Miracle-dz/UniFAR-FTUs huggingface dataset:
The Prevalence of Human Metapneumovirus and Respiratory Syncytial Virus and Coinfection With Both in Hospitalized Children With Acute Respiratory Infection in South of Iran

Background: Viral infections are the most frequent causes of morbidity and mortality due to respiratory dysfunction worldwide, especially in children under five years of age. Several studies have reported the association of human metapneumovirus (hMPV) and respiratory syncytial virus (RSV) with acute respiratory infection. Objectives: The present study aimed to investigate the prevalence of hMPV, RSV, and their coinfection in children with respiratory symptoms hospitalized in Shiraz City, Fars Province, Iran. The study also attempted to determine the association between asthma and wheezing with hMPV, RSV, and coinfection with both in studied children. Patients and Methods: The study included 280 younger than five years old children with non-influenza infection that were hospitalized for respiratory infection from 2011 to 2013. Nasopharyngeal swabs were collected from patients and tested for RSV and hMPV with reverse transcriptase polymerase chain reaction. Results: The hMPV and RSV were detected in 44 (15.7%) and 84 (30.0%) samples, respectively. Coinfection with both viruses was found in ten patients (3.57%). The incidence of hMPV and RSV infections were observed in children younger than one year old. Infections occurred predominantly from October to April. The most common clinical symptoms were bronchiolitis, wheezing, and cough. Conclusions: Infection with hMPV and RSV are most frequent infections among pediatric patients with respiratory tract symptoms. Coinfection with these viruses may exacerbate the clinical symptoms and increase hospitalization rates, especially in children younger than one year old.
Medication compliance in outpatients with schizophrenia in one veterans hospital in Taiwan

Medication compliance is an important determinant in schizophrenia treatment outcomes. This study aimed to investigate medication compliance in cases of patients receiving a single antipsychotic medication among adult outpatients with schizophrenia, and examine whether their antipsychotic therapy and other factors may affect the medication compliance. Subjects with schizophrenia who had received any single outpatient first- or second-generation antipsychotic therapy from the Yuli Veterans Hospital, Taiwan, during August and November 2006 were identified from medical chart reviews. The selected subjects were surveyed for information including their medication compliance, sociodemographics, treatment-related side effects, social support, and perceived treatmentrelated benefits. Their physicians were also surveyed on their medication compliance, Clinical Global Impression (CGI) scores, and comorbid mental illness (es). Good medication compliance was defined as consumption of more than 75% of prescribed antipsychotics in the previous month. Subjects were categorized into this group when both their self-reported consumption and their physicians' estimation were higher than 75%. A logistic regression model was adopted to evaluate the association of each factor with medication compliance. Of the 76 subjects surveyed, 39 (51%) received second-generation antipsychotics (amisulpride, risperidone, or olanzapine), while 37 (49%) received first-generation antipsychotics (haloperidol or sulpiride). Thirty-eight (50%) consumed more than 75% of prescribed medications in the previous month. The average age was 41, and 62% of the sample was male. Education level and employment type were significantly different between individuals with good and poor medication compliance. The regression result indicated that education of above nine years was significantly associated with an increased likelihood of good medication compliance. Employment and perceived treatment benefits were marginally significantly correlated with good medication compliance. Second-generation antipsychotics, however, had no correlation with good medication compliance.
Alpha‐receptor blockade improves muscle perfusion and glucose uptake in heart failure

Alpha‐adrenergic receptor‐mediated vasoconstriction might underlie the insulin resistance seen in conditions associated with increased sympathetic tone, like chronic heart failure (CHF). Alpha‐adrenergic receptor blockade by phentolamine could improve forearm blood flow (FBF) and forearm glucose uptake (FGU) in CHF patients.
Antenatal thyroid screening and childhood cognitive function.

