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The COVID-19 pandemic drastically impacted the travel industry. Additionally, the recent combination of a sociopolitical crisis, natural disasters and an economic crisis resulted in increased price sensitivity and consciousness in consumer spending. However, the travel industry continues to recover as more countries ease travel restrictions. As travel volumes gradually increase in many parts of the world, product development teams focusing on the User Experience (UX) of travel websites are critical for user satisfaction and business success. User-centric design is the process of building a product or service based on the wants, needs and challenges of the users. However, being truly user-centric requires an active means of listening to users through UX research methods. When implementing such methods, organisations typically transition through different stages of UX research maturity; namely, from the beginning stages where there is a lack of resources and ad-hoc implementation, to a mature state where user research informs business strategy. This case study focuses on practice-based insights of methods used to increase the UX research maturity of an online accommodation comparison platform in the travel industry. The study covers a period of two years, analysing the outcome of the methods introduced to increase the UX research maturity. The case study aimed to achieve the following to increase the maturity: creating awareness of UX Research and the user; exposing UX Research to the wider team; and extending research ownership to product teams. The methods used included: diary study; jobs-to-be-done framework; organisational structural changes; involving product team members in research activities; increasing the frequency of interviews with users; and enabling the product team to conduct small research activities. The results included an increase in the UX Research maturity of the organisation. The product development approach increased its user-centric focus. Non-UX roles within the product team grew closer to the user by doing small research activities. User-centricity was introduced as a company value in the organisation. The results of this study are specifically of value for practitioners and academia in the travel industry and have implications for Product, UX and Research practitioners.

Distributed Acoustic Sensing (DAS) is increasingly recognised as a valuable tool for glaciological seismic applications, although analysing the large data volumes generated in acquisitions poses computational challenges. We show the potential of active-source DAS to image and characterise subglacial sediment beneath a fast-flowing Greenlandic outlet glacier, estimating the thickness of sediment layers to be 20–30 m. However, the lack of subglacial velocity constraint limits the accuracy of this estimate. Constraint could be provided by analysing cryoseismic events in a counterpart 3-day record of passive seismicity through, for example, seismic tomography, but locating them within the 9 TB data volume is computationally inefficient. We describe experiments with data compression using the frequency-wavenumber (f-k) transform ahead of training a convolutional neural network, that provides a ~300-fold improvement in efficiency. In combining active and passive-source and our machine learning framework, the potential of large DAS datasets could be unlocked for a range of future applications.

Purpose This study aims to investigate the main areas in which researchers are focusing their efforts in terms of sustainability in higher education (curriculum, campus greening, research, governance or outreach), the format in which this research is performed (in terms of individual or combined efforts) and the primary research focus (in terms of local or global issues). Design/methodology/approach Trends on sustainability research were investigated by means of an online survey – the World Survey on Sustainability Publishing and Research in Higher Education, which was disseminated among members of the European School of Sustainability Science and Research and the Inter-University Sustainable Development Research Programme. Findings The survey collected responses from 103 researchers across over 40 countries. Three trends emerged: in spite of the intrinsic value of sustainability research in higher education, this area is not as mature as one could expect; the range of themes covered is wide and addresses a variety of areas; and individuals working alone is the most common means of doing research, whereas research at the university, department and faculty level appears to be less common. Originality/value The paper outlines some measures via which higher education institutions may be able to take more advantage of the many opportunities sustainability research offers to them.

Self-directed learning skills are known to influence successful learning outcomes in a higher education environment. Moreover, first year students entering higher education lack self-directed learning skills, as these are not always developed at school level. A digital promise tool was used for a first-year student cohort to reflect on their personal learning experiences and behaviour over a period of two semesters. The researchers used the augmented community of inquiry as the theoretical framework in this study, focusing on the student learning presence. Two cycles of data were collected using student reflective and reflexive responses. The first cycle included developing a digital promise, where students reflected on their typical learning behaviour and commitments during their journey. After this cycle, opportunities were given for students to adjust their digital promise for the second semester. The results from the student reflections indicated an increase in self-motivated and self-directed student learning during the second semester.

This article critically examines existing literature on the importance of incorporating the arts into the teaching and learning of science subjects in schools. It explores the significance of the STEAM educational approach as an option in science teaching and learning that might provide a range of benefits to STEM learners. STEM is an acronym for Science, Technology, Engineering, and Mathematics while STEAM stands for Science, Technology, Engineering, Arts, and Mathematics. The argument in the article is focused on why leveraging such skills as creativity, problem-solving, critical thinking, communications, self-direction, initiative, and collaboration, which are inherent in the arts, to strengthen the effective teaching and learning of science within the STEAM educational context is important for STEM learners. The STEM educational approach to science teaching and learning employs an interdisciplinary approach to problem-solving aimed at equipping learners with 21st century skills such as critical thinking, creativity, problem-solving, self-direction, initiative, collaboration, effective communication, and morals. It also aims at providing them with the opportunity to apply these skills through the practices, contexts, and processes of hands-on activities. These are targeted at understanding science and viewing science differently, which might enable them to participate in a STEM-career pathway. However, the framework for STEM does not fully support an understanding that creativity can exist in science and that science can be taught in multiple ways, including application of the arts. STEAM, on the other hand, is grounded in a transdisciplinary approach to science teaching and learning. It explores the application of the arts in science teaching and learning. This is aimed at improving the confidence, attitudes, and interests of learners in science through new approaches to problem-solving which might strengthen positive attitudes towards science. This approach incorporates the common processes of science and arts, which includes discovery, observation, experimentation, description, interpretation, analysis, evaluation, wondering, visualising, exploring, and communication.

