Increased Readmission Risk and Healthcare Cost for Delirium Patients without Immediate Hospitalization in the Emergency Department

I Chun Ma,Kao Chin Chen,Wei Tseng Chen,Hsin Chun Tsai,Chien-Chou Su,Ru-Band Lu,Po See Chen,Wei Hung Chang,Yen Kuang Yang 대한정신약물학회 2018 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.16 No.4

Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson’s comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities (CCI≥3) or older patients (≥65 years). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

Assembly yield prediction of plastically encapsulated packages with a large number of manufacturing variables by advanced approximate integration method

Wei, H.P.,Han, B.,Youn, B.D.,Shin, H.,Kim, I.,Moon, H. Pergamon Press 2017 Microelectronics reliability Vol.78 No.-

<P>An advanced approximate integration scheme called eigenvector dimension reduction (EDR) method is implemented to predict the assembly yield of a plastically encapsulated package. A total of 12 manufacturing input variables are considered during the yield prediction, which is based on the JEDEC reflow flatness requirements. The method calculates the statistical moments of a system response (i.e., warpage) first through dimensional reduction and eigenvector sampling, and a probability density function (PDF) of random responses is constructed subsequently from the statistical moments by a probability estimation method. Only 25 modeling runs are needed to produce an accurate PDF for 12 input variables. The results prove that the EDR provides the numerical efficiency required for the tail-end probability prediction of manufacturing problems with a large number of input variables, while maintaining high accuracy. (c) 2017 Elsevier Ltd. All rights reserved.</P>

Toward a Galactic Distribution of Planets. I. Methodology and Planet Sensitivities of the 2015 High-cadence<i>Spitzer</i>Microlens Sample

Zhu, Wei,Udalski, A.,Novati, S. Calchi,Chung, S.-J.,Jung, Y. K.,Ryu, Y.-H.,Shin, I.-G.,Gould, A.,Lee, C.-U.,Albrow, M. D.,Yee, J. C.,Han, C.,Hwang, K.-H.,Cha, S.-M.,Kim, D.-J.,Kim, H.-W.,Kim, S.-L.,Ki American Institute of Physics 2017 The Astronomical journal Vol.154 No.5

<P>We analyze an ensemble of microlensing events from the 2015 Spitzer microlensing campaign, all of which were densely monitored by ground-based high-cadence survey teams. The simultaneous observations from Spitzer and the ground yield measurements of the microlensing parallax vector pi(E), from which compact constraints on the microlens properties are derived, including less than or similar to 25% uncertainties on the lens mass and distance. With the current sample, we demonstrate that the majority of microlenses are indeed in the mass range of M dwarfs. The planet sensitivities of all 41 events in the sample are calculated, from which we provide constraints on the planet distribution function. In particular, assuming a planet distribution function that is uniform in log q, where q is the planet-to-star mass ratio, we find a 95% upper limit on the fraction of stars that host typical microlensing planets of 49%, which is consistent with previous studies. Based on this planet-free sample, we develop the methodology to statistically study the Galactic distribution of planets using microlensing parallax measurements. Under the assumption that the planet distributions are the same in the bulge as in the disk, we predict that similar to 1/3 of all planet detections from the microlensing campaigns with Spitzer should be in the bulge. This prediction will be tested with a much larger sample, and deviations from it can be used to constrain the abundance of planets in the bulge relative to the disk.</P>

Structural and functional characterization of <i>Caenorhabditis elegans</i> α-catenin reveals constitutive binding to β-catenin and F-actin

Kang, Hyunook,Bang, Injin,Jin, Kyeong Sik,Lee, Boyun,Lee, Junho,Shao, Xiangqiang,Heier, Jonathon A.,Kwiatkowski, Adam V.,Nelson, W. James,Hardin, Jeff,Weis, William I.,Choi, Hee-Jung American Society for Biochemistry and Molecular Bi 2017 The Journal of biological chemistry Vol.292 No.17