1. Hammond ME, Hayes DF, Dowsett M, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 2010; 28:2784-95. [Erratum, J Clin Oncol 2010;28:3543. ] 2. Tamaki K, Sasano H, Ishida T, et al. Comparison of core needle biopsy (CNB) and surgical specimens for accurate preoperative evaluation of ER, PgR and HER2 status of breast cancer patients. Cancer Sci 2010;101:2074-9.
Improved pharmacological therapy of chronic heart failure in primary care: a randomized Study of NT‐proBNP Guided Management of Heart Failure – SIGNAL‐HF (Swedish Intervention study – Guidelines and NT‐proBNP AnaLysis in Heart Failure)

Treatment of chronic heart failure (CHF) guided by natriuretic peptides has been studied in clinical trials with conflicting results. The aim of this study was to investigate if N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP)‐guided therapy in symptomatic heart failure patients in primary care would improve clinical outcomes over and above treatment according to guidelines.
FDA approval of cardiac implantable electronic devices via original and supplement premarket approval pathways, 1979-2012.

IMPORTANCE The US Food and Drug Administration (FDA) evaluates high-risk medical devices such as cardiac implantable electronic devices (CIEDs), including pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy devices, via the premarket approval (PMA) process, during which manufacturers submit clinical data demonstrating safety and effectiveness. Subsequent changes to approved high-risk devices are implemented via "supplements," which may not require additional clinical testing. OBJECTIVE To characterize the prevalence and characteristics of changes to CIEDs made through the PMA supplement process. DESIGN Using the FDA's PMA database, we reviewed all CIEDs approved as original PMAs or supplements from 1979 through 2012. For each supplement, we collected the date approved, type of supplement (panel-track, 180-day, real-time, special, and 30-day notice), and the nature of the changes. We calculated the number of supplements approved per PMA and analyzed trends relating to different supplement regulatory categories over time. For supplements approved via the 180-day regulatory pathway, which often involve significant design changes, from 2010-2012, we identified how often additional clinical data were collected. RESULTS From 1979-2012, the FDA approved 77 original and 5829 supplement PMA applications for CIEDs, with a median of 50 supplements per original PMA (interquartile range [IQR], 23-87). Excluding manufacturing changes that do not alter device design, the number of supplements approved each year was stable around a mean (SD) of 2.6 (0.9) supplements per PMA per year. Premarket approvals remained active via successive supplements over a median period of 15 years (IQR, 8-20), and 79% of the 77 original PMAs approved during our study period were the subject of at least 1 supplement in 2012. Thirty-seven percent of approved supplements involved a change to the device's design. Among 180-day supplements approved from 2010-2012, 23% (15/64) included new clinical data to support safety and effectiveness. CONCLUSIONS AND RELEVANCE Many CIED models currently used by clinicians were approved via the PMA supplement process, not as original PMAs. Most new device models are deemed safe and effective without requiring new clinical data, reinforcing the importance of rigorous postapproval surveillance of these devices.
Soft multifocal simultaneous image contact lenses: a review

Soft multifocal simultaneous image contact lenses have boomed in recent years due to the growing number of presbyopic patients demanding visual solutions, allowing them to maintain their current standard of living. The concept of ‘simultaneous image’ is based on blur interpretation and/or blur tolerance of superimposed multiple images on the retina formed by various powers of a contact lens. This is the basis for a specific type of multifocal contact lens developed for the compensation of presbyopia. Manufacturers have released a great variety of soft simultaneous image lens designs to meet different patient needs but their fitting is still unsatisfactory in some cases. Some presbyopes discontinue wearing contact lenses due to some limitations in visual quality and comfort that can be overcome with an appropriate contact lens selection based on a comprehensive pre‐fitting evaluation. This paper aims to review the different types of soft multifocal contact lenses that are currently available for presbyopic correction and to define the steps and factors crucial for their fitting, such as pupil, aberrations, accommodation and centring. A discussion about useful tools to achieve a customised fitting leading to a successful outcome, such as the defocus curve, power profile and questionnaires, is performed.
Inicio de diálisis y mortalidad en una población con enfermedad renal crónica en Colombia

