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Search Results: 1 - 10 of 223293 matches for " Henry C. Chueh "
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Assessing Hospital Readmission Risk Factors in Heart Failure Patients Enrolled in a Telemonitoring Program
Adrian H. Zai,Jeremiah G. Ronquillo,Regina Nieves,Henry C. Chueh,Joseph C. Kvedar,Kamal Jethwani
International Journal of Telemedicine and Applications , 2013, DOI: 10.1155/2013/305819
Abstract: The purpose of this study was to validate a previously developed heart failure readmission predictive algorithm based on psychosocial factors, develop a new model based on patient-reported symptoms from a telemonitoring program, and assess the impact of weight fluctuations and other factors on hospital readmission. Clinical, demographic, and telemonitoring data was collected from 100 patients enrolled in the Partners Connected Cardiac Care Program between July 2008 and November 2011. 38% of study participants were readmitted to the hospital within 30 days. Ten different heart-failure-related symptoms were reported 17,389 times, with the top three contributing approximately 50% of the volume. The psychosocial readmission model yielded an AUC of 0.67, along with sensitivity 0.87, specificity 0.32, positive predictive value 0.44, and negative predictive value 0.8 at a cutoff value of 0.30. In summary, hospital readmission models based on psychosocial characteristics, standardized changes in weight, or patient-reported symptoms can be developed and validated in heart failure patients participating in an institutional telemonitoring program. However, more robust models will need to be developed that use a comprehensive set of factors in order to have a significant impact on population health. 1. Introduction Several predictive models can identify the risk status of patients with heart failure [1]. However, predictors used in those models are often not actionable, as they are typically based on demographic (e.g., age, race/ethnicity) or clinical data (e.g., medical history, billing or laboratory data). In our previous work, we aimed to identify a subset of high-risk patients with reversible risk factors, as our goal was to prevent their readmission by connecting those patients to appropriate interventions. Since psychosocial factors might be a root cause for cardiac decompensation, we set ourselves to develop a multivariable logistic regression model based on psychosocial predictors [2]. In that work, we identified 5 psychosocial predictors “dementia,” “depression,” “adherence,” “declining/refusal of services,” and “missed clinical appointments” as significant predictors of readmission [2]. Similarly, patient-reported symptoms and other factors collected by a telemonitoring system could potentially serve as reversible predictors to eventually strengthen our original model. In fact, body weight gain among heart failure patients is already a known factor linked to early readmissions [3]. Telemonitoring is a promising innovation that allows clinicians to monitor
Inference of Biological Pathway from Gene Expression Profiles by Time Delay Boolean Networks
Tung-Hung Chueh, Henry Horng-Shing Lu
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0042095
Abstract: One great challenge of genomic research is to efficiently and accurately identify complex gene regulatory networks. The development of high-throughput technologies provides numerous experimental data such as DNA sequences, protein sequence, and RNA expression profiles makes it possible to study interactions and regulations among genes or other substance in an organism. However, it is crucial to make inference of genetic regulatory networks from gene expression profiles and protein interaction data for systems biology. This study will develop a new approach to reconstruct time delay Boolean networks as a tool for exploring biological pathways. In the inference strategy, we will compare all pairs of input genes in those basic relationships by their corresponding -scores for every output gene. Then, we will combine those consistent relationships to reveal the most probable relationship and reconstruct the genetic network. Specifically, we will prove that state transition pairs are sufficient and necessary to reconstruct the time delay Boolean network of nodes with high accuracy if the number of input genes to each gene is bounded. We also have implemented this method on simulated and empirical yeast gene expression data sets. The test results show that this proposed method is extensible for realistic networks.
Constructing Biological Pathways by a Two-Step Counting Approach
Hsiuying Wang, Henry Horng-Shing Lu, Tung-Hung Chueh
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0020074
Abstract: Networks are widely used in biology to represent the relationships between genes and gene functions. In Boolean biological models, it is mainly assumed that there are two states to represent a gene: on-state and off-state. It is typically assumed that the relationship between two genes can be characterized by two kinds of pairwise relationships: similarity and prerequisite. Many approaches have been proposed in the literature to reconstruct biological relationships. In this article, we propose a two-step method to reconstruct the biological pathway when the binary array data have measurement error. For a pair of genes in a sample, the first step of this approach is to assign counting numbers for every relationship and select the relationship with counting number greater than a threshold. The second step is to calculate the asymptotic p-values for hypotheses of possible relationships and select relationships with a large p-value. This new method has the advantages of easy calculation for the counting numbers and simple closed forms for the p-value. The simulation study and real data example show that the two-step counting method can accurately reconstruct the biological pathway and outperform the existing methods. Compared with the other existing methods, this two-step method can provide a more accurate and efficient alternative approach for reconstructing the biological network.