<P>Intercellular epithelial junctions formed by classical cadherins, beta-catenin, and the actin-binding protein alpha-catenin link the actin cytoskeletons of adjacent cells into a structural continuum. These assemblies transmit forces through the tissue and respond to intracellular and extracellular signals. However, the mechanisms of junctional assembly and regulation are poorly understood. Studies of cadherin-catenin assembly in a number of metazoans have revealed both similarities and unexpected differences in the biochemical properties of the cadherin center dot catenin complex that likely reflect the developmental and environmental requirements of different tissues and organisms. Here, we report the structural and biochemical characterization of HMP-1, the Caenorhabditis elegans alpha-catenin homolog, and compare it with mammalian alpha-catenin. HMP-1 shares overall similarity in structure and actin-binding properties, but displayed differences in conformational flexibility and allosteric regulation from mammalian alpha-catenin. HMP-1 bound filamentous actin with an affinity in the single micromolar range, even when complexed with the beta-catenin homolog HMP-2 or when present in a complex of HMP-2 and the cadherin homolog HMR-1, indicating that HMP-1 binding to F-actin is not allosterically regulated by the HMP-2.HMR-1 complex. The middle (i.e. M) domain of HMP-1 appeared to be less conformationally flexible than mammalian alpha-catenin, which may underlie the dampened effect of HMP-2 binding on HMP-1 actin-binding activity compared with that of the mammalian homolog. In conclusion, our data indicate that HMP-1 constitutively binds beta-catenin and F-actin, and although the overall structure and function of HMP-1 and related alpha-catenins are similar, the vertebrate proteins appear to be under more complex conformational regulation.</P>

New self-activated eulytite-type compounds of M₇Zr(PO₄)₆ (M=Ca, Sr, Ba)

Qin, L.,Wei, D.,Huang, Y.,Kim, S.I.,Yu, Y.M.,Seo, H.J. Elsevier Sequoia 2013 Journal of alloys and compounds Vol.574 No.-

Eulytite-type orthophosphates M<SUB>7</SUB>Zr(PO<SUB>4</SUB>)<SUB>6</SUB> (M=Ca, Sr, Ba) were prepared by conventional high temperature solid-state reaction. Sr<SUB>7</SUB>Zr(PO<SUB>4</SUB>)<SUB>6</SUB> and Ba<SUB>7</SUB>Zr(PO<SUB>4</SUB>)<SUB>6</SUB> crystallize in the pure eulytite-type phase with cubic space group (I4@?3d). The impurity phase β-Ca<SUB>3</SUB>(PO<SUB>4</SUB>)<SUB>2</SUB> was inevitably coexisted with the Ca<SUB>7</SUB>Zr(PO<SUB>4</SUB>)<SUB>6</SUB> phase. The luminescence properties are investigated by UV-VUV excitation and emission spectroscopy and X-ray-excited luminescence (XEL) spectroscopy. The broad excitation and emission bands are observed due to the charge transfer transition from Zr<SUP>4+</SUP> to O<SUP>2-</SUP> in M<SUB>7</SUB>Zr(PO<SUB>4</SUB>)<SUB>6</SUB> (M=Ca, Sr, Ba) eulytite. The characteristics of the phosphors including the luminescence mechanism are explained by Stokes shift, decay curves, and CIE color coordinates. The Sr<SUB>7</SUB>Zr(PO<SUB>4</SUB>)<SUB>3</SUB> and Ba<SUB>7</SUB>Zr(PO<SUB>4</SUB>)<SUB>3</SUB> phosphors exhibit unusual spectral features with the emission bands at 470 and 480nm, respectively. The weak luminescence centered at 495nm is observed in the Ca<SUB>7</SUB>Zr(PO<SUB>4</SUB>)<SUB>6</SUB> eulytite with lifetime of 4.67μs. The unusual self-activated luminescence is discussed on the base of the crystal structure of eulytite.

Sawtooth-triggered limit-cycle oscillations and I-phase in the HL-2A tokamak

Zhao, K.J.,Cheng, J.,Diamond, P.H.,Dong, J.Q.,Yan, L.W.,Hong, W.Y.,Xu, M.,Tynan, G.,Miki, K.,Huang, Z.H.,Itoh, K.,Itoh, S.-I.,Fujisawa, A.,Nagashima, Y.,Inagaki, S.,Wang, Z.X.,Wei, L.,Song, X.M.,Lei, IOP Publishing 2013 Nuclear fusion. Fusion nucléaire. &n.Illiga Vol.53 No.12

Impact of fatty liver on long-term outcomes in chronic hepatitis B: a systematic review and matched analysis of individual patient data meta-analysis

Yu Jun Wong,Vy H. Nguyen,Hwai-I Yang,Jie Li,Michael Huan Le,Wan-Jung Wu,Nicole Xinrong Han,Khi Yung Fong,Elizabeth Chen,Connie Wong,Fajuan Rui,Xiaoming Xu,Qi Xue,Xin Yu Hu,Wei Qiang Leow,George Boon-B 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.3