Antecedentes. La enfermedad renal cronica (ERC) se asocia con una alta morbimortalidad. En todo el mundo, se han desarrollado programas preventivos con el fin de afrontar tal enfermedad, que han resultado eficaces para lograr mejores desenlaces clinicos. En Colombia, una red de centros clinicos renales comenzo un programa preventivo secundario donde los pacientes de ERC reciben cuidado multidisciplinario con el objetivo de controlar la mortalidad y retrasar el inicio de dialisis. Objetivo. Determinar la frecuencia de inicio de dialisis y mortalidad en un grupo de adultos con ERC avanzada y evaluar que variables clinicas y demograficas se asocian con estos desenlaces. Materiales y metodos. Estudio de cohorte retrospectiva en el que se evaluaron 511 pacientes con ERC en estadios 3 a 5, admitidos en un programa de prevencion entre abril 2010 y mayo 2013. Se calcularon tasas de densidad de incidencia. La asociacion entre los factores clinicos y demograficos con los desenlaces se evaluo usando regresion de Cox. Resultados. Los 551 pacientes evaluados contribuyeron con 1199 anos-riesgo; tuvieron una mediana de 6 visitas durante el seguimiento. Del total de pacientes, 301 (54.6%) fueron mujeres; la media de edad fue de 75.8 anos; las principales causas de ERC fueron hipertension en 431 pacientes (78.2%) y diabetes en 101 (18.3%). En el momento de ingreso al estudio, la mediana de tasa de filtracion glomerular (TFG) fue de 40.9 ml/min/1. 73m² y la de indice de masa corporal (IMC) fue de 22.9 kg/m². La tasa de inicio de dialisis fue 2.1 por 100 pacientes-ano; se observo que otras causas de ERC (diferentes a hipertension) y la diabetes predicen mayor riesgo de dicho desenlace; por el contrario, una mayor TFG y una mayor edad, menor riesgo. La tasa de mortalidad fue 2.9 por 100 pacientes-ano, los mejores predictores encontrados para este desenlace fueron TFG, IMC y sexo masculino; la elevacion de la TFG y del IMC estan asociadas con menor riesgo.La tasa de mortalidad fue mayor que la tasa de inicio de dialisis. Conclusion. Una mayor TFG disminuye el riesgo para ambos desenlaces; a diferencia de otros estudios, la edad avanzada parece ser predictor de bajo riesgo de mortalidad y no fue un buen predictor de inicio de dialisis.
Prolonged QTc-Interval in Liver Cirrhotic Patient: Prevalence and Its Relationship with Severity of Liver Dysfunction

Background : The aim of the study was to determine the prevalence of prolonged QTc -interval and it’s relationship with the severity of liver dysfunction in liver cirrhotic patient in the outpatient clinic of Hepatology, Dr. Cipto Mangunkusumo General National Hospital Methods : cross sectional study. Eighty one subjects was recruited and being followed as a consecutive non random sampling. The patient was divided according to the modified Child-Pugh classification and undergo to the ECG examination (with minimal 2 leads have measured QT-interval; one of these is II, aVL, V2 or V3 lead). Result : The prolonged QTc-interval prevalence in liver cirrhotic patient was found in 55 subjects (67,9%) with the mean 448.6 msec (SD = 28,9; 95% CI = 442.2 - 454.8). Using the Forward Stepwise Method in multivariate analysis to the independent variables (p < 0.05) was found only the modified Child-Pugh classification had strongly correlation with the prolonged QTc-interval (OR = 11.2; 95% CI = 3.57-35.47; p = 0.000) Conclusion : The prolonged QTc-interval prevalence in liver cirrhotic patient is 67.9%. The prolonged QTc-interval were strongly associated with the severity of liver dysfunction. Keywords : The prolonged QTc-interval, liver dysfunction, liver cirrhosis
Effect of a telemonitoring‐facilitated collaboration between general practitioner and heart failure clinic on mortality and rehospitalization rates in severe heart failure: the TEMA‐HF 1 (TElemonitoring in the MAnagement of Heart Failure) study

Chronic heart failure (CHF) patients are frequently rehospitalized within 6 months after an episode of fluid retention. Rehospitalizations are preventable, but this requires an extensive organization of the healthcare system. In this study, we tested whether intensive follow‐up of patients through a telemonitoring‐facilitated collaboration between general practitioners (GPs) and a heart failure clinic could reduce mortality and rehospitalization rate.
Soluble ST2 is associated with adverse outcome in patients with heart failure of ischaemic aetiology

