Virtual reality training for Hajj pilgrims as an innovative community translation dissemination medium

During the Islamic pilgrimage known as Hajj, Muslim pilgrims from all over the world, with many different backgrounds, gather together and coexist in the city of Mecca in Saudi Arabia. Managing a large and diverse congregation for the safe and successful completion of Hajj requires effective communication channels between speakers of the mainstream languages and international pilgrims or non-Arabic-speaking pilgrims. The focus of the study is on the use of innovative media in community translation (CT) dissemination methods and will determine which CT dissemination media are the most effective for English-speaking Hajj pilgrims. The study compares three forms of media: the booklet and video guides from the official Mnask Academy media produced by Hajj authorities; and the prototype of this study, an immersive virtual reality-based Hajj training media “VR-Hajj”. The methodology of the study consisted of three stages, starting with the development of assessment tools. Community translation usability (CTX) and medium usability (MX) for the different community translation dissemination media, which were based on the literature on CT studies and user-centred translation (UCT) studies, as well as usability studies (UX). The next stage was prototyping, which involved the collaboration between the researcher and virtual reality experts (developers and designers). The final stage was testing the three community translation dissemination media mentioned earlier with English-speaking Muslim users. A total of 96 Muslim respondents were surveyed, three groups were formed, and each participant evaluated a community translation dissemination medium. The self-administered questionnaire elicited perceptions and feedback about CTX and MX from the three groups. Quantitative data was processed using Statistical Package for the Social Sciences (SPSS), while qualitative data was analysed using the Thematic Analysis (TA) method. The results of the present study revealed significant differences between the levels of community translation perception and medium usability achieved by participants from each group. In addition, the results revealed the shortcomings of the conventional Mnask Academy training media currently in use, as well as the promising advantages of using innovative immersive virtual reality technology for Hajj training. The study concludes that immersive virtual reality technology, which allows pilgrims to mentally travel to the Hajj area, is more effective for understanding community translation, Hajj rituals and related cultural aspects than passively-created community translation media

Virological failure and development of new resistance mutations according to CD4 count at combination antiretroviral therapy initiation

Objectives: No randomized controlled trials have yet reported an individual patient benefit of initiating combination antiretroviral therapy (cART) at CD4 counts > 350 cells/μL. It is hypothesized that earlier initiation of cART in asymptomatic and otherwise healthy individuals may lead to poorer adherence and subsequently higher rates of resistance development. Methods: In a large cohort of HIV-positive individuals, we investigated the emergence of new resistance mutations upon virological treatment failure according to the CD4 count at the initiation of cART. Results: Of 7918 included individuals, 6514 (82.3%), 996 (12.6%) and 408 (5.2%) started cART with a CD4 count ≤ 350, 351-499 and ≥ 500 cells/μL, respectively. Virological rebound occurred while on cART in 488 (7.5%), 46 (4.6%) and 30 (7.4%) with a baseline CD4 count ≤ 350, 351-499 and ≥ 500 cells/μL, respectively. Only four (13.0%) individuals with a baseline CD4 count > 350 cells/μL in receipt of a resistance test at viral load rebound were found to have developed new resistance mutations. This compared to 107 (41.2%) of those with virological failure who had initiated cART with a CD4 count < 350 cells/μL. Conclusions: We found no evidence of increased rates of resistance development when cART was initiated at CD4 counts above 350 cells/μL. HIV Medicin