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Article ; Online: Cost-effectiveness of liposomal amphotericin B for HIV-associated cryptococcal meningitis.

Boettiger, David C / Lin, Tracy Kuo

2022 Volume 10, Issue 12, Page(s) e1705–e1706

MeSH term(s)	Humans ; Meningitis, Cryptococcal/drug therapy ; Cost-Benefit Analysis ; Amphotericin B/therapeutic use ; HIV Infections/complications ; HIV Infections/drug therapy
Chemical Substances	liposomal amphotericin B ; Amphotericin B (7XU7A7DROE)
Language	English
Publishing date	2022-09-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2723488-5
ISSN	2214-109X ; 2214-109X
ISSN (online)	2214-109X
ISSN	2214-109X
DOI	10.1016/S2214-109X(22)00476-4
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Article ; Online: Survey of state conjunctivitis policies for school-age students.

Lee, Tracy / Kuo, Irene C

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus

2022 Volume 26, Issue 3, Page(s) 115.e1–115.e5

Abstract: Purpose: To examine state policies regarding school-age students with conjunctivitis.: Methods: Analysis included the following evidence: publicly available policies for disposition of affected students; indications for exclusion and return to ... ...

Abstract	Purpose: To examine state policies regarding school-age students with conjunctivitis. Methods: Analysis included the following evidence: publicly available policies for disposition of affected students; indications for exclusion and return to classroom; and completeness of information, including mention of different etiologies of conjunctivitis; signs and symptoms of viral versus bacterial conjunctivitis; student disposition and treatment based on etiology; internally consistent recommendations; reference to credible resources; and mention of the possibility of a conjunctivitis outbreak. Results: Fifteen of 50 states have no policies. Ten states allow students to remain in school, 5 allow return 24 hours after initiation of antibiotic treatment, and 5 require physician approval. Seventeen states and Washington, DC, offer little detail or internally inconsistent recommendations, such as choice of antibiotic use or provider note. Twelve policies are thoroughly presented. Twenty-three states refer to sources like the Centers for Disease Control and Prevention and the American Academy of Pediatrics. No policy references the American Academy of Ophthalmology. Conclusions: State policies on conjunctivitis in students vary widely. Antibiotic use as a prerequisite for return to school has drawbacks of cost to parents, increasing antibiotic resistance, and lack of efficacy against nonbacterial etiologies, for example, viral conjunctivitis. Publicly available information and guidelines could be improved, aiming for fewer absentee days, reduced outbreak risk, and reduced risk of antibiotic resistance.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Child ; Conjunctivitis ; Humans ; Schools ; Students ; Surveys and Questionnaires ; United States/epidemiology
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-04-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	1412476-2
ISSN	1528-3933 ; 1091-8531
ISSN (online)	1528-3933
ISSN	1091-8531
DOI	10.1016/j.jaapos.2022.02.002
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Article ; Online: Projected impact of population aging on non-communicable disease burden and costs in the Kingdom of Saudi Arabia, 2020-2030.

Boettiger, David C / Lin, Tracy Kuo / Almansour, Maram / Hamza, Mariam M / Alsukait, Reem / Herbst, Christopher H / Altheyab, Nada / Afghani, Ayman / Kattan, Faisal

BMC health services research

2023 Volume 23, Issue 1, Page(s) 1381

Abstract: Background: The number of people aged greater than 65 years per 100 people aged 20-64 years is expected to almost double in The Kingdom of Saudi Arabia (KSA) between 2020 and 2030. We therefore aimed to quantify the growing non-communicable disease (NCD) ...

