Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of Viral Load and Drug Resistance on Mortality among Chinese HIV-Infected Patients Receiving Antiretroviral Treatment

Background: The Chinese National Free Antiretroviral Treatment Program (NFATP) for HIV-infected patients has saved lives. However, there is no data on the effect of HIV drug resistance on mortality among Chinese patients receiving antiretroviral treatment. Methods: We linked patient records from two national databases: baseline HIV drug resistance and viral load data were obtained from four national drug resistance surveys in 2004, 2005, 2006 and 2009, and all-cause mortality was ascertained in a prospective way in NFATP database. Factors associated with death were identified by Cox regression model. Results: A total of 5421 HIV-infected patients who participated in the drug resistance surveys and received combination antiretroviral therapy (cART) from NFATP were included in the analysis. Approximately one-third of patients (1462/5421) had baseline plasma HIV-1 viral load ≥1,000 copies/ml, and 48.4% (708/1462) of these patients with virologic failure had resistance to any type of HIV drug. The mortality rate was 2.8 per 100 person-years in all participating patients, 4.8 in patients with virologic failure, and 5.7 in patients with drug resistance. Multivariate Cox regression analyses showed that older age, female, transmission through plasma/blood and drug injection, lower CD4 count, virologic failure and drug resistance, and didanosine-based regimens had statistically significant associations with increased risk of mortality. Conclusions: Virologic failure and drug resistance are common among Chinese HIV-infected patients receiving antiretroviral treatment. Virologic failure and drug resistance are associated with an increased risk of mortality. Treatment adherence should be promoted to reduce the risks of both virologic failure and drug resistance, and virologic and clinical monitoring of treatment should be enhanced to guide more appropriate use of cART drugs.
Elevated platelet expression of CD36 may contribute to increased risk of thrombo-embolism in active inflammatory bowel disease

Abstract Context: Inflammatory bowel disease (IBD) induces increased risk of thrombo-embolism. CD36 is involved in platelet activation, glucose metabolism and inflammation. Objective: The relationship between CD36 expression on platelets and monocytes, plasma sCD36, and CD36-positive platelet-derived microparticles (PDMPs) and inflammation in both active IBD and after one week of anti-tumour necrosis alpha antibody (anti-TNF) treatment was investigated. Material and methods: Patients with exacerbation of Crohn’s disease (n = 8) or ulcerative colitis (n = 5) and 13 healthy controls were enrolled. Seven patients underwent anti-TNF treatment for one week. Platelet, monocyte, and PDMP-CD36 were measured by flow-cytometry. Results: Platelet CD36 expression was 34% higher in patients, and correlated with insulin resistance and fasting glucose. sCD36 was 37% lower and restored after anti-TNF treatment. Conclusion: Elevated platelet CD36 expression may contribute to increased risk of thrombo-embolism in active IBD. This may not entirely be attributed to inflammation and secondary insulin resistance may play a role.
Academic Staff Retention As A Human Resource Factor: University Perspective

The shortage of academic staff and the failure of universities to retain quality academic staff continue to be crucial to the changing prospects and potentials of knowledge formation and learning. This paper intends to examine factors that influence the poor retention rate of academic staff at selected universities in South Africa. The survey involved 80 academic staff lecturing at the selected institutions. The sample was chosen in such a way that more than 35 percent of the selected academic staff have worked at higher education institutions for more than 10 years. Prior to conducting the study, a provisional literature review was performed on recent research regarding reasons for academic staff quitting the profession or changing universities. The study attracted responses from 80 academic staff and the survey discovers job satisfaction as the main factor keeping academic staff in their profession. However, job satisfaction was also linked with career growth and academic development. The study could not rule out the probabilities of working conditions as a factor influencing retention. While these intrinsic factors play an important role, there were also extrinsic factors, as construed from the findings. Respondents considered an academic profession to be a meager paying job, with little opportunity for growth. However, it can be argued that salary is a concern, even though academic staff considers that the academic profession has a superior reputation in society. Nonetheless, many academics believe that the profession has a heavy workload, making it difficult to meet promotion requirements and poor mentoring and capacity development, which would benefit from academic support, unambiguous promotion guidelines and clear, homogenous salary packages.
El papel del Fondo de Protección contra Gastos Catastróficos en la cobertura de atención a pacientes con cataratas

