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Huan Guo

Bio: Huan Guo is an academic researcher from Huazhong University of Science and Technology. The author has contributed to research in topics: Lung cancer & Medicine. The author has an hindex of 37, co-authored 174 publications receiving 5678 citations. Previous affiliations of Huan Guo include Chinese Ministry of Education & Yale University.


Papers
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Journal ArticleDOI
19 May 2020-JAMA
TL;DR: A series of multifaceted public health interventions was temporally associated with improved control of the COVID-19 outbreak in Wuhan, China, and may inform public health policy in other countries and regions.
Abstract: Importance Coronavirus disease 2019 (COVID-19) has become a pandemic, and it is unknown whether a combination of public health interventions can improve control of the outbreak. Objective To evaluate the association of public health interventions with the epidemiological features of the COVID-19 outbreak in Wuhan by 5 periods according to key events and interventions. Design, Setting, and Participants In this cohort study, individual-level data on 32 583 laboratory-confirmed COVID-19 cases reported between December 8, 2019, and March 8, 2020, were extracted from the municipal Notifiable Disease Report System, including patients’ age, sex, residential location, occupation, and severity classification. Exposures Nonpharmaceutical public health interventions includingcordons sanitaire, traffic restriction, social distancing, home confinement, centralized quarantine, and universal symptom survey. Main Outcomes and Measures Rates of laboratory-confirmed COVID-19 infections (defined as the number of cases per day per million people), across age, sex, and geographic locations were calculated across 5 periods: December 8 to January 9 (no intervention), January 10 to 22 (massive human movement due to the Chinese New Year holiday), January 23 to February 1 (cordons sanitaire, traffic restriction and home quarantine), February 2 to 16 (centralized quarantine and treatment), and February 17 to March 8 (universal symptom survey). The effective reproduction number of SARS-CoV-2 (an indicator of secondary transmission) was also calculated over the periods. Results Among 32 583 laboratory-confirmed COVID-19 cases, the median patient age was 56.7 years (range, 0-103; interquartile range, 43.4-66.8) and 16 817 (51.6%) were women. The daily confirmed case rate peaked in the third period and declined afterward across geographic regions and sex and age groups, except for children and adolescents, whose rate of confirmed cases continued to increase. The daily confirmed case rate over the whole period in local health care workers (130.5 per million people [95% CI, 123.9-137.2]) was higher than that in the general population (41.5 per million people [95% CI, 41.0-41.9]). The proportion of severe and critical cases decreased from 53.1% to 10.3% over the 5 periods. The severity risk increased with age: compared with those aged 20 to 39 years (proportion of severe and critical cases, 12.1%), elderly people (≥80 years) had a higher risk of having severe or critical disease (proportion, 41.3%; risk ratio, 3.61 [95% CI, 3.31-3.95]) while younger people ( Conclusions and Relevance A series of multifaceted public health interventions was temporally associated with improved control of the COVID-19 outbreak in Wuhan, China. These findings may inform public health policy in other countries and regions.

1,307 citations

Journal ArticleDOI
TL;DR: Results suggest that genetic variants in 3q28, 5p15.33, 13q 12.12 and 22q12.2 may contribute to the susceptibility of lung cancer in Han Chinese.
Abstract: Hongbing Shen and colleagues report a genome-wide association study for lung cancer in individuals of Han Chinese ancestry. The authors identify two new lung cancer susceptibility loci.

