Geographic and temporal trends in the molecular epidemiology and genetic mechanisms of transmitted HIV-1 drug resistance:an individual-patient- and sequence-level meta-analysis

Regional and subtype-specific mutational patterns of HIV-1 transmitted drug resistance (TDR) are essential for informing first-line antiretroviral (ARV) therapy guidelines and designing diagnostic assays for use in regions where standard genotypic resistance testing is not affordable. We sought to understand the molecular epidemiology of TDR and to identify the HIV-1 drug-resistance mutations responsible for TDR in different regions and virus subtypes.status: publishe

Effects of a Newly Developed Early Post-hatch Feed for Poultry Hatchlings on the Performance of Poultry

Usually, 24h or sometimes more are necessary for hatchlings to arrive at farms after hatching. During this period, the chicks are supplied neither feed nor water. To overcome the disadvantages caused by the long-term fasting, a new early post-hatch feed named ‘Chick-aide’ was developed, which was moistened before use and used in hatcheries and at farms. Extruded pellets of 2.5mm in diameter were produced using natural feed ingredients. This contained 3.05McalME/kg, 30.7%CP and 11.2%CF at mash base before extrusion. Chicks were usually supplied with 200g of ‘Chick-aide’ per 100 birds in the hatcheries and 100g at farms. With the trials in experimental houses, ‘Chick-aide’ increased intestinal weight of newly hatched layer male chicks by 62.4 or 42.0% at 24h after feeding, compared to the 24h fasted group. Intestinal length was also increased by 12.6%. The chicks supplied with ‘Chick-aide’ on the day of hatch and after 24h at farms showed increased body weight by 5.7% at 1 week and 4.4% at 2 weeks age compared to the control. In a field trial with 10,000 layer hatchlings, ‘Chick-aide’ increased body weight by 6.9% at 1 week age in comparison to control chicks treated in a customary manner. Other field trials with 10,000 small sized broilers produced by immature breeders and 9,400 ordinary broilers showed that the body weight of small male chicks was increased by 150g at nearly shipping age (51 days) and that of ordinary chicks by 190g (52 days) with ‘Chick-aide’, compared to the control. The results showed that ‘Chick-aide’ developed intestine of early post-hatch chicks remarkably and improved the subsequent growth. Benefit vs cost calculation for broilers suggested that ‘Chick-aide’ was cost-effective. The early post-hatch feeds such as ‘Chick-aide’ which supply hatchlings with nutrients and water together are considered to be essential for the maximum poultry performance

Effects of communication skill training (CST) based on SPIKES for insurance-covered pharmacy pharmacists to interact with simulated cancer patients

Abstract Background With the development of pharmacotherapy and radiotherapy, cancer treatment is being shifted from surgical to outpatient services, consequently increasing insurance-covered pharmacies’ frequency of dealing with cancer patients. As the psychology of these patients is complex, it is necessary for pharmacists to educate them in consideration of their cognitive/medical and psychosocial aspects. This study analyzed cancer patient management by pharmacists working in such pharmacies and their communication skills before and after communication skill training based on SPIKES, a six-step protocol for delivering bad news, to confirm the usefulness of such training. Methods The study involved 20 pharmacists working in insurance-covered pharmacies within Aichi Prefecture. Before and after communication skill training, role-play sessions were held using standardized patients, whose levels of satisfaction were subsequently measured. Patient management by the pharmacists was analyzed using the Roter Interaction Analysis System as a method to analyze dialogues. Results The rate of each category, representing the pharmacists’ conversation styles when dealing with the patients, changed after communication skill training as follows: [Giving information]: decreased from 37.0 to 27.6%; [Empathy statements]: increased from 12.0 to 17.2%; and [Data gathering]: increased from 18.0 to 23.3%. The increase was particularly marked in: [Acceptance], accepting patients’ emotions and events in line with [Empathy statements]; [Promoting dialogues] as a sub-category of [Building a relationship]; and [Checks for understanding] as a sub-category of [Data gathering]. Furthermore, the results of pharmacist assessment by the patients, including their levels of overall satisfaction, showed significant correlations with [Empathy statements] and [Building a relationship]. Conclusions Communication skill training may be effective to improve pharmacists’ conversation styles to listen to patients more attentively, accept their emotions, and provide education in accordance with their needs, rather than unilaterally providing information. Trial registration The study was approved by the Ethical Review Board of Meijo University as a research activity involving humans (approval number: H26-1 )