Avocado is one of the world's fastest growing tropical fruit industries, and the pathogen avocado sunblotch viroid (ASBVd) is a major threat to both production and access to international export markets. ASBVd is seed transmissible, with infection possible via either the male (pollen) or female gametes. Surveillance for ASBVd across commercial orchards is a major logistical task, particularly when aiming to meet the stringent standards of evidence required for a declaration of pest freedom. As with many fruit crops, insect pollination is important for high avocado yields, and honey bee ( Apis mellifera) hives are typically moved into orchards for paid pollination services. Exploiting the foraging behavior of honey bees can provide a complementary strategy to traditional surveillance methods. High-throughput sequencing (HTS) of bee samples for plant viruses shows promise, but this surveillance method has not yet been tested for viroids or in a targeted plant biosecurity context. Here, we tested samples of bees and pollen collected from pollination hives in two ASBVd orchard locations, one in Australia, where only four trees in a block were known to be infected, and a second in South Africa, where the estimated incidence of infection was 10%. Using real-time RT-PCR and HTS (total RNA-seq and small RNA-seq), we demonstrated that ASBVd can be confidently detected in bees and pollen samples from hives within 100 m of infected trees. The potential for using this approach in ASBVd surveillance for improved orchard management and supporting market access is discussed.

Frontline workers have been distinctively impacted by the rapid spread of the COVID-19 pandemic. Teachers, as frontline employees in the educational system, had to contend with unprecedented changes to their work role, as well as new job demands coupled with insufficient resources and the effects of the pandemic on their personal lives. While some teachers struggled to cope and reported intense levels of fear of COVID-19 and burnout, others were able to adapt and experienced a sense of growth and accomplishment. Therefore, the current study aimed to examine the role of resilience in the relationship between fear of COVID-19 and burnout among South African school teachers using a survey design.- School teachers in South Africa (N=355) were administered the Maslach Burnout Inventory, the Fear of COVID-19 Scale, and the Connor-Davidson Resilience Scale-10.- The results showed a positive relationship between fear of COVID-19 and emotional exhaustion and depersonalization. Moreover, structural equation modeling confirmed a health-sustaining role for resilience as it had a significant direct effect on burnout. Resilience also partially mediated the impact of fear of COVID-19 on depersonalization as well as emotional exhaustion, and fully mediated the impact of fear of COVID-19 on personal accomplishment.- Our findings underscore that promoting individual- and institutional-level strategies to support teachers is necessary to build resilience, especially in the context of the COVID-19 pandemic.– Les travailleurs essentiels (ou travailleurs de première ligne) ont été particulièrement touchés par la propagation rapide de la pandémie de COVID-19. Les enseignants, en tant qu’employés clés du système éducatif, ont dû faire face à des changements sans précédent dans leur rôle professionnel, ainsi qu'à de nouvelles exigences professionnelles associées à des ressources insuffisantes et aux effets de la pandémie sur leur vie personnelle. Alors que certains enseignants ont eu du mal à faire face à cette situation et ont signalé des niveaux intenses de peur de la COVID-19 et d'épuisement professionnel, d'autres ont pu s'adapter et ont ressenti un sentiment de croissance et d'accomplissement. Par conséquent, la présente étude vise à examiner le rôle de la résilience dans la relation entre la peur de la COVID-19 et l'épuisement professionnel chez les enseignants sud-africains à l'aide d’une d'enquête spécialement dédiée à cette question.Matériel et méthode. – Cette étude a considéré les enseignants d'Afrique du Sud (N = 355) sous l’angle de l’inventaire de burn out de Maslach, de l’échelle de la peur de la COVID-19 et de l’échelle-10 de résilience de Connor–Davidson.Résultats. – Les résultats ont montré une relation positive entre la peur de la COVID-19 et l'épuisement émotionnel et la dépersonnalisation. De plus, la modélisation par équation structurelle a confirmé le rôle de la résilience dans le maintien de la bonne santé, car elle a un effet direct significatif sur l'épuisement professionnel. La résilience a également partiellement modéré l'impact de la peur de la COVID-19 sur la dépersonnalisation ainsi que l'épuisement émotionnel et a entièrement réduit l'impact de la peur du COVID-19 sur l'accomplissement personnel. Cette étude a aussi fourni des informations sur les interventions appropriées. Les enseignants qui souffrent de fatigue chronique, de désillusion et de dépersonnalisation courent un risque accru de problèmes physiques et psychologiques. Cela, à son tour, pourrait avoir un impact négatif sur le rendement au travail et entraîner un taux de roulement élevé qui a un impact négatif sur les expériences d'apprentissage des étudiants. L'amélioration de la résilience des enseignants face à la COVID-19 nécessite une approche à plusieurs niveaux qui se concentre à la fois sur les réponses individuelles et sur les réponses organisationnelles plus larges. Des interventions telles que la réduction du stress basée sur la discussion, fondée sur la théorie cognitivo-comportementale et concentrée sur le recadrage cognitif des pensées stressantes provoquant de l'anxiété, se sont avérées efficaces pour promouvoir la résilience des enseignants au niveau individuel.– Dans l'ensemble, les résultats de cette étude confirment que la résilience est un facteur de protection important dans l'association entre l'épuisement professionnel et la peur de la COVID-19 chez les enseignants sud-africains. Nos résultats soulignent que la promotion de stratégies individuelles et institutionnelles pour soutenir les enseignants est nécessaire pour renforcer la résilience, en particulier dans le contexte de la pandémie de la COVID-19.