Objective. To describe the effect of the Fund against Catastrophic Expenditures in Health on the provision of services for patients with cataract. Materials and methods. We used administrative dataset on hospital discharges and official figures on population to estimate the rate of care and the coverage for cataract. To estimate the variation on resources, we used data from the National System of Health Information. Results. Coverage for this disease had a significant increase between 2000 and 2010, passing from 24 per thousand cataract patients receiving attention to 58.8 per thousand. This growth is mainly due to the incorporation of cataract to the catalog of diseases covered by the Fund against Catastrophic Expenditures in Health, although this variation is not based on additional resources but in a higher productivity. The growth of services is noticeable in Aguascalientes, Coahuila, Distrito Federal and Nayarit. Conclusions. Our results suggest that policy-making based on evidence have actually brought benefits for Mexican population.
CAREGIVER WELLNESS: AN INQUIRY OF HEALTH RISKS AMONG FRONTLINE DIRECT CAREGIVERS OF THE ELDERLY AND DISABLED

This study investigated relationships among mental and physical health risks, social networks, stress, and job satisfaction, as reported by frontline direct caregivers of the elderly and disabled in the United States. Perceptions of recent turnover among frontline direct caregivers were also explored to identify why professional frontline direct caregivers leave their jobs. A predictive correlational Internet survey research design with a convenience sample of 515 frontline direct caregivers was used. Survey respondents were primarily family caregivers 233 (86%). Frontline direct caregivers reported high levels of stress, low levels of job satisfaction, and poor physical health, mental health, and social networks. Issues of access to care, cost, supports, and the identification of applicable theories to provide solutions to the aforementioned challenges among frontline direct caregivers are paramount to practitioners in the health care field. This study adds to the empirical research by providing professional insight into the phenomenon of frontline direct caregiving as well as by providing an understanding of the complexity of the role frontline direct caregivers face under the current health care infrastructure.
EurOOHnet—the European research network for out-of-hours primary health care

Abstract Background and rationale: European countries face similar challenges in the provision of health care. Demographic factors like ageing, population growth, changing patient behaviour, and lack of work force lead to increasing demands, costs, and overcrowding of out-of-hours (OOH) care (i.e. primary care services, emergency departments (EDs), and ambulance services). These developments strain services and imply safety risks. In the last few decades, countries have been re-organizing their OOH primary health care services. Aim and scope of the network: We established a European research network for out-of-hours primary health care (EurOOHnet), which aims to transfer knowledge, share experiences, and conduct research. Combining research competencies and integrating results can generate a profound information flow to European researchers and decision makers in health policy, contributing towards feasible and high-quality OOH care. It also contributes to a more comparable performance level within European regions. Conducted research projects: The European research network aims to conduct mutual research projects. At present, three projects have been accomplished, among others concerning the diagnostic scope in OOH primary care services and guideline adherence for diagnosis and treatment of cystitis in OOH primary care. The future: Future areas of research will be organizational models for OOH care; appropriate use of the OOH services; quality of telephone triage; quality of medical care; patient safety issues; use of auxiliary personnel; collaboration with EDs and ambulance care; and the role of GPs in OOH care.
Strengthening primary health care—but how?

