BACKGROUND & AIMS: AIM:This paper reviews how the interpreter's role is described in empirically based, qualitative cross-cultural interview studies and how trustworthiness is determined. BACKGROUND:Increased immigration during the past decades has created a multiethnic society in many countries. This development poses a challenge to healthcare staff, in that they need to understand how people from different cultures experience health and illness. One way to assess immigrants' experiences is through cross-cultural interview studies, involving an interpreter. Thorough knowledge of the interpreter's role is needed in order to increase the trustworthiness of this kind of nursing research. METHOD:Literature searches were conducted from October to November 2004 using PubMed, CINAHL, Psycinfo, Sociological abstract, Your Journals@ovid, and Eric databases. Qualitative interview studies written in English and performed with an interpreter were included. The Matrix Method was used to review the literature. FINDINGS:In almost all of the 13 relevant papers found, the role of the interpreter(s) in the research process was only sparsely described. In addition, all studies except one employed different techniques to established trustworthiness. The most common techniques were prolonged engagement, member check or triangulation, the latter performed either on the data, investigators or methods. CONCLUSION:Methodological issues with respect to interpreters have received only limited attention in cross-cultural interview studies. Researchers in the field of nursing need to consider (1) the interpreter's role/involvement in the research process; (2) the interpreter's competence and the style of interpreting; (3) the interpreter's impact on the findings. This information is a prerequisite when trying to determine the trustworthiness of a cross-cultural study.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The purpose of this research was to locate cultural competence within the experiential domain of the non-English-speaking patient. DESIGN:Seven language-specific focus groups were held with 59 hospital patients and carers of patients with limited English to better understand their experience and to identify critical factors leading to their constructions of care. Grounded theory analysis within a constructivist perspective was undertaken. RESULTS:While the majority of patients were positive about their hospital experience, the theme of powerlessness appeared central to many patient experiences. Language facilitation was the most common issue. Inattention to specific cultural mores and racism in some instances contributed to negative experiences. Patients primarily valued positive engagement, information and involvement, compassionate, kind and respectful treatment, and the negotiated involvement of their family. CONCLUSION:Because of the specific nature of each patient-provider interaction within its particular social and political environment, culturally competent behaviour in one context may be culturally incompetent in another. We propose a model of cultural empowerment that reflects the phenomenological basis of cultural competence in that cultural competence must be consistently renegotiated with any particular patient in a particular healthcare context. Similarly, ongoing community consultations are needed for health services and organisations to retain cultural competence.

背景与目标：

BACKGROUND & AIMS: :The irrelevant speech effect (ISE) refers to the impairment of visual information processing by background speech. Prior research on the ISE has focused on short-term memory for visually presented word lists. The present research extends this work by using measurements of eye movements to examine effects of irrelevant background speech during Chinese reading. This enabled an examination of the ISE for a language in which access to semantic representations is not strongly mediated by phonology. Participants read sentences while exposed to meaningful irrelevant speech, meaningless speech (scrambled meaningful speech) or silence. A target word of high or low lexical frequency was embedded in each sentence. The results show that meaningful, but not meaningless, background speech produced increased re-reading. In addition, the appearance of a normal word frequency effect, characterised by longer fixation times on low- compared to high-frequency words, was delayed when meaningful or meaningless speech was present in the background. These findings show that irrelevant background speech can disrupt normal processes of reading comprehension and, in addition, that background noise can interfere with the early processing of words. The findings add to evidence showing that normal reading processes can be disrupted by environmental noise such as irrelevant background speech.

背景与目标： : 无关语音效应 (ISE) 是指背景语音对视觉信息处理的损害。先前对ISE的研究集中在视觉呈现的单词列表的短期记忆上。本研究通过使用眼动测量来检查中文阅读过程中无关背景语音的影响，从而扩展了这项工作。这使得能够检查ISE中的一种语言，在该语言中，对语义表示的访问不是由语音学强烈介导的。参与者阅读句子，同时暴露于有意义的无关演讲，无意义的演讲 (加扰的有意义演讲) 或沉默。每个句子中都嵌入了词频高低的目标词。结果表明，有意义但并非毫无意义的背景演讲产生了更多的重读。此外，当背景中存在有意义或无意义的语音时，正常词频效果的出现会延迟，其特征是低频率单词的固定时间比高频率单词长。这些发现表明，无关的背景语音会破坏正常的阅读理解过程，此外，背景噪声还会干扰单词的早期处理。研究结果增加了证据，表明正常的阅读过程可能会被环境噪声 (例如不相关的背景语音) 破坏。