Abstract	Background: The number of people aged greater than 65 years per 100 people aged 20-64 years is expected to almost double in The Kingdom of Saudi Arabia (KSA) between 2020 and 2030. We therefore aimed to quantify the growing non-communicable disease (NCD) burden in KSA between 2020 and 2030, and the impact this will have on the national health budget. Methods: Ten priority NCDs were selected: ischemic heart disease, stroke, type 2 diabetes, chronic obstructive pulmonary disease, chronic kidney disease, dementia, depression, osteoarthritis, colorectal cancer, and breast cancer. Age- and sex-specific prevalence was projected for each priority NCD between 2020 and 2030. Treatment coverage rates were applied to the projected prevalence estimates to calculate the number of patients incurring treatment costs for each condition. For each priority NCD, the average cost-of-illness was estimated based on published literature. The impact of changes to our base-case model in terms of assumed disease prevalence, treatment coverage, and costs of care, coming into effect from 2023 onwards, were explored. Results: The prevalence estimates for colorectal cancer and stroke were estimated to almost double between 2020 and 2030 (97% and 88% increase, respectively). The only priority NCD prevalence projected to increase by less than 60% between 2020 and 2030 was for depression (22% increase). It is estimated that the total cost of managing priority NCDs in KSA will increase from USD 19.8 billion in 2020 to USD 32.4 billion in 2030 (an increase of USD 12.6 billion or 63%). The largest USD value increases were projected for osteoarthritis (USD 4.3 billion), diabetes (USD 2.4 billion), and dementia (USD 1.9 billion). In scenario analyses, our 2030 projection for the total cost of managing priority NCDs varied between USD 29.2 billion - USD 35.7 billion. Conclusions: Managing the growing NCD burden in KSA's aging population will require substantial healthcare spending increases over the coming years.
MeSH term(s)	Male ; Female ; Humans ; Aged ; Diabetes Mellitus, Type 2 ; Noncommunicable Diseases/epidemiology ; Noncommunicable Diseases/therapy ; Cost of Illness ; Saudi Arabia/epidemiology ; Osteoarthritis ; Stroke ; Aging ; Colorectal Neoplasms ; Dementia ; Health Care Costs
Language	English
Publishing date	2023-12-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-10309-w
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Article ; Online: A Retrospective Global Assessment of Factors Associated With COVID-19 Policies and Health Outcomes

Angela Jeong Choi / Andrew C. Hean / Julia K. Lee / Nguyen D. Tran / Tracy Kuo Lin / Dorie E. Apollonio

Frontiers in Public Health, Vol

2022 Volume 10

Abstract: BackgroundThe 2019 Global Health Security (GHS) Index measured the capacities of countries to prepare for and respond to epidemics and pandemics. However, the COVID-19 pandemic revealed that GHS Index scores were poorly correlated with ability to respond ...

Abstract	BackgroundThe 2019 Global Health Security (GHS) Index measured the capacities of countries to prepare for and respond to epidemics and pandemics. However, the COVID-19 pandemic revealed that GHS Index scores were poorly correlated with ability to respond to infectious disease threats. It is critical to understand how public health policies may reduce the negative impacts of pandemics.ObjectiveTo identify non-pharmaceutical interventions (NPIs) that can minimize morbidity and mortality during the COVID-19 and future pandemics, this study examined associations between country characteristics, NPI public health policies, and COVID-19 outcomes during the first year of the pandemic, prior to the introduction of the COVID-19 vaccine. This global analysis describes worldwide trends in policy implementation and generates a stronger understanding of how NPIs contributed to improved health outcomes.DesignThis cross-sectional, retrospective study relied on information drawn from publicly available datasets through December 31, 2020.Primary and Secondary Outcome MeasuresWe conducted multivariate regressions to examine associations between country characteristics and policies, and policies and health outcomes.ResultsCountries with higher health service coverage prior to the pandemic implemented more policies and types of policies. Countries with more bordering countries implemented more border control policies (0.78*), and countries with denser populations implemented more masking policies (0.24). Across all countries, fewer COVID-19 cases and deaths per million were associated with masking (−496.10, −7.57), testing and tracing (−108.50, −2.47), and restriction of movement (−102.30, −2.10*) policies, with stronger associations when these policies were mandatory rather than voluntary.ConclusionsCountry characteristics, including health service coverage, number of bordering countries, and population density, may predict the frequency and nature of public health interventions. Countries with higher health service ...
Keywords	pandemics ; COVID-19 ; SARS-CoV-2 ; health policy ; health services ; masks ; Public aspects of medicine ; RA1-1270
Subject code	300
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
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Article ; Online: Projected impact of population aging on non-communicable disease burden and costs in the Kingdom of Saudi Arabia, 2020–2030

David C. Boettiger / Tracy Kuo Lin / Maram Almansour / Mariam M Hamza / Reem Alsukait / Christopher H. Herbst / Nada Altheyab / Ayman Afghani / Faisal Kattan

BMC Health Services Research, Vol 23, Iss 1, Pp 1-

2023 Volume 7

Abstract: Abstract Background The number of people aged greater than 65 years per 100 people aged 20–64 years is expected to almost double in The Kingdom of Saudi Arabia (KSA) between 2020 and 2030. We therefore aimed to quantify the growing non-communicable ... ...