Mild or asymptomatic disease is now the dominating presentation of primary hyperparathyroidism (PHPT). However, bone involvement with decreased bone mineral density (BMD) and an increased risk of fractures has been demonstrated. Indications for parathyroidectomy (PTX) in mild PHPT have been debated for years. There is a need of long-term randomized studies comparing PTX with observation without intervention (OBS). Here, we present bone health data from the Scandinavian Investigation of Primary Hyperparathyroidism (SIPH), a randomized controlled trial, comparing PTX to OBS. This study included 191 patients (96 OBS/95 PTX), and 129 patients (64 OBS/65 PTX) were followed for 10 years to the end of study (EOS). BMD was measured with dual-energy X-ray absorptiometry (DXA), peripheral fractures were noted, and spine radiographs were obtained for vertebral fracture assessment. There was a significant treatment effect of PTX on BMD compared with OBS for all analyzed compartments, most explicit for the lumbar spine (LS) and femoral neck (FN) (p < 0.001). The mean changes in T-score from baseline to 10 years were from 0.41 for radius 33% (Rad33) to 0.58 for LS greater in the PTX group than in the OBS group. There was a significant decrease in BMD for all compartments in the OBS group, most pronounced for FN, Rad33, and ultradistal radius (UDR) (p < 0.001). Even though there was a significant treatment effect of PTX compared with OBS, there was only a significant increase in BMD over time for LS (p < 0.001). We found no difference between groups in fracture frequency in the 10-year cohort, neither with modified intention-to-treat (mITT) analysis nor per protocol analysis. Because BMD is only a surrogate endpoint of bone health and PTX did not reduce fracture risk, observation could be considered a safe option for many patients with mild PHPT regarding bone health in a 10-year perspective.

Aims We have shown that human cardiac muscle patches (hCMPs) containing three different types of cardiac cells—cardiomyocytes (CMs), smooth muscle cells (SMCs), and endothelial cells (ECs), all of which were differentiated from human pluripotent stem cells (hPSCs)—significantly improved cardiac function, infarct size, and hypertrophy in a pig model of myocardial infarction (MI). However, hPSC-derived CMs (hPSC-CMs) are phenotypically immature, which may lead to arrhythmogenic concerns; thus, since hPSC-derived cardiac fibroblasts (hPSC-CFs) appear to enhance the maturity of hPSC-CMs, we compared hCMPs containing hPSC-CMs, -SMCs, -ECs, and -CFs (4TCC-hCMPs) with a second hCMP construct that lacked hPSC-CFs but was otherwise identical [hCMP containing hPSC-CMs, -AECs, and -SMCs (3TCC-hCMPs)]. Methods and results hCMPs were generated in a fibrin scaffold. MI was induced in severe combined immunodeficiency (SCID) mice through permanent coronary artery (left anterior descending) ligation, followed by treatment with cardiac muscle patches. Animal groups included: MI heart treated with 3TCC-hCMP; with 4TCC-hCMP; MI heart treated with no patch (MI group) and sham group. Cardiac function was evaluated using echocardiography, and cell engraftment rate and infarct size were evaluated histologically at 4 weeks after patch transplantation. The results from experiments in cultured hCMPs demonstrate that the inclusion of cardiac fibroblast in 4TCC-hCMPs had (i) better organized sarcomeres; (ii) abundant structural, metabolic, and ion-channel markers of CM maturation; and (iii) greater conduction velocities (31 ± 3.23 cm/s, P < 0.005) and action-potential durations (APD50 = 365 ms ± 2.649, P < 0.0001; APD = 408 ms ± 2.757, P < 0.0001) than those (velocity and APD time) in 3TCC-hCMPs. Furthermore, 4TCC-hCMPs transplantation resulted in better cardiac function [ejection fraction (EF) = 49.18% ± 0.86, P < 0.05], reduced infarct size (22.72% ± 0.98, P < 0.05), and better engraftment (15.99% ± 1.56, P < 0.05) when compared with 3TCC-hCMPs (EF = 41.55 ± 0.92%, infarct size = 39.23 ± 4.28%, and engraftment = 8.56 ± 1.79%, respectively). Conclusion Collectively, these observations suggest that the inclusion of hPSC-CFs during hCMP manufacture promotes hPSC-CM maturation and increases the potency of implanted hCMPs for improving cardiac recovery in mice model of MI.