BACKGROUND & AIMS: OBJECTIVES:Analysing the influence of additional carcinoma in situ (CIS) and background parenchymal enhancement (BPE) in preoperative MRI on repeated surgeries in patients with invasive lobular carcinoma (ILC) of the breast. METHODS:Retrospective analysis of 106 patients (mean age 58.6±9.9years) with 108 ILC. Preoperative tumour size as assessed by MRI, mammography and sonography was recorded and compared to histopathology. In contrast-enhanced MRI, the degree of BPE was categorised by two readers. The influence of additionally detected CIS and BPE on the rate of repeated surgeries was analysed. RESULTS:Additional CIS was present in 45.4% of the cases (49/108). The degree of BPE was minimal or mild in 80% of the cases and moderate or marked in 20% of the cases. In 17 cases (15.7%) at least one repeated surgery was performed. In n=15 of these cases, repeated surgery was performed after BCT (n=9 re-excisions, n=6 conversions to mastectomy), in n=2 cases after initial mastectomy. The initial surgical procedure (p=0.008) and additional CIS (p=0.046) significantly influenced the rate of repeated surgeries, while tumour size, patient age and BPE did not (p=ns). CONCLUSIONS:Additional CIS was associated with a higher rate of repeated surgeries, whereas BPE had no influence.

背景与目标：

BACKGROUND & AIMS: :Recognition of ethnic/racial disparities in mental health services has not directly resulted in the development of culturally responsive psychosocial interventions. There remains a fundamental need for assessment of sociocultural issues that have been linked with the expectations, needs, and goals of culturally diverse consumers with severe and persistent mental illness. The authors posit that embedding the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions to the diversity encountered in everyday practice. This paper provides an overview of the need for culturally and clinically relevant assessment practices and asserts that by improving the assessment of sociocultural issues the clinical competence of service providers is enhanced. The authors offer a conceptual framework for linking clinical assessment of sociocultural issues to consumer outcomes and introduce an assessment tool adapted to facilitate the process in psychosocial rehabilitation settings. Emphasizing competent clinical assessment skills will ultimately offer a strategy to address disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness.

背景与目标： : 认识到精神卫生服务中的族裔/种族差异并没有直接导致对文化有反应的心理社会干预措施的发展。仍然需要对与患有严重和持续精神疾病的文化多样性消费者的期望，需求和目标相关的社会文化问题进行评估。作者认为，将社会文化问题的评估纳入社会心理康复实践是设计与文化相关的经验支持实践的一步。它成为从业者可以检查其干预措施与日常实践中遇到的多样性的相关性的基础。本文概述了对文化和临床相关评估实践的需求，并断言通过改善对社会文化问题的评估，可以增强服务提供商的临床能力。作者提供了一个概念框架，用于将社会文化问题的临床评估与消费者的结果联系起来，并引入了一种评估工具，以促进社会心理康复环境中的过程。强调合格的临床评估技能将最终提供一种策略，以解决患有严重和持续性精神疾病的文化多样性消费者的研究不足人群的治疗结果差异。

