Antiretroviral-naive and -treated HIV-1 patients can harbour more resistant viruses in CSF than in plasma

Objectives The neurological disorders in HIV-1-infected patients remain prevalent. The HIV-1 resistance in plasma and CSF was compared in patients with neurological disorders in a multicentre study. Methods Blood and CSF samples were collected at time of neurological disorders for 244 patients. The viral loads were >50 copies/mL in both compartments and bulk genotypic tests were realized. Results On 244 patients, 89 and 155 were antiretroviral (ARV) naive and ARV treated, respectively. In ARV-naive patients, detection of mutations in CSF and not in plasma were reported for the reverse transcriptase (RT) gene in 2/89 patients (2.2%) and for the protease gene in 1/89 patients (1.1%). In ARV-treated patients, 19/152 (12.5%) patients had HIV-1 mutations only in the CSF for the RT gene and 30/151 (19.8%) for the protease gene. Two mutations appeared statistically more prevalent in the CSF than in plasma: M41L (P = 0.0455) and T215Y (P = 0.0455). Conclusions In most cases, resistance mutations were present and similar in both studied compartments. However, in 3.4% of ARV-naive and 8.8% of ARV-treated patients, the virus was more resistant in CSF than in plasma. These results support the need for genotypic resistance testing when lumbar puncture is performe

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Land reform and its impact on the arid South African environment: Riemvasmaak as a case study

The 75 000 ha, hyper-arid area of Riemvasmaak represents one of the first land restitution cases in post-apartheid South Africa. People who were forcibly removed in 1974 were resettled in 1995. We describe the impact that people and domestic livestock have had on the vegetation of Riemvasmaak since resettlement. Matched photographs and botanical surveys undertaken at 10-year intervals (1995, 2005 and 2015) were used to estimate the percentage cover of herbaceous (primarily grasses) and woody vegetation of the major land forms (slopes, plains, ephemeral streams). The results of a linear mixed-effects model suggest that herbaceous vegetation decreased significantly from 1995 to 2005 (p < 0.001) and increased significantly from 2005 to 2015 (p < 0.001), whereas woody cover did not change significantly over the study period. Linear regressions of size class and density of individuals for Vachellia erioloba indicate little recruitment over the period 1995–2015, compared with the period before the initial survey in 1995. Precipitation, as well as the density of grazers and browsers, driven by the socioeconomic and cultural changes occurring in Riemvasmaak since 1995, has influenced the change in vegetation cover and the recruitment of V. erioloba. Keywords: complex adaptive systems, disequilibrium, rangeland condition, Northern Cap

Estratégias, organização e gestão de empresas em mercados globalizados: a experiência recente do Brasil Strategies, organization and management of industrial companies in globalized markets: the recent experience of Brazil

No novo contexto de economia globalizada, as perspectivas de cada país são função das competências adquiridas por seus elementos constitutivos: pessoas, empresas, instituições. Este estudo analisa as mudanças em curso na indústria brasileira, recentemente envolvida na globalização produtiva, e suas conseqüências em termos de formação de competências. Destaca as profundas mudanças em termos de estratégias, arquiteturas organizacionais e sistemas de gestão que estão ocorrendo, tanto nas empresas estrangeiras quanto nas brasileiras. Mesmo que no curto prazo essas mudanças possam ser consideradas positivas, no longo prazos os seus efeitos serão prejudiciais para o desenvolvimento de competências locais, o que afetará o desempenho competitivo da indústria brasileira.<br>This study analyses the changes that are taking place in the Brazilian industry, recently involved in the process of productive globalization. It shows that drastic changes in terms of strategies, organization and management are in course, both in terms of transnational and Brazilian enterprises. The main conclusion is that knowledge intensive functions such as R&D, Strategic Management and Management Systems are being transferred abroad by the TNCs and the Logistics function is becoming the most "strategic" function in the operation of their subsidiaries. The Brazilian enterprises which succeed in operating in globalized productive chains are adopting similar structures. In the long run, those changes will be detrimental for the formation of local capabilities and consequently, for the maintenance of the competitive position of Brazilian industry

As bases históricas da gestão da qualidade: a abordagem clássica da administração e seu impacto na moderna gestão da qualidade The historical principles of quality management: the classical management approach and its impact on modern quality management

Este artigo mostra como a Gestão da Qualidade, tal qual conhecemos hoje, embasou seu desenvolvimento em escolas fundamentais da Administração. Em particular, enfoca-se aqui a Escola Clássica, suas identidades e confrontos com a Gestão da Qualidade e seus reflexos nas suas principais ferramentas. Esta análise permite entender o verdadeiro alcance de conceitos e estratégias da Gestão da Qualidade, garantindo assim sua correta aplicação.<br>This paper shows how Quality Management, as we understand it today, has used the main concepts of fundamental management approaches. Here the impact of Classical Management Theory on Quality Management is considered. This analysis allows us to understand correctly the main concepts of Quality Management, as well as its main tools, in order to guarantee their correct application

A percepção dos usuários sobre a oferta de programas de promoção da saúde e prevenção de doenças: o caso de uma operadora de autogestão The users' perception of a health promotion and prevention program offer: a self-management operator case

A coexistência do setor público e privado de saúde no Brasil é antiga e os arranjos percorridos têm contribuído para a construção de um sistema fragmentado e complexo. Na busca por estabelecer políticas setoriais em harmonia com o Sistema Único de Saúde, a Agência Nacional de Saúde Suplementar tem estimulado o desenvolvimento de programas de promoção da saúde e prevenção de doenças no setor. Essas ações são consideradas como um conjunto heterogêneo de estratégias na consolidação de políticas que visem à saúde da população. Este é um estudo de caráter qualitativo que objetiva analisar esses programas em uma operadora de autogestão, com o intuito de compreender se eles produzem dispositivos biopolíticos. Foram coletados os discursos dos usuários dos programas por meio de um roteiro semiestruturado e utilizou-se a técnica de análise de conteúdo. Os resultados mostram que se encontram em curso alguns processos de reestruturação da produção do cuidado, e os aspectos relacionais têm sido priorizados nesses programas. Essas ações configuram-se em dispositivos biopolíticos conduzindo formas de viver. É importante a existência de equilíbrio entre as práticas desses poderes e a produção de liberdade, atentando para que não haja intervenções biopolíticas arbitrárias e autoritárias na produção das ações de saúde.<br>The coexistence of public and private health care systems in Brazil is old and their arrangements have contributed to the construction of a fragmented system. In seeking to establish policies in agreement with the Brazilian Unifed Health System, the National Agency of Supplemental Health insurance has encouraged the development of programs for health promotion and disease prevention on the private sector. These actions are a heterogeneous set of strategies to consolidate policies aiming at the population's health. This is a qualitative study that analyzes these preventive programs in a private health insurance agency, to understand whether they produce bio-political devices. Speeches were collected from users of the programs through a semi-structured script using the technique of content analysis. The results show that some restructuring processes of care production are ongoing, and relational aspects have been targeted in these programs. These actions are configured in devices leading biopolitical forms of life. It is important to have balance between these powers and the production practices of freedom, noting that there is no arbitrary and authoritarian biopolitical interventions in the production of health actions