Abstract	Abstract Background The number of people aged greater than 65 years per 100 people aged 20–64 years is expected to almost double in The Kingdom of Saudi Arabia (KSA) between 2020 and 2030. We therefore aimed to quantify the growing non-communicable disease (NCD) burden in KSA between 2020 and 2030, and the impact this will have on the national health budget. Methods Ten priority NCDs were selected: ischemic heart disease, stroke, type 2 diabetes, chronic obstructive pulmonary disease, chronic kidney disease, dementia, depression, osteoarthritis, colorectal cancer, and breast cancer. Age- and sex-specific prevalence was projected for each priority NCD between 2020 and 2030. Treatment coverage rates were applied to the projected prevalence estimates to calculate the number of patients incurring treatment costs for each condition. For each priority NCD, the average cost-of-illness was estimated based on published literature. The impact of changes to our base-case model in terms of assumed disease prevalence, treatment coverage, and costs of care, coming into effect from 2023 onwards, were explored. Results The prevalence estimates for colorectal cancer and stroke were estimated to almost double between 2020 and 2030 (97% and 88% increase, respectively). The only priority NCD prevalence projected to increase by less than 60% between 2020 and 2030 was for depression (22% increase). It is estimated that the total cost of managing priority NCDs in KSA will increase from USD 19.8 billion in 2020 to USD 32.4 billion in 2030 (an increase of USD 12.6 billion or 63%). The largest USD value increases were projected for osteoarthritis (USD 4.3 billion), diabetes (USD 2.4 billion), and dementia (USD 1.9 billion). In scenario analyses, our 2030 projection for the total cost of managing priority NCDs varied between USD 29.2 billion - USD 35.7 billion. Conclusions Managing the growing NCD burden in KSA’s aging population will require substantial healthcare spending increases over the coming years.
Keywords	Aging ; Non-communicable Disease ; Costs ; Saudi Arabia ; Public aspects of medicine ; RA1-1270
Subject code	333
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Retrospective Global Assessment of Factors Associated With COVID-19 Policies and Health Outcomes.

Choi, Angela Jeong / Hean, Andrew C / Lee, Julia K / Tran, Nguyen D / Lin, Tracy Kuo / Apollonio, Dorie E

Frontiers in public health

2022 Volume 10, Page(s) 843445

Abstract: Background: The 2019 Global Health Security (GHS) Index measured the capacities of countries to prepare for and respond to epidemics and pandemics. However, the COVID-19 pandemic revealed that GHS Index scores were poorly correlated with ability to ... ...

Abstract	Background: The 2019 Global Health Security (GHS) Index measured the capacities of countries to prepare for and respond to epidemics and pandemics. However, the COVID-19 pandemic revealed that GHS Index scores were poorly correlated with ability to respond to infectious disease threats. It is critical to understand how public health policies may reduce the negative impacts of pandemics. Objective: To identify non-pharmaceutical interventions (NPIs) that can minimize morbidity and mortality during the COVID-19 and future pandemics, this study examined associations between country characteristics, NPI public health policies, and COVID-19 outcomes during the first year of the pandemic, prior to the introduction of the COVID-19 vaccine. This global analysis describes worldwide trends in policy implementation and generates a stronger understanding of how NPIs contributed to improved health outcomes. Design: This cross-sectional, retrospective study relied on information drawn from publicly available datasets through December 31, 2020. Primary and secondary outcome measures: We conducted multivariate regressions to examine associations between country characteristics and policies, and policies and health outcomes. Results: Countries with higher health service coverage prior to the pandemic implemented more policies and types of policies. Countries with more bordering countries implemented more border control policies (0.78 Conclusions: Country characteristics, including health service coverage, number of bordering countries, and population density, may predict the frequency and nature of public health interventions. Countries with higher health service coverage may have the infrastructure to react more efficiently to a pandemic, leading them to implement a greater number of policies. Mandatory masking, testing and tracing, and restriction of movement policies were associated with more favorable COVID-19 population health outcomes. While these results are consistent with existing COVID-19 mathematical models, policy effectiveness depends on how well they are implemented. Our results suggest that social distancing policies were less effective in reducing infectious disease risk, which may reflect difficulties with enforcement and monitoring.
MeSH term(s)	COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19 Vaccines ; Cross-Sectional Studies ; Humans ; Outcome Assessment, Health Care ; Pandemics/prevention & control ; Public Policy ; Retrospective Studies ; SARS-CoV-2
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2022-05-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.843445
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Article ; Online: Survival After Adrenalectomy for Metastatic Lung Cancer.