Background/Aims: Chronic hepatitis B (CHB) and fatty liver (FL) often co-exist, but natural history data of this dual condition (CHB-FL) are sparse. Via a systematic review, conventional meta-analysis (MA) and individual patient-level data MA (IPDMA), we compared liver-related outcomes and mortality between CHB-FL and CHB-no FL patients. Methods: We searched 4 databases from inception to December 2021 and pooled study-level estimates using a random- effects model for conventional MA. For IPDMA, we evaluated outcomes after balancing the two study groups with inverse probability treatment weighting (IPTW) on age, sex, cirrhosis, diabetes, ALT, HBeAg, HBV DNA, and antiviral treatment. Results: We screened 2,157 articles and included 19 eligible studies (17,955 patients: 11,908 CHB-no FL; 6,047 CHB-FL) in conventional MA, which found severe heterogeneity (I2=88–95%) and no significant differences in HCC, cirrhosis, mortality, or HBsAg seroclearance incidence (P=0.27–0.93). IPDMA included 13,262 patients: 8,625 CHB-no FL and 4,637 CHB-FL patients who differed in several characteristics. The IPTW cohort included 6,955 CHB-no FL and 3,346 CHB-FL well-matched patients. CHB-FL patients (vs. CHB-no FL) had significantly lower HCC, cirrhosis, mortality and higher HBsAg seroclearance incidence (all P≤0.002), with consistent results in subgroups. CHB-FL diagnosed by liver biopsy had a higher 10-year cumulative HCC incidence than CHB-FL diagnosed with non-invasive methods (63.6% vs. 4.3%, P<0.0001). Conclusions: IPDMA data with well-matched CHB patient groups showed that FL (vs. no FL) was associated with significantly lower HCC, cirrhosis, and mortality risk and higher HBsAg seroclearance probability.

Development and application of a multiplex PCR assay for rapid detection of 4 major bacterial pathogens in ducks

Wei, B.,Cha, S.-Y.,Kang, M.,Park, I.-J.,Moon, O.-K.,Park, C.-K.,Jang, H.-K. Poultry Science Association 2013 Poultry science Vol.92 No.5

<P>Infections with <I>Pasteurella multocida</I>, <I>Salmonella enterica</I>, <I>Riemerella anatipestifer</I>, and <I>Escherichia coli</I> result in high morbidity and mortality, which cause significant economic loss in the poultry industry. It can be difficult to distinguish these pathogens based on clinical signs because these pathogens can cause similar clinical signs and coinfections can occur. Thus, rapid and sensitive detection of these 4 major bacterial pathogens are important in ducks. The aim of this study was to develop a multiplex PCR (mPCR) assay for simultaneously detecting and identifying these 4 pathogenic bacteria in a single tube reaction. The target genes used were KMT1 of <I>P. multocida</I>, the invasion protein gene of <I>S. enterica</I>, 16S rDNA of <I>R</I>.<I> anatipestifer</I>, and the alkaline phosphatase gene of <I>E. coli</I>. The detection limit of the assay for all bacterial DNA was 10 pg. The mPCR did not produce any nonspecific amplification products when tested against other related pathogens, including <I>Staphylococcus aureus</I>, <I>Streptococcus pyogenes</I>, <I>Clostridium perfringens</I>, <I>Mycoplasma gallinarum</I>, <I>Mycoplasma synoviae</I>, and <I>Mycoplasma gallisepticum</I>, which can also infect ducks. We applied mPCR to field samples, and the results were the same as the single PCR results. These results suggest that mPCR for the 4 bacteria is a useful and rapid technique to apply to field samples.</P>

High-resolution metabolomics of occupational exposure to trichloroethylene

Walker, Douglas I,Uppal, Karan,Zhang, Luoping,Vermeulen, Roel,Smith, Martyn,Hu, Wei,Purdue, Mark P,Tang, Xiaojiang,Reiss, Boris,Kim, Sungkyoon,Li, Laiyu,Huang, Hanlin,Pennell, Kurt D,Jones, Dean P,Rot Oxford University Press 2016 International journal of epidemiology Vol.45 No.5

