The definition,characteristics and roles of experiencing rural tourism were discussed in this study,which confirmed the relationship between the development of experiencing rural tourism and the new socialist countrys...The definition,characteristics and roles of experiencing rural tourism were discussed in this study,which confirmed the relationship between the development of experiencing rural tourism and the new socialist countryside construction,and some development strategies were put forward.展开更多
The philosopher Eugene Gendlin argues that a distinctive mode of reasoning, called experiencing, is necessary for working through personally salient problems such as are encountered in psychotherapy. We review support...The philosopher Eugene Gendlin argues that a distinctive mode of reasoning, called experiencing, is necessary for working through personally salient problems such as are encountered in psychotherapy. We review supporting empirical support. It is now possible to consider Gendlin’s ideas from a neurological perspective. Work directed at understanding the neurological underpinnings of consciousness and self-related processing, as well as comparative neuroanatomical work, are all consistent with and elucidated by Gendlin’s experiencing construct. We argue from this data that the human mind is composed of three interacting systems that are unique to or enhanced in humans compared to other primates. Two are dedicated to “hot and cold” cognition. The most important, least well-studied third system is dedicated to mediating between these forms of cognition. We outline how interactions between these systems define different forms of psychopathology and what they suggest about the structure of the human mind.展开更多
College English plays a vital role in English teaching in China. However, any teaching is inseparable from the assistance of teaching material. Among the various English teaching materials currently, what are most oft...College English plays a vital role in English teaching in China. However, any teaching is inseparable from the assistance of teaching material. Among the various English teaching materials currently, what are most often used are Experiencing English and New Horizon College English. These two English teaching materials are both adapted according to new teaching syllabus and the practical teaching needs. Both teaching materials have their own advantages and disadvantages.展开更多
The 50 years of friendship and exchange between China and Tanzania allow for a greater understanding between the people. Here three Tanzanians share with ChinAfrica their life and memories about China.
REMEMBER the days when people used to have a phone, a computer and a camera？ I do - simply because it wasn＇t that long ago. However, as technology hurtles along at the speed of light, it might have escaped some peo...REMEMBER the days when people used to have a phone, a computer and a camera？ I do - simply because it wasn＇t that long ago. However, as technology hurtles along at the speed of light, it might have escaped some people＇s attention that all these three devices now come together in the form of a smartphone, There＇s no need to carry all three devices when visiting a tourist site or monument - your handy smartphone can take a picture, log on to the Internet to post your picture on social media, and then use the calling function to tell your friends about the pictures you＇ve just posted.展开更多
The Spring Festival is the largest and most important festival in China and among Chinese communities worldwide.Having experienced the festival for six years in China,I have developed a deep appreciation for its cultu...The Spring Festival is the largest and most important festival in China and among Chinese communities worldwide.Having experienced the festival for six years in China,I have developed a deep appreciation for its cultural,social,and economic significance.展开更多
The Tibet Pavilion at the World Expo in Shanghai serves to introduce vips to the wonders of this beautiful area It is not hard to see why the Tibet pavilion is so popular; its combination of beautiful
AIM:To report incidence,indications,and visual outcomes of intraocular lens(IOL)exchange/explantation surgery.METHODS:Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^(st) Januar...AIM:To report incidence,indications,and visual outcomes of intraocular lens(IOL)exchange/explantation surgery.METHODS:Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^(st) January 2017 and 31^(st) December 2022.The overall outcomes as well as comparison between the trainee versus experienced surgeons were analyzed.RESULTS:Out of 39778 cataract surgeries(with no preexisting ocular co-morbidities)during a six-year period(2017-2022),60(0.15%)needed IOL exchange/explantation.Surgeons-under-training performed 36/60 cases(60%)while 24/60(40%)were by experienced surgeons.The commonest indication was subluxated IOL in 26(43.3%),followed by dislocated IOL in 20(33.3%),postoperative refractive surprise in 7(11.6%),IOL induced uveitis in five and broken haptic in two eyes.Twenty-four(40%)eyes had intraoperative complications during primary surgery.Posterior chamber IOL(PCIOL)was the commonest secondary IOL in 21(35%)eyes,scleral fixated in 20(31.6%),anterior chamber IOL(ACIOL)in 13(21.6%),iris fixated IOL in three(5%)and three eyes(5%)were left aphakic.The mean time between primary and secondary surgery was 168d(168±338.8).Best corrected visual acuity(BCVA)of>20/60 was obtained in 43 eyes(71.66%),20/80-20/200 in 14(23.33%),20/250 in two and hand movements in one.No statistically significant difference in visual outcome was noted at post-op one month between trainees versus experienced surgeons(UCVA 0.45±0.29 vs 0.53±0.32,P=0.20,BCVA 0.34±0.25 vs 0.37±0.26,P=0.69).CONCLUSION:IOL subluxation as the commonest indication and posterior capsular rupture is the commonest intraoperative risk factor.This complication can be effectively addressed with selection of the appropriate secondary IOL achieving good visual outcomes in over 70% of patients.展开更多