Krumeich, Lauren N / Roses, Robert E / Kuo, Lindsay E / Lindeman, Brenessa M / Nehs, Matthew A / Tavakkoli, Ali / Parangi, Sareh / Hodin, Richard A / Fraker, Douglas L / James, Benjamin C / Wang, Tracy S / Solórzano, Carmen C / Lubitz, Carrie C / Wachtel, Heather

Annals of surgical oncology

2022 Volume 29, Issue 4, Page(s) 2571–2579

Abstract: Background: Adrenal metastasectomy is associated with increased survival in non-small cell lung cancer (NSCLC) with isolated adrenal metastases. Although clinical use of adrenal metastasectomy has expanded, indications remain poorly defined. The aim of ... ...

Abstract	Background: Adrenal metastasectomy is associated with increased survival in non-small cell lung cancer (NSCLC) with isolated adrenal metastases. Although clinical use of adrenal metastasectomy has expanded, indications remain poorly defined. The aim of this study was to evaluate the clinical benefit of adrenal metastasectomy for all lung cancer subtypes. Patients and methods: We performed a retrospective cohort study of patients who underwent adrenal metastasectomy for metastatic lung cancer at six institutions between 2001 and 2015. The primary outcomes were disease-free survival (DFS) and overall survival (OS). Cox proportional hazards regressions and Kaplan-Meier survival analysis were performed. Results: For 122 patients, the mean age was 60.5 years and 49.2% were female. Median time to detection of the metastasis was 11 months, and 41.8% were ipsilateral to the primary lung cancer. Median DFS was 40 months (1 year: 64.8%; 5 year: 42.9%). Factors associated with longer DFS included primary tumor resection [hazard ratio (HR): 0.001; p = 0.005], longer time to adrenal metastasis (HR: 0.94; p = 0.005), and ipsilateral metastases (HR: 0.13; p = 0.004). Shorter DFS corresponded with older age (HR: 1.11; p = 0.01), R1 resection (HR: 8.94; p = 0.01), adjuvant radiation (HR: 9.45; p = 0.02), and open adrenal metastasectomy (HR: 10.0; p = 0.03). Median OS was 47 months (1 year: 80.2%; 5 year: 35.2%). Longer OS was associated with ipsilateral metastasis (HR: 0.55; p = 0.02) and adjuvant chemotherapy (HR: 0.35; p = 0.02). Shorter OS was associated with extra-adrenal metastases at adrenalectomy (HR: 3.52; p = 0.007), small cell histology (HR: 15.0; p = 0.04), and lung radiation (HR: 3.37; p = 0.002). Discussion: Durable survival was observed in patients undergoing adrenal metastasectomy and should be considered for isolated adrenal metastases of NSCLC. Small cell histology and extra-adrenal metastases are relative contraindications to adrenal metastasectomy.
MeSH term(s)	Adrenalectomy ; Carcinoma, Non-Small-Cell Lung/surgery ; Disease-Free Survival ; Female ; Humans ; Lung Neoplasms/pathology ; Metastasectomy ; Middle Aged ; Retrospective Studies ; Survival Rate
Language	English
Publishing date	2022-01-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-021-11192-7
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Article ; Online: Impact of the COVID-19 pandemic on the practice of endocrine surgery.

Beninato, Toni / Laird, Amanda M / Graves, Claire E / Drake, F Thurston / Alhefdhi, Amal / Lee, James A / Kuo, Jennifer H / Grubbs, Elizabeth G / Wang, Tracy S / Pasieka, Janice L / Lubitz, Carrie C

American journal of surgery

2021 Volume 223, Issue 4, Page(s) 670–675

Abstract: Background: This study investigates the impact of the COVID-19 pandemic on endocrine surgeons.: Methods: A survey on the professional, educational, and clinical impact was sent to active and corresponding members of the American Association of ... ...

Abstract	Background: This study investigates the impact of the COVID-19 pandemic on endocrine surgeons. Methods: A survey on the professional, educational, and clinical impact was sent to active and corresponding members of the American Association of Endocrine Surgeons (AAES) in September 2020. Chi-square and paired t-test were used for analysis. Results: 77 surgeons responded (14.8 %). All reported suspension of elective surgeries; 37.7 % were reassigned to other duties during this time. The median number of cases backlogged was 30 (IQR 15-50). Most surgeons reported decreased clinical volume (74.6 %). The use of virtual platforms for clinical and educational purposes increased from pre-COVID-19 levels (all p < 0.001). Use of in-office procedures (p < 0.001) and length of observation prior to discharge for thyroid surgery (p < 0.05) decreased. Conclusion: The COVID-19 pandemic led to suspension of operations and decreased practice volume for endocrine surgeons. Surgeons increased use of virtual platforms, decreased in-office procedures, and decreased duration of observation for thyroid surgery in response.
MeSH term(s)	COVID-19/epidemiology ; Endocrine Surgical Procedures ; Humans ; Pandemics ; SARS-CoV-2 ; Surgeons ; Surveys and Questionnaires ; United States/epidemiology
Language	English
Publishing date	2021-07-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2021.07.009
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Article ; Online: Mechanisms controlling expression of the RAG locus during lymphocyte development.

