bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV type-1 clade C resistance genotypes in treatment-naive patients and after first virological failure in a large community antiretroviral therapy programme
Authors: Orrell Catherine , Walensky Rochelle P , Losina Elena , Pitt Jennifer , Freedberg Kenneth A , Wood Robin
Published: April 2022

Background

This study aimed to evaluate HIV type-1 (HIV-1) drug resistance pretreatment and in those failing first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART) in South Africa.

Methods

This was an observational cohort. Genotypic resistance testing was performed on treatment-naive individuals and those failing first-line ART (confirmed HIV-1 RNA>1,000 copies/ml) from public sector clinics in Cape Town (2002–2007). Resistance profiles and mutations relative to timing of known virological failure were examined.

Results

In total, 230 patients (120 treatment-naive and 110 with virological failure) were included: 98% had clade C virus. Among treatment-naive patients, prevalence of primary resistance was 2.5% (95% confidence interval 0.0–5.3). Three patients had one significant reverse transcriptase mutation: K65R, Y181C and G190A. Among treatment-experienced patients, 95 (86%) individuals had therapy-limiting NNRTI mutations, including K103N (55%), V106M (31%) and Y181C (9%). The M184V mutation was the most common mutation, found in 86 (78%) patients. In total, 10 (9%) patients had the K65R mutation. More individuals tended to develop thymidine analogue mutations when sampling occurred after 6 months of detected therapy failure (10/31 [32%] individuals) compared with those who had genotyping before 6 months (15/79 [19%] patients; P=0.246).

Conclusions

Prevalence of primary resistance in a sample of ART-naive clade C HIV-1-infected individuals in South Africa was low during the study period. Patients failing first-line ART most often developed resistance to NNRTIs and nucleoside reverse transcriptase inhibitors, the two drug classes used in first-line therapy. Viral load monitoring in this setting is crucial and individual genotypes in those failing first-line therapy should be considered.
Effect of rifampicin-based antitubercular therapy and the cytochrome P450 2B6 516G>T polymorphism on efavirenz concentrations in adults in South Africa
Authors: Cohen Karen , Grant Alison , Dandara Collet , McIlleron Helen , Pemba Lindiwe , Fielding Katherine , Charalombous Salome , Churchyard Gavin , Smith Peter , Maartens Gary
Published: April 2022

Background

Rifampicin induces expression of the cytochrome P450 isoenzyme 2B6 (CYP2B6), which metabolizes efavirenz. The CYP2B6 516G>T polymorphism impairs efavirenz metabolism and occurs more commonly in Africans than in Caucasians. We explored the effect of rifampicin-based antitubercular therapy and the 516G>T polymorphism on efavirenz concentrations in HIV- infected patients in South Africa.

Methods

Between-patient and within-patient comparisons were made of mid-dosing interval efavirenz plasma concentrations in adults on antiretroviral therapy including efavirenz 600 mg daily, with and without antitubercular therapy.

Results

There were 142 participants (40 were on antitubercular therapy and 102 were controls), the mean weight was 66 kg. Median efavirenz concentration was 2.4 mg/l (interquartile range [IQR] 1.3–3.1) and 1.8 mg/l (IQR 1.4–4.4) in participants on antitubercular therapy and controls, respectively ( P=0.734). Paired efavirenz concentrations during and after antitubercular therapy in 17 participants were also similar ( P=0.113). Genotyping results were 60 (49%) G/G homozygotes, 46 (38%) G/T heterozygotes and 16 (13%) T/T homozygotes. In a multivariate logistic regression model adjusted for sex, weight and concomitant antitubercular therapy, the 516G>T polymorphism was strongly associated with high (>4 mg/l) efavirenz concentrations: odds ratio (OR) 4.4 (95% confidence interval [CI] 1.3–14.9) for G/T versus G/G and 31.1 (95% CI 6.6–146.6) for T/T versus G/G. High efavirenz concentrations were associated with severe sleep disturbance ( P=0.048). Low (<1 mg/l) efavirenz concentrations were associated with virological failure (OR 12.5, 95% CI 2.7–57.3).

Conclusions

Efavirenz can be used together with rifampicin-based antitubercular therapy without dose adjustment in this population. The 516G>T polymorphism occurred commonly and was associated with high efavirenz concentrations.
Short-term randomized proof-of-principle trial of TMC278 in patients with HIV type-1 who have previously failed antiretroviral therapy
Authors: Arastéh Keikawus , Rieger Armin , Yeni Patrick , Pozniak Anton , Boogaerts Griet , van Heeswijk Rolf , de Béthune Marie-Pierre , Peeters Monika , Woodfall Brian
Published: April 2022

Background

In vitro, TMC278, an investigational next-generation non-nucleoside reverse transcriptase inhibitor (NNRTI), has shown activity against wild-type and NNRTI-resistant HIV type-1 (HIV-1) and a higher genetic barrier to the development of resistance than efavirenz or nevirapine. This Phase II open-label trial evaluated the short-term (7-day) antiviral activity of TMC278 administered at three different doses replacing either the protease inhibitor (PI) or NNRTI of an ongoing failing treatment regimen in HIV-1-infected patients.