From November 26 to December 3,2023,Professor Wu Dong of the International Wushu Development Research Center of the China Wushu School,Beijing Sport University went to Tanzania and Mauritius to give lectures.During th...From November 26 to December 3,2023,Professor Wu Dong of the International Wushu Development Research Center of the China Wushu School,Beijing Sport University went to Tanzania and Mauritius to give lectures.During the 8-day China Story Taijiquan lecture series,the people of Tanzania and Mauritius have got close to Taijiquan,understood the mystery of Taijiquan and experienced its effects on health.展开更多
CHINA Promising Drone Industry China’s drone industry has experienced rapid development,with a massive surge in the number of newly registered unmanned aerial vehicles(UAVs)in H1 of 2024.
To explore the relationship between rear-end crash risk and its influencing factors, on-road experiments were conducted for measuring the individual vehicle trajectory data associated with novice and experienced drive...To explore the relationship between rear-end crash risk and its influencing factors, on-road experiments were conducted for measuring the individual vehicle trajectory data associated with novice and experienced drivers. The rear-end crash potential probability based on the time to collision was proposed to represent the interpretation of rear-end crash risk.One-way analysis of variance was applied to compare the rearend crash risks for novice and experienced drivers. The rearend crash risk models for novice and experienced drivers were respectively developed to identify the effects of contributing factors on the driver rear-end crash risk. Also, the cumulative residual method was used to examine the goodness-of-fit of models. The results show that there is a significant difference in rear-end risk between the novice and experienced drivers.For the novice drivers, three risk factors including the traffic volume, the number of lanes and gender are found to significantly impact on the rear-end crash risk, while significant impact factors for experienced drivers are the vehicle speed and traffic volume. The rear-end crash risk models perform well based on the existing limited data samples.展开更多
A number of prominent solution-focused brief therapists have expressed the view that, to its detriment, this school of therapy tends to downplay emotion. Accordingly, we contend that, given that emotion is a primal bi...A number of prominent solution-focused brief therapists have expressed the view that, to its detriment, this school of therapy tends to downplay emotion. Accordingly, we contend that, given that emotion is a primal binding force, the bonding component of the crucially important therapeutic alliance risks being compromised in the current practice of this approach. We further argue that the prioritization of the depiction of actions that accompany the emotion expressed by the client over the actual participation in this emotion by the therapist tends to superficialize therapeutic communication. This is especially likely to happen when the therapist lapses into a formulaic, action-soliciting interrogatory mode in response to the emotion expressed by the client. In addition, we claim that the incorporation of emotion- and body-based approaches into the solution-focused canon could remedy the affective lacuna referred to above. We note, however, that such a modification would most likely face stiff resistance from some of the gatekeepers of solution-faced therapy, in particular those who subscribe to the “surface-only” descriptive approach advocated by the philosopher Ludwig Wittgenstein. And yet, the effectiveness of depth-oriented therapies, such as sensorimotor psychotherapy and somatic experiencing, is supported by neurophysiological considerations. Finally, we suggest that these therapies, and even creativogenic elements of psychoanalysis, can actually synergize solution-focused brief therapy through the generation of affect-laden images, sensations and thoughts that lend themselves to the realization of outcomes desired by the client, which is the raison d’etre of solution-focused brief therapy. This paper pleads for the incorporation of the above-noted depth approaches into solution-focused brief therapy with a view to augmenting its effectiveness through a stronger therapeutic bond owing to an increased emotional engagement on the part of the therapist.展开更多
AIM： To clarify the effectiveness of CO2 insufflation in potentially difficult colonoscopy cases, particularly in relation to the experience level of colonoscopists. METHODS： One hundred twenty potentially difficult...AIM： To clarify the effectiveness of CO2 insufflation in potentially difficult colonoscopy cases, particularly in relation to the experience level of colonoscopists. METHODS： One hundred twenty potentially difficult cases were included in this study, which involved females with a low body mass index and patients with earlier abdominal and/or pelvic open surgery or previously diagnosed left-side colon diverticulosis. Patients receiving colonoscopy examinations without sedation using a pediatric variable-stiffness colonoscope were divided into two groups based on either CO2 or standard air insuffiation. Both insufflation procedures were also evaluated according to the experience level of the respective colonoscopists who were divided into an experienced colonoscopist （EC） group and a less experienced colonoscopist （LEC） group. Study measurements included a 100-mm visual analogue scale （VAS） for patient pain during and after colonoscopy examinations, in addition to insertion to the cecum and withdrawal times. RESULTS： Examination times did not differ, however, VAS scores in the CO2 group were significantly better than in the air group （P〈 0.001, two-way ANOVA） from immediately after the procedure and up to 2 h later. There were no significant differences between either insufflation method in the EC group （P = 0.29）, however, VAS scores for CO2 insufflation were significantly better than air insufflation in the LEC group （P = 0.023） immediately after colonoscopies and up to 4 h afterwards. CONCLUSION： CO2 insufflation reduced patient pain after colonoscopy in potentially difficult cases when performed by LECs.展开更多