Kuo, Tracy C / Schlissel, Mark S

Current opinion in immunology

2009 Volume 21, Issue 2, Page(s) 173–178

Abstract: Recombination activating genes (RAG)1 and RAG2 are expressed in developing B and T lymphocytes and are required for the rearrangement of antigen receptor genes. In turn, RAG expression is regulated by the products of these assembled immunoglobulin (Ig) ... ...

Abstract	Recombination activating genes (RAG)1 and RAG2 are expressed in developing B and T lymphocytes and are required for the rearrangement of antigen receptor genes. In turn, RAG expression is regulated by the products of these assembled immunoglobulin (Ig) and T cell receptor (TCR) genes. Upon successful assembly of Ig genes, the antigen receptor is expressed on the immature B cell surface and tested for autoreactivity leading to either maintenance or inactivation of RAG expression. Successful assembly of TCR genes is followed by surface TCR expression and testing for its ability to interact with self-MHC, which if appropriate leads to the inactivation of RAG expression. Recent studies in B and T lymphocytes demonstrate that the reduction in RAG expression at the immature B and double-positive (DP) T cell stages is mediated through tonic (foreign antigen independent) receptor signaling. In B cells, tonic signaling activates PI(3)K and Akt kinases, which phosphorylate and lead to the cytoplasmic sequestration of FoxO proteins, the key transcriptional activators of RAG expression. In T cells, tonic signaling activates Abl and Erk kinases, leading to the transcriptional inactivation of RAGs.
MeSH term(s)	Animals ; DNA-Binding Proteins/genetics ; DNA-Binding Proteins/metabolism ; Gene Expression Regulation ; Homeodomain Proteins/genetics ; Homeodomain Proteins/metabolism ; Humans ; Lymphocytes/cytology ; Lymphocytes/metabolism ; Models, Biological ; Nuclear Proteins/genetics ; Nuclear Proteins/metabolism ; Protein Processing, Post-Translational ; Receptors, Antigen, B-Cell/genetics ; Receptors, Antigen, B-Cell/metabolism ; Receptors, Antigen, T-Cell/genetics ; Receptors, Antigen, T-Cell/metabolism
Chemical Substances	DNA-Binding Proteins ; Homeodomain Proteins ; Nuclear Proteins ; RAG2 protein, human ; Receptors, Antigen, B-Cell ; Receptors, Antigen, T-Cell ; RAG-1 protein (128559-51-3)
Language	English
Publishing date	2009-04-07
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1035767-1
ISSN	1879-0372 ; 0952-7915
ISSN (online)	1879-0372
ISSN	0952-7915
DOI	10.1016/j.coi.2009.03.008
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Article: AID for innate immunity to retroviral transformation.

Schlissel, Mark S / Kuo, Tracy C

Immunity

2006 Volume 24, Issue 6, Page(s) 671–672

Abstract: AID is a cytidine deaminase essential for class switch recombination and somatic hypermutation during the humoral immune response. In this issue of Immunity, Gourzi et al. (2006) show that AID also plays a critical role in innate immunity to virally ... ...

Abstract	AID is a cytidine deaminase essential for class switch recombination and somatic hypermutation during the humoral immune response. In this issue of Immunity, Gourzi et al. (2006) show that AID also plays a critical role in innate immunity to virally induced acute pro-B cell leukemia.
MeSH term(s)	Abelson murine leukemia virus/immunology ; Animals ; Cytidine Deaminase/genetics ; Cytidine Deaminase/physiology ; Leukemia, Experimental/enzymology ; Leukemia, Experimental/genetics ; Leukemia, Experimental/immunology ; Mice ; Retroviridae Infections/enzymology ; Retroviridae Infections/genetics ; Retroviridae Infections/immunology ; Tumor Virus Infections/enzymology ; Tumor Virus Infections/genetics ; Tumor Virus Infections/immunology
Chemical Substances	AICDA (activation-induced cytidine deaminase) (EC 3.5.4.-) ; Cytidine Deaminase (EC 3.5.4.5)
Language	English
Publishing date	2006-01-23
Publishing country	United States
Document type	Comment ; Journal Article ; Review
ZDB-ID	1217235-2
ISSN	1097-4180 ; 1074-7613
ISSN (online)	1097-4180
ISSN	1074-7613
DOI	10.1016/j.immuni.2006.06.005
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