Methods

A total of 36 patients on failing antiretroviral therapy containing either an NNRTI or a PI (with evidence of ≥1 NNRTI resistance-associated mutation at screening for the PI group) and plasma viral load (VL)>1,000 copies/ml were randomized to one of three once-daily TMC278 doses (25 mg, 50 mg or 150 mg) for 7 days, while continuing NRTIs used at screening. The primary efficacy parameter was the change on day 8 in log10 plasma VL from baseline.

Results

On day 8, median (min, max) changes from baseline in plasma VL were -0.87 (-2.3, 0.0), -0.95 (-1.8, 0.4) and -0.66 (-1.3, -0.2) log10 copies/ml for the 25 mg, 50 mg and 150 mg once-daily TMC278 groups, respectively ( P<0.001–<0.01). Overall, the median change from baseline was -1.19 log10 copies/ml in the PI-substituted therapy group and -0.71 log10 copies/ml in the NNRTI-substituted therapy group. TMC278 was generally safe and well tolerated with no apparent differences in safety among the three dose groups.

Conclusions

Once-daily TMC278 showed significant antiviral activity against HIV-1 in treatment-experienced patients with NNRTI failure and/or resistance, and was generally safe and well tolerated.
Prevention of cytomegalovirus disease using preemptive treatment after solid organ transplant in patients at high risk for cytomegalovirus infection
Authors: BenMarzouk-Hidalgo Omar Jesus , Cordero Elisa , Martín-Peña Almudena , García-Prado Elena , Gentil Miguel Angel , Gomez-Bravo Miguel Angel , Barrera-Pulido Lydia , Cisneros Jose Miguel , Perez-Romero Pilar
Published: April 2022

Background

The use of pre-emptive or prophylactic treatment to control cytomegalovirus (CMV) replication after solid organ transplant (SOT) remains controversial. The aim of this study was to evaluate whether administration of pre-emptive treatment to control viral replication guided by a highly sensitive diagnostic tool is an effective approach for preventing CMV disease, even in high-risk transplant recipients.

Methods

Plasma samples from eight SOT patients were tested using antigenaemia and real-time PCR (RT-PCR) assays. Pre-emptive treatment was administered guided by RT-PCR when viral load values were >1,000 copies/ml.

Results

All patients developed episodes of CMV infection, but none of them developed CMV disease or indirect effects. No patient in this study died or experienced graft rejection. Treatment was needed in 10 replication episodes. At the end of treatment, four had undetectable levels and the other six were cleared 3 weeks later. In 42.6% of tested samples RT-PCR was more sensitive for detecting viral infection.

Conclusions

Pre-emptive monitoring of SOT patients at high risk for CMV infection protected patients from developing CMV disease during the first 6 months after transplant. The use of this sensitive method for guiding pre-emptive treatment diminished viral load early enough that it did not have consequences for patient health.
Improved Survival and Reduced Clinical Progression in HIV-Infected Patients with Advanced Disease Treated with Saquinavir plus Zalcitabine
Authors: Haubrich Richard , Lalezari Jacob , Follansbee Stephen E , Gill M John , Hirsch Martin , Richman Douglas , Mildvan Donna , Burger Hans Ulrich , Beattie Doreen , Donatacci Lucille , Salgo Miklos P ,   The NV14256 Study Team, Berry Paul , Frechette Gervais , LeFebvre; Eric , Torres Ramon , Rachlis Anita , Loveless Mark , Tai Edmund , Jensen Peter , Brand David , Hauptman Stephen , Pollard Richard , Collier Ann , Hardy W David , Johiro Anna K , Mitsuyasu Ronald T , Martin Maureen , Klimas Nancy , Gordin Fred , Gilbert Cynthia , Hyslop Newton , RamirezRonda Carlos , Beall Gildon , Miller Susan , Thompson Melanie , Smaill Fiona , Henry David , Volberding Paul , Cohen Stuart , Dobkin Jay , Pottage John , Powderly William , Spotkov Jared , Koletar Susan , Skolnik Paul , Marlowe Steven , Hammer Scott , Baxter John , Kaufman David , Cooper Richard , Fischl Margaret , Jayaweera DT , Scerpeila Ernesto , Sargent Susie , Turner Paul , Tsoukas Christos , MacArthur Rodger , Remick Scott , Cunniff Dennis , Henry Keith , Clark Rebecca , Snyder Ron , Boswell Stephen , Sax Paul
Published: April 2022

