Molnupiravir, an oral direct-acting antiviral effective in vitro against SARS-CoV-2, has been largely employed during the COVID-19 pandemic, since December 2021. After marketing and widespread usage, a progressive increase in SARS-CoV-2 lineages characterized by a higher transition/transversion ratio, a characteristic signature of molnupiravir action, appeared in the Global Initiative on Sharing All Influenza Data (GISAID) and International Nucleotide Sequence Database Collaboration (INSDC) databases. Here, we assessed the drug effects by SARS-CoV-2 whole-genome sequencing on 38 molnupiravir-treated persistently positive COVID-19 outpatients tested before and after treatment. Seventeen tixagevimab/cilgavimab-treated outpatients served as controls. Mutational analyses confirmed that SARS-CoV-2 exhibits an increased transition/transversion ratio seven days after initiation of molnupiravir. Moreover we observed an increased G->A ratio compared to controls, which was not related to apolipoprotein B mRNAediting enzyme, catalytic polypeptide-like (APOBEC) activity. In addition, we demonstrated for the first time an increased diversity and complexity of the viral quasispecies.

This study views sustainability after the exit of development assistance for health (DAH) as a shared responsibility between donors and recipients and sees transitioning DAH-supported interventions into domestic health policy as a pathway to this sustainability. It aims to uncover and understand the reemergent aspects of the donor-recipient dynamic in DAH and how they contribute to formulating domestic health policy and post-DAH sustainability.
We conducted a case study on two DAH-supported interventions: medical financial assistance in the Basic Health Services Project supported by the World Bank and UK (1998-2007) and civil society engagement in the HIV/AIDS Rolling Continuation Channel supported by the Global Fund (2010-2013) in China. From December 2021 to December 2022, we analyzed 129 documents and interviewed 46 key informants. Our data collection and coding were guided by a conceptual framework based on Walt and Gilson\'s health policy analysis model and the World Health Organization\'s health system building blocks. We used process tracing for analysis.
According to the collected data, our case study identified three reemergent, interrelated aspects of donor-recipient dynamics: different preferences and compromise, partnership dialogues, and responsiveness to the changing context. In the case of medical financial assistance, the dynamic was characterized by long-term commitment to addressing local needs, on-site mutual learning and understanding, and local expertise cultivation and knowledge generation, enabling proactive responses to the changing context. In contrast, the dynamic in the case of HIV/AIDS civil society engagement marginalized genuine civil society engagement, lacked sufficient dialogue, and exhibited a passive response to the context. These differences led to varying outcomes in transnational policy diffusion and sustainability of DAH-supported interventions between the cases.
Given the similarities in potential alternative factors observed in the two cases, we emphasize the significance of the donor-recipient dynamic in transnational policy diffusion through DAH. The study implies that achieving post-DAH sustainability requires a balance between donor priorities and recipient ownership to address local needs, partnership dialogues for mutual understanding and learning, and collaborative international-domestic expert partnerships to identify and respond to contextual enablers and barriers.

[This corrects the article DOI: 10.3389/fped.2023.1050508.].

Shore power connects ships to land-side electricity grids, cutting fuel use in port to reduce carbon dioxide emissions and air pollution. It also enables the transition towards greater use of electric vessels. Despite these benefits, the global deployment of shore power is slow, particularly in countries such as the UK. This paper presents findings from a qualitative case study using two theoretical frameworks from the transitions literature to assess barriers to UK shore power deployment. The findings identify a need for capital funding and taxation policies, and illustrate that shipping\'s low status in the political hierarchy impedes implementation. Measures to strengthen interactions between shipping actors would help increase the political pressure required to implement policies supporting shore power and shipping more broadly. These changes in the governance and organisation of shipping are essential to deliver the near-term emission cuts necessary for aligning UK shipping emissions with the Paris Agreement.

UNASSIGNED: Transplant professionals are specialized in providing lifesaving organs to patients in whom organ failure including bone marrow, in a way that gives strong hope to patients and families. We should be aware of that patients with advanced medical conditions must have an advanced care planning (ACP) in place, though it is difficult to balance possible outcomes and hope.
UNASSIGNED: This case report showed our serious illness conversation program (SICP) could transit gradually a patient with bone marrow transplant (BMT) and palliative care (PC) needs to hospice care. Initially, she had difficulty in accepting the relapse of her hematological disease, with the main focus on disease treatment and blood parameters. After the transition, this patient\'s symptoms got better, she felt more stable emotionally, her muscle strength improved, and her hope was reignited because she wanted to go to her daughter\'s wedding. All these have been facilitated by the PC team.
UNASSIGNED: In this case, use of SIC can be regarded as a tool to facilitate better communication and so lead to faster and smoother transition to PC and subsequently hospice care. The use of chemotherapy (e.g., vidaza), on the other hand, had important palliative roles including for symptom control, maintaining patient\'s mobility and quality of life. Despite her condition being gradually deteriorated, her grief could be largely resolved if most of the wishes fulfilled.