<P><B>Background:</B> Occupational exposure to trichloroethylene (TCE) has been linked to adverse health outcomes including non-Hodgkin’s lymphoma and kidney and liver cancer; however, TCE’s mode of action for development of these diseases in humans is not well understood.</P><P><B>Methods:</B> Non-targeted metabolomics analysis of plasma obtained from 80 TCE-exposed workers [full shift exposure range of 0.4 to 230 parts-per-million of air (ppm<SUB>a</SUB>)] and 95 matched controls were completed by ultra-high resolution mass spectrometry. Biological response to TCE exposure was determined using a metabolome-wide association study (MWAS) framework, with metabolic changes and plasma TCE metabolites evaluated by dose-response and pathway enrichment. Biological perturbations were then linked to immunological, renal and exposure molecular markers measured in the same population.</P><P><B>Results:</B> Metabolic features associated with TCE exposure included known TCE metabolites, unidentifiable chlorinated compounds and endogenous metabolites. Exposure resulted in a systemic response in endogenous metabolism, including disruption in purine catabolism and decreases in sulphur amino acid and bile acid biosynthesis pathways. Metabolite associations with TCE exposure included uric acid (<I>β</I> = 0.13, <I>P</I>-value = 3.6 × 10<SUP>−5</SUP>), glutamine (<I>β</I> = 0.08, <I>P</I>-value = 0.0013), cystine (<I>β</I> = 0.75, <I>P</I>-value = 0.0022), methylthioadenosine (<I>β</I> = −1.6, <I>P</I>-value = 0.0043), taurine (<I>β</I> = −2.4, <I>P</I>-value = 0.0011) and chenodeoxycholic acid (<I>β</I> = −1.3, <I>P</I>-value = 0.0039), which are consistent with known toxic effects of TCE, including immunosuppression, hepatotoxicity and nephrotoxicity. Correlation with additional exposure markers and physiological endpoints supported known disease associations.</P><P><B>Conclusions:</B> High-resolution metabolomics correlates measured occupational exposure to internal dose and metabolic response, providing insight into molecular mechanisms of exposure-related disease aetiology.</P>

The 5p15.33 Locus Is Associated with Risk of Lung Adenocarcinoma in Never-Smoking Females in Asia

Hsiung, Chao Agnes,Lan, Qing,Hong, Yun-Chul,Chen, Chien-Jen,Hosgood III, H. Dean,Chang, I-Shou,Chatterjee, Nilanjan,Brennan, Paul,Wu, Chen,Zheng, Wei,Chang, Gee-Chen,Wu, Tangchun,Park, Jae Yong,Hsiao, Public Library of Science 2010 PLoS genetics Vol.6 No.8

<▼1><P>Genome-wide association studies of lung cancer reported in populations of European background have identified three regions on chromosomes 5p15.33, 6p21.33, and 15q25 that have achieved genome-wide significance with p-values of 10<SUP>−7</SUP> or lower. These studies have been performed primarily in cigarette smokers, raising the possibility that the observed associations could be related to tobacco use, lung carcinogenesis, or both. Since most women in Asia do not smoke, we conducted a genome-wide association study of lung adenocarcinoma in never-smoking females (584 cases, 585 controls) among Han Chinese in Taiwan and found that the most significant association was for rs2736100 on chromosome 5p15.33 (p = 1.30×10<SUP>−11</SUP>). This finding was independently replicated in seven studies from East Asia totaling 1,164 lung adenocarcinomas and 1,736 controls (p = 5.38×10<SUP>−11</SUP>). A pooled analysis achieved genome-wide significance for rs2736100. This SNP marker localizes to the <I>CLPTM1L</I>-<I>TERT</I> locus on chromosome 5p15.33 (p = 2.60×10<SUP>−20</SUP>, allelic risk = 1.54, 95% Confidence Interval (CI) 1.41–1.68). Risks for heterozygote and homozygote carriers of the minor allele were 1.62 (95% CI; 1.40–1.87), and 2.35 (95% CI: 1.95–2.83), respectively. In summary, our results show that genetic variation in the <I>CLPTM1L-TERT</I> locus of chromosome 5p15.33 is directly associated with the risk of lung cancer, most notably adenocarcinoma.</P></▼1><▼2><P><B>Author Summary</B></P><P>Worldwide, approximately 15% of lung cancer cases occur among nonsmokers. Genome-wide association studies (GWAS) of lung cancer conducted in populations of European background have identified three regions on chromosomes 5, 6, and 15 that harbor genetic variants that confer risk for lung cancer. Prior studies were conducted primarily in cigarette smokers, raising the possibility that the associations could be related to tobacco use, lung carcinogenesis, or both. A GWAS of lung cancer among never-smokers is an optimal setting to discover effects that are independent of smoking. Since most women in Asia do not smoke, we conducted a GWAS of lung adenocarcinoma among never-smoking females (584 cases, 585 controls) in Taiwan, and observed a region on chromosome 5 significantly associated with risk for lung cancer in never-smoking women. The finding was independently replicated in seven studies from East Asia totaling 1,164 lung adenocarcinomas and 1,736 controls. To our knowledge, this study is the first reported GWAS of lung cancer in East Asian women, and together with the replication studies represents the largest genetic association study in this population. The findings provide insight into the genetic contribution of common variants to lung carcinogenesis.</P></▼2>