The objective of this randomized, double-blind, controlled multicentre study was to evaluate the efficacy of saquinavir alone or in combination with zalcitabine compared to zalcitabine monotherapy in reducing progression of human immunodeficiency virus (HIV) disease. Nine hundred and forty HIV-infected patients with more than 16 weeks of prior zidovudine therapy and pre-study entry CD4 cell counts between 50 and 300 cells/mm3 were randomized to saquinavir 600 mg every 8 h, zalcitabine 0.75 mg every 8 h or the combination of both drugs. In an intent-to-treat analysis, the treatment arms were balanced with respect to demographics, baseline HIV RNA (mean 5.0 log10 copies/ml) and CD4 lymphocyte count (mean 170 cells/mm3). More patients in the zalcitabine arm stopped therapy because of toxicity than in the other two arms (25% versus 16%; P=0.005). Peripheral neuropathy was the most common treatment-limiting toxicity. Fifty-one patients in the saquinavir plus zalcitabine group developed an AIDS-defining event or died compared to 84 and 88 in the saquinavir and zalcitabine monotherapy groups respectively. Combination treatment with saquinavir plus zalcitabine reduced the risk of progression to AIDS by 49% (95% confidence interval 0.36 to 0.72, P=0.0001) and reduced death by 68% (95% confidence interval 0.16 to 0.64, P=0.001) compared to zalcitabine monotherapy. The addition of saquinavir to zalcitabine resulted in a significant reduction in progression to AIDS or death compared with zalcitabine alone.
The Ultrasensitive NASBA Assay for Quantifying HIV-1 Viral Load
Authors: Mas Antonio , Soriano Vicenç , Gómez-Cano María , Rodríguez-Rosado Rafael , Pérez-Olmeda Mayte , González-Lahoz Juan
Published: April 2022

The maintenance of undetectable levels of human immunodeficiency virus (HIV) viraemia seems to assure sustained benefit of antiretroviral therapy, since ongoing virus replication under drug pressure offers the opportunity for resistant variants to emerge and replicate. The early recognition of even low levels of virus replication should be helpful, allowing clinicians to consider switching therapy before accumulation of drug-resistant mutations has occurred. In this context, ultrasensitive assays could be very helpful. The new nucleic acid sequence-based assay (NASBA) (Nuclisens, Organon-Teknika), which has a limit of detection of 20 HIV RNA copies/ml, was tested in clinical specimens from 42 HIV-infected patients receiving different antiretroviral treatments and having undetectable levels of plasma viraemia (<500 copies/ml) using another less sensitive quantification method. Overall, 21 (50%) samples were positive and yielded quantitative values using Nuclisens. Since complete suppression of virus replication may be necessary to avoid the development of drug-resistant mutants, the introduction of ultrasensitive methods for monitoring response to treatment should be recommended when eradicative strategies are pursued.
Zidovudine Resensitization and Dual HIV-1 Resistance to Zidovudine and Lamivudine in the Delta Lamivudine Roll-Over Study
Authors: Masquelier B , Descamps D , Carrière I , Ferchal F , Collin G , Denayrolles M , Ruffault A , Chanzy B , Izopet J , Buffet-Janvresse C , Schmitt MP , Race E , Fleury HJA , Aboulker JP , Yeni P , Brun-Vézinet F
Published: April 2022

Objective

To study zidovudine resensitization and dual resistance to zidovudine/lamivudine in HIV-1 isolates from nucleoside reverse transcriptase (RT) inhibitor-experienced patients during selective pressure exerted by zidovudine/lamivudine combination therapy.

Design and methods

HIV-1 isolates from 29 patients receiving zidovudine/lamivudine combination therapy in the Delta roll-over study were analysed at entry and during a 1 year follow-up period for phenotypic susceptibility to zidovudine and lamivudine in the ANRS PBMC assay. The RT gene from codon 20 to 230 and at codon 333 was analysed by nucleotide sequencing of the corresponding isolates.

Results

HIV-1 isolates from 23 of the 29 patients were phenotypically resistant to zidovudine at baseline; 61% of these patients showed significant zidovudine resensitization during follow-up. The zidovudine IC50 value correlated positively with log10 plasma HIV-1 RNA ( P=0.02) and negatively with the CD4 cell count ( P=0.004). Zidovudine resensitization (related to acquisition of the M184V mutation) was transient, with evolution towards dual resistance to zidovudine and lamivudine in 20 of the 29 patients. The phenotype of certain dually resistant isolates coincided with the emergence of multiple mutations in the 5’ part of the RT gene.

Conclusions

M184V-mediated zidovudine resensitization of HIV-1 is transient in most patients who are given zidovudine/lamivudine combination therapy when zidovudine resistance has already emerged. The subsequent evolution towards dual phenotypic resistance to zidovudine/lamivudine corresponds to complex genotypic profiles.
Effect of Weekly Adefovir (PMEA) Infusions on HIV-1 Virus Load: Results of a Phase I/II Study
Authors: Kamp Walter , Schokker Johan , Cambridge Eric , De Jong Sem , Schuurman Rob , De Groot Tom , Boucher Charles AB
Published: April 2022