China has experienced dramatic changes in food consumption patterns over the last three decades. However, there are different opinions regarding the future trends in consumption. By adopting the well-developed partial...China has experienced dramatic changes in food consumption patterns over the last three decades. However, there are different opinions regarding the future trends in consumption. By adopting the well-developed partial equilibrium model-China Agricultural Policy Simulation Model（CAPSi M）, the demand for livestock products and the main feed crops over 2011–2030 is predicted and analyzed. It is found that China＇s per capita consumption of livestock products will continue to rise during this period, even though its growth rate will slow down gradually. Meanwhile, the expansion of livestock production will pose great challenges for feed supply in China. More accurately, China will be confronted with feed security rather than grain security in the future.展开更多
The objective of this research was to assess the characteristics of seismic induced damage and the deformation patterns of pre-stressed cement-grouted cables that are used for rock slope stabilization projects subject...The objective of this research was to assess the characteristics of seismic induced damage and the deformation patterns of pre-stressed cement-grouted cables that are used for rock slope stabilization projects subjected to quasi-static cyclic loading.The experimental configuration includes the installation of 15 pre-stressed cables in a slope model made of concrete blocks(theoretically rigid rock mass) on top of a pre-existing sliding surface.The study showed that:(i) The pre-stressed cables exhibited great seismic performance.Rapid displacement of the model blocks was observed after the complete loss of the initial pre-stress load under continued applied cyclic loads and exceedance of the state of equilibrium,which implies the higher the initial pre-stress load,the better the seismic performance of the rock anchor;(ii) The failure of the pre-stressed cables was due to fracture at the connection of the tendons and cable heads under cyclic loading.The sequence of failure had a distinct pattern.Failure was first observed at the upper row of cables,which experienced the most severe damage,including the ejection of cable heads.No evidence of de-bonding was observed during the cyclic loading;(iii) The stress distribution of the bond length for pre-stressed cables was highly non-uniform.High stress concentrations were observed at both the fixed end and the free end of the bond length both before and immediately after the state of equilibrium is exceeded.The results obtained can be used to evaluate the overall performance of pre-stressed rock anchors subject to seismic loading and their potential as rockfall prevention and stabilization measures.展开更多
We describe an observational study of clinical, virologic and drug resistance profiles in HIV-positive antiretroviral adherent subjects with stable low level viremia (LLV) 50 - 1000 copies/mL for more than 12 months. ...We describe an observational study of clinical, virologic and drug resistance profiles in HIV-positive antiretroviral adherent subjects with stable low level viremia (LLV) 50 - 1000 copies/mL for more than 12 months. Subjects were followed from time of first detectable viral load (VL). In total, 102 episodes of LLV were detected among 80 individuals. The median (mean, range) HIV copy number at genotyping was 250 (486, - 3900) copies/mL after 14 (17.9, 0 - 58) months of LLV. Few patients maintained LLV for the entire 9 years period of observation, with half (52%) experiencing viremic progression following a stable period of LLV either spontaneously or after treatment interruption or failed regimen intensification. In the setting of prolonged periods of sustained LLV, mean duration 22 (range 8 - 106) months, drug resistance (DR) was almost universal. Resistance to ≥1 on-treatment drugs was defined in 97% of specimens and DR to all drugs in the treatment regimen in over half of all patients. Evolution of DR mutations during the period of LLV was observed in 20/28 (71%) subjects with specimens available for follow-up testing. This evolution was associated with viremic progression to levels >1000 copies/mL (p = 0.03). Our data suggest that DR present in patients with LLV is likely to impact long term clinical outcomes, highlighting the importance of optimizing techniques to detect the presence of drug resistant HIV in the setting of LLV and the need for larger prospective studies to assess the emergence of DR in the setting of sustained LLV and the impact of this DR on treatment outcomes.展开更多
文摘The definition,characteristics and roles of experiencing rural tourism were discussed in this study,which confirmed the relationship between the development of experiencing rural tourism and the new socialist countryside construction,and some development strategies were put forward.