A Single Institution’s Overweight Pediatric Population and Their Associated Comorbid Conditions
Sigrid Bairdain,Chueh Lien,Alexander P. Stoffan,Michael Troy,Donald C. Simonson,Bradley C. Linden
ISRN Obesity , 2014, DOI: 10.1155/2014/517694
Abstract: Background. Obesity studies are often performed on population data. We sought to examine the incidence of obesity and its associated comorbidities in a single freestanding children’s hospital. Methods. We performed a retrospective analysis of all visits to Boston Children’s Hospital from 2000 to 2012. This was conducted to determine the incidence of obesity, morbid obesity, and associated comorbidities. Each comorbidity was modeled independently. Incidence rate ratios were calculated, as well as odds ratios. Results. A retrospective review of 3,185,658 person-years in nonobese, 26,404 person-years in obese, and 25,819 person-years in the morbidly obese was conducted. Annual rates of all major comorbidities were increased in all patients, as well as in our obese and morbidly obese counterparts. Incidence rate ratios (IRR) and odds ratios (OR) were also significantly increased across all conditions for both our obese and morbidly obese patients. Conclusions. These data illustrate the substantial increases in obesity and associated comorbid conditions. Study limitations include (1) single institution data, (2) retrospective design, and (3) administrative undercoding. Future treatment options need to address these threats to longevity and quality of life. 1. Introduction The increased prevalence of overweight and obese children is not new, yet it has been viewed more recently as a public health epidemic [1–3]. According to the Centers for Disease Control and Prevention (CDC), approximately 12.5 million, or 17%, of American children are obese. More recent studies show that over 10% of 2–5-year-olds would be classified as overweight, whereas this number increases to 15% in the adolescent age group [4]. Interestingly, in 2000 the US Preventive Services Task Force (USPSTF) did not find enough evidence to recommend for or against routine screening for overweight status in either children or adolescents as a means of mitigating further health sequelae, yet now the task force is revisiting this idea as of 2010 [5]. It is known that a higher prevalence of comorbid diseases attributable to obesity is seen in both adults and children, especially modifiable cardiovascular risk factors and sequelae. In the long-standing Bogalusa Heart study, body mass indexes (BMI) performed in childhood and adolescence, as a measurement for obesity, predicted intima-media thickness in adults [6]. Obesity is not only related to modifiable cardiovascular risk factors, but also to several other health-related conditions that may persist or worsen in adulthood [7, 8]. This includes
Ifitm3 Limits the Severity of Acute Influenza in Mice
Charles C. Bailey ,I-Chueh Huang,Christina Kam,Michael Farzan
PLOS Pathogens , 2012, DOI: 10.1371/journal.ppat.1002909
Abstract: Interferon-induced transmembrane (IFITM) proteins are a family of viral restriction factors that inhibit the entry processes of several pathogenic viruses, including influenza A virus (IAV), in vitro. Here we report that IAV-infected knockout mice lacking the Ifitm locus on chromosome 7 exhibited accelerated disease progression, greater mortality, and higher pulmonary and systemic viral burdens as compared to wild type controls. We further observed that the phenotype of Ifitm3-specific knockout mice was indistinguishable from that of mice lacking the entire Ifitm locus. Ifitm3 was expressed by IAV target cells including alveolar type II pneumocytes and tracheal/bronchial respiratory epithelial cells. Robust Ifitm3 expression was also observed in several tissues in the absence of infection. Among murine Ifitm promoters, only that of Ifitm3 could be induced by type I and II interferons. Ifitm3 could also be upregulated by the gp130 cytokines IL-6 and oncostatin M on cells expressing appropriate receptors, suggesting that multiple cytokine signals could contribute to Ifitm3 expression in a cell or tissue-specific manner. Collectively, these findings establish a central role for Ifitm3 in limiting acute influenza in vivo, and provide further insight into Ifitm3 expression and regulation.
Laparoscopic Adjustable Gastric Banding and Hypoglycemia
Sigrid Bairdain,Mark Cleary,Chueh Lien,Ashley H. Vernon,Bradley C. Linden,David B. Lautz
Case Reports in Endocrinology , 2013, DOI: 10.1155/2013/671848
Abstract: Obesity is commonplace, and surgical treatment usually includes Roux-en-Y gastric bypasses (RYGBs). RYGBs have the most documented side effects including vitamin deficiencies, rebound weight gain, and symptomatic hypoglycemia; fewer series exist describing hypoglycemia following other bariatric operations. We reviewed all patients undergoing laparoscopic adjustable gastric banding (LAGB) at our institution between 2008 and 2012. Three patients were identified to have symptomatic hypoglycemia following LAGB. Mean time from surgery was 33 months (range 14–45 months), and mean weight loss was 32.7?kg (range 15.9–43.1?kg). None of the patients had preexisting diabetes. Therefore, symptomatic hypoglycemia should be investigated irrespective of bariatric operation. 