340 citations

Journal ArticleDOI
Qing Lan1, Chao A. Hsiung2, Keitaro Matsuo, Yun Chul Hong3, Adeline Seow4, Zhaoming Wang1, H. Dean Hosgood5, H. Dean Hosgood1, Kexin Chen6, Jiucun Wang7, Nilanjan Chatterjee1, Wei Hu1, Maria Pik Wong8, Wei Zheng9, Neil E. Caporaso1, Jae Yong Park10, Chien-Jen Chen11, Yeul Hong Kim12, Young Tae Kim3, Maria Teresa Landi1, Hongbing Shen13, Charles E. Lawrence14, Laurie Burdett1, Meredith Yeager1, Jeffrey Yuenger1, Kevin B. Jacobs1, I. Shou Chang2, Tetsuya Mitsudomi15, Hee Nam Kim16, Gee-Chen Chang17, Bryan A. Bassig1, Bryan A. Bassig18, Margaret A. Tucker1, Fusheng Wei, Zhihua Yin19, Chen Wu20, She-Juan An, Biyun Qian6, Victor Ho Fun Lee8, Daru Lu7, Jianjun Liu21, Jianjun Liu22, Hyo Sung Jeon10, Chin-Fu Hsiao2, Jae Sook Sung12, Jin Hee Kim3, Yu Tang Gao, Ying-Huang Tsai23, Yoo Jin Jung3, Huan Guo24, Zhibin Hu13, Amy Hutchinson1, Wen Chang Wang2, Robert J. Klein25, Charles C. Chung1, In-Jae Oh16, Kuan-Yu Chen26, Sonja I. Berndt1, Xingzhou He27, Wei Wu19, Jiang Chang20, X. Zhang, Ming Shyan Huang28, Hong Zheng6, Junwen Wang8, Xueying Zhao7, Yuqing Li21, Jin Eun Choi10, Wu Chou Su29, Kyong Hwa Park12, Sook Whan Sung3, Xiao-Ou Shu9, Yuh Min Chen17, Li Liu24, Chang Hyun Kang3, Lingmin Hu13, Chung Hsing Chen2, William Pao9, Young-Chul Kim16, Tsung-Ying Yang, Jun Xu8, Peng Guan19, Wen Tan20, Jian Su, Chih-Liang Wang23, Haixin Li6, Alan D. L. Sihoe8, Zhenhong Zhao7, Ying Chen4, Yi Young Choi10, Jen Yu Hung28, Jun Suk Kim12, Ho Il Yoon3, Qiuyin Cai9, Chien Chung Lin29, In Kyu Park3, Ping Xu, Jing Dong13, Christopher Kim1, Qincheng He19, Reury Perng Perng, Takashi Kohno30, Sun-Seog Kweon16, Chih Yi Chen31, Roel Vermeulen32, Junjie Wu7, Wei-Yen Lim4, Kun-Chieh Chen, Wong Ho Chow1, Bu Tian Ji1, John K.C. Chan, Minjie Chu13, Yao Jen Li11, Jun Yokota30, Jihua Li, Hongyan Chen7, Yong-Bing Xiang, Chong-Jen Yu26, Hideo Kunitoh33, Guoping Wu, Li Jin7, Yen Li Lo2, Kouya Shiraishi30, Ying Hsiang Chen2, HC Lin2, Tangchun Wu24, Yi-Long Wu, Pan-Chyr Yang26, Baosen Zhou19, Min-Ho Shin16, Joseph F. Fraumeni1, Dongxin Lin20, Stephen J. Chanock1, Nathaniel Rothman1 
TL;DR: It is observed that there is no evidence of association for lung cancer at 15q25 in never-smoking women in Asia, providing strong evidence that this locus is not associated with lung cancer independent of smoking.
Abstract: To identify common genetic variants that contribute to lung cancer susceptibility, we conducted a multistage genome-wide association study of lung cancer in Asian women who never smoked. We scanned 5,510 never-smoking female lung cancer cases and 4,544 controls drawn from 14 studies from mainland China, South Korea, Japan, Singapore, Taiwan and Hong Kong. We genotyped the most promising variants (associated at P < 5 × 10(-6)) in an additional 1,099 cases and 2,913 controls. We identified three new susceptibility loci at 10q25.2 (rs7086803, P = 3.54 × 10(-18)), 6q22.2 (rs9387478, P = 4.14 × 10(-10)) and 6p21.32 (rs2395185, P = 9.51 × 10(-9)). We also confirmed associations reported for loci at 5p15.33 and 3q28 and a recently reported finding at 17q24.3. We observed no evidence of association for lung cancer at 15q25 in never-smoking women in Asia, providing strong evidence that this locus is not associated with lung cancer independent of smoking.

279 citations

Posted ContentDOI
06 Mar 2020-medRxiv
TL;DR: Considerable countermeasures have effectively controlled the Covid-19 outbreak in Wuhan, China, and special efforts are needed to protect vulnerable populations, including healthcare workers, elderly and children.
Abstract: BACKGROUND We described the epidemiological features of the coronavirus disease 2019 (Covid-19) outbreak, and evaluated the impact of non-pharmaceutical interventions on the epidemic in Wuhan, China. METHODS Individual-level data on 25,961 laboratory-confirmed Covid-19 cases reported through February 18, 2020 were extracted from the municipal Notifiable Disease Report System. Based on key events and interventions, we divided the epidemic into four periods: before January 11, January 11-22, January 23 - February 1, and February 2-18. We compared epidemiological characteristics across periods and different demographic groups. We developed a susceptible-exposed-infectious-recovered model to study the epidemic and evaluate the impact of interventions. RESULTS The median age of the cases was 57 years and 50.3% were women. The attack rate peaked in the third period and substantially declined afterwards across geographic regions, sex and age groups, except for children (age <20) whose attack rate continued to increase. Healthcare workers and elderly people had higher attack rates and severity risk increased with age. The effective reproductive number dropped from 3.86 (95% credible interval 3.74 to 3.97) before interventions to 0.32 (0.28 to 0.37) post interventions. The interventions were estimated to prevent 94.5% (93.7 to 95.2%) infections till February 18. We found that at least 59% of infected cases were unascertained in Wuhan, potentially including asymptomatic and mild-symptomatic cases. CONCLUSIONS Considerable countermeasures have effectively controlled the Covid-19 outbreak in Wuhan. Special efforts are needed to protect vulnerable populations, including healthcare workers, elderly and children. Estimation of unascertained cases has important implications on continuing surveillance and interventions.

