Analisis Struktur Daerah Integral dari Himpunan Polinomial Berdasarkan Struktur Polinomial Gelanggang

Himpunan R[x] polinomial dengan koefisien dari gelanggang R juga merupakan sebuah gelanggang dengan berbagai operasi polinomial jumlahan dan perkalian, dan bahwa R merupakan gelanggang bagian dari R[x]. Oleh karena itu akan ditunjukkan bahwa jika D adalah sebuah daerah integral maka demikian juga dengan himpunan polinomial dengan koefisien di dalam D, yaitu D[X]

Economic and clinical burden of viral hepatitis in California: A population-based study with longitudinal analysis

<div><p>Background</p><p>Economic burden of HBV and HCV infection are trending upwards.</p><p>Aims</p><p>Compare hepatitis B virus (HBV) and hepatitis C virus (HCV) related hospital admission rates, charges, mortality rates, causes of death in a US population-based study.</p><p>Methods</p><p>Retrospective cohort analysis of HBV and HCV patients from the California Office of Statewide Health Planning and Development (2006–2013) database.</p><p>Results</p><p>A total of 23,891 HBV and 148,229 HCV patients were identified. Across the 8-year period, the mean increase for all-cause ($1,863 vs$1,388) and liver-related hospitalization charges ($1,175 vs$675) were significantly higher for the HBV cohort compared to the HCV cohort. HBV patients had significantly higher liver-related hospital charges per person per year than HCV patients after controlling for covariates ($123,239 vs$111,837; <i>p</i> = 0.002). Compared to HCV patients, adjusted mortality hazard ratio was slightly lower in HBV patients (relative risk = 0.96; 95% CI 0.94–0.99). The major causes and places of death were different. The three major causes of death for HBV were: other malignant neoplasms (35%), cardiovascular disease/other circulatory disorders (17%), and liver-related disease (15%) whereas for HCV patients were: liver-related disease (22%), other malignant neoplasms (20%), and cardiovascular disease (16%). Regarding the place of death, 53% of HBV patients and 44% of HCV patients died in hospital inpatient, respectively.</p><p>Conclusions</p><p>HBV patients incurred higher liver-related hospital charges and higher mean increase for all-cause and liver-related hospitalization charges over the 8-year period compared to HCV patients. HBV patients had slightly lower mortality rate and their major causes and places of death were noticeably different from HCV patients.</p></div

Mortality rates and causes of death for inpatient HBV and HCV patients.

<p>Mortality rates and causes of death for inpatient HBV and HCV patients.</p

Trends in all-cause hospital charges between 2006 and 2013 in HBV and HCV patients.

<p>A. All-cause hospital charge per patient per year (median). B. All-cause total charges.</p

Characteristics of HBV and HCV patients admitted to hospital by year, US, 2006–2013.

<p>Characteristics of HBV and HCV patients admitted to hospital by year, US, 2006–2013.</p

Gaps in hepatocellular carcinoma surveillance in a United States cohort of insured patients with cirrhosis

Surveillance for hepatocellular carcinoma (HCC) is known to be underutilized; however, neither the variation of surveillance adherence by cirrhosis etiology nor the patient-side economic burden of surveillance are well understood. To identify potential barriers to HCC surveillance, we assessed utilization patterns and costs among US patients with cirrhosis monitored in routine clinical practice. We conducted a retrospective study of insured adult patients with cirrhosis using national administrative claims data from January 2013 through June 2019. Time up-to-date with recommended surveillance, correlates of surveillance receipt, and surveillance-associated costs were assessed during a ≥ 6-month follow-up. Among 15,543 patients with cirrhosis (mean [SD] age 64.0 [11.1] years, 50.7% male), 45.8% and 58.7% had received any abdominal imaging at 6 and 12 months, respectively. Patients were up-to-date with recommended surveillance for only 31% of a median 1.3-year follow-up. Those with viral hepatitis were more likely to receive surveillance than those with other etiologies (hazard ratio [HR] 1.55, 95% CI 1.11–2.17, p = .010 for patients without a baseline gastroenterologist [GI] visit and 2.69, 95% CI 1.77–4.09, p  HCC surveillance was underutilized and was lowest among patients with nonviral etiologies and those who had not seen a gastroenterologist. Surveillance-related out-of-pocket expenses and lost productivity were substantial. The development of surveillance strategies that reduce patient burden, such as those using blood-based biomarkers, may help improve surveillance adherence and effectiveness.</p

Regional differences in treatment rates for patients with chronic hepatitis C infection: Systematic review and meta-analysis

<div><p>Background & aims</p><p>Treatment rates with interferon-based therapies for chronic hepatitis C have been low. Our aim was to perform a systematic review of available data to estimate the rates and barriers for antiviral therapy for chronic hepatitis C.</p><p>Methods</p><p>We conducted a systematic review and meta-analysis searching MEDLINE, SCOPUS through March 2016 and abstracts from recent major liver meetings for primary literature with available hepatitis C treatment rates. Random-effects models were used to estimate effect sizes and meta-regression to test for potential sources of heterogeneity.</p><p>Results</p><p>We included 39 studies with 476,443 chronic hepatitis C patients. The overall treatment rate was 25.5% (CI: 21.1–30.5%) and by region 34% for Europe, 28.3% for Asia/Pacific, and 18.7% for North America (<i>p</i> = 0.008). On multivariable meta-regression, practice setting (tertiary vs. population-based, <i>p</i> = 0.04), region (Europe vs. North America <i>p</i> = 0.004), and data source (clinical chart review vs. administrative database, <i>p</i> = 0.025) remained significant predictors of heterogeneity. The overall treatment eligibility rate was 52.5%, and 60% of these received therapy. Of the patients who refused treatment, 16.2% cited side effects, 13.8% cited cost as reasons for treatment refusal, and 30% lacked access to specialist care.</p><p>Conclusions</p><p>Only one-quarter of chronic hepatitis C patients received antiviral therapy in the pre-direct acting antiviral era. Treatment rates should improve in the new interferon-free era but, cost, co-morbidities, and lack of specialist care will likely remain and need to be addressed. Linkage to care should even be of higher priority now that well-tolerated cure is available.</p></div