BACKGROUND & AIMS: AIMS/HYPOTHESIS:The aim of this work was to evaluate the efficacy and safety of canagliflozin vs placebo and sitagliptin in patients with type 2 diabetes who were being treated with background metformin. METHODS:This randomised, double-blind, four-arm, parallel-group, Phase 3 study was conducted at 169 centres in 22 countries between April 2010 and August 2012. Participants (N = 1,284) with type 2 diabetes aged ≥ 18 and ≤ 80 years who had inadequate glycaemic control (HbA1c ≥ 7.0% [53 mmol/mol] and ≤10.5% [91 mmol/mol]) on metformin therapy received canagliflozin 100 mg or 300 mg, sitagliptin 100 mg, or placebo (n = 368, 367, 366, 183, respectively) for a 26 week, placebo- and active-controlled period followed by a 26 week, active-controlled period (placebo group switched to sitagliptin [placebo/sitagliptin]) and were included in the modified intent-to-treat analysis set. Randomisation was performed using a computer-generated schedule; participants, study centres and the sponsor were blinded to group assignment. The primary endpoint was change from baseline in HbA1c at week 26; secondary endpoints included changes in HbA1c (week 52) and fasting plasma glucose (FPG), body weight, and systolic blood pressure (BP; weeks 26 and 52). Adverse events (AEs) were recorded throughout the study. RESULTS:At week 26, canagliflozin 100 mg and 300 mg reduced HbA1c vs placebo (-0.79%, -0.94%, -0.17%, respectively; p < 0.001). At week 52, canagliflozin 100 mg and 300 mg demonstrated non-inferiority, and canagliflozin 300 mg demonstrated statistical superiority, to sitagliptin in lowering HbA1c (-0.73%, -0.88%,-0.73%, respectively); differences (95% CI) vs sitagliptin were 0% (-0.12, 0.12) and -0.15% (-0.27, -0.03), respectively. Canagliflozin 100 mg and 300 mg reduced body weight vs placebo (week 26: -3.7%, -4.2%, -1.2%, respectively; p < 0.001) and sitagliptin (week 52: -3.8%, -4.2%, -1.3%, respectively; p < 0.001). Both canagliflozin doses reduced FPG and systolic BP vs placebo (week 26) and sitagliptin (week 52) (p < 0.001). Overall AE and AE-related discontinuation rates were generally similar across groups, but higher with canagliflozin 100 mg. Genital mycotic infection and osmotic diuresis-related AE rates were higher with canagliflozin; few led to discontinuations. Hypoglycaemia incidence was higher with canagliflozin. CONCLUSIONS/INTERPRETATION:Canagliflozin improved glycaemia and reduced body weight vs placebo (week 26) and sitagliptin (week 52) and was generally well tolerated in patients with type 2 diabetes on metformin. CLINICAL TRIAL REGISTRY:ClinicalTrials.gov NCT01106677 FUNDING: This study was supported by Janssen Research & Development, LLC.

背景与目标：

BACKGROUND & AIMS: :While cultural competency is widely promoted, the lack of a measure of cultural competency limits our ability to evaluate interventions and to understand the effects of cultural competency on health care quality. Based on a conceptual framework of cultural competency derived from expert focus groups, we developed a patient-reported measure of physician culturally competent communication behaviors that we validated in a group of 429 adult primary-care patients with diabetes and/or hypertension and their 53 physicians. Construct validity was supported by a moderate association with both patient satisfaction (r = .32, p < .001) and patient trust (r = .53, p < .001). Predictive validity was supported by an association with a decrease in blood pressure among hypertensive patients (r = -.18; p < .05). This new measure may be useful in assessing levels of culturally competent provider behavior and investigating associations between provider cultural competency and health care processes and outcomes.

背景与目标： : 尽管文化能力得到了广泛推广，但缺乏文化能力的衡量标准限制了我们评估干预措施和了解文化能力对医疗质量的影响的能力。基于来自专家焦点小组的文化能力概念框架，我们开发了一种患者报告的医生文化能力沟通行为的措施，我们在一组429名患有糖尿病和/或高血压的成人初级保健患者及其53名医生中进行了验证。结构效度与患者满意度 (r = 0.32，p <.001) 和患者信任 (r = 0.53，p <.001) 之间的中度关联支持。与高血压患者血压降低相关的预测效度得到支持 (r = -.18; p <.05)。这项新措施可能有助于评估具有文化能力的提供者行为水平，并调查提供者文化能力与医疗保健过程和结果之间的关联。

BACKGROUND & AIMS: :This paper proposes a novel prewhitening eigenspace beamformer suitable for magnetoencephalogram (MEG) source reconstruction when large background brain activities exist. The prerequisite for the method is that control-state measurements, which contain only the contributions from the background interference, be available, and that the covariance matrix of the background interference can be obtained from such control-state measurements. The proposed method then uses this interference covariance matrix to remove the influence of the interference in the reconstruction obtained from the target measurements. A numerical example, as well as applications to two types of MEG data, demonstrates the effectiveness of the proposed method.

背景与目标： : 本文提出了一种新型的预白化特征空间波束形成器，适用于存在大背景脑活动时的脑磁图 (MEG) 源重建。该方法的先决条件是仅包含来自背景干扰的贡献的控制状态测量是可用的，并且可以从这种控制状态测量中获得背景干扰的协方差矩阵。然后，所提出的方法使用此干扰协方差矩阵来消除从目标测量获得的重建中的干扰的影响。一个数值示例以及在两种类型的MEG数据中的应用证明了该方法的有效性。

BACKGROUND & AIMS: :Following publication of the original article [1], the corresponding author reported an error on the name of the fourth author.

