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Yee Hui Yeo,Jamil S. Samaan,Wee Han Ng,Peng-Sheng Ting,Hirsh Trivedi,Aarshi Vipani,Walid Ayoub,Ju Dong Yang,Omer Liran,Brennan Spiegel,Alexander Kuo 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.3
Background/Aims: Patients with cirrhosis and hepatocellular carcinoma (HCC) require extensive and personalized care to improve outcomes. ChatGPT (Generative Pre-trained Transformer), a large language model, holds the potential to provide professional yet patient-friendly support. We aimed to examine the accuracy and reproducibility of ChatGPT in answering questions regarding knowledge, management, and emotional support for cirrhosis and HCC. Methods: ChatGPT’s responses to 164 questions were independently graded by two transplant hepatologists and resolved by a third reviewer. The performance of ChatGPT was also assessed using two published questionnaires and 26 questions formulated from the quality measures of cirrhosis management. Finally, its emotional support capacity was tested. Results: We showed that ChatGPT regurgitated extensive knowledge of cirrhosis (79.1% correct) and HCC (74.0% correct), but only small proportions (47.3% in cirrhosis, 41.1% in HCC) were labeled as comprehensive. The performance was better in basic knowledge, lifestyle, and treatment than in the domains of diagnosis and preventive medicine. For the quality measures, the model answered 76.9% of questions correctly but failed to specify decision-making cut-offs and treatment durations. ChatGPT lacked knowledge of regional guidelines variations, such as HCC screening criteria. However, it provided practical and multifaceted advice to patients and caregivers regarding the next steps and adjusting to a new diagnosis. Conclusions: We analyzed the areas of robustness and limitations of ChatGPT’s responses on the management of cirrhosis and HCC and relevant emotional support. ChatGPT may have a role as an adjunct informational tool for patients and physicians to improve outcomes.
Michael H. Le,Yee Hui Yeo,Biyao Zou,Scott Barnet,Linda Henry,Ramsey Cheung,Mindie H. Nguyen 대한간학회 2022 Clinical and Molecular Hepatology(대한간학회지) Vol.28 No.4
Background/Aims: Due to increases in obesity and type 2 diabetes, the prevalence of nonalcoholic fatty liver disease (NAFLD) has also been increasing. Current forecast models may not include non-obese NAFLD. Here, we used the Bayesian approach to forecast the prevalence of NAFLD through the year 2040. Methods: Prevalence data from 245 articles involving 2,699,627 persons were used with a hierarchical Bayesian approach to forecast the prevalence of NAFLD through 2040. Subgroup analyses were performed for age, gender, presence of metabolic syndrome, region, and smoking status. Sensitivity analysis was conducted for clinical setting and study quality. Results: The forecasted 2040 prevalence was 55.7%, a three-fold increase since 1990 and a 43.2% increase from the 2020 prevalence of 38.9%. The estimated average yearly increase since 2020 was 2.16%. For those aged <50 years and ≥50 years, the 2040 prevalence were not significantly different (56.7% vs. 61.5%, P=0.52). There was a significant difference in 2040 prevalence by sex (males: 60% vs. 50%) but the trend was steeper for females (annual percentage change: 2.5% vs. 1.5%, P=0.025). There was no difference in trends overtime by region (P=0.48). The increase rate was significantly higher in those without metabolic syndrome (3.8% vs. 0.84%, P=0.003) and smokers (1.4% vs. 1.1%, P=0.011). There was no difference by clinical/community setting (P=0.491) or study quality (P=0.85). Conclusions: By 2040, over half the adult population is forecasted to have NAFLD. The largest increases are expected to occur in women, smokers, and those without metabolic syndrome. Intensified efforts are needed to raise awareness of NAFLD and to determine long-term solutions addressing the driving factors of the disease.
( Jie Li ),( Biyao Zou ),( Hideki Fujii ),( Yee Hui Yeo ),( Fanpu Ji ),( Dong Hyun Lee ),( Yuemin Feng ),( Xiaoyu Xie ),( Wanhua Ren ),( Qiang Zhu ),( Mindie H. Nguyen ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: NAFLD is generally correlated with the obesity epidemic. Asia is a heterogeneous region with varying socioeconomic levels and obesity prevalence; therefore, our goal was to estimate the prevalence of NAFLD in Asia through a meta-analytic approach. Methods: PubMed and EMBASE databases were searched from 1989 to 2017 for relevant studies reporting NAFLD prevalence in Asia. All studies were reviewed by three independent investigators. We used random-effects models to provide point estimates with 95% confidence interval (CI) of prevalence. Publication bias was assessed by Egger weighted regression Methods. Results: From the 2700 titles and abstracts reviewed, 195 papers from 13 countries met the inclusion criteria and included 1,753,168 subjects. The overall pooled prevalence for NAFLD in Asia was 31% (95% CI: 29-32). Individual country prevalence was shown in Table 1. In countries with more than 3 studies, the lowest prevalence was seen in Japan (24%, 95% CI: 21-28) and the highest in Iran (36%, 95%CI 31-41). Notably, pooled prevalence from studies with sample <1,000 subjects was much higher (34%, 95% CI: 31-38, 45 studies, n=23,857) than estimate from larger studies (≥1,000 subjects) (30%, 95% CI: 28- 31, 150 studies, n=172,9311). By sub-regions within Asia (Table 2), there was significant regional differences (P<0.01) with the highest NAFLD prevalence seen in West Asia (33%, 95% CI: 28-39, 13 studies, n=32,142) and the lowest in Southeast Asia (24%, 95% CI: 15-33, 5 studies, n=3457). By country income levels, NAFLD prevalence was 30% (95% CI: 29-32, 89 studies, n=1,005,409) for high-income countries and 31% (95% CI: 29-33, 106 studies, n=747,759) for middle-income countries (P<0.63). Conclusions: Overall NAFLD prevalence in Asia is 31% similar to Western countries and by country-income levels within Asia but varies by some sub-regions or Asia with the highest prevalence in West Asia (33%).
