The aim of the study was to assess adherence with antiretroviral medication in a sample of HIV patients in Hong Kong and identify predictors of adherence. The study used a cross-sectional ...correlational design. Adherence behaviour was assessed with the use of self-reports. Other scales assessed knowledge with HIV medication, coping, health locus of control, anxiety, depression and fatigue. A blood sample was also obtained to assess CD4+ counts and viral load. Sociodemographic characteristics and medical information were obtained from the medical records. A high adherence rate was found in this sample of 136 predominantly Chinese patients. There were only 13.7% of the patients being classified as non-adherent. Predictors of adherence included high self-efficacy in terms of being certain that the medication schedule will be followed all or most of the time as directed, low tension-anxiety scores, and low intensity of nausea and vomiting (R2=0.304). An expanded regression model revealed additional factors influencing adherence, including coping variables, pain and numbness in the hands and feet, age, disease stage, internal locus of control, fatigue, family support and taking medication twice daily. This model explained 49% of the variance in adherence. The results suggest that adherence is a multidimensional concept. Every effort should be made to assess in individuals those variables found to affect adherence and alter them whenever possible. Continuous support of patients and individualized medication programmes that will help patients adjust their treatment to their lifestyle are recommended.
A random population based study was carried out to understand HIV-related attitudes and behaviors and self-reported sexually transmitted diseases (STDs) among men who have had sex with men (MSM) in ...Hong Kong. A special computerized telephone survey method was used and 85 MSM were identified (from a total sample of 2,074 men), 47.1% of whom had at least one male sex partner in the past 6 months. Among these 85 MSM, 29.4% had multiple partners and 37.5% had had anal sex in the last 6 months (67% of them were inconsistent condom users). MSM were more likely to have contracted at least one STD in the last 6 months (10.6%) and were less likely to perceive susceptibility for contracting HIV (62.4%) than those other respondents who visited a female sex worker (FSW) in the past 6 months (4.3% and 43%, respectively). About 45% of the MSM did not perceive condom use to be efficacious for HIV prevention (vs. 30% for male clients of FSW). The study is limited by its small number; however, it suggests that MSM in Hong Kong may be at high risk of contracting HIV. Prevention programs should attempt to change attitudes (e.g., perceived efficacy of condom use, perceived susceptibility, awareness of risk involved, etc.) as well as behaviors. The feasibility for establishing a behavioral surveillance system for this population was demonstrated.
Background: Male clients of female sex workers (FSWs) are an important group vulnerable to HIV infection. Goals: The goal was to administer and assess behavioral surveillance surveys of male clients ...of FSWs in Hong Kong. Study Design: Three population-based telephone surveys of males aged 18 to 60 were conducted from 1998 to 2001 (n = 5159). Results: Of all respondents, about 10.8% to 14% had patronized FSWs in the previous 6 months. Among male clients of FSWs, about 25% did not always use condoms, 4% to 6% had contracted a sexually transmitted disease, 16% had undergone HIV antibody testing, and 20% or more reported having four or more sex partners in the previous 6 months. There was no improvement in condom use over time. Cross-border (from Hong Kong to mainland China) commercial sex was common. Conclusion: The level of risk behaviors associated with male clients of FSWs remained substantial. The overall effectiveness and coverage of relevant prevention programs were questioned.
Analyzing high resolution whole slide images (WSIs) with regard to information across multiple scales poses a significant challenge in digital pathology. Multi-instance learning (MIL) is a common ...solution for working with high resolution images by classifying bags of objects (i.e. sets of smaller image patches). However, such processing is typically performed at a single scale (e.g., 20x magnification) of WSIs, disregarding the vital inter-scale information that is key to diagnoses by human pathologists. In this study, we propose a novel cross-scale MIL algorithm to explicitly aggregate inter-scale relationships into a single MIL network for pathological image diagnosis. The contribution of this paper is three-fold: (1) A novel cross-scale MIL (CS-MIL) algorithm that integrates the multi-scale information and the inter-scale relationships is proposed; (2) A toy dataset with scale-specific morphological features is created and released to examine and visualize differential cross-scale attention; (3) Superior performance on both in-house and public datasets is demonstrated by our simple cross-scale MIL strategy. The official implementation is publicly available at https://github.com/hrlblab/CS-MIL.
The study investigated the general population's perceived infectivity of asymptomatic & recovered severe acute respiratory syndrome (SARS) patients & factors associated with avoidance & ...discriminatory attitudes, including demographic background, SARS-related perceptions & emotional response to the SARS epidemic. A population-based survey was conducted in Hong Kong during 3 December 2003 through 4 January 2004; 475 Hong Kong Chinese adults participated in the survey. Perceptions of the infectivity & health conditions of recovered SARS patients & avoidance & discrimination towards them were measured. Of the respondents, 75.7% & 16.2%, respectively, believed that SARS could be transmitted via asymptomatic SARS patients & those patients who have recovered from SARS for 18 months; 72.7% of the respondents believed that the health of SARS patients would severely & permanently be damaged; 16.6% showed some tendency of avoiding recovered SARS patients & 35.7% expressed some sort of job-related discriminatory attitudes. Perceived infectivity of asymptomatic & recovered SARS patients, health sequelae & emotional distress from SARS were independently associated with avoidance & discriminatory attitudes. The study showed that misconceptions about the infectivity of asymptomatic & recovered SARS patients were common. Recovered SARS patients may also be facing avoidance & discrimination. Tables, References. Adapted from the source document.
Many anomaly detection approaches, especially deep learning methods, have been recently developed to identify abnormal image morphology by only employing normal images during training. Unfortunately, ...many prior anomaly detection methods were optimized for a specific "known" abnormality (e.g., brain tumor, bone fraction, cell types). Moreover, even though only the normal images were used in the training process, the abnormal images were often employed during the validation process (e.g., epoch selection, hyper-parameter tuning), which might leak the supposed ``unknown" abnormality unintentionally. In this study, we investigated these two essential aspects regarding universal anomaly detection in medical images by (1) comparing various anomaly detection methods across four medical datasets, (2) investigating the inevitable but often neglected issues on how to unbiasedly select the optimal anomaly detection model during the validation phase using only normal images, and (3) proposing a simple decision-level ensemble method to leverage the advantage of different kinds of anomaly detection without knowing the abnormality. The results of our experiments indicate that none of the evaluated methods consistently achieved the best performance across all datasets. Our proposed method enhanced the robustness of performance in general (average AUC 0.956).
