Standing genetic variation and the evolution of drug resistance in HIV

Drug resistance remains a major problem for the treatment of HIV. Resistance can occur due to mutations that were present before treatment starts or due to mutations that occur during treatment. The relative importance of these two sources is unknown. We study three different situations in which HIV drug resistance may evolve: starting triple-drug therapy, treatment with a single dose of nevirapine and interruption of treatment. For each of these three cases good data are available from literature, which allows us to estimate the probability that resistance evolves from standing genetic variation. Depending on the treatment we find probabilities of the evolution of drug resistance due to standing genetic variation between 0 and 39%. For patients who start triple-drug combination therapy, we find that drug resistance evolves from standing genetic variation in approximately 6% of the patients. We use a population-dynamic and population-genetic model to understand the observations and to estimate important evolutionary parameters. We find that both, the effective population size of the virus before treatment, and the fitness of the resistant mutant during treatment, are key-parameters that determine the probability that resistance evolves from standing genetic variation. Importantly, clinical data indicate that both of these parameters can be manipulated by the kind of treatment that is used.Comment: 33 pages 6 figure

Health-promoting lifestyle and quality of life among Chinese nursing students

202208 bckwVersion of RecordSelf-fundedPublishe

Exploring Hong Kong’s Role as Strategic Partner for “Belt and Road” Countries - Closing the Cultural Gap

Belt and Road (B&R) is an ambitious collaborative infrastructure development initiative launched by the Chinese government in 2013, covering over 60 countries with about two-third of world population and one-third of global GDP at the time, which has now extended to over 100 countries. This makes it an unprecedented plan for long-term economic growth with a lasting impact on the fortunes of the individual partner countries and the global economy as a whole. The overall time-scale for the project has been set at roughly 35 years and the total investment value in excess of US$10 trillion. The B&R initiative aims to build a shared cross-border infrastructure to facilitate foreign policy through economic cooperation and minimization of any conflict risk. However, B&R involves significantly weaker cross-border integration than an economic union like European Union by focusing on creating shared transport links among the partner countries and China but not doing anything with the production infrastructure in each country. The public response to B&R has been rather mixed across the various partner countries because people are still not sure about how this would benefit or harm their individual and national interests. In view of the uncertainty about the potential outcomes of a huge initiative like B&R, we aim to explore how it is perceived by the managers in both China and all the B&R partner countries. In this chapter, we aim to explore the nature and extent of ‘B&R-Readiness’, which we define as the ability of the managers working in China and B&R partner countries, to meaningfully engage with each other in order to face the challenges and tap the opportunities offered by the B&R initiative. Next, we introduce a self-administered structured questionnaire to help these managers and their employers to assess their level of B&R-Readiness. We also explore the impact of psychic distance (differences in cultural values and business practices) and cultural familiarity between managers in China and the B&R countries. Finally, we identify and discuss the ways in which Hong Kong government and businesses can play a strategic role to prepare the managers in China and the B&R countries to be B&R-ready