212 citations

Journal ArticleDOI
TL;DR: Results show that genetic variation in the CLPTM1L-TERT locus of chromosome 5p15.33 is directly associated with the risk of lung cancer, most notably adenocarcinoma.
Abstract: 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 27 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=1.30610 211 ). This finding was independently replicated in seven studies from East Asia totaling 1,164 lung adenocarcinomas and 1,736 controls (p=5.38610 211 ). A pooled analysis achieved genome-wide significance for rs2736100. This SNP marker localizes to the CLPTM1L-TERT locus on chromosome 5p15.33 (p=2.60610 220 , 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 CLPTM1LTERT locus of chromosome 5p15.33 is directly associated with the risk of lung cancer, most notably adenocarcinoma.

210 citations


Cited by
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01 Jan 2014
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Abstract: XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

9,618 citations

Book ChapterDOI
01 Jan 2010

5,842 citations

Journal ArticleDOI
25 Aug 2020-JAMA
TL;DR: This review discusses current evidence regarding the pathophysiology, transmission, diagnosis, and management of COVID-19, the novel severe acute respiratory syndrome coronavirus 2 pandemic that has caused a worldwide sudden and substantial increase in hospitalizations for pneumonia with multiorgan disease.
Abstract: Importance The coronavirus disease 2019 (COVID-19) pandemic, due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a worldwide sudden and substantial increase in hospitalizations for pneumonia with multiorgan disease. This review discusses current evidence regarding the pathophysiology, transmission, diagnosis, and management of COVID-19. Observations SARS-CoV-2 is spread primarily via respiratory droplets during close face-to-face contact. Infection can be spread by asymptomatic, presymptomatic, and symptomatic carriers. The average time from exposure to symptom onset is 5 days, and 97.5% of people who develop symptoms do so within 11.5 days. The most common symptoms are fever, dry cough, and shortness of breath. Radiographic and laboratory abnormalities, such as lymphopenia and elevated lactate dehydrogenase, are common, but nonspecific. Diagnosis is made by detection of SARS-CoV-2 via reverse transcription polymerase chain reaction testing, although false-negative test results may occur in up to 20% to 67% of patients; however, this is dependent on the quality and timing of testing. Manifestations of COVID-19 include asymptomatic carriers and fulminant disease characterized by sepsis and acute respiratory failure. Approximately 5% of patients with COVID-19, and 20% of those hospitalized, experience severe symptoms necessitating intensive care. More than 75% of patients hospitalized with COVID-19 require supplemental oxygen. Treatment for individuals with COVID-19 includes best practices for supportive management of acute hypoxic respiratory failure. Emerging data indicate that dexamethasone therapy reduces 28-day mortality in patients requiring supplemental oxygen compared with usual care (21.6% vs 24.6%; age-adjusted rate ratio, 0.83 [95% CI, 0.74-0.92]) and that remdesivir improves time to recovery (hospital discharge or no supplemental oxygen requirement) from 15 to 11 days. In a randomized trial of 103 patients with COVID-19, convalescent plasma did not shorten time to recovery. Ongoing trials are testing antiviral therapies, immune modulators, and anticoagulants. The case-fatality rate for COVID-19 varies markedly by age, ranging from 0.3 deaths per 1000 cases among patients aged 5 to 17 years to 304.9 deaths per 1000 cases among patients aged 85 years or older in the US. Among patients hospitalized in the intensive care unit, the case fatality is up to 40%. At least 120 SARS-CoV-2 vaccines are under development. Until an effective vaccine is available, the primary methods to reduce spread are face masks, social distancing, and contact tracing. Monoclonal antibodies and hyperimmune globulin may provide additional preventive strategies. Conclusions and Relevance As of July 1, 2020, more than 10 million people worldwide had been infected with SARS-CoV-2. Many aspects of transmission, infection, and treatment remain unclear. Advances in prevention and effective management of COVID-19 will require basic and clinical investigation and public health and clinical interventions.

3,371 citations