Alzheimer’s disease (AD) is a debilitating neurodegenerative disorder affecting 50 million people globally. It is characterized by the presence of extracellular senile plaques and intracellular neurofibrillary tangles, consisting of amyloid-β and hyperphosphorylated tau proteins, respectively. Despite global research efforts, there is currently no cure available, due in part to an incomplete understanding of the disease pathogenesis. Numerous possible mechanisms, or hypotheses, explaining the origins of sporadic or late-onset AD have been proposed, including the amyloid-β, inflammatory, vascular, and infectious hypotheses. However, despite ample evidence, the failure of multiple trial drugs at the clinical stage illuminates the possible pitfalls of these hypotheses. Systems biology is a strategy which aims to elucidate the interactions between parts of a whole. Using this approach, the current paper shows how the four previously mentioned hypotheses of AD pathogenesis can be intricately connected. This approach allows for seemingly contradictory evidence to be unified in a system-focused explanation of sporadic AD development. Within this view, it is seen that infectious agents, such as P. gingivalis, may play a central role. The data presented here shows that when present, P. gingivalis or its virulence factors, such as gingipains, may induce or exacerbate pathologies underlying sporadic AD. This evidence supports the view that infectious agents, and specifically P. gingivalis, may be suitable treatment targets in AD.

Long COVID, die lang anhaltende Krankheit und Erschöpfung, die bei einem kleinen Teil der SARS-CoV-2-Infizierten auftritt, stellt eine zunehmende Belastung für die Betroffenen und die Gesellschaft dar. Eine virtuelle Tagung der Physiological Society im Februar 2022 brachte Kliniker und Forscher zusammen, um das aktuelle Verständnis der Mechanismen, Risikofaktoren und Genesung nach Long COVID zu erörtern. In dieser Übersichtsarbeit werden die Themen behandelt, die sich aus dieser Tagung ergeben haben. Die Übersichtsarbeit befasst sich mit der Natur von Long COVID, untersucht den Zusammenhang mit anderen postviralen Erkrankungen wie der myalgischen Enzephalomyelitis/dem chronischen Erschöpfungssyndrom und zeigt auf, wie die Forschung zu Long COVID helfen kann, Patienten mit allen möglichen postviralen Syndromen besser zu unterstützen. Die Forschung zu Long COVID hat besonders rasche Fortschritte bei Bevölkerungsgruppen gemacht, die ihre körperliche Leistungsfähigkeit routinemäßig überwachen, insbesondere beim Militär und bei Leistungssportlern. In der Übersichtsarbeit wird hervorgehoben, inwiefern das hohe Niveau von Diagnose, Intervention und Erfolgskontrolle in diesen aktiven Bevölkerungsgruppen Informationen über Managementstrategien für die Allgemeinbevölkerung liefern kann. Anschließend wird untersucht, wie eine Schlüsselkomponente der Leistungsüberwachung bei diesen aktiven Bevölkerungsgruppen, das kardiopulmonale Training, Long-COVID-bedingte Veränderungen in der Physiologie aufdeckt – einschließlich Veränderungen der peripheren Muskelfunktion, der ventilatorischen Ineffizienz und der autonomen Dysfunktion. Das Wesen und die Auswirkungen der Dysautonomie werden im Zusammenhang mit dem posturalen orthostatischen Tachykardiesyndrom, der Fatigue und den Behandlungsstrategien, die darauf abzielen, der Überaktivierung des Sympathikus durch Stimulation des Vagusnervs entgegenzuwirken, erörtert. Anschließend untersuchen wir die Mechanismen, die den Symptomen von Long COVID zugrunde liegen. Dabei konzentrieren wir uns auf die gestörte Sauerstoffversorgung durch Mikrokoagulation und die Störung des zellulären Energiestoffwechsels, bevor wir Behandlungsstrategien betrachten, die direkt oder indirekt auf diese Mechanismen abzielen. Dazu gehören ein fernbetreutes Atemmuskeltraining und integrierte Versorgungspfade, die Rehabilitation und medikamentöse Interventionen mit der Erforschung des Zugangs zur Long-COVID-Versorgung in verschiedenen Bevölkerungsgruppen kombinieren. Insgesamt zeigt diese Übersichtsarbeit, wie im Rahmen der physiologischen Forschung die bei Long COVID auftretenden Veränderungen aufgedeckt werden und wie verschiedene therapeutische Strategien zur Bekämpfung dieser Erkrankung entwickelt und getestet werden.

The ongoing push for the 4th industrial revolution is setting the stage to digitise, persist and verify identity along with credentials. Academic and skills credentials are currently verified manually and have much scope for automation using cryptographic techniques but requires standardisation to facilitate future systems interoperability. The Distributed Ledger Technology (DLT) and World Wide Web Consortium (W3C) Verifiable Credentials (VC) standards presents the possibility to achieve this credential verification automation. To accomplish this, an understanding of various DLTs and requirements for a viable skills tracking system is important. Therefore, this research aims to access the selected DLTs against the assessment criterion presented and an analysis has been completed to determine which DLT is suitable for the proposed system. The DLTs are assessed in terms of their ability to support the rapid prototyping of such a system and provide recommendations to guide a future development path from the perspective of standards compliance. We conclude that few DLTs possess the maturity to provide proper requirements coverage due to the emergent nature of the DLT space. Additionally, this paper presents the high-level requirements to achieve a minimally viable solution that can demonstrate such digital credential verification in the academic and skills tracking context.

