Publications by authors named "Chi-hong Tseng"
Several trials of endovascular treatment for patients with large-core acute ischemic stroke have been completed. Whereas future stroke clinical guidelines will provide specific recommendations, this advisory aims to summarize the results of these trials, analyze the commonalities and differences among the studies, and discuss the clinical implications of these new results.
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- The study examines thyroid tumors with isolated RAS mutations, comparing their oncologic outcomes to tumors with isolated BRAF mutations using comprehensive molecular testing.
- A total of 368 patients with Bethesda III-VI thyroid nodules were reviewed, revealing that 14% had isolated RAS mutations, with a 46% malignancy rate but no instances of structural recurrence after 5 years.
- The findings suggest that isolated RAS-mutated tumors have lower aggressive characteristics, indicating that thyroid lobectomy may be an adequate treatment option for these patients.
Higher-order disease interactions in multimorbidity measurement: marginal benefit over additive disease summation.
J Gerontol A Biol Sci Med Sci
November 2024
Background: Current multimorbidity measures often oversimplify complex disease interactions by assuming a merely additive impact of diseases on health outcomes. This oversimplification neglects clinical observations that certain disease combinations can exhibit synergistic effects. Thus, we aimed to incorporate simultaneous higher-order disease interactions into the validated ICD-coded multimorbidity-weighted index (MICD), to assess for model improvement.
View Article and Find Full Text PDFContext: BRAF V600E mutation is the most common genetic driver of papillary thyroid cancer (PTC), where it is found with various allele frequency (AF), reflecting the proportion of cells carrying the mutant and wild-type gene alleles.
Objective: To determine whether BRAF V600E AF can improve prognostication and inform initial surgical management of PTC.
Design: Retrospective cohort study (2016-2019).
Higher center and surgeon volume correspond to better outcomes for patients with thyroid cancer. This study aims to investigate how a hospital's safety-net burden, the proportion of a hospital's patients who are insured by state Medicaid plans or are uninsured, influences the outcomes of high-volume (HV) surgeons. We performed a retrospective cohort study of all patients who underwent surgery for thyroid cancer in California from 1999 to 2017.
View Article and Find Full Text PDFObjectives: Health systems are increasingly accountable for patients and require accurate electronic health record (EHR) vital status. We recently demonstrated that 19% of seriously ill primary care patients in one system were not marked dead in the EHR and 80% of these decedents had an encounter or appointment outstanding after death. Herein we describe the mechanism of identifying decedents whose death is not captured at the level of the EHR, characterize these decedents, and describe medications refilled after death.
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- Hypertension is a prevalent non-communicable disease in sub-Saharan Africa, yet there's limited knowledge about patient preferences regarding its care, prompting a study in Malawi.
- A discrete choice experiment was conducted with 1003 adults, exploring preferences for care attributes like distance, waiting time, provider friendliness, group versus individual care, medication supply, and dispensing frequency.
- Results indicated a strong preference for individual care over group visits, especially among people living with HIV, and favored less frequent medication dispensing, highlighting important considerations for improving hypertension care in Malawi.
Purpose: The purpose of this study was to compare the outcomes of manual and automated corneal epithelial thickness (CET) assessments using anterior segment optical coherence tomography in eyes with limbal stem cell deficiency (LSCD).
Methods: Eighty-seven eyes from 64 patients with LSCD and 65 eyes from 39 healthy subjects were included in this cross-sectional study. OCT images of corneas were acquired using a Fourier-domain anterior segment optical coherence tomography.
Article Synopsis
- The study investigates the effectiveness of China's clean air initiatives, APPCAP (2013-2017) and BSDW (2018-2020), in reducing polycyclic aromatic hydrocarbons (PAHs) exposure in Beijing, which are among the highest in the world.
- Results show a significant decrease in PM-bound benzo[a]pyrene equivalents (BaPeq) by 96.6% from 2014 to 2021, primarily due to reduced emissions from traffic, coal, and biomass.
- Additionally, PAH metabolite concentrations in urine samples from travelers showed a 52.3% decrease in Beijing, indicating improved air quality and reduced human exposure linked to these initiatives.
Article Synopsis
- Racial and ethnic disparities in diabetes care quality exist even in high-performing healthcare facilities, highlighting that overall high-quality ratings do not guarantee equitable care for all groups.
- * The study focused on veterans receiving diabetes care from the Veterans Health Administration between March 2020 and February 2021, revealing specific inequities affecting American Indian or Alaska Native, Black, and Hispanic patients compared to White patients.
- * Addressing these disparities is crucial; incorporating equity into quality measures can promote improvements in care for underrepresented groups in healthcare settings.
Purpose: To investigate whether neurotrophic keratopathy is present in limbal stem cell deficiency (LSCD), by measuring corneal sensation and characterizing corneal subbasal nerve plexus.
Design: Prospective, cross-sectional, case-control comparative study.
Methods: A total of 46 eyes with LSCD and 14 normal eyes were recruited from 2019 to 2022.
Background: Post-traumatic stress disorder (PTSD) is associated with increased rates of incident ischemic heart disease (IHD) in women.
Objectives: The purpose of this study was to determine mechanisms of the PTSD-IHD association in women.
Methods: In this retrospective longitudinal cohort study, data were obtained from electronic health records of all U.