Chae, Jung-Woo,Chua, Peh Siang,Ng, Terence,Yeo, Angie Hui Ling,Shwe, Maung,Gan, Yan Xiang,Dorajoo, Sreemanee,Foo, Koon Mian,Loh, Kiley Wei-Jen,Koo, Si-Lin,Chay, Wen Yee,Tan, Tira Jing Ying,Beh, Sok Yu Springer-Verlag 2018 Breast cancer research and treatment Vol.168 No.3
<P>This is the first study to show that the reduction of mtDNA content in peripheral blood is associated with the onset of CRF in patients receiving chemotherapy. Further validation studies are required to confirm the findings.</P>
Hock, Lim Kuang,Ghazali, Sumarni Mohd,Cheong, Kee Chee,Kuay, Lim Kuang,Li, Lim Hui,Ying, Chan Ying,Huey, Tay Chien,Yee, Lai Wai,Ying, Ong Shiau,Yen, Yeo Lay,Abdullah, Norhamimah,Wymen, Seet,Ibrahim, N Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.11
Background: Smoking among adolescents has been linked to a variety of adverse and long term health consequences. "Susceptibility to smoking" or the lack of cognitive commitment to abstain from smoking is an important predictor of adolescent smoking. In 2008, we conducted a study to determine the psycho-sociological factors associated with susceptibility to smoking among secondary school students in the district of Kota Tinggi, Johor. Materials and Methods: Two thousand seven hundred students were randomly selected by proportional stratified sampling. Analyses on 1,736 non-smoking students revealed that prevalence of adolescents susceptible to smoking was 16.3%. Results: Male gender (aOR=2.05, 95%CI= 1.23-3.39), poor academic achievement (aOR 1.60, 95%CI 1.05-2.44), ever-smoker (aOR 2.17, 95%CI 1.37-3.44) and having a smoking friend (aOR 1.76, 95%CI 1.10-2.83) were associated with susceptibility to smoking, while having the perception that smoking prohibition in school was strictly enforced (aOR 0.55, 95%CI 0.32-0.94), and had never seen friends smoking in a school compound (aOR 0.59, 95%CI 0.37-0.96) were considered protective factors Conclusions: These results indicate that follow-up programmes need to capitalise on the modifiable factors related to susceptibility to smoking by getting all stakeholders to be actively involved to stamp out smoking initiation among adolescents.
Michael H. Le,David M. Le,Thomas C. Baez,Hansen Dang,Vy H. Nguyen,KeeSeok Lee,Christopher D. Stave,Takanori Ito,Yuankai Wu,Yee Hui Yeo,Fanpu Ji,Ramsey Cheung,Mindie H. Nguyen 대한간학회 2024 Clinical and Molecular Hepatology(대한간학회지) Vol.30 No.2
Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is associated with a multitude of adverse outcomes. We aimed to estimate the pooled incidence of NAFLD-related adverse events. Methods: We performed a systematic review and meta-analysis of cohort studies of adults with NAFLD to evaluate the pooled incidence of adverse events. Results: 19,406 articles were screened, 409 full-text articles reviewed, and 79 eligible studies (1,377,466 persons) were included. Mean age was 51.47 years and body mass index 28.90 kg/m2. Baseline comorbidities included metabolic syndrome (41.73%), cardiovascular disease (CVD) (16.83%), cirrhosis (21.97%), and nonalcoholic steatohepatitis (NASH) (58.85%). Incidence rate per 1,000 person-years for mortality included: all-cause (14.6), CVD-related (4.53), non-liver cancer-related (4.53), and liver-related (3.10). Incidence for liver-related events included overall (24.3), fibrosis progression (49.0), cirrhosis (10.9), liver transplant (12.0), and hepatocellular carcinoma (HCC) (3.39). Incidence for non-liver events included metabolic syndrome (25.4), hypertension (25.8), dyslipidemia (26.4), diabetes (19.0), CVD (24.77), renal impairment (30.3), depression/anxiety (29.1), and non-liver cancer (10.5). Biopsy-proven NASH had higher incidence of HCC (P=0.043) compared to non-NASH. Higher rates of CVD and mortality were observed in North America and Europe, hypertension and non-liver cancer in North America, and HCC in Western Pacific/Southeast Asia (P<0.05). No significant differences were observed by sex. Time-period analyses showed decreasing rates of cardiovascular and non-liver cancer mortality and increasing rates of decompensated cirrhosis (P<0.05). Conclusions: People with NAFLD have high incidence of liver and non-liver adverse clinical events, varying by NASH, geographic region, and time-period, but not sex.