The compound 9-(2-phosphonylmethoxyethyl)adenine (adefovir; PMEA) is a potent inhibitor of a number of viruses in vitro, such as human immunodeficiency virus (HIV) type 1 and 2, herpes simplex virus (HSV) type 1 and 2, human papillomavirus virus (HBV) and Epstein–Barr virus (EBV). Adefovir also proved to be effective in vivo against feline immunodeficiency virus (FIV) in cats and simian immunodeficiency virus (SIV) in rhesus monkeys. In an open, non-placebo-controlled trial the antiviral activity of weekly doses of adefovir in nine patients with AIDS or AIDS-related complex was studied for a period of 11 weeks. CD4 cell counts at baseline were between 10 and 450 cells/mm3, HIV-1 RNA levels at baseline were between 24210 copies/ml and 406197 copies/ml. The drug was administered intravenously at a dose of 1000 mg every week and plasma viral load was assessed at multiple points during the study. Administration of adefovir was tolerated well and no severe side effects were seen. The response to adefovir treatment differed widely between patients. The increase in CD4 cell count at end point ranged from -40 to 120 cell/mm3. The lowest HIV RNA levels were measured after 3–5 days, showing an increase thereafter. The nadir in viral load was achieved after 2 weeks, with a mean viral load decline of 0.7 from baseline. The decrease of the HIV RNA level at end point ranged from -0.3 log10 to 1.8 log10, with a mean decrease of 0.4 log10. Our results indicate that adefovir given intravenously once weekly has a short-lasting initial antiviral effect. The effect of more frequent dosing requires further evaluation. If adefovir is to be useful clinically, it needs to be combined with other antiviral agents.
Being on the same page about social rules and norms: Effects of shared relational models on cooperation in work teams
Authors: Arendt Johannes F. W. , Kugler Katharina G. , Brodbeck Felix C.
Published: April 2022

In working teams, each member has an individual understanding of the social rules and norms that underlie social relationships in the team, as well as about what behavior is appropriate and what behavior can be expected from others. What happens if the members of a team are not “on the same page” with respect to these social rules and norms? Drawing on relational models theory, which posits four elemental relational models that people use to coordinate their social interactions, we examined the effects of a common understanding of relational models in teams (i.e., “shared relational models”) on various aspects of cooperative and uncooperative behaviors. We hypothesized that a shared understanding of relational models in a team is positively related to justice perception and negatively related to relationship conflict, which are in turn related to helping behavior and knowledge hiding. We conducted a field study, collecting data from 46 work teams ( N = 189 total participants) in various organizations, and found support for all proposed hypotheses. Our findings emphasize the importance of a shared understanding of relational models for (un)cooperative behavior in teams, thereby opening a new door for research on relational models in organizations.
Melting aspects in flow of second grade nanomaterial with homogeneous–heterogeneous reactions and irreversibility phenomenon: A residual error analysis
Authors: Alzahrani Faris , Khan Muhammad Ijaz
Published: April 2022

Here, we scrutinize the entropy analysis in magnetohydrodynamic flow of second-grade nanomaterials with melting effect subject to stretchable bended surface. Heat attribution is modeled through first law of thermodynamics with radiation effect. Major physical effect of random and thermophoretic motion is also addressed. Feature of irreversibility (entropy rate) analysis is also discussed. Isothermal cubic autocatalyses chemical reaction at catalytic surface is discussed. Nonlinear dimensionless differential system is developed through adequate transformation. Optimal homeotypic analysis method (OHAM) is employed to construct convergent solution. Influence of physical variables on entropy rate, fluid flow, concentration, and thermal field is discussed. An augmentation in fluid flow is noticed through curvature variable, while reverse effect holds for magnetic variable. A reverse effect holds for fluid flow and thermal field through melting variable. Entropy analysis is augmented with variation in melting variable. Reduction occurs in concentration through thermophoretic variable, while an opposite effect holds for thermal field. An increment in melting variable leads to reduced concentration. Larger estimation of radiation variable improves entropy analysis.
Building Blocks Towards a Proportionate Chemicals Policy With a Focus on the Netherlands
Authors: Helsloot Ira , Hanekamp Jaap C.
Published: April 2022

In this contribution, we propose that ‘sound’ government policy should be characterised by a proportionate, integral vision with due consideration to tradeoffs between social costs and benefits. This principle also applies to government policy regarding the protection of workers from exposure to chemicals. It should be taken into account that having a job is a huge health benefit. Less educated people are statistically likely to enjoy ten additional healthy years, if employed. Although there is no debate about the risks of exposure to high doses of chemicals, there is most certainly debate on the magnitude, nature and possible cumulative effects of low-dose exposure to chemicals. These are established by model-based assumptions. The current advisory structure in which the Health Council of the Netherlands restricts its focus to the immediate health benefits for workers on the basis of risk avoidance models, and the Social and Economic Council of the Netherlands which focuses primarily on policy costs for trade and industry, is hardly a sound basis for well-considered decision making. The challenge for the scientific experts is to provide political administrators with an insightful social cost-benefit analysis, including all the concomitant uncertainties.
Guerrilla gardening as normalised law-breaking: Challenges to land ownership and aesthetic order
Authors: Millie Andrew
Published: April 2022

This article considers guerrilla gardening that involves taking on other people’s land for gardening, usually without their permission. It is a practice that is overlooked largely by criminology, yet it can tell us something about attitudes to law and land ownership and challenges the approved aesthetic order of where we live. It can soften the look and feel of the city, leading to a different emotional and affective interaction with urbanity. Evidence is presented from a qualitative study of guerrilla gardeners from the North West of England. The discussion is informed theoretically by work on aesthetic criminology, do-it-yourself and temporary urbanism and the idea of urban commons. In this study, guerrilla gardening is found to be a normalised form of law-breaking that, despite not necessarily being to everyone’s taste and the gardeners having an autocratic view of property, is a form of urban intervention that is broadly accepted and welcomed, even by those who enforce the law.
“The darkest time in our history”: An analysis of news media constructions of liquor theft in Canada’s settler colonial context
Authors: Kohm Steven , Maier Katharina
Published: April 2022