Starting with the Alma Ata declaration in 1978, sustaining, developing and strengthening primary health care (PHC) has been on the political agenda of many countries. Based on ever increasing scientifi c evidence that strong primary care contributes to improved health system performance and on key publications that extend the declaration of Alma Ata (1), several eff orts to accomplish its goals have been undertaken. In some countries, health care systems with new models of PHC services have been introduced. In other countries, specialists are re-trained for a few months in general practice/family medicine (GP/FM) to increase workforce for the primary care level (2). Some countries have introduced specialty training and specialty status in GP/FM and many medical schools have introduced chairs for GP/FM to facilitate teaching and research in FM for undergraduate and graduate students. However, there is no evidence that the various eff orts to strengthen PHC have been successful. In Austria for example, statements about strengthening PHC can be found in the coalition agreements from all recent legislation periods. However, there is a continuous decrease in the attractiveness of working in the primary care sector and an increasing brain drain of medical graduates to other countries in Europe. A promising approach implementing measures to strengthen PHC comes from the current government, which plans to facilitate the change from traditional solo practices of GP to multidisciplinary PHC teams. It remains to be seen, whether this plan with its necessary consequences for the health care sector will reverse the ongoing trends. Based on my observations and experience from Austria and several other countries, I would like to point out what it needs to strengthen PHC.
Patient satisfaction with family practice in Turkey: Three-year trend from 2010 to 2012

Background: After the health reform in 2003, a need emerged to monitor patient satisfaction in Turkey. Objective: To evaluate patient satisfaction with family practice in Turkey and compare with some other European countries. Methods: The study was performed on a countrywide representative sample from all the 81 provinces of Turkey. Data were collected during the years 2010–2012 from patients visiting family practice centres. A three-year repeated cross-sectional study was conducted using the EUROPEP instrument. Twenty-six questions with a five-point Likert scale were applied. Primary outcome measures of the study were the mean EUROPEP scores (min. 1, max. 5). Results: Mean (± SD) EUROPEP scores for the years 2010 (n = 34 472), 2011 (n = 34 764), and 2012 (n = 32 667) were 4.09 ± 0.77, 4.29 ± 0.59, and 4.42 ± 0.54 respectively (F = 1565.37; P < 0.001). The mean satisfaction percentage was calculated as 88.3%. Areas of lowest satisfaction were ‘Being able to speak to the GP on the telephone,’ ‘Getting through to the practice on the phone,’ and ‘Physical conditions of the family practice. ’ Conclusion: Although in small increments, patient satisfaction with family practices in Turkey has increased during the last few years.
Exploring the Anomalous Positive Relationship between AIDS and Poverty in Africa

HIV/AIDS is very different from most epidemic diseases in the basis of its patterning at the local, national and international scales. Unlike most epidemic diseases, HIV/AIDS is not a disease directly associated with poverty and a lack of development; in Africa it disproportionately affects the wealthy, the educated and the mobile, and prevalence rates are much higher in richer Africa countries than in the poorest countries. The anomalous relationships between HIV/AIDS and poverty in Sub-Saharan Africa are discussed to illustrate firstly, that the disease is not directly caused by extreme poverty, nor by lack of development in the region, as are most common communicable epidemic diseases, such as malaria or measles, and secondly, that it is not a disease that can be or will be eradicated or even greatly alleviated in its severity by ‘development’, as traditionally conceived in terms of rising incomes or better health services and public health.
Prevalence of high-risk alleles in the LOXL1 gene and its association with pseudoexfoliation syndrome and exfoliation glaucoma in a Latin American population

Purpose: Pseudoexfoliation syndrome (XFS) is a major risk factor for exfoliation glaucoma (XFG). A significant association exists between XFG and several SNPs in the lysyl oxidase-like 1 (LOXL1) gene. The purpose of this study was to report the results of the first association study between LOXL1 polymorphisms and XFS and/or XFG in a Latin American population. Methods: Genotypes of three high-risk SNPs of LOXL1 (rs1048661, rs3825942, and rs2165241) were analyzed by direct sequencing. A case-control study was conducted with 102 unrelated XFS/XFG Mexican patients (42 XFS/60 XFG) as well as 97 control subjects. Allele frequencies, Hardy-Weinberg equilibrium, and haplotype association analysis were assessed with the Haplo View software. Results: The T allele of the intronic SNP rs2165241 was more frequent in XFS/XFG patients than in controls (OR [95% CI] = 2.41 [1.59–3.64]; p = 0.00001). The G allele of rs3825942 was found in a higher frequency in XFS/XFG than in controls (100% vs 95% respectively, p = 0.0019). No significant association between XFS and the rs1048661 (R141L) SNP was observed. The TGT haplotype was observed in a higher frequency in patients than in controls (p = 0.025), and produced the highest risk in our study (OR [95% CI] = 3.20 [1.09–9.39]; p = 0.025). Conclusions: This is the first study associating LOXL1 gene polymorphism and XFS/XFG in Latin America. LOXL1 variants are associated with an elevated risk for XFS/XFG in the Mexican population. A higher risk was conferred by the T allele of the intronic rs2165241 SNP rather than by the worldwide “high-risk” G allele of rs3825942.
7Ps in corporate hospitals - Administrators' perspective