BACKGROUND: The transition from case-based learning to problem-based learning can be challenging and may have negative effects on the academic, psychological, emotional, or social well-being of student nurses. As a result, this exposes student nurses to high failure rates, anxiety disorders, a loss of uniqueness, and fear of the unknown. However, student nurses employ different strategies aimed at overcoming challenges faced during this transition period.
METHODS: An exploratory, and descriptive research approach was used. A purposive non-probability sampling technique was used to select participants. Focus group discussions via Zoom video communication were used to collect data, which were analysed using Braun and Clarke\'s six steps of thematic analysis.
RESULTS: The following three themes emerged: challenges regarding facilitation, challenges regarding assessment, and strategies to overcome challenges.
CONCLUSIONS: The study established that student nurses are faced with different challenges during the transition from one teaching strategy to another. Student nurses suggested strategies that could be used to overcome these challenges. However, these strategies are not enough and therefore more needs to be done to support and empower student nurses.

Selexipag, a selective prostacyclin receptor agonist, is approved for treating pulmonary arterial hypertension in WHO Group 1 adult patients. Compared to parenteral prostacyclin formulations, selexipag offers a significant improvement in patient\'s and caregiver\'s quality of life because of its oral formulation, frequency of administration, and mechanism of action. Although experience in the pediatric population is limited to case reports in older adolescent patients and selexipag is not approved for use in the pediatric pulmonary hypertension population, many pediatric centers are expanding the use of this therapy to this population. We report our institution\'s experience in the use of selexipag to treat pulmonary hypertension in children under 10 years of age, between 10 and 30 kg. Seven patients were initiated on selexipag therapy including de novo initiation and transition from intravenous treprostinil to oral selexipag. All patients were on stable background therapy with phosphodiesterase-5 inhibitor and endothelin receptor antagonist therapies at baseline. All patients reached their planned goal selexipag dose during admission without the need for changes to the titration schedule and without hemodynamic deterioration. In our experience, oral selexipag is safe and well-tolerated in young pediatric patients with pulmonary hypertension. Based on our favorable experience, we developed an institution-specific selexipag process algorithm for continued successful use in the pediatric population.

The final year offers students the opportunity to explore their future role as a physician in different environments. Learning success depends in large part on how students experience these assignments. The aim of this study is to analyze students\' self-reported experiences to derive factors that promote experience-based learning in the transition phase during the final year of medical school in order to optimally prepare students for professional practice.
Data were collected from 2013 to 2019 via written survey after each assignment in the final year. Students were asked to report their pleasant and unpleasant experiences in free-text fields. The text material was analyzed using quantitative content analysis.
The authors included 1762 questionnaires for analysis. They formed 12 main categories from the text material, equally covering pleasant and unpleasant experiences. Supervisors and teamwork played a central role in both questions, responsibility and working areas frequently led to positive experiences, and working conditions to negative ones.
This study confirms the great importance of supervision. Above all, successful collaboration serves as a door opener into a feeling of security which students need to take on responsibility. The authors adapted Dornan\'s model of experience-based learning to the transition phase to help medical schools establish tailored conditions for students\' successful entry into professional practice.

Cell culture techniques are strongly connected with modern scientific laboratories and production facilities. Thus, choosing the most suitable medium for the cells involved is vital, not only directly to optimise cell viability but also indirectly to maximise the reliability of the experiments performed with the cells. Fetal bovine or calf serum (FBS or FCS, respectively) is the most commonly used cell culture medium supplement, providing various nutritional factors and macromolecules essential for cell growth. Yet, the use of FBS encompasses a number of disadvantages. Scientifically, one of the most severe disadvantages is the lot-to-lot variability of animal sera that hampers reproducibility. Therefore, transitioning from the use of these ill-defined, component-variable, inconsistent, xenogenic, ethically questionable and even potentially infectious media supplements, is key to achieving better data reproducibility and thus better science. To demonstrate that the transition to animal component-free cell culture is possible and achievable, we highlight three different scenarios and provide some case studies of each, namely: i) the adaptation of single cell lines to animal component-free culture conditions by the replacement of FBS and trypsin; ii) the adaptation of multicellular models to FBS-free conditions; and (iii) the replacement of FBS with human platelet lysate (hPL) for the generation of primary stem/stromal cell cultures for clinical purposes. By highlighting these examples, we aim to foster and support the global movement towards more consistent science and provide evidence that it is indeed possible to step out of the currently smouldering scientific reproducibility crisis.

BACKGROUND: On rare occasions, there can be a transition from Hashimoto\'s to Graves\' disease. However, there are no reported cases of transition from Hashimoto\'s to Graves\' disease triggered by the onset of Guillain-Barré syndrome.
METHODS: Sixteen years prior, a 55-year-old woman was diagnosed with Hashimoto\'s disease and followed up without medication. One week after the appearance of signs of intestinal inflammation, weakness in the extremities was observed, and a cerebrospinal fluid test was positive for anti-GM1 IgG antibody, leading to the diagnosis of Guillain-Barré syndrome. In addition, hyperthyroidism was observed at the time of admission, and Graves\' disease was diagnosed based on autoantibodies and thyroid echoes. Numbness in the extremities was relieved by high-dose intravenous gamma globulin.
CONCLUSIONS: With the onset of Guillain-Barré syndrome, helper T cells became predominantly type 1, effector B cells increased in number, and thyroid-stimulating antibodies were produced, leading to the conclusion that Hashimoto\'s disease progressed to Graves\' disease. Therefore, it is necessary to pay attention to the transition of thyroid function during Guillain-Barré syndrome.