In September 2018, there was a surge of news stories about liquor store theft in Winnipeg, Canada that resulted in public and political calls for action, and ultimately led to the introduction of a range of new security and surveillance measures at government owned liquor stores. This brief news cycle provided opportunities for various social actors, politicians, and authorities to make claims about the nature of crime and society more broadly. This article analyzes recent news media coverage of liquor store theft in Winnipeg, Canada and the social construction of an ostensibly new crime trend in the city: “brazen” liquor store thefts. We employ a qualitative content analysis of news articles about liquor store theft published in local Winnipeg news media between 2018 and 2020 (n = 147). Drawing on the social constructionist paradigm, and Fishman’s conceptualization of “crime waves,” we argue that the framing of liquor theft via news media reflects longstanding cultural tropes and myths about crime, as well as hinting at but never fully confronting, deeply engrained colonial and racialized stereotypes. This paper contributes to our understanding of the ways putative social problems are made intelligible in the media. We demonstrate how “crime waves” are shaped by and shape dominant tropes about crime, safety, and citizenship. We argue that something as mundane as liquor theft reveals much about the historical, colonial and social roots of crime in local and national contexts.
Risk Factors of Frailty in Patients with Distal Radius Fractures
Authors: Kang Jeong-Hyun , Hong Seok Woo
Published: April 2022

Aim

The aim of this study was to determine risk factors for the incidence of frailty in patients with distal radius fractures (DRFs).

Methods

In total, 116 patients (mean age, 66.3 ± 7.7 years) with DRFs were recruited. The participants were categorized into two groups, “frail” and “non-frail,” according to the presence or absence of frailty, respectively. The areal bone mineral densities (aBMDs) of the total hip, femoral neck, and lumbar spine were measured using dual-energy x-ray absorptiometry. The participants’ levels of resilience, depression, anxiety, nutritional intake, oral health-related quality of life, and social support were evaluated by self-reported questionnaires. The participants’ grip strength, gait speed, number of teeth present in their oral cavities, circumference of their upper arms and calves, and serum levels of vitamin D were also assessed.

Results

The participants in the “frail” group seemed to have lower aBMDs and muscle function and mass than those in the “non-frail” group. There were significant differences in grip strength, calf circumference, gait speed, and aBMD of the total hip, femoral neck, and lumbar spine between the groups. There were also significant differences in the levels of resilience and depression between the groups. A multivariate logistic regression analyses demonstrated that levels of sarcopenia, malnutritional status, and aBMDs of the total hip and femoral neck had significant relationships with the development of frailty in patients with DRFs.

Conclusions

An interdisciplinary approach involving the management of osteoporosis, sarcopenia, oral health, social relationships, and psychological support would be required for the proper management of DRF patients in preventing frailty.
Choose to be Optimistic, it Feels Better! The Role of Career Decision-making Self-efficacy on the Relationship between Boundaryless Career Orientation and Career Optimism
Authors: Ahmad Bilal , Nasir Nadia
Published: April 2022

Drawing on the conservation of resources (CoR) theory, this study examined whether career decision-making self-efficacy (CDSE) intervenes in the association of employees’ boundaryless career orientation and career optimism. The study further sets out to assess the interactional contribution of employees’ consideration of distant future consequences—future (CFC-F) on the fore connection of employees’ CDSE and optimism. In this vein, data were collected from 211 electronic media employees through cluster sampling via an electronically administered questionnaire. SPSS 21 and SmartPLS 3.0 were used for preliminary data analyses and hypothesis testing, respectively. The results showed that CDSE significantly and positively intervened in the relationship between boundaryless career orientation and career optimism. Furthermore, the interactional effect of CFC-F was also found significant in a way that employees demonstrated a higher degree of career optimism at the higher levels of CFC-F. Hence, the premise of CoR theory that constructive resources (e.g., boundaryless career orientation) help individuals to gain other key resources (e.g., CDSE, optimism) was substantiated. Theoretical and practical implications of the study were also discussed.
Comparative study on molecular epidemiology of measles H1 outbreak and sporadic cases in Shandong Province, 2013–2019
Authors: Wang Suting , Wang Changyin , Liu Xiaodong , Liu Yao , Xiong Ping , Tao Zexin , Chen Meng , Xu Qing , Zhang Li , Xu Aiqiang
Published: April 2022

Background

Measles caused by measles virus (MeV) is a highly contagious viral disease which has also been associated with complications including pneumonia, myocarditis, encephalitis, and subacute sclerosing panencephalitis. The current study isolated 33 strains belonging to 2 groups, outbreak and sporadic strains, in 13 cities of Shandong province, China from 2013 to 2019. Comparison of genetic characterization among 15 outbreak strains and 18 sporadic strains was performed by analyzing nucleotide sequences of the C-terminal region of N protein gene (N-450).