1. Introduction Obesity is one of the biggest health issues facing medicine. Diet and medication programs alone are often unable to maintain durable weight loss; thus, bariatric surgery has proven to provide long-term weight loss that corresponds to reduced mortality [1, 2]. The mainstay of bariatric surgery is the Roux-en-Y gastric bypass (RYGB), which has to date the most durable, documented long-term weight loss. However, long-term complications include nutrient deficiencies, hernias, excess skin, neuropathic changes, and hyperinsulinism [3]. One of the most striking side effects of this particular surgery is postgastric bypass hypoglycemia. Theories exist regarding the underlying etiology for this postgastric bypass hypoglycemia including both pancreatic-mediated (beta-cell) and nonpancreatic mediated mechanisms. Briefly speaking, the pancreatic mediated (beta-cell) mechanisms include the following mechanisms (1) enhanced insulin sensitivity, (2) increased density of insulin islets, and (3) enhanced hormonal secretion in the bypassed limb [4]. On the other hand, nonpancreatic mechanisms have included the following mechanisms: (1) decreased levels of the appetite-stimulating and insulin counter-regulatory gastrointestinal hormone, ghrelin, and (2) alterations in other counter regulatory hormones [5]. More recently, Rabiee et al. [4] have suggested that it is the persistent exaggerated hypersecretion of GLP-1, which has previously shown to be insulinotropic, insulinomimetic, and glucagonostatic. The overexpression of the islet cell transcription factor, PDX-1, caused by prolonged hypersecretion of GLP-1 causes the hypoglycemia [4]. The most likely explanation is that it is not just one of the aforementioned mechanisms solely but a combination of beta-cell proliferation, an alteration of the
Two-dimensional electrochemical model for mixed conductors: a study of ceria
Francesco Ciucci,William C. Chueh,Sossina M. Haile,David G. Goodwin
Physics , 2009,
Abstract: A two-dimensional small bias model has been developed for a patterned metal current collector $|$ mixed oxygen ion and electronic conductor (MIEC) $|$ patterned metal current collector electrochemical cell in a symmetric gas environment. Specifically, we compute the electrochemical potential distributions of oxygen vacancies and electrons in the bulk and near the surface for $\text{Pt} | \text{Sm}_{0.15}\text{Ce}_{0.85}\text{O}_{1.925} | \text{Pt}$ symmetric cell in a $\text{H}_2-\text{H}_2\text{O}-\text{Ar}$ (reducing) atmosphere from 500 to $650^o C$. Using a two-dimensional finite-element model, we show that two types of electronic current exist within the cell: an in-plane drift-diffusion current that flows between the gas $|$ ceria chemical reaction site and the metal current collector, and a cross-plane current that flows between the two metal electrodes on the opposite side of the cell. By fitting the surface reaction constant $\tilde k_f^0$ to experimental electrode resistance values while fixing material properties such as bulk ionic and electronic equilibrium defect concentrations and mobilities, we are able to separate the electrode polarization into the surface reaction component and the in-plane electron drift-diffusion component. We show that for mixed conductors with a low electronic conductivity (a function of oxygen partial pressure) or a high surface reaction rate constant, the in-plane electron drift-diffusion resistance can become rate-limiting in the electrode reaction.
On Distributions of Physiological and Anatomical Variables in Pathological Conditions: Dopamine D2 Receptors in Schizophrenia and Their Occupancies after Drug Treatment
Henry C. Tuckwell
Computational and Mathematical Methods in Medicine , 2001, DOI: 10.1080/10273660108833075
Abstract: If a physiological, biochemical or anatomical variable has a normal distribution then the tails of such a distribution may be associated with pathological function. In certain cases this can lead to a bimodal distribution for the variable in individuals with the resultant pathology. We illustrate with a study of dopamine receptors. PET data suggest that the distribution of dopamine DA2 receptor densities in schizophrenic patients might be bimodal. A quantitative model based on the classical theory of drug action and a simple differential equation for receptor synthesis and degradation is used to estimate the effects of neuroleptics on D2 receptor occupancy. It is found that individuals in the upper tail, with higher than normal receptor densities, may eventually attain an equilibrium D2 occupancy after treatment which is in the normal range, whereas individuals with lower than normal receptor densities are predicted to have equilibrium D2 occupancies after treatment which may fall below normal values. Thus, a factor which might determine whether there is a successful outcome in the treatment of schizophrenia with classical neuroleptics is in which tail of the assumed normal distribution, a patient's D2 receptor count falls.
Torsión primaria de epiplón: Caso clínico
USCáTEGUI C,HENRY;
Revista chilena de cirugía , 2010, DOI: 10.4067/S0718-40262010000400016
Abstract: we report a 40 years old female consulting in the emergency room for abdominal pain and a mass in the left lower quadrant. an abdominal cat sean showed an omental torsion. the patient was operated, excising the involved omentum. the postoperative period was uneventful and the patient was discharged three days after admission.
Transforming Representations of Intangible Heritage at Iziko (National) Museums, South Africa
Henry C. Jatti Bredekamp
International Journal of Intangible Heritage , 2006,
Abstract: The article is about the dilemma of transforming five former national museums in South Africa into one amalgamated heritage institution subscribing to a post-apartheidnational agenda and UNESCO’s broad definition of intangible heritage. By way of introduction it situates the intangible heritage discourse in the country against the backdrop of a transformation process initiated after 1994, which led, inter alia, to the formation of Iziko Museums by an Act of Parliament. The larger part of the paper is devoted to the question of the extent to which Iziko Museums can regard its inherited collections (from 1825) in the Social History, Natural History and Art Collections functional units - representing the various domains of expressions of living cultural heritage - as genuine representations of intangible heritage from the Cape to Cairo and beyond.
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