背景与目标： : 在原始文章 [1] 发表后，通讯作者报告了第四作者的姓名错误。

BACKGROUND & AIMS: :This case study depicts the cultural conflict that occurred when an American Roma (Gypsy) woman delivered her baby at a small hospital that had no knowledge or experience with the Roma culture. The case is analyzed based on the three modes of nursing actions and decisions for culturally congruent nursing care, an important tenet of Leininger's culture care theory. Culture care preservation and maintenance efforts included enabling family presence, respecting the culture's moral code, and acknowledging child-rearing norms. Cultural care accommodation and negotiation focused on the patient's hospital room accommodation, negotiating adherence to identification and security measures, and formulating the discharge plan. Cultural care repatterning and restructuring was not attempted. Recommendations for nursing practice are made based on this case, migration trends, and recent cultural changes.

背景与目标： : 此案例研究描述了一名美国罗姆人 (吉普赛) 妇女在一家对罗姆人文化没有知识或经验的小医院分娩时发生的文化冲突。根据Leininger文化护理理论的重要宗旨，基于文化一致护理的三种护理行动和决策模式对案例进行了分析。文化关怀的保护和维护工作包括使家庭存在，尊重文化的道德准则以及承认育儿规范。文化关怀的住宿和谈判重点是患者的病房住宿，协商对识别和安全措施的遵守，并制定出院计划。没有尝试对文化护理进行重组和重组。根据这种情况，迁移趋势和最近的文化变化提出了护理实践建议。

BACKGROUND & AIMS: BACKGROUND:Self-care refers to behaviors that individuals adopt to prevent or maintain the stability of an illness (self-care maintenance), to monitor signs and symptoms (self-care monitoring), and to respond to signs and symptoms of an illness exacerbation (self-care management). A generic measure of self-care, the Self-Care of Chronic Illness Inventory, based on the Theory of Self-Care of Chronic Illness, was developed for use in individuals with any number and type of chronic conditions. OBJECTIVE:The current study investigated the measurement equivalence of the Self-Care of Chronic Illness Inventory in individuals from three different cultural groups. We were interested in determining if Italians, Swedes, and Americans interpret the measure in a conceptually similar way. METHODS:This cross-sectional study enrolled 1629 patients, 784 recruited in Italy, 438 in Sweden and 407 in the United States. Self-care (self-care maintenance, self-care monitoring and self-care management) was measured with the Self-Care of Chronic Illness Inventory. A multi-group confirmatory factor analytic approach was used to assess the equivalence of the measures across the three countries. Configural, metric, scalar and strict invariance were tested through a series of nested models where increasingly stringent equality constraints were posited. RESULTS:Participants were mostly males (56.3%), older adults (69.8%) and had at least two chronic conditions. Results indicated that three out of four measurement equivalence levels were partially or totally supported in all three of the Self-Care of Chronic Illness Inventory scales. The partial scalar invariance level was reached for self-care maintenance [χ2(50) = 63.495, p = 0.095; RMSEA = 0.022, p = 0.999, 90% CI = 0.000 0.038; CFI = 0.981; TLI = 0.977; SRMR = 0.036], self-care monitoring [χ2(22) = 28.770, p = 0.095; RMSEA = 0.024, p = 0.978, 90% CI = 0.000 0.046; CFI = 0.996; TLI = 0.995; SRMR = 0.054], and self-care management [χ2(51) = 91.334, p = 0.001; RMSEA = 0.048, p = 0.576, 90% CI = 0.031 0.063; CFI = 0.949; TLI = 0.937; SRMR = 0.047] scales. CONCLUSIONS:These findings suggest that patients in the three countries used an identical cognitive framework or mental model when responding and used the 1-5 Likert response scale in an almost identical way, almost without bias. In spite of sociocultural differences, patients in these countries seem to share the same fundamental view of self-care. The results of the Self-Care of Chronic Illness Inventory will be comparable in these countries.