The prime objective of the paper is to study 7Ps - Product, Price, Place, Promotion, People, Physical Evidence and Process - in selected corporate hospitals in India which is very pivotal in strengthening the effectiveness of a hospital. It is needless to say how important service sector is in the national economy. In India, more than 50% of the GDP is now accounted for by the service sector. Though this sector has gaining prominence in terms of its dominant role at the national level, much thought has not yet been given by academics in terms of introducing the marketing strategies towards improving the effectiveness and efficiency of the hospital. It is gratifying to note that there has been phenomenal growth in hospital services in India. There is multifold increase in the number of hospitals, doctors, nursing and paramedical staff. Recognizing the importance of this service, corporate sector is investing huge amount of money and so it has become vital to think in terms of effective utilization, with a view to provide effective service to the clientele and to give maximum returns on investment to the share holders. In this new environment, age old methods may not yield handsome returns. Application of service would pave avenues in rationalizing and standardizing the services. Marketing has become a buzz word to the service providers in present day hospitals. Hence, an attempt has been made in this article to study 7Ps in sample corporate hospitals. For this purpose, administrators’ perceptions were elicited and analyzed with the help of relevant statistical tools like Means, Standard Deviation and ANOVA to know variations in the perceptions of the respondents. At the end, certain suggestions were given to the policy makers of the hospital. It is sure that if they follow the given suggestions one can overcome the problems of these hospitals to a great extent. Key words: Hospital marketing, product mix, service brand, Physician – patient relationship, core services, auxiliary services, distribution channels, advertising, promotional aids, physical setting.
Pattern of steroid-resistant nephrotic syndrome in children and the role of histopathology: A single-centre study

Background. Steroid-resistant nephrotic syndrome (SRNS) is a common problem in paediatric nephrology practice. There is currently little information on the spectrum of histopathological lesions in children presenting with SRNS in India and other south-east Asian countries. Objective. To determine the histopathological lesions in children presenting with SRNS at our institution. Methods. The study was conducted at Sardar Vallabh Bhai Patel Postgraduate Institute of Paediatrics and Sriram Chandra Bhanja Medical College, Cuttack, Odisha, India, from January 2009 to March 2013. All children aged 1 - 14 years presenting with primary SRNS and in whom renal biopsies were performed were included in the study. Their demographic, clinical, laboratory and histopathological data were retrieved from files and original renal biopsy forms. Results. A total of 40 children had a clinical diagnosis of SRNS; 23 were males and 17 females (male:female ratio 1.35). Their mean age (± standard deviation) was 4.47 (±2.98) years (range 1 - 14 years). The histopathological lesions seen on renal biopsy specimens comprised minimal-change disease (MCD) ( n =18), focal segmental glomerulosclerosis (FSGS) ( n =12), immunoglobulin A nephropathy (IgAN) ( n =5), immunoglobulin M nephropathy ( n =2), membranous nephropathy ( n =2) and idiopathic mesangial proliferative glomerulonephritis ( n =1). Conclusion. MCD is the predominant lesion in children with SRNS at our institution, followed by FSGS and IgAN.
Three Variants of or near VEGF-A Gene are Not Associated with Neovascular Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy in a Han Chinese Population

