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Introduction:Few clinical trials and cohort studies have evaluated the efficacy of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in people with HIV (PWH) with preexisting M184V/I or other nucleos(t)ide reverse transcriptase inhibitor (NRTI) resistance-associated mutations (RAMs). Real-world data are also scarce.Methods:Retrospective review of treatment-experienced patients who started B/F/TAF in a cohort of PWH. HIV-RNA less than 50 copies/ml was analyzed at 48 weeks in an intention-to-treat (ITT) analysis (missing=failure) and per protocol analysis (patients with missing data or changes for reasons other than virological failure were excluded). Results were compared in patients with and without previous NRTI-RAMs.Results:Five hundred and six PWH were included (16.2% women). Median age and time with HIV infection were 52.3 and 18.9 years, respectively. At baseline, viral load was less than 50 copies/ml in 440 patients (86.6%). Overall, 69 (13.6%) participants had documented preexisting NRTI-RAMs: 57 (11.2%) M184V/I and 30 (5.9%) tenofovir RAMs. In the ITT analysis, 83% (420/506) had HIV-RNA less than 50 copies/ml [82.2% (359/437) and 88.4% (61/69) in persons without and with NRTI-RAMs, respectively (P = 0.2)]. In the per protocol analysis 94.2% (420/445) had HIV-RNA less than 50 copies/ml [94.4% (359/380) vs. 93.8% (61/65); P = 0.2]. A total of 61 participants were excluded from the per protocol analysis (23 missing data, 19 discontinued B/F/TAF because of toxicity, 13 for other reasons, and 6 died).Conclusion:Switching to B/F/TAF is well tolerated and effective in the real-world setting, even in patients with preexisting NRTI RAMs, such as M184V and RAMs conferring resistance to tenofovir. These results confirm the robustness of this combination.

The construction site is a hazardous place. The dynamic, complex interaction between workers, machinery, and the environment leads to dangerous risks. In response to such risks, the goal is to fulfill the zero accidents philosophy, which requires the development of safety skills among workers and the provision of tools for risk prevention. In pursuit of that vision, this work studies collective protective equipment (CPE). Traditional methodologies propose visual inspections using checklists, the effectiveness of which depends on the quality of the inspection by the safety advisor (SA). This paper analyses the traditional process of safety inspections in building projects: the traditional methods, main pain points, and bottlenecks are identified, along with the key performance indicators (KPIs) needed to complete these processes correctly. Because of this, a methodology that digitises the CPE inspection process is proposed. Augmented reality (AR) is used as a 3D viewer with an intuitive interface for the SA, and, accordingly, functional requirements are detailed and different information layers and user interfaces for AR applications are proposed. In addition, the workflow and KPIs are shown. To demonstrate the feasibility of the proposal, a proof of concept is developed and evaluated. The relevance of this work lies in providing background for the use of AR in safety inspection processes on construction sites and in offering methodological recommendations for the development and evaluation of these applications.

Two of the differential characteristics of the AECO sector (architecture, engineering, construction and operation) are barriers for the mass creation of training materials for its workers. On the one hand, the workplace is unique and changing over time; on the other, the aging trend of its workers and the unattractive nature of the industry for new generations of professionals. These two problems can be tackled by virtual reality technologies, which allow the agile creation of all kinds of scenarios, while their current technology may be attractive to young people and intuitive for everyone. This work shows the results of an investigation that seeks to provide automated tools based on virtual reality experiences to support learning in occupational risk prevention. This objective is part of the development of a culture for prevention, which allows the treatment of the human factor, with all its complexity and casuistry. The proposal includes the development of a process and tools that allow replicating the specific scenario where the work will be carried out, incorporating risks and probable incidents, systematically establishing cause-effect relationships, incorporating a narrative (storytelling) that provides emotional meaning to users and Lastly, the creation of a workflow that facilitates the agile development of these virtual reality experiences for each specific work.

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Background Despite evidence shown of dolutegravir-related neurotoxicity, which may be more common when combined with abacavir, its reversibility has not been explored in a clinical trial. Methods Randomized, multicentre, open-label, pilot-trial to evaluate the reversibility of patient-reported neuropsychiatric symptoms, developed or worsened on dolutegravir/abacavir/lamivudine (DTG/ABC/3TC), in virologically suppressed patients switched to cobicistat-boosted-elvitegravir/emtricitabine/tenofovir-alafenamide (EVG/COBI/FTC/TAF). Participants were randomized to immediate switch (baseline) or to defer switch (week 4) and then, all completed 24 weeks of follow up on EVG/COBI/FTC/TAF. At each visit, participants completed Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression (HAD) scales and were interviewed about 11 neuropsychiatric symptoms potentially related with DTG through a questionnaire. At baseline and at the end of follow-up, they also performed neurocognitive testing. Our primary objective was to compare changes in neuropsychiatric symptoms and PSQI and HAD scales between arms at week 4. Secondary objectives were to evaluate changes in neuropsychiatric symptoms and PSQI and HAD scales at weeks 4, 12 and 24 after switching to EVG/COBI/FTC/TAF and in neurocognitive performance and MRI biomarkers at end of follow up. Results Thirty-eight participants were included. Study arms were similar at baseline. At week 4, neuropsychiatric symptoms and PSQI and HAD scores remained unchanged in participants receiving DTG/ABC/3TC while improved significantly in participants receiving EVG/COBI/FTC/TAF. These significant improvements were also observed at weeks 4, 12 and 24 after all participants switched to EVG/COBI/FTC/TAF. Also, global neurocognitive performance improved (NPZ-7) after switching to EVG/COBI/FTC/TAF. Conclusion Neuropsychiatric symptoms in patients on DTG/ABC/3TC could resolve or improve after switching to EVG/COBI/FTC/TAF.

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