European and Australian guidelines for cystic fibrosis (CF) reproductive carrier screening recommend testing a small number of high frequency CF causing variants, rather than comprehensive CFTR sequencing. The study objective was to determine variant detection rates of commercially available targeted reproductive carrier screening tests in Australia.Next-generation DNA sequencing of the CFTR gene was performed on 2552 individuals from a whole population sample to identify CF causing variants. The variant detection rates of two commercially available Australian reproductive carrier screening tests, which target 50 or 175 CF causing variants, in this population were calculated. The ethnicity of individuals was determined using principal component analysis.Variant detection rates of the tests for 50 and 175 CF causing variants were 88.2% and 90.8%, respectively. No CF causing variants in individuals of East Asian ethnicity (n = 3) were detected by either test, while86.6% (n = 69) of CF causing variants in Europeans would be identified by either test.Reproductive carrier screening tests for a targeted set of high frequency CF variants are unable to detect approximately 10% of CF variants in a multiethnic Australian population, and individuals of East Asian ethnicity are disproportionally affected by this test limitation.

Teaching and learning in higher education still largely use traditional approaches that promote memorisation of content knowledge. These traditional approaches are in stark contrast to the world of work, which encourages problem-solving and higher-order thinking. In a first-year civil engineering concrete technology course, we used reflection on an authentic learning task to encourage a deeper learning experience for students. We hoped that by including reflection and an authentic learning task in the module, students would be more actively engaged with the module content. The research question addressed in this study is: how does reflective practice and an authentic learning activity support student learning in a practical component within a first-year civil engineering module? Reflection should allow students to think deeply about what worked well and what did not during conceptualisation, development and submission of their authentic learning project. This case study collected qualitative data to generate the findings. The data consisted of student reflections during and after completion of the practical component. Students’ reflections indicated that the authentic learning task resulted in much deeper learning as opposed to surface learning and memorisation of content knowledge. The results indicate that the reflective exercise encouraged students to think deeply about their learning and on how to improve their skills, knowledge and attitudes throughout the project. Finally, this process shifted the focus from content knowledge dissemination to development of critical thinking and lifelong learning skills.

Identifying the factors that contribute to differential vulnerability in the face of adversity is key to psychology fulfilling its mandate as a helping profession. One such factor, fortitude, which is described as the psychological strength to manage adversity and to stay well, has consistently been linked to psychological well-being. The objective of the research was to statistically integrate studies examining the relationship between fortitude and the indices of psychological well-being by using a meta-analysis. We used a random-effects model for the meta-analysis. In addition to the overall effect size, we examined publication bias and the moderating role of age and methodological quality. We also performed a subgroup analysis to compare between studies with positive and negative indicators of psychological well-being. In addition, we used robust variance estimation to account for effect-size dependencies, as some studies have reported more than one correlation coefficient. A total of 13 studies reporting 35 correlation coefficients pertaining to the relationship between fortitude and the indices of psychological well-being were extracted. The meta-analysis revealed a significant overall effect ( r = .44, p

INTRODUCTION: Previous studies on bereavement have focused on the implications for bereaved individuals from behavioural and psychological perspectives. Limited literature discusses occupational therapists' perceived ability to treat bereaved individuals and how activities can be used to create new meaning to their lives. METHOD: A descriptive qualitative design was employed in the study to elicit occupational therapists' perceived ability to treat bereaved individuals find new meaning in their life. Thirty-five occupational therapists were recruited, and nine participated in two focus groups. Data collected were thematically analysed. FINDINGS: Three themes emerged, namely: (1) activities used in occupational therapy creates opportunities for new meaning to life after loss of a loved one, (2) appropriate occupational therapists' helping skills and professional behaviour to assist and treat the bereaved, and (3) perceived barriers to positive outcomes in treating the bereaved. CONCLUSION: Bereaved individuals often have impaired performance in occupations and emotional processing. The effects of bereavement were addressed using the appropriate occupational therapist helping skills and professional behaviour to guide holistic, occupation-based and client-centred treatment. Bereaved individuals were treated through purposeful activities, facilitation of therapeutic groups and self-management skills training which seemed to create opportunities for new meaning in their life. Occupational therapists need to be cognisant of the barriers that negatively influence the positive outcome of occupational therapy services.