Results

All 33 stains belonged to genotype H1. The outbreak strains and sporadic strains distributed crossly in phylogenetic tree. Sequences alignment revealed some interesting G to A transversion which changed the amino acids on genomic sites 1317, 1422, and 1543. The nucleotide and amino acid similarities among outbreak isolates were 98–100% (0–10 nucleotide variations) and 97.7–100%, respectively; They were 97.3–100% and 96.6–100%, respectively for sporadic isolates. Evolutionary genetics analysis revealed that the mean evolution rates of outbreak and sporadic isolates were 1.26 N 10− 3and 1.48 N 10− 3substitutions per site per year separately, which were similar with corresponding data before 2012. Local transmission analysis suggested that there were three transmission chains in this study, two of them originated from Japan. Outbreak cases and sporadic cases emerged alternatively and were reciprocal causation on the transmission chains.

Conclusions

Our study investigated the phylogeny and evolutional genetics of MeV during a 7-year surveillance, and compared epidemic and genetic characteristics of outbreak strains and sporadic strains. These results underscore the importance of evolutionary study alongside with sporadic cases in discovering and tracing possible outbreaks, especially in the stage of measles elimination.
The microbiomes of the eyelid and buccal area of patients with uveitic glaucoma
Authors: Shin Jong Hoon , Lee Ji-Woong , Lim Su-Ho , Yoon Byung Woo , Lee Young , Seo Je Hyun
Published: April 2022

Background

The microbiome could trigger inflammation leading to epigenetic changes and is involved in the pathophysiology of eye diseases; however, its effect on uveitic glaucoma (UG) has not been fully investigated. This study analysed the differences in eyelid and buccal microbiomes in patients with UG using next-generation sequencing.

Methods

The eyelid and buccal specimens of 34 UG and 25 control patients were collected. The taxonomic composition of the microbiome was obtained via 16S ribosomal DNA sequencing. Diversity and differential gene expression analyses (DEG) determined taxon differences between the microbiomes of UG and control groups.

Results

In both the eyelid and buccal microbiomes, alpha-diversity was lower in UG patients than controls, while beta-diversity in patients with UG was higher than in controls. DEG analysis of the eyelid microbiome revealed various taxa differences, including enrichment ofPaenibacillusandDermacoccus(p-value, 1.31e−6and 1.55e−7, respectively) and depletion ofMorganellaandLactococcus(p-value, 6.26e−12and 2.55e−6, respectively) in patients with UG. In the buccal microbiome, taxa such asLactococcuswas significantly depleted (p-value, 1.31e−17), whereasFaecalibacteriumwas enriched in patients with UG (p-value, 6.12e−8).

Conclusions

The eyelid and buccal microbiomes in patients with UG differ from controls, which raises concerns surrounding environmental influences on the pathogenesis of UG. The reducedLactococcusin the eyelid and buccal area suggest that microbiota dysbiosis is associated with UG.
Changes in professional commitment of undergraduate nurse students before and after internship: a longitudinal study
Authors: Zhao Ling , Su Yinhua , Jiang Na , Zhou Fanhua , Liao Li , Liu Yannan
Published: April 2022

Background

Experiencing internship shapes nursing students’ professional commitment and aggravates its changes. However, few studies have been investigated how this changes empirically.

Objectives

The aims of this study are to investigate (a) what are the changes of professional commitment of nursing students before and after the internship? (b) Which of multiple independent variables is the strongest predictor?

Methods

A longitudinal study was conducted with 996 senior undergraduate nursing students (ready to enter clinical practice) in the China universities. The survey was conducted in the spring of 2015 and autumn of 2016. The data were collected by a paper-and-pencil questionnaire. The instruments used included Professional Commitment Scale and Perceived Stress Scale. Analysis of paired t-test and linear regression analysis were performed on the data.

Results

Nursing students showed lower professional commitment (2.79 ± 0.36) than they were (2.92 ± 0.36) before internship. Socio-demographic variables, pre-internship professional commitment and stress perceived during internship predicted 40.1% of the variance in the post-internship commitment.

Discussion

These data summarize the nursing students’ professional commitment changes and the main influential factors that contribute to post-internship professional commitment of undergraduate nursing student. The findings are timely, which indicate that senior nursing students’ professional commitment can be increased by enhancing pre-internship commitment and reducing students’ stress levels during internship.
What is needed to sustain improvements in hospital practices post-COVID-19? a qualitative study of interprofessional dissonance in hospital infection prevention and control
Authors: Gilbert Gwendolyn L. , Kerridge Ian
Published: April 2022

Background

Hospital infection prevention and control (IPC) depends on consistent practice to achieve its purpose. Standard precautions are embedded in modern healthcare policies, but not uniformly observed by all clinicians. Well-documented differences in attitudes to IPC, between doctors and nurses, contribute to suboptimal IPC practices and persistence of preventable healthcare-associated infections. The COVID-19 pandemic has seriously affected healthcare professionals’ work-practices, lives and health and increased awareness and observance of IPC. Successful transition of health services to a ‘post-COVID-19’ future, will depend on sustainable integration of lessons learnt into routine practice.

Methods

The aim of this pre-COVID-19 qualitative study was to investigate factors influencing doctors’ IPC attitudes and practices, whether they differ from those of nurses and, if so, how this affects interprofessional relationships. We hypothesised that better understanding would guide new strategies to achieve more effective IPC. We interviewed 26 senior clinicians (16 doctors and 10 nurses) from a range of specialties, at a large Australian tertiary hospital. Interview transcripts were reviewed iteratively, and themes identified inductively, using reflexive thematic analysis.