背景与目标：

BACKGROUND & AIMS: PURPOSE:Efficient tumor volume delineation by the combined use of PET/CT scanning is necessary for the proper treatment of non-small cell lung cancer (NSCLC). To understand the effect of variation in background intensity on PET-based gross tumor volume (GTV) delineation, we determined the background standard uptake values (SUVs) in normal lung, aorta (blood pool), and liver tissues and determined GTVs using different methods. METHODS:Thirty-seven previously untreated patients with pathologically confirmed NSCLC underwent PET/CT scanning with (18)F-fluorodeoxyglucose ((18)F-FDG). To obtain (18)F-FDG uptake values in normal tissues, regions of interest in the lung lobes (left upper, left lower, right upper, right middle, and right lower), aorta, and liver zones (left, intermediate, and right) were measured. The coefficient of variation (CV) of the SUV was measured for each normal structure. The CT-based GTV (GTV(CT)) was considered as the standard to which all PET-based GTVs were compared, and the correlation coefficient was analyzed to compare GTV obtained by the various delineation methods. Linear and logarithmic regression analyses were used to determine the relationship between GTV(CT) and GTV(PET). RESULTS:Normal lung tissue showed a significantly lower SUV and less stability than tissue of the aorta or liver. For the lung, aorta, and liver, the maximum SUV (SUV(max)) was 0.82 ± 0.32, 2.35 ± 0.37, and 3.24 ± 0.50 (CV: 38.79%, 15.82%, and 15.30%) and average SUV (SUV(ave)) was 0.49 ± 0.18, 1.68 ± 0.32, and 2.34 ± 0.36 (CV: 36.38%, 18.92%, and 15.44%), respectively. The SUVs of the lung varied from lobe to lobe. The GTV delineation method using the SUV(ave) of the lung lobe in which the tumor was found as background in the source-to-background ratio (SBR) method showed the best correlation with the volume of CT-based GTV (r=0.81). CONCLUSIONS:Our results show vast variation in the SUV among normal tissues, as well as in the different lung lobes. The tumor volume delineated using the SBR method correlated well with the CT-based tumor volume. We conclude that it is reasonable and precise to contour GTV in patients with NSCLC after taking into account the background intensity of the lung lobe in which the tumor is found.

背景与目标：

BACKGROUND & AIMS: :Cannabinoid receptors and their ligands play significant roles in regulating bone metabolism. Previous studies of type 1 cannabinoid receptor-deficient mice have shown that genetic background influences the skeletal phenotype. Here, we investigated the effects of genetic background on the skeletal phenotype of mice with type 2 cannabinoid receptor deficiency (Cnr2 (-/-)). We studied Cnr2 (-/-) mice on a CD1 background and compared the findings with those previously reported in Cnr2 (-/-) C57BL/6 mice. Young female Cnr2 (-/-) CD1 mice had low bone turnover and high trabecular bone mass compared with wild-type (WT), contrasting with the situation in Cnr2 (-/-) C57BL/6 mice where trabecular bone mass has been reported to be similar to WT. The Cnr2 (-/-) CD1 mice lost more trabecular bone at the tibia with age than WT due to reduced bone formation, and at 12 months there was no difference in trabecular bone volume between genotypes. This differs from the phenotype previously reported in C57BL/6 Cnr2 (-/-) mice, where bone turnover is increased and bone mass reduced with age. There were no substantial differences in skeletal phenotype between Cnr2 (-/-) and WT in male mice. Cortical bone phenotype was similar in Cnr2 (-/-) and WT mice of both genders. Deficiency of Cnr2 has site- and gender-specific effects on the skeleton, mainly affecting trabecular bone, which are influenced by genetic differences between mouse strains. Further evaluation of the pathways responsible might yield new insights into the mechanisms by which cannabinoid receptors regulate bone metabolism.

背景与目标： 大麻素受体及其配体在调节骨代谢中起重要作用。先前对1型大麻素受体缺陷小鼠的研究表明，遗传背景会影响骨骼表型。在这里，我们研究了遗传背景对2型大麻素受体缺乏症 (Cnr2 (-/-)) 小鼠骨骼表型的影响。我们研究了CD1背景下的Cnr2 (-/-) 小鼠，并将发现与先前在Cnr2 (-/-) C57BL/6小鼠中报道的结果进行了比较。与野生型 (WT) 相比，年轻的雌性Cnr2 (-/-) CD1小鼠的骨转换低，小梁骨量高，与Cnr2 (-/-) C57BL/6小鼠的情况相反，据报道小梁骨量与WT相似。Cnr2 (-/-) CD1小鼠由于骨形成减少，随着年龄的增长，胫骨的小梁骨损失比WT多，并且在12个月时，基因型之间的小梁骨体积没有差异。这与先前在C57BL/6 Cnr2 (-/-) 小鼠中报道的表型不同，在C57BL/6 Cnr2 (-/-) 小鼠中，随着年龄的增长，骨量增加，骨量减少。在雄性小鼠中，Cnr2 (-/-) 和WT之间的骨骼表型没有实质性差异。两种性别的Cnr2 (-/-) 和WT小鼠的皮质骨表型相似。Cnr2缺乏对骨骼有位点和性别特异性影响，主要影响小梁骨，小梁骨受小鼠品系之间遗传差异的影响。对负责途径的进一步评估可能会对大麻素受体调节骨代谢的机制产生新的见解。