Article Synopsis
- The study aimed to investigate how matching participants with their preferred financial incentive designs affected their adherence to behavioral goals in a weight management intervention among individuals with obesity.
- It involved a secondary analysis of quantitative and qualitative data from 668 participants from socioeconomically disadvantaged communities in New York City and Los Angeles, specifically examining the reasons behind their preferred incentive types.
- Results indicated that a majority preferred goal-directed incentives, and those who were matched with their preference showed higher adherence rates in certain areas, suggesting that preference alignment might enhance engagement in some program activities.
Article Synopsis
- Cytokine release syndrome (CRS) is a common side effect of CAR-T cell therapy, but researchers have developed self-regulating T cells that help reduce its severity by secreting cytokine inhibitors.
- In preclinical studies using a humanized mouse model, T cells that secrete a modified version of tocilizumab (Toci) showed less CRS-related toxicity and improved safety compared to traditional tocilizumab treatment.
- Additionally, these Toci-secreting CAR-T cells demonstrated better antitumor effects and enhanced the presence of beneficial T-cell types in the tumor microenvironment, indicating a promising strategy for making CAR-T therapy safer and more effective.
Article Synopsis
- The study aimed to compare the effectiveness of electronic health record (EHR)-based portal reminders and text message reminders in increasing influenza vaccination rates in a health system.
- Conducted as a randomized clinical trial from September 2022 to April 2023 at UCLA, the trial included over 262,000 patients across different reminder strategies.
- Results showed differences in vaccination rates based on the type of reminder sent, indicating that tailored reminders could enhance public health efforts to improve flu vaccination participation.
Extent of Surgery for Medullary Thyroid Cancer and Prevalence of Occult Contralateral Foci.
JAMA Otolaryngol Head Neck Surg
March 2024
Article Synopsis
- The standard treatment for medullary thyroid cancer (MTC) is total thyroidectomy with central neck dissection, but reasons for this approach in patients with only one affected side are not well-defined.
- A study aimed to find hidden contralateral MTC lesions, which weren't visible through ultrasounds, to justify the total thyroid removal.
- From 176 patients studied, 26% had contralateral disease, and 5% had undetected lesions, suggesting genetic background influences the likelihood of hidden cancer in the other thyroid lobe.
Objectives: Low-value esophagogastroduodenoscopies (EGDs) for uncomplicated gastro-oesophageal reflux disease (GERD) can harm patients and raise patient and payer costs. We developed an electronic health record (EHR) 'eMeasure' to detect low-value EGDs.
Design: Retrospective cohort of 518 adult patients diagnosed with GERD who underwent initial EGD between 1 January 2019 and 31 December 2019.
Article Synopsis
- Rural and frontier areas have worse thyroid cancer outcomes compared to urban regions, with higher disease incidence and mortality rates.
- The study analyzed data from nearly 93,000 thyroid cancer patients in California between 1999-2017, highlighting demographic differences and disease stages at diagnosis.
- Key findings show that rural and frontier patients are more likely to be Native American or White, uninsured, and face socioeconomic disadvantages, leading to increased likelihood of distant disease at diagnosis and being lost to follow-up care.*
Influence of depression on racial and ethnic disparities in diabetes control.
BMJ Open Diabetes Res Care
November 2023
Introduction: We tested the hypotheses that depression diagnoses influence racial and ethnic disparities in diabetes control and that mental health treatment moderates that relationship.
Research Design And Methods: We created a national cohort of Veterans Health Administration (VHA) patients with diabetes using administrative data (n=815 067). Cross-sectional linear mixed effects regression models tested the hypothesized indirect effect of depression on poor diabetes control (glycosylated hemoglobin >9%) and tested whether mental health treatment (visits or antidepressant prescriptions) moderated the effect of depression (α=0.
Article Synopsis
- Indeterminate thyroid nodules with Hürthle cell cytology pose diagnostic challenges, prompting a study on the effectiveness of molecular tests like Afirma Gene Sequencing Classifier and Thyroseq v3.
- In a trial with 140 nodules, Afirma showed a higher benign call rate (84%) compared to Thyroseq (56%), indicating better reliability in identifying non-cancerous nodules.
- The results suggest that these molecular tests can significantly help patients avoid unnecessary surgeries, highlighting their importance in managing Hürthle cell nodules.
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- The FIReWoRk clinical trial found that financial incentives for weight loss were more effective than just providing resources like gym memberships and monitors for participants with obesity in low-income neighborhoods.
- A cost-effectiveness analysis showed that the average program costs were highest for goal-directed incentives ($1271), followed by outcome-based ($1194) and resources-only groups ($834), with significant differences between the groups.
- While quality of life remained similar across groups, participants receiving incentives lost more weight, with the goal-directed and outcome-based groups losing an average of 2.34 kg and 1.79 kg more than the resources-only group, respectively, indicating strong cost-effectiveness for incentive strategies.
Article Synopsis
- The study examined HIV-HBV co-infection in pregnant women in sub-Saharan Africa, finding that 4.4% had HBV co-infection, with prevalence varying significantly by country.
- It highlighted that HBeAg positivity was a strong predictor of high maternal HBV viral load, and only 40% of those with high viral loads were receiving appropriate antiviral treatment.
- The research emphasized the need for regular HBsAg screening and the use of combination treatment for HBV to improve outcomes in this population.