Results

Participants from both professions painted clichéd portraits of ‘typical’ doctors and nurses and recounted unflattering anecdotes of their IPC behaviours. Doctors were described as self-directed and often unaware or disdainful of IPC rules; while nurses were portrayed as slavishly following rules, ostensibly to protect patients, irrespective of risk or evidence. Many participants believed that doctors object to being reminded of IPC requirements by nurses, despite many senior doctors having limited knowledge of correct IPC practice. Overall, participants’ comments suggested that the ‘doctor-nurse game’—described in the 1960s, to exemplify the complex power disparity between professions—is still in play, despite changes in both professions, in the interim.

Conclusions

The results suggest that interprofessional differences and inconsistencies constrain IPC practice improvement. IPC inconsistencies and failures can be catastrophic, but the common threat of COVID-19 has promoted focus and unity. Appropriate implementation of IPC policies should be context-specific and respect the needs and expertise of all stakeholders. We propose an ethical framework to guide interprofessional collaboration in establishing a path towards sustained improvements in IPC and bio-preparedness.
Health complaints in individual visiting primary health care: population-based national electronic health records of Iran
Authors: Khatami Farnaz , Shariati Mohammad , Abbasi Zahra , Muka Taulant , Khedmat Leila , Saleh Narges
Published: April 2022

Background

The mission of medical schools is a sustainable commitment to orient education, research, and services based on the priorities and expectations of society. The most common complaints of patients from comprehensive health service centers (CHSCs) based on the data from electronic health records were assessed in order to determine primary health care (PHC) priorities for the educational planning of medical students in Iran.

Methods

A population-based national study was designed to assess clinical complaints of patients in all age groups who were referred to CHSCs at least once to be visited by physicians. All the data in the census were extracted from electronic health records in PHC system during 2015–2020, classified by the International Classification of Primary Care 2nd edition (ICPC-2e-English), and statistically analyzed. The total number of complaints that were recorded in the system was 17,430,139.

Results

59% of the referring patients were women. The highest number of referrals was related to the age group of 18–59 years (56.9%), while the lowest belonged to the elderly people (13.3%). In all age and sex groups, the first ten complaints of patients with three top priorities in each category included process (follow-up, consultation, and results exam), digestive (toothache and gum complaint, abdominal pain, and diarrhea), respiratory (cough, sore throat, and runny nose), general (fever, pain, and weakness and fatigue), musculoskeletal (back pain, leg complaint, and knee injuries), endocrine and nutritional (weight gain, Feeding problem, and weight loss), cardiovascular (hypertension, palpitations, and Postural hypotension), neurological (headache, dizziness, and paralysis), sexual dysfunction (vaginal complaint, discharge, and irregular menstruation), and dermatological (pruritus, rash, and inflammation) problems.

Conclusion

High priorities in referring to PHC had a key role in assessing the country's health needs. Since this study was in line with the national pattern of complaints and patients' profile, the present findings can be helpful to amend policy-making, educational planning and curricula development in medical schools.
Effect of RG (Coptis root and ginseng) formula in patients with type 2 diabetes mellitus: a study protocol for a randomized controlled and double-blinding trial
Authors: Jiang Li , Fu Qiang , Wang Shidong , Chen Yu , Li Jiayue , Xiao Yonghua , Sun Ruixi , Shen Esther Aijia , Wang Junheng , Zhang Yaofu , Li Zhuang , Liu Jiangteng , Fu Xiaozhe , Liu Yuanyuan , Zhao Yu , Su Guanxun , Huang Weijun , Zhao Jinxi
Published: April 2022

Background

Type 2 diabetes mellitus (T2DM) is a common metabolic disease with significant health, social, and economic consequences. Traditional Chinese medicine (TCM) could effectively regulate blood sugar and influence gut microbiota in T2DM patients. Preliminary studies showed that the Coptis root and ginseng (RG) formula could relieve insulin resistance and prevent the progression of diabetes in mice.

Objectives

The purpose of this study is to explore the efficacy and safety of RG formula in the treatment of adult patients with T2DM, as well as observing its effects on gut microbiota.

Methods and analysis

This trial is a randomized, double-blind, placebo-controlled study. A total of 60 participants will be randomized in a 1:1 ratio into an experiment group (RG formula) and a control group (placebo). Patients in both groups will be given diabetes education and basic blood glucose control. Glucose-lowering drugs with significant influence on gut microbiota will be avoided. This trial will last 25 weeks including 1-week run-in, 12-week intervention, and 12-week follow-up visit. The primary outcome is the change in the HbA1c. The secondary outcomes comprise the change in the fasting blood glucose (FBG), postprandial blood glucose (PBG), fasting insulin (FIL), fasting C-peptide(C-P), insulin resistance index (IRI), inflammatory factors, and species abundance of gut microbiota between the two groups. Safety of medication will also be evaluated. The correlation analysis will be explored between the glycemic indicators, inflammatory factors, and abundance of gut microbiota.

Discussion

This study will provide the clinical evidence for the efficacy of RG formula in regulating blood sugar and influencing gut microbiota, which will be beneficial to form the integrated therapeutic regimen in T2DM with TCM.

