IFNL3 (IL28B) favorable genotype escapes hepatitis C virus-induced microRNAs and mRNA decay

The IFNL3 (IL28B) gene has received immense attention in the hepatitis C virus (HCV) field as multiple independent genome-wide association studies identified a strong association between polymorphisms near the IFNL3 gene and HCV clearance. However, the mechanism underlying this association has remained elusive. In this study, we report the identification of a functional polymorphism (rs4803217) located in the 3′ untranslated region (3′ UTR) of the IFNL3 mRNA that dictates transcript stability. This polymorphism influences AU-rich element-mediated decay as well as the binding of HCV-induced microRNAs during infection. Together, these pathways mediate robust repression of the unfavorable IFNL3 genotype. These data reveal a novel mechanism by which HCV attenuates the antiviral response and uncover new potential therapeutic targets for HCV treatment

International Construction Measurement Standards: Global Consistency in Presenting Construction Costs

This publication presents an international cost classification system for infrastructure projects. It aims to provide global consistency in classifying, defining, measuring, analysing and presenting the cost of infrastructure projects

Convergent Evolution of Escape from Hepaciviral Antagonism in Primates

Escape from antagonism by hepatitis C and related viruses has repeatedly evolved in antiviral factor MAVS via convergent evolution, revealing an ancient history of previous viral encounters in primates

Virology under the microscope—a call for rational discourse

Viruses have brought humanity many challenges: respiratory infection, cancer, neurological impairment and immunosuppression to name a few. Virology research over the last 60+ years has responded to reduce this disease burden with vaccines and antivirals. Despite this long history, the COVID-19 pandemic has brought unprecedented attention to the field of virology. Some of this attention is focused on concern about the safe conduct of research with human pathogens. A small but vocal group of individuals has seized upon these concerns – conflating legitimate questions about safely conducting virus-related research with uncertainties over the origins of SARS-CoV-2. The result has fueled public confusion and, in many instances, ill-informed condemnation of virology. With this article, we seek to promote a return to rational discourse. We explain the use of gain-of-function approaches in science, discuss the possible origins of SARS-CoV-2 and outline current regulatory structures that provide oversight for virological research in the United States. By offering our expertise, we – a broad group of working virologists – seek to aid policy makers in navigating these controversial issues. Balanced, evidence-based discourse is essential to addressing public concern while maintaining and expanding much-needed research in virology

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Relationship Between Trust and Perceived Value of Faculty Unionization Among Full-Time Faculty in Selected Michigan Community Colleges

Problem Statement. There are conflicting studies on the relationship between the union and nonunion faculty and trust. Studies have shown that the union environment inherently produces a distrustful atmosphere and, with a union, employees are actually more dissatisfied than their nonunion counterparts. On the other hand, this has created a cycle where faculty may not trust administration, and administration may not trust faculty. For example, when doing negotiations, each party fights on behalf of itself, instead of fighting for the betterment of the organization. However, unions can give faculty a voice with administration and state and federal government, and may positively influence extrinsic rewards such as salary and benefits. This study investigated the relationship between faculty trust towards administration, other faculty, and union membership—specifically how trust is related to the relationships of faculty, administration, and the union. Method. This study used ex post facto or non-experimental research, which is a systematic inquiry where the researcher does not have control over the independent variables. It was used to determine if there is a relationship between faculty’s level of trust and their desire to be unionized, or if already unionized their desire was to stay unionized. This type of research displays the relationships among the variables but does not assume cause or effect. The Omnibus T-Scale developed by Hoy and Tschannen-Moran in 2003 was used to measure trust with their colleagues (other faculty), trust with administration, and trust total. The trust survey was sent to the full-time faculty at five Michigan community colleges. Community colleges selected were similar in size, demographics, and setting. The main difference for all of the community colleges is their union membership. Three nonunionized community colleges in Michigan were selected along with two unionized community colleges similar to the non-unionized community colleges in demographics, socioeconomic status, student population, and full-time faculty. Results. Based on these findings, this study led to the conclusion that there is a relationship between unionization and trust between faculty at unionized schools and administration. There is not a significant difference between trust at unionized and nonunionized schools and faculty. In fact, these findings are consistent with the literature that says, “There is usually an inverse relationship between rules and trust: the more people depend on rules to regulate their interactions, the less they trust others, and vice versa.” On the other hand, one important finding of this study that does not seem to be addressed in the literature is that there does not seem to be a relationship between trust and faculty and other faculty in regard to unionization status. Conclusion. According to the findings of this study, trust tends to make a difference on faculty trust with administration in a unionized environment. Trust is foundational to all relationships; it may positively influence faculty job satisfaction, student retention, and student engagement, and improve organizational effectiveness. It is my expectation that this study will help community college administrators develop strategies to increase trus