In patients with ischaemic heart failure (HF), myocardial dysfunction often progresses. Elevated levels of soluble ST2 (sST2) are associated with a poor prognosis, but an association between sST2 and worsening heart failure per se has not been established. We assessed the association between sST2 and cause‐specific outcome in 1449 patients enrolled in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA study).
Women and Heart Disease: Knowledge Differences between Primary Care and Speciality Practices

Problem Statement: Cardiovascular disease (CVD) is the leading cause of death in the United States for women and the second leading cause of death in Pitt County North Carolina. Evidence in the literature supports diminished awareness of heart disease among women and limited data as to provider knowledge of the current guidelines for the prevention of CVD in women. Purpose: This Doctor of Nursing (DNP) project examined the differences in knowledge, barriers, and practice of the 2011 Guidelines for the Prevention of CVD in Women by administering a survey to healthcare providers (HCPs) in primary care and selected specialty practices at a rural Southeastern US university clinic setting. Questions: (1) Is there a difference in knowledge of women and heart disease between primary care, cardiology, and OB/GYN practices? (2) What are the barriers affecting the provision of CVD risk therapies in women? (3) Is there a difference in the practice of women and heart disease between primary care, cardiology, and OB/GYN practices? Methods: Self-administered web-based anonymous questionnaire with a convenience sample of 147 Advanced Practice Registered Nurses, Physician Assistants, and Physicians in specialty and primary care settings. Analysis: Descriptive statistical analysis calculated by Statistical Package for the Social Sciences® (SPSS) using frequencies and percentages, and cross-tabulation to compare variables with practice site and HCP type. Waist circumference measurement and depression screening was performed less than half the time. Significance: Education of HCPs on the current guidelines and implementation into electronic health record.
Why and how do elderly patients with heart failure die? Insights from the TIME‐CHF study

Specific causes and modes of death (COD and MOD) of patients with heart failure (HF) are not well described, particularly in those with preserved ejection fraction >45% (HFPEF) and at old age. Thus, using the database of the TIME‐CHF study, patients with HFPEF were compared with those with reduced ejection fraction ≤45% (HFREF), and patients ≥75 with those 60–74 years of age to identify MOD and COD, predictors of death, and event rates before death as compared with survivors.
Excessive wave reflections on admission predict post‐discharge events in patients hospitalized due to acute heart failure

The role of wave reflections in the pathogenesis of acute heart failure syndrome (AHFS) remains unclear. The present study investigated the long‐term prognostic values of the carotid augmentation index (cAI), carotid augmented pressure (cAP), amplitude of the reflected pressure wave from a decomposed carotid pressure wave (Pb), and carotid pulse pressure (PP) on admission in patients hospitalized due to AHFS.
The benefits of using a heart failure management programme in Swedish primary healthcare

Heart failure (HF) is a common condition with which high mortality, morbidity, and poor quality of life are associated. It has previously been shown that use of HF management programmes (HFMPs) in HF clinics can be beneficial. The purpose of this study was to evaluate if the use of HFMPs also has beneficial effects on HF patients in primary healthcare (PHC).
Exploring determinants of male involvement in PMTCT programs in chibombo district of central province of zambia