BACKGROUND & AIMS: :Yersinia pestis is a Gram-negative bacterium that is the causative agent of bubonic and pneumonic plague. It is commonly acquired by mammals such as rodents and humans via the bite of an infected flea. We previously reported that multiple substrains of the 129 mouse background are resistant to pigmentation locus-negative (pgm(-)) Yersinia pestis and that this phenotype maps to a 30-centimorgan (cM) region located on chromosome 1. In this study, we have further delineated this plague resistance locus to a region of less than 20 cM through the creation and phenotyping of recombinant offspring arising from novel crossovers in this region. Furthermore, our experiments have revealed that there are at least two alleles in this initial locus, both of which are required for resistance on a susceptible C57BL/6 background. These two alleles work in trans since resistance is restored in offspring possessing one allele contributed by each parent. Our studies also indicated that the Slc11a1 gene (formerly known as Nramp1) located within the chromosome1 locus is not responsible for conferring resistance to 129 mice.

背景与目标： 鼠疫耶尔森菌是一种革兰氏阴性细菌，是鼠疫和肺鼠疫的病原体。它通常是由啮齿动物和人类等哺乳动物通过被感染的跳蚤叮咬而获得的。我们先前报道了129小鼠背景的多个亚株对色素沉着位点阴性 (pgm(-)) 鼠疫耶尔森氏菌具有抗性，并且该表型映射到位于1号染色体上的30厘摩根 (cM) 区域。在这项研究中，我们通过在该区域产生新的交叉产生的重组后代的创建和表型分析，进一步将鼠疫抗性基因座描述为小于20 cM的区域。此外，我们的实验表明，在该初始基因座中至少存在两个等位基因，这两个等位基因都是易感C57BL/6背景上的抗性所必需的。这两个等位基因在反式中起作用，因为在每个亲本贡献一个等位基因的后代中恢复了抗性。我们的研究还表明，位于染色体1基因座内的Slc11a1基因 (以前称为Nramp1) 不负责赋予129小鼠抗性。

BACKGROUND & AIMS: INTRODUCTION:At least 30% of people living with HIV (PLWH) infection have non-alcoholic fatty liver disease (NAFLD), which has now become a leading cause of hepatic fibrosis and cirrhosis. Management is based largely on lifestyle modifications, which are difficult to achieve, and therapeutic options are urgently needed. Maraviroc (MVC), through antagonism of CCR5 receptors, may reduce hepatic fibrosis progression and could be an effective treatment for NAFLD. However, dosing is usually two times per day, unlike most currently recommended antiretroviral therapies. This study will investigate the feasibility and acceptability of addition of MVC to combination antiretroviral therapy in PLWH and NAFLD as a treatment for NAFLD. METHODS AND ANALYSIS:This is a phase IV, randomised, open-label, non-invasive feasibility study. Sixty individuals with well-controlled HIV-1 and NAFLD will be recruited from UK HIV clinics and randomised 1:1 to receive either optimised background therapy (OBT) plus MVC or OBT alone. Follow-up will be every 24 weeks for 96 weeks. The primary outcome measures will include recruitment and retention rates, adverse events and adherence. Secondary outcomes will include changes in markers of hepatic fibrosis, including the Enhanced Liver Fibrosis score, median liver stiffness measurement and controlled attenuation parameter scores on Fibroscan, and quality of life assessments. Analyses will be performed according to intention-to-treat principles. For secondary outcomes, estimated differences and 95% CIs between the groups using a t-method will be presented for continuous variables and as exact 95% binomial CIs for categorical variables. ETHICS AND DISSEMINATION:Ethical approval was obtained through the London Dulwich UK Research Ethics Committee (reference 17/LO/2093). Results will be disseminated both through community groups and peer-reviewed scientific literature.Trial registration number SRCTN31461655. EudraCT number 2017-004141-24; Pre-results.

背景与目标：