There are limited data on the prevalence of doravirine (DOR)-associated drug resistance mutations in people with HIV (PWH) in Botswana. This cross-sectional, retrospective study aimed to explore the prevalence of DOR-associated resistance mutations among ART-naïve and -experienced PWH in Botswana enrolled in the population-based Botswana Combination Prevention Project (BCPP).A total of 6078 HIV-1C pol sequences were analysed for DOR-associated resistance mutations using the Stanford HIV drug resistance database, and their levels were predicted according to the Stanford DRM penalty scores and resistance interpretation. Virologic failure was defined as HIV-1 RNA load (VL)400 copies/mL.Among 6078 PWH, 5999 (99%) had known ART status, and 4529/5999 (79%) were on ART at time of sampling. The suppression rate among ART-experienced was 4517/4729 (96%). The overall prevalence of any DOR-associated resistance mutations was 181/1473 (12.3% [95% confidence interval {CI}: 10.7-14.1]); by ART status: 42/212 (19.8% [95% CI: 14.7-25.4]) among ART-failing individuals (VL ≥400 copies/mL) and 139/1261 (11.0% [95% CI: 9.3-12.9]) among ART-naïve individuals (P0.01). Intermediate DOR-associated resistance mutations were observed in 106/1261 (7.8% [95% CI: 6.9-10.1]) in ART-naïve individuals and 29/212 (13.7% [95% CI: 9.4-8.5]) among ART-experienced participants (P0.01). High-level DOR-associated resistance mutations were observed in 33/1261 (2.6% [95% CI: 1.8-3.7]) among ART-naïve and 13/212 (6.1% [95% CI: 3.6-10.8]) among ART-failing PWH (P0.01). PWH failing ART with at least one EFV/NVP-associated resistance mutation had high prevalence 13/67 (19.4%) of high-level DOR-associated resistance mutations.DOR-associated mutations were rare (11.0%) among ART-naive PWH but present in 62.7% of Botswana individuals who failed NNRTI-based ART with at least one EFV/NVP-associated resistance mutation. Testing for HIV drug resistance should underpin the use of DOR in PWH who have taken first-generation NNRTIs.

We present a case of end-stage lung disease secondary to mixed connective tissue disease (MCTD) with concomitant myocarditis found on explant at time of transplant. The patient is a 37-year-old man who was first diagnosed with interstitial lung disease secondary to MCTD at 30 years of age. He underwent en bloc heart-lung transplant for progressive decline in left ventricular ejection fraction and severe pulmonary fibrosis despite immunosuppression with hydroxychloroquine, mycophenolate, and azathioprine. Cardiac MRI failed to demonstrate findings suggestive of myocarditis; however, explant demonstrated significant lymphocytic infiltrate with myocyte damage and areas of fibrosis with myocyte hypertrophy. In patients presenting with unexplained systolic dysfunction in the setting of MCTD, fluorodeoxyglucose-positron emission tomography may be a screening tool and if myocardial inflammation is noted, there may be a role for increased immunosuppression. While this strategy was not employed in our patient, his improvement in left ventricular ejection fraction while on mycophenolate mofetil as compared with HCQ and explant histology suggests a process that may have been further responsive to escalation of immunosuppression.

Background: Fibrin(ogen) amyloid microclots and platelet hyperactivation are key pathological findings in patients with acute COVID-19 infection and also in those with Long COVID/Post-Acute Sequelae of COVID-19 (PASC). These pathologies may represent a suitable target for pharmacological treatment of Long COVID. Methods: Here we report on the symptoms displayed by a cohort of 91 South African Long COVID patients at baseline and after a clinician-initiated anticoagulant regime was completed. For laboratory analysis, patients provided a blood sample before and after treatment. Fibrinaloid microclot presence was studied by adding thioflavin T to platelet poor plasma (PPP), whilst platelet hyperactivation was studied using two platelet markers- PAC1 and CD62P (P-selectin). The anticoagulant regime included dual antiplatelet therapy (DAPT- Clopidogrel 75mg + Aspirin 75mg) once a day, and a direct oral anticoagulant (DOAC- Apixaban) 5mg twice a day. A proton pump inhibitor (PPI) pantoprazole 40 mg/day was also prescribed for gastric protection. Each of the treated cases reported their main Long COVID symptoms, and whether their symptoms resolved following treatment or not. Results: In our cohort a most participants did not report any comorbidities before acute COVID-19 infection. Hypertension and dyslipidaemia were the commonest underlying illnesses, whilst the most commonly reported Long COVID symptoms included fatigue, cognitive dysfunction, shortness of breath, and joint and muscle pains. Following completion of treatment, each of the different symptoms resolved in the majority of patients. This was also reflected in the laboratory analysis, where a decrease in the severity of fibrin amyloid microclotting and the degree of platelet pathology was noted. No serious adverse bleeding events were reported. Conclusions: Fibrin amyloid microclots, platelet hyperactivation/ aggregation, and widespread endothelialitis inhibit the transport of oxygen at a capillary/cellular level. This provides a ready explanation for the symptoms of Long COVID. By normalizing the failed clotting physiology and reversal of the endothelialitis, triple anticoagulant therapy represents a promising treatment option that appears to be highly efficacious, and warrants controlled clinical studies. We caution that such a regime must only be followed under expert medical supervision in view of the risk of bleeding.

In this article the performances of the singer Neil Diamond in South Africa are studied to enable the author, a lecturer at a South African university, to learn from Diamond how to develop on professional level. Since the singer announced in 2018 that he would, because of a diagnosis of Parkinson’s disease, no longer be performing live, the study was conducted in reflection on his performing career, which stretched over more than four decades, and the effect that it has had on the lecturer’s professional development. Embedded in the theory of transformative learning, the methodology that was used, namely the 5D framework of appreciative inquiry, was selected because it provided the scaffolding for the reflective research process. After conducting interviews with six people who attended one of Diamond’s performances, five themes were identified and are presented and discussed in this paper: the interaction between Diamond and his audiences; keeping up with the latest technology; Diamond’s enjoyment of what he did and his enthusiasm about his performances; his neat black clothes and professional appearance; and his passionate immersion in those performances. To capture the essence of Diamond’s performances, the author wrote a poem and painted a painting to represent what he learned from Diamond. The effect that his engagement with Diamond has had on the technology and decoration in his lecture hall is also explained.

