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.
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