ABSTRACT Introduction: The role that men can play in the prevention of HIV is cardinal in changing the course of the epidemic. When men take part in the Prevention of Mother to Child Transmission (PMTCT) of HIV, their knowledge of HIV increases, they become supportive to their partners and their response to HIV testing improves. The main aim of this study was to determine factors that influence male involvement in PMTCT programs in Chibombo district of Central Province in Zambia. Methodology: The study was a cross sectional one conducted in Chibombo district in central province of Zambia. The information was collected from 240 male participants whose partners either had or had not attended ANC and PMTCT programs from 1 st January, 2008 to 31 st December, 2013 using a semi structured questionnaire, and from six focus group discussions (FGDs). Results: The participants had a mean age of 35years, and that age was not statistically significant (p = 0.353). Factors such as education, and knowledge of PMTCT (P = 0.007and 0.01 respectively) had an association with men’s willingness to attend PMTCT programs. The occupation of respondents who were in formal employment was statistically significant (p= 0.026) indicating an association with male involvement in PMTCT programs. There was no association between age (p= 0.480), residence (p= 0.209), financial earnings (p =0.151) and PMTCT program attendance and only 134(58.3%) knew partners antenatal care (ANC) appointment. The majority of the respondents, 219(91.7%) indicated that they would accept couple counselling and testing during PMTCT programs. Conclusion and Recommendations: The level of male involvement in PMTCT programs was associated with knowledge of PMTCT, occupation and education level of male partners. The willingness of males to get involved in PMTCT was low (63.7%) hence the need for more concerted effort to persuade men to be attending PMTCT programs. Findings from the focus group discussions revealed that there were individual, socio economic, health related factors that had an effect on men’s participation in PMTCT services, hence the need for community sensitization for men on the benefits of prevention of mother to child transmission of HIV and also that timing and what is offered during the programs should include men’s reproductive health needs.
What happens to gazelles? The role of dynamic management strategies

The starting point of this study is Gibrat’s Law, which is contrasted with strategic management. This logic is subsequently applied to a group of remarkably dynamic, high-growth firms: gazelles. Strategic management theory emphasises the importance of firms adjusting strategies in response to changes in the external environment. In our study, it is used to explain several key empirical findings using a novel British data set containing information on more than 100 gazelles. These findings help explain: (1) why Gibrat’s Law of random firm growth processes does not generally hold, (2) which strategy and environmental variables have a predictable influence on firm performance and (3) why routine application of ‘best practice’ strategies is unlikely to foster firm growth in a changing economic environment. In so doing, this paper contributes to the large body of literature on small-firm growth.
Genotyping of high‐risk human papillomaviruses in p16/Ki‐67‐positive urothelial carcinoma cells: even a worm will turn

Co‐expression of p16INK4a protein and Ki‐67 (p16/Ki‐67) is noted in almost all high‐grade urothelial lesions. However, the aetiological role or, conversely, the absence of causative effect of high‐risk human papillomaviruses (hr‐HPVs) has not been documented. The purpose of this study is to evaluate HPV DNA in p16/Ki‐67‐positive, high‐grade urothelial tumour cells.
General health checks in adults for reducing morbidity and mortality from disease.

CLINICAL QUESTION What are the benefits and harms of general health checks for adult populations? BOTTOM LINE Compared with usual care, offers of health checks were not associated with lower rates of all-cause mortality, mortality from cardiovascular disease, or mortality from cancer. Health checks may be associated with more diagnoses and more drug treatment. Morbidity was infrequently reported, as were most harms, such as use of diagnostic procedures.
Understanding Level of Maternal and Child Health Indicators used in Health Management Information System among Peripheral Level Health Functionaries in Two Districts of India

Millennium Development Goal indicators in context of maternal and child health can be met with a robust Health Management Information System (HMIS )in India . To achieve this the web based HMIS was started in 2008 to capture public health data from health institutions across the country. Standard formats were prepared, rationalized and e‐enabled in HMIS web portal, a change from the manual reporting. Further, it is necessary that staff involved in data collection and management be aware of the interpretations of different indicators used in HMIS format for its effective use. The current study was conducted in one district each of two states, to assess understanding of the health functionaries in the field regarding data collection and use of health indicators. The observations indicate that some indicators for maternal and child health in format of monthly reports, are difficult to comprehend by system, no norms for analysis and use of data, and incomplete switchover from use of old to new formats leading to duplication. Efforts needed to address these for optimum functioning
Assessing Health Literacy

Abstract Seniors have been found to be the greatest users of health care services, but also have a lower ability to read and comprehend health information and to navigate the health care system. Health information must be provided at a level and in a form that is useable for seniors. A study was conducted to determine if the problem of inadequate health literacy was an issue for the seniors in northern Idaho. Close to 30% of the senior participants needed at least supplemental teaching materials to the written instruction forms normally given upon discharge from the hospital. Comparisons with other study findings are made and suggestions for improved or alternate forms of communicating health information for seniors are discussed.