文摘The philosopher Eugene Gendlin argues that a distinctive mode of reasoning, called experiencing, is necessary for working through personally salient problems such as are encountered in psychotherapy. We review supporting empirical support. It is now possible to consider Gendlin’s ideas from a neurological perspective. Work directed at understanding the neurological underpinnings of consciousness and self-related processing, as well as comparative neuroanatomical work, are all consistent with and elucidated by Gendlin’s experiencing construct. We argue from this data that the human mind is composed of three interacting systems that are unique to or enhanced in humans compared to other primates. Two are dedicated to “hot and cold” cognition. The most important, least well-studied third system is dedicated to mediating between these forms of cognition. We outline how interactions between these systems define different forms of psychopathology and what they suggest about the structure of the human mind.
文摘College English plays a vital role in English teaching in China. However, any teaching is inseparable from the assistance of teaching material. Among the various English teaching materials currently, what are most often used are Experiencing English and New Horizon College English. These two English teaching materials are both adapted according to new teaching syllabus and the practical teaching needs. Both teaching materials have their own advantages and disadvantages.
文摘The 50 years of friendship and exchange between China and Tanzania allow for a greater understanding between the people. Here three Tanzanians share with ChinAfrica their life and memories about China.
文摘REMEMBER the days when people used to have a phone, a computer and a camera？ I do - simply because it wasn＇t that long ago. However, as technology hurtles along at the speed of light, it might have escaped some people＇s attention that all these three devices now come together in the form of a smartphone, There＇s no need to carry all three devices when visiting a tourist site or monument - your handy smartphone can take a picture, log on to the Internet to post your picture on social media, and then use the calling function to tell your friends about the pictures you＇ve just posted.
文摘The Spring Festival is the largest and most important festival in China and among Chinese communities worldwide.Having experienced the festival for six years in China,I have developed a deep appreciation for its cultural,social,and economic significance.
文摘The Tibet Pavilion at the World Expo in Shanghai serves to introduce vips to the wonders of this beautiful area It is not hard to see why the Tibet pavilion is so popular; its combination of beautiful
文摘AIM:To report incidence,indications,and visual outcomes of intraocular lens(IOL)exchange/explantation surgery.METHODS:Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^(st) January 2017 and 31^(st) December 2022.The overall outcomes as well as comparison between the trainee versus experienced surgeons were analyzed.RESULTS:Out of 39778 cataract surgeries(with no preexisting ocular co-morbidities)during a six-year period(2017-2022),60(0.15%)needed IOL exchange/explantation.Surgeons-under-training performed 36/60 cases(60%)while 24/60(40%)were by experienced surgeons.The commonest indication was subluxated IOL in 26(43.3%),followed by dislocated IOL in 20(33.3%),postoperative refractive surprise in 7(11.6%),IOL induced uveitis in five and broken haptic in two eyes.Twenty-four(40%)eyes had intraoperative complications during primary surgery.Posterior chamber IOL(PCIOL)was the commonest secondary IOL in 21(35%)eyes,scleral fixated in 20(31.6%),anterior chamber IOL(ACIOL)in 13(21.6%),iris fixated IOL in three(5%)and three eyes(5%)were left aphakic.The mean time between primary and secondary surgery was 168d(168±338.8).Best corrected visual acuity(BCVA)of>20/60 was obtained in 43 eyes(71.66%),20/80-20/200 in 14(23.33%),20/250 in two and hand movements in one.No statistically significant difference in visual outcome was noted at post-op one month between trainees versus experienced surgeons(UCVA 0.45±0.29 vs 0.53±0.32,P=0.20,BCVA 0.34±0.25 vs 0.37±0.26,P=0.69).CONCLUSION:IOL subluxation as the commonest indication and posterior capsular rupture is the commonest intraoperative risk factor.This complication can be effectively addressed with selection of the appropriate secondary IOL achieving good visual outcomes in over 70% of patients.