Trial registration

“Clinical Study on the Intervention of Coptis Root and Ginseng,” Chinese Clinical Trials Registry ChiCTR 2100042126. Registered on 14 January 2021
Application of image recognition technology in digital twinning technology: Taking tangram splicing as an example
Authors: Yang Yifan , Yang Xuezhou , Li Yuefeng , Zou Jun , Shi Mingming , Yang Bobo , Guo Chunfeng , Hu Rongrong , Shi Chengzhang , Lu Xin , Li Yang
Published: April 2022

Background: With the rapid development of digital twinning technology, the compatibility of digital twinning technology to other technologies is continuously enhanced. It is because of this that the application of image recognition technology in digital twinning technology becomes a reality. However, the key technology of digital twin, the virtual-actual mutual control technology, is not mature enough, and the image recognition technology applied in digital twin technology also has the problem of coordinate system transformation, which becomes an important link of image recognition technology in digital twin.

Methods: Based on the above two problems, we take the tangram splicing project as an example to realize a virtual-actual mutual control method, so that the digital twinning technology can be well presented. Furthermore, we implement an image recognition applied to the conversion of digital twinning technology, so that digital twinning technology and image recognition have a seamless connection, allowing the application range of digital twinning technology to be further expanded.

Results: In this paper, image recognition technology is successfully applied to digital twin technology by adopting the conversion between different coordinate systems and the real and virtual real time control, which makes the applicability of digital twin technology in high-tech fields such as smart factories and smart manufacturing to a higher level.

Conclusions: Finally, through the tangram splicing project, the motion trajectories of the robotic arm and the tangram are consistent with the virtual robotic arm and the tangram in the computer. It is proved that our method can well combine digital twinning technology and image recognition technology.
Factors associated with knowledge and awareness of stroke among the Lebanese population: A cross-sectional study
Authors: Malaeb Diana , Dia Nada , Haddad Chadia , Hallit Souheil , Sacre Hala , Barakat Muna , Mansour Sara , Salameh Pascale , Hosseini Hassan
Published: April 2022

Background: Evaluation of the knowledge about stroke in the general population is extremely vital as it prevents stroke development, limits complications, and achieves better quality of life.  We assume that the general Lebanese population lacks awareness about stroke and its associated complications. This study aims to evaluate stroke knowledge and determine the factors associated with stroke awareness among the general Lebanese population.

Methods: This cross-sectional study assessed respondents’ sociodemographic characteristics and the identification of risk factors, warning signs, stroke consequences, and early response to stroke symptoms. A total of 551 Lebanese adults without a history of stroke filled in an online self-reported questionnaire publicly shared on social applications. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. 

Results: Among the 551 participants enrolled, 403 (74.2%) were females and 312 (56.7%) were under 30 years of age. Females compared to males and employed compared to unemployed had significantly higher odds of identifying at least one risk factor (OR=4.3 [95%CI=1.1;16.8] and 6 [95%CI=1.2;29.6], respectively). Also, when compared to unemployed, employed participants had significantly higher odds of recognizing at least one of the early stroke symptoms (OR=3.3 [95%CI=1.2;8.9]) and identifying at least one of the stroke consequences (OR=5.3 [95%CI=1.1;25.9]). Reaching a university level of education compared to a school level was associated with significantly higher odds (OR=2.3 [95%CI=1.1;4.8]) of taking a patient to a hospital.

Conclusion: Well-educated, employed, and female participants were more knowledgeable about stroke. Tailored interventions focusing on individuals with inadequate stroke literacy are needed. Further studies, more representative of the general Lebanese population with a larger sample size, are necessary to confirm our findings.
Quality care process metrics for nurses working in general practice, mapping the evidence: a scoping review protocol
Authors: Loftus Moran Orla , Casey Mary , O'Connor Laserina , Cullen Walter
Published: April 2022

Background: Irish general practice nursing roles have developed and grown exponentially in response to changing policy, clinical and workforce demands, this is reflective of international primary healthcare nursing trends. However, as nursing care in general practice advances, comprehensive evaluation of the general practice nurse (GPN) role has not been undertaken. Therefore, processes which enable robust data collection to assess the role and facilitate development of services are required. Nursing quality care metrics are an established mechanism which evaluate quality of care. Nursing quality care process metrics (QCP-Ms) specifically refer to measurement of care delivered directly to patients by nurses, benchmarking these interventions adherence to best practice guidance. The use of nursing metrics has been adopted within seven distinct healthcare settings in Ireland but not general practice. This scoping review is the first stage of a project which aims to inform development and implementation of QCP-Ms by Irish GPNs.

Aim: To explore and map the literature regarding the development and implementation of QCP-Ms within general practice settings.

Methods: The following five-stage methodological framework for scoping reviews proposed by Arksey and O’Malley will be used: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting/mapping the data and (5) collating, summarizing, and reporting results. The review will be conducted and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR).

Conclusions: The focus of this scoping review relates to QCP-Ms which specifically measure the work of general practice nurses. It is envisioned that synthesis of international literature will give a broad perspective about nursing QCP-Ms, their use in general practice or primary healthcare settings, enriching understanding regarding their development. It is anticipated that findings will provide key information to policy makers and health professionals interested in planning, strengthening, and delivering primary healthcare.