Despite the societal increase in mental health disorders during the initial stages of the COVID-19 pandemic, many individuals were able to cope effectively with new mental health challenges. The heterogeneity in responses to adversity underscores the influence of protective factors in promoting coping behaviour. The current study investigates fortitude as a potential protective resource by examining the potential direct, mediating, and moderating roles of fortitude in the relationship between perceived vulnerability to disease, fear of COVID-19, and indices of psychological well-being. Participants ( n = 355) were schoolteachers who completed the Perceived Vulnerability to Disease Questionnaire, Fear of COVID-19 Scale, Fortitude Questionnaire, UCLA Loneliness Scale, trait scale of the State-Trait Anxiety Inventory, Beck Hopelessness Scale, and the Center for Epidemiological Studies Depression Scale. Path analysis indicated that fortitude had a health-sustaining effect that was evident in its association with all indices of psychological well-being. Fortitude also mediated the relationship between perceived vulnerability to disease and depression, anxiety, and loneliness. In addition, fortitude moderated the relationship between fear of COVID-19 and depression. The significant moderating and mediating effects of fortitude on psychological outcomes support its potential for counterbalancing the negative mental health impacts of COVID-19. Interventions aimed at enhancing fortigenic appraisals of self and others may prove beneficial in promoting psychological well-being.

Purpose: Newly qualified registered nurses often lack the competence to efficiently execute their professional roles and responsibilities. They might fail to execute their nursing functions and make clinical judgement because of lack of confidence. The aim of the study is to develop a conceptual framework as basis for the development of a transition support programme to facilitate the competencies of newly qualified registered nurses (NQRNs) at public hospitals in Namibia. Methods: The Programme Logic Model (Knowlton & Phillips, 2013 was adapted as it allowed the researcher to present the conceptual framework in a systematic and visual way, while presenting and sharing the ideas and understanding of the relationships among the resources needed to develop the transition support programme, the planning of programme activities, and the changes or results you hope to achieve. Results: The results of the development of the conceptual framework served as basis for the transition support programme to facilitate the competencies of newly qualified registered nurses. Conclusion: The conceptual framework could serve an effective tool in guiding the development of the transition support programme to facilitate the competencies of newly qualified registered nurses.

of the hepatic veins and any variation thereof is pivotal for successful hepatic surgeries, as these vessels serve as a hepatic field guideline in living donor liver transplantations (LDLT) and hepatic resections. To date, numerous morphological variations in different populations other than a South African population have been published and thus the following research study was conducted to investigate and document morphological variations in a South African population. The following descriptive study aimed to contribute to a better preoperative understanding of hepatic vein anatomy impacting surgeries conducted in South Africa. This research study was conducted on 40 livers from donated bodies of 20 females and 20 males, used for academic purposes in the Department of Human Biology, at the University of Cape Town. The age range was between 33 to 105 years old with an average age of 75. The livers were removed, and the liver tissue was scraped away to expose the hepatic veins from their origin of the inferior vena cava (IVC) to their terminating branching points within the various hepatic segments. All the livers presented all three major hepatic veins, 90.0% of the livers had a common trunk (n = 36), and the remaining 10.0% had no common trunk (n = 4). The major and minor hepatic veins were observed for all the livers. This study found various morphological variations in a South African population that are of clinical significance with a high prevalence of accessory right hepatic veins.

The aim of this study was to understand how dementia caregivers in the township of Soweto, South Africa interpret their role in the context of caregiving through the personal constructs identified using the Self- Characterization technique. Thirty family caregivers were recruited via purposive sampling methods and completed a Self-Characterization Sketch during semi-structured interviews. Content analysis of construct pairs was thematically coded using the Classification System for Personal Constructs (CSPC) - a reliable method to analyse personal constructs that are generated by constructivist assessments. Findings revealed that caregivers' interpretations of themselves was characterized by moral, emotional and cognitive attributes. Specifically, a sense of mastery, self-efficacy, strength, selflessness and unconditional positive regard characterized the most meaningful constructs of care within caregiver narratives in response to their loved ones with dementia. These adaptive outcomes, despite the challenging, pervasive, complex nature of dementia and its manifestations, suggest psychological and emotional resilience, higher levels of adjustment and caregiver well-being. However, it is important to consider possible consequences such as physical fatigue and burnout despite adaptive outcomes. Therefore, it is recommended that approaches to psychoeducational initiatives, emotional and psychological interventions and awareness campaigns include teaching caregivers how to self-care encourage the importance of consistent exercise, rest, sleep, nutrition as well as reaching out for social support. Lastly, empowering caregivers to use their personal resources would prove valuable in support groups, and individual to facilitate self-awareness, sustained coping and mental health.