文摘From November 26 to December 3,2023,Professor Wu Dong of the International Wushu Development Research Center of the China Wushu School,Beijing Sport University went to Tanzania and Mauritius to give lectures.During the 8-day China Story Taijiquan lecture series,the people of Tanzania and Mauritius have got close to Taijiquan,understood the mystery of Taijiquan and experienced its effects on health.
文摘CHINA Promising Drone Industry China’s drone industry has experienced rapid development,with a massive surge in the number of newly registered unmanned aerial vehicles(UAVs)in H1 of 2024.
基金The National Natural Science Foundation of China(No.51478110)
文摘To explore the relationship between rear-end crash risk and its influencing factors, on-road experiments were conducted for measuring the individual vehicle trajectory data associated with novice and experienced drivers. The rear-end crash potential probability based on the time to collision was proposed to represent the interpretation of rear-end crash risk.One-way analysis of variance was applied to compare the rearend crash risks for novice and experienced drivers. The rearend crash risk models for novice and experienced drivers were respectively developed to identify the effects of contributing factors on the driver rear-end crash risk. Also, the cumulative residual method was used to examine the goodness-of-fit of models. The results show that there is a significant difference in rear-end risk between the novice and experienced drivers.For the novice drivers, three risk factors including the traffic volume, the number of lanes and gender are found to significantly impact on the rear-end crash risk, while significant impact factors for experienced drivers are the vehicle speed and traffic volume. The rear-end crash risk models perform well based on the existing limited data samples.
文摘A number of prominent solution-focused brief therapists have expressed the view that, to its detriment, this school of therapy tends to downplay emotion. Accordingly, we contend that, given that emotion is a primal binding force, the bonding component of the crucially important therapeutic alliance risks being compromised in the current practice of this approach. We further argue that the prioritization of the depiction of actions that accompany the emotion expressed by the client over the actual participation in this emotion by the therapist tends to superficialize therapeutic communication. This is especially likely to happen when the therapist lapses into a formulaic, action-soliciting interrogatory mode in response to the emotion expressed by the client. In addition, we claim that the incorporation of emotion- and body-based approaches into the solution-focused canon could remedy the affective lacuna referred to above. We note, however, that such a modification would most likely face stiff resistance from some of the gatekeepers of solution-faced therapy, in particular those who subscribe to the “surface-only” descriptive approach advocated by the philosopher Ludwig Wittgenstein. And yet, the effectiveness of depth-oriented therapies, such as sensorimotor psychotherapy and somatic experiencing, is supported by neurophysiological considerations. Finally, we suggest that these therapies, and even creativogenic elements of psychoanalysis, can actually synergize solution-focused brief therapy through the generation of affect-laden images, sensations and thoughts that lend themselves to the realization of outcomes desired by the client, which is the raison d’etre of solution-focused brief therapy. This paper pleads for the incorporation of the above-noted depth approaches into solution-focused brief therapy with a view to augmenting its effectiveness through a stronger therapeutic bond owing to an increased emotional engagement on the part of the therapist.
基金Supported by The Japanese Foundation for Research and Promotion of Endoscopy (JFE)
文摘AIM： To clarify the effectiveness of CO2 insufflation in potentially difficult colonoscopy cases, particularly in relation to the experience level of colonoscopists. METHODS： One hundred twenty potentially difficult cases were included in this study, which involved females with a low body mass index and patients with earlier abdominal and/or pelvic open surgery or previously diagnosed left-side colon diverticulosis. Patients receiving colonoscopy examinations without sedation using a pediatric variable-stiffness colonoscope were divided into two groups based on either CO2 or standard air insuffiation. Both insufflation procedures were also evaluated according to the experience level of the respective colonoscopists who were divided into an experienced colonoscopist （EC） group and a less experienced colonoscopist （LEC） group. Study measurements included a 100-mm visual analogue scale （VAS） for patient pain during and after colonoscopy examinations, in addition to insertion to the cecum and withdrawal times. RESULTS： Examination times did not differ, however, VAS scores in the CO2 group were significantly better than in the air group （P〈 0.001, two-way ANOVA） from immediately after the procedure and up to 2 h later. There were no significant differences between either insufflation method in the EC group （P = 0.29）, however, VAS scores for CO2 insufflation were significantly better than air insufflation in the LEC group （P = 0.023） immediately after colonoscopies and up to 4 h afterwards. CONCLUSION： CO2 insufflation reduced patient pain after colonoscopy in potentially difficult cases when performed by LECs.