Abstract Purpose: To investigate whether three previously identified variants for age-related macular degeneration (AMD), the single nucleotide polymorphism (SNP) variants of or near the vascular endothelial growth factor A gene (VEGFA), were associated with neovascular AMD or polypoidal choroidal vasculopathy (PCV) in a Han Chinese cohort. Methods: This was a case-control study comprising 251 PCV patients, 157 neovascular AMD patients, and 204 control participants in a Han Chinese population. The rs833069, rs943080 and rs4711751 SNP were genotyped using the Multiplex SNaPshot system. Genotypes and allele frequencies of patients and controls were evaluated for the SNPs using PLINK software. Results: None of the allelic or genotypic effects of these three variants was significantly associated with PCV, neovascular AMD or combined both patient categories. Conclusions: No association was found to support the role for the rs833069, rs943080 and rs4711751 variants of or near VEGFA gene in susceptibility to either PCV or neovascular AMD in Han Chinese population. Further replication is necessary to validate these results.
Mammography Screening Practices and Health Beliefs of Women in East Tennessee

One of every eight women in the United States will be diagnosed with breast cancer in her lifetime. Although early detection of breast cancer is the most effective method of assuring survival, many women throughout the country do not avail themselves of this advantage. This study examined mammography screening practices of women age 55 and older who attended senior citizen centers in rural, non-metro, and metro counties in the areas designated by the Tennessee Department of Health as the Eastern Grand Division of Tennessee. Data were collected from four hundred women from fourteen counties in East Tennessee using the Champion Health Belief Survey instrument. Data analysis was done using SPSS software. Descriptive analyses were presented consisting of the percentage or mean responses for each of the survey items. Chi Square and ANOVA were used to test whether the observed proportions for mammography screening differed from the hypothesized proportions. Results from this study revealed that health beliefs and demographic characteristics were associated with a higher likelihood of having recent mammography. The health beliefs of participants concerning the perceived benefits of mammograms and the perceived barriers to obtaining mammograms significantly impact one’s willingness to engage in breast cancer screening practices. Also, the woman’s perceived susceptibility to the disease of breast cancer and her perceived seriousness of the disease of breast cancer have a significant impact on breast cancer screening practices. Additionally, a significant difference was found in the screening practices of women based on whether they had health insurance and if their physician recommended a mammogram.
Evaluating the Association between Keratoconus and Reported Genetic Loci in a Han Chinese Population

ABSTRACT Background: Keratoconus (KC) is a complex degenerative disorder of the cornea. Genetic, environmental, and lifestyle factors may all contribute to the pathogenesis of KC. Most of the reported KC-associated SNPs have been detected in Caucasians and Australians. To investigate whether the reported associated SNPs can be found in a Chinese population, we performed a replication study of the significantly associated SNPs. Materials and Methods: A total of 210 unrelated Chinese KC patients and 191 unrelated controls were included in the present study. SNPs rs4954218 (Near RAB3GAP1 (5′)), rs4894535 (FNDC3B), rs2956540 (LOX), rs3735520 (Near HGF (5′)), rs1324183 (MPDZ-NF1B), rs1536482 (RXRA-COL5A1), rs7044529 (COL5A1), rs2721051 (Near FOXO1 (3′)), rs9938149 (BANP-ZNF469) and rs6050307 (VSX1) were assessed for their association with KC. The genotype of each SNP was detected using the Sequenom MassARRAY-Assay. Results: SNP rs1324183 located in MPDZ-NF1B was associated with an increased risk of KC (OR = 3.108, 95% CI = 1.366–7.072, p = 0.005), and SNP rs2956540 in the LOX gene may confer a reduced risk of KC with a borderline p value in our population (OR = 0.664, 95% CI = 0.447–0.986, p = 0.042). No significant difference was observed between patients and controls in the other eight SNP genotypes and allele frequencies. Conclusions: The replication association of rs1324183 (MPDZ-NF1B) with KC in our population and the results, which are identical to those in different populations, suggest that rs1324183 (MPDZ-NF1B) is a common genetic risk for KC and should be further investigated.