Stakeholder efforts to mitigate antiretroviral therapy interruption among people living with HIV during the COVID-19 pandemic in China: a qualitative study.

INTRODUCTION: The COVID-19 pandemic has affected antiretroviral therapy (ART) continuity among people living with HIV (PLHIV) worldwide. We conducted a qualitative study to explore barriers to ART maintenance and solutions to ART interruption when stringent COVID-19 control measures were implemented in China, from the perspective of PLHIV and relevant key stakeholders. METHODS: Between 11 February and 15 February 2020, we interviewed PLHIV, community-based organization (CBO) workers, staff from centres for disease control and prevention (CDC) at various levels whose work is relevant to HIV care (CDC staff), HIV doctors and nurses and drug vendors from various regions in China. Semi-structured interviews were conducted using a messaging and social media app. Challenges and responses relevant to ART continuity during the COVID-19 pandemic were discussed. Themes were identified by transcript coding and mindmaps. RESULTS: Sixty-four stakeholders were recruited, including 16 PLHIV, 17 CBO workers, 15 CDC staff, 14 HIV doctors and nurses and two drug vendors. Many CDC staff, HIV doctors and nurses responsible for ART delivery and HIV care were shifted to COVID-19 response efforts. Barriers to ART maintenance were (a) travel restrictions, (b) inadequate communication and bureaucratic obstacles, (c) shortage in personnel, (d) privacy concerns, and (e) insufficient ART reserve. CBO helped PLHIV maintain access to ART through five solutions identified from thematic analysis: (a) coordination to refill ART from local CDC clinics or hospitals, (b) delivery of ART by mail, (c) privacy protection measures, (d) mental health counselling, and (e) providing connections to alternative sources of ART. Drug vendors contributed to ART maintenance by selling out-of-pocket ART. CONCLUSIONS: Social and institutional disruption from COVID-19 contributed to increased risk of ART interruption among PLHIV in China. Collaboration among key stakeholders was needed to maintain access to ART, with CBO playing an important role. Other countries facing ART interruption during current or future public health emergencies may learn from the solutions employed in China

LHASA URBAN MORPHOLOGY EVOLUTION AND CONSTRUCTION PATTERNS ANALYSIS

Proceedings of the XXV ISUF International Conference “Urban Form and Social Context: from Traditions to Newest Demands” (Krasnoyarsk, July 5–9, 2018)With the rapid development of Lhasa, a huge collision has emerged between the traditional urban form and the modern urban form. This article takes the temple areas, independently constructed settlements, modern apartments and modern service-centers as case studies, compares the textures, the lanes, the architectural prototypes and the living styles of these case studies from the comparative view of spontaneous construction mode and planning & construction mode. Finally, it explores Lhasa's urban form characteristics and evolution patterns so as to provide the theoretical support and the reference to the study on individualized and localized urban forms in Lhasa

A COMPARATIVE STUDY ON THERMAL ENVIRONMENTAL PERFORMANCE OF THE URBAN FORM PROTOTYPES BASED ON LOCAL CLIMATE ZONE (LCZ) SCHEME

Proceedings of the XXV ISUF International Conference “Urban Form and Social Context: from Traditions to Newest Demands” (Krasnoyarsk, July 5–9, 2018)The local climate zones (LCZ) classification was introduced by Stewart and Oke to standardize climatic observations. It aims at linking the different land cover patterns to their corresponding thermal properties directly from the perspective of urban geography. Yet the classification needs further development when it is applied into local urban form studies. The World Urban Database and Access Portal Tools (WUDAPT) strives to produce a global shared database capturing information on urban form and function for climate applications. Chengdu has been chosen as one of the testbeds around the world for WUDAPT level 1 and level 2 development. This article tries to develop the urban form typology study from the perspective of urban climatology, and to integrate the scheme of “local climate zones (LCZ)” landscape classification and “urban form typology”. It takes Chengdu as the testbed in hot-summer and cold-winter area. Firstly, based on the survey of the actual urban form, it extracts and purifies the theoretical prototypes of LCZ1 ~ 6. Based on the numerical simulation model “ENVI-met”, it compares the outdoor thermal performance of different LCZ theoretical prototypes in winter, it validates the applicability of LCZ theory in Chengdu and it has found that the result rules are basically consistent with the LCZ assumptions in the hot summer and cold winter areas. Finally, it proposes a research paradigm for the application of urban form typology to the further development of (LCZ) scheme

Case analysis and literature review of 3 children with short stature with ACAN gene mutation

Objective: To analyze the clinical features and genetic changes of 3 children in short stature with ACAN gene mutation. Methods: The clinical data, laboratory examinations, and genetic testing results of 3 children with ACAN gene mutations diagnosed with short stature at our pediatric endocrine disease clinic from 2018 to 2020 were collected, and the literature was reviewed for analysis and summary. Results: All the three children had a short family history, and their clinical manifestations were short stature. One patient had a slight limitation of the flexion activity of the thoracolumbar spine, and no other system abnormalities were found. Among them, the oldest of the 3 children was 5 years and 1 month, and the bone age was roughly consistent with or slightly advanced than the actual age, and the peak growth hormone challenge in 2 cases was less than 10 μg/L. The variations in the ACAN gene are c.G1877A and c.7360, respectively_ 7361del and c.7038_ 7039insCGGTGT, case 1 and case 2 are novel mutations that have not been reported in major databases. After the application of recombinant human growth hormone, the height of all three children improved. Reviewing the literature at home and abroad, we found that there were 120 children and 216 relatives reported at present. Among them, there were 80 ACAN gene variants related to short stature registered in HGMD, of which short stature was the most important clinical manifestation, followed by skeletal dysplasia. Conclusions: Mutations of ACAN gene mainly lead to short stature and skeletal dysplasia in children, and their clinical bone phenotypes are diverse, which can also only be manifested as short stature. For children with short stature, especially those with short stature family history, no matter whether they have skeletal abnormalities, they should be alert to this gene mutation

Single nucleus analysis of the chromatin landscape in mouse forebrain development

ABSTRACT Genome-wide analysis of chromatin accessibility in primary tissues has uncovered millions of candidate regulatory sequences in the human and mouse genomes 1–4 . However, the heterogeneity of biological samples used in previous studies has prevented a precise understanding of the dynamic chromatin landscape in specific cell types. Here, we show that analysis of the transposase-accessible-chromatin in single nuclei isolated from frozen tissue samples can resolve cellular heterogeneity and delineate transcriptional regulatory sequences in the constituent cell types. Our strategy is based on a combinatorial barcoding assisted single cell assay for transposase-accessible chromatin 5 and is optimized for nuclei from flash-frozen primary tissue samples (snATAC-seq). We used this method to examine the mouse forebrain at seven development stages and in adults. From snATAC-seq profiles of more than 15,000 high quality nuclei, we identify 20 distinct cell populations corresponding to major neuronal and non-neuronal cell-types in foetal and adult forebrains. We further define cell-type specific cis regulatory sequences and infer potential master transcriptional regulators of each cell population. Our results demonstrate the feasibility of a general approach for identifying cell-type-specific cis regulatory sequences in heterogeneous tissue samples, and provide a rich resource for understanding forebrain development in mammals

Author Correction: Single-nucleus analysis of accessible chromatin in developing mouse forebrain reveals cell-type-specific transcriptional regulation.

In the version of this article initially published online, the accession code was given as GSE1000333. The correct code is GSE100033. The error has been corrected in the print, HTML and PDF versions of the article