基金support from the National Natural Science Foundation of China(71373255)the Institute of Geographic Sciences and Natural Resources Research,Chinese Academy of Sciences(2012RC102)the National Maize Industrial Technical System,China(nycytx-02)
文摘China has experienced dramatic changes in food consumption patterns over the last three decades. However, there are different opinions regarding the future trends in consumption. By adopting the well-developed partial equilibrium model-China Agricultural Policy Simulation Model（CAPSi M）, the demand for livestock products and the main feed crops over 2011–2030 is predicted and analyzed. It is found that China＇s per capita consumption of livestock products will continue to rise during this period, even though its growth rate will slow down gradually. Meanwhile, the expansion of livestock production will pose great challenges for feed supply in China. More accurately, China will be confronted with feed security rather than grain security in the future.
基金financially supported by the National Basic Research Program of China (973 Program) (Grant No.2013CB733202)the National Natural Science Foundation of China (Grant No.41102191)+1 种基金the State Key Laboratory of Geohazard Prevention and Geoenvironment Protection (Chengdu University of Technology) (Grant No.SKLGP2011Z019)the National Natural Science Foundation of China (Grant No.11670589)
文摘The objective of this research was to assess the characteristics of seismic induced damage and the deformation patterns of pre-stressed cement-grouted cables that are used for rock slope stabilization projects subjected to quasi-static cyclic loading.The experimental configuration includes the installation of 15 pre-stressed cables in a slope model made of concrete blocks(theoretically rigid rock mass) on top of a pre-existing sliding surface.The study showed that:(i) The pre-stressed cables exhibited great seismic performance.Rapid displacement of the model blocks was observed after the complete loss of the initial pre-stress load under continued applied cyclic loads and exceedance of the state of equilibrium,which implies the higher the initial pre-stress load,the better the seismic performance of the rock anchor;(ii) The failure of the pre-stressed cables was due to fracture at the connection of the tendons and cable heads under cyclic loading.The sequence of failure had a distinct pattern.Failure was first observed at the upper row of cables,which experienced the most severe damage,including the ejection of cable heads.No evidence of de-bonding was observed during the cyclic loading;(iii) The stress distribution of the bond length for pre-stressed cables was highly non-uniform.High stress concentrations were observed at both the fixed end and the free end of the bond length both before and immediately after the state of equilibrium is exceeded.The results obtained can be used to evaluate the overall performance of pre-stressed rock anchors subject to seismic loading and their potential as rockfall prevention and stabilization measures.
文摘We describe an observational study of clinical, virologic and drug resistance profiles in HIV-positive antiretroviral adherent subjects with stable low level viremia (LLV) 50 - 1000 copies/mL for more than 12 months. Subjects were followed from time of first detectable viral load (VL). In total, 102 episodes of LLV were detected among 80 individuals. The median (mean, range) HIV copy number at genotyping was 250 (486, - 3900) copies/mL after 14 (17.9, 0 - 58) months of LLV. Few patients maintained LLV for the entire 9 years period of observation, with half (52%) experiencing viremic progression following a stable period of LLV either spontaneously or after treatment interruption or failed regimen intensification. In the setting of prolonged periods of sustained LLV, mean duration 22 (range 8 - 106) months, drug resistance (DR) was almost universal. Resistance to ≥1 on-treatment drugs was defined in 97% of specimens and DR to all drugs in the treatment regimen in over half of all patients. Evolution of DR mutations during the period of LLV was observed in 20/28 (71%) subjects with specimens available for follow-up testing. This evolution was associated with viremic progression to levels >1000 copies/mL (p = 0.03). Our data suggest that DR present in patients with LLV is likely to impact long term clinical outcomes, highlighting the importance of optimizing techniques to detect the presence of drug resistant HIV in the setting of LLV and the need for larger prospective studies to assess the emergence of DR in the setting of sustained LLV and the impact of this DR on treatment outcomes.