INTRODUCTION: Despite the well-known increased risk of exposure to the Covid-19 virus in a dental setting, vaccination rates among staff members are low. This information, as well as the possible associations to demographic profiles, may be useful for authorities to adequately address specific concerns and uncertainties Aims and Objectives: To determmine the attitudes and perceptions towards the COVID-19 vaccine among dental staff at the UWC Oral Health Centers. DESIGN: A cross-sectional design was used METHODS: An anonymous, online, validated questionnaire was used to collect the data RESULTS: Majority (91.4%) of the participants had received the Covid-19 vaccine while just over 12% stated that they would not take the booster vaccination. Significant associations between the level of education and the attitudes and perceptions of staff were found CONCLUSIONS: While the majority had a positive attitude towards the Covid-19 vaccine, specific concerns and uncertainties were identified and will need to be addressed in order to improve vaccination rates among staff members

Untreated menopause may have serious health implications, but treatments can have dangerous side effects. We evaluate menopausal symptoms as well as available treatments -the routes of administration and their effect on blood coagulation. Menopausal females may experience hot flushes, vulva- and vaginal atrophy and osteoporosis. Many treatments are available to relieve these symptoms such as Conjugated Equine Estrogen and bioidentical hormones. The routes of administration include oral and transdermal. Hormones that are administered orally undergo a hepatic first pass metabolism. The by-products have a lower efficacy and possibly enhanced side effects. Furthermore, hormone treatments influence the coagulation cascade through coagulation factors or their regulators. Increased coagulation poses a risk for venous thromboembolism. Currently a definite conclusion on whether the side effects from hormone treatments exceed the risk of untreated menopause cannot be made. However, a more individualised approach to hormone treatments may be the most feasible solution to this dilemma.

PurposeThis paper intends to investigate the empirical link between governance and energy investment in PPP. To succinctly account for biases in the fixed effects (FE) model, the authors adopted different bias-corrected techniques. The majority of these techniques provided evidence that PPP investments in energy are boosted by increasing the desire for accountability, prioritising the voice of the masses and disabusing the rule of laws. This study could not find any positive influence from the control of corruption to PPP investment in energy.Design/methodology/approachThe acute shortage of power supply in SSA has attracted PPP investments in the energy subsector of the economy, leading to the recent debate on governance and public, private investment. The authors contributed to this argument by examining the impact of country governance on PPP investment in energy using a sample of countries in SSA.FindingsTherefore, the authors concluded that low control of corruption is responsible for the inadequate volume of PPP investments. In the light of this, the government should redefine the anti-corruption bill of their sovereignty to accommodate severe sanctions when necessary.Originality/valueThis paper uses the fixed effects (FE) model by introducing batteries of nonlinear panel models to capture the relationship between the impacts of country governance on PPP investment in energy.

The aim of this study was to determine the incidence, characteristics and in-hospital mortality of non-ventilator-associated hospital-acquired pneumonia (NV-HAP) in a regional (Modified Monash Model 2) Australian hospital.All cases with NV-HAP were obtained from the Business Analysis and Decision Support (BADS) Unit between 1st January 2013 and 31st December 2018. Medical records were reviewed, and data pertaining to incidence, characteristics (age and gender), length of stay, co-morbidities (measured using the Charlson Comorbidity Index) and in-hospital mortality were extracted. Incidence rate was calculated as a proportion of NV-HAP cases per 1000 bed-days.A retrospective study design was used to review all cases of NV-HAP between 1 January 2013 and 31 December 2018 at a single regional Australian hospital. Using the Modified Monash Model (MMM), our regional setting is classified as a regional centre (MMM-2).Rockhampton Hospital, Australia.Patient cases.Incidence rate, Incidence proportion, mortality.A total of 501 cases were identified with an incidence rate of 0.98 cases per 1000 bed-days over the study period 2013-2018. Cases with NV-HAP had a median age of 78.2 years (interquartile range 18.8), a median length of stay of 13.0 days (interquartile range 12.0) and a median Charlson Comorbidity Index score of 3.0 out of 39 (interquartile range 3.0), and a greater proportion was male (n = 297, 57%). The in-hospital mortality rate for NV-HAP cases was 18.9%.This study revealed an overall incidence rate of 0.98 cases per 1000 bed-days from 2013 to 2018 in a regional Australian hospital. In addition, this study provided the descriptive characteristics for patients with NV-HAP at our regional hospital.

‘Long COVID’ is the term used to describe the phenomenon in which patients who have survived a COVID-19 infection continue to experience prolonged SARS-CoV-2 symptoms. Millions of people across the globe are affected by Long COVID. Solving the Long COVID conundrum will require drawing upon the lessons of the genomics, medicine, data science, and computer science collaborated, sharing data and pooling resources to attack the problem from multiple angles. Thus far, there has been no global consensus on the definition, diagnosis, and most effective treatment of Long COVID. In this work, we examine the possible applications of data sharing and data science in general with a view to, ultimately, understand Long COVID in greater detail and hasten relief for the millions of people experiencing it. We examine the literature and investigate the current state, challenges, and opportunities of data sharing in Long COVID research. Significance:Although millions of people across the globe have been diagnosed with Long COVID, there still exist many research gaps in our understanding of the condition and its underlying causes. This work aims to elevate the discussion surrounding data sharing and data science in the research community and to engage data sharing as an enabler to fast-track the process of finding effective treatment for Long COVID.