/ojs.2012.23034
Abstract: We propose a subsampling method for robust estimation of regression models which is built on classical methods such as the least squares method. It makes use of the non-robust nature of the underlying classical method to find a good sample from regression data contaminated with outliers, and then applies the classical method to the good sample to produce robust estimates of the regression model parameters. The subsampling method is a computational method rooted in the bootstrap methodology which trades analytical treatment for intensive computation; it finds the good sample through repeated fitting of the regression model to many random subsamples of the contaminated data instead of through an analytical treatment of the outliers. The subsampling method can be applied to all regression models for which non-robust classical methods are available. In the present paper, we focus on the basic formulation and robustness property of the subsampling method that are valid for all regression models. We also discuss variations of the method and apply it to three examples involving three different regression models.
Chemistry and Biochemistry of Dietary Polyphenols
Rong Tsao
Nutrients , 2010, DOI: 10.3390/nu2121231
Abstract: Polyphenols are the biggest group of phytochemicals, and many of them have been found in plant-based foods. Polyphenol-rich diets have been linked to many health benefits. This paper is intended to review the chemistry and biochemistry of polyphenols as related to classification, extraction, separation and analytical methods, their occurrence and biosynthesis in plants, and the biological activities and implications in human health. The discussions are focused on important and most recent advances in the above aspects, and challenges are identified for future research.
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