BackgroundMany HIV databases and applications focus on a limited domain of HIV knowledge. Since even a “simple” organism like HIV represents a very complex system with many interacting elements, the fractured structure of existing databases and applications likely limits our ability to investigate and understand HIV. To facilitate research, therefore, we have built HIVToolbox, which integrates much of the knowledge about HIV proteins and presents the data in an interactive web application. HIVToolbox allows quick and convenient hypotheses generation, experiment interpretation, and potential new drug structure creation.MethodsHIVToolbox was built as a standard three-tier J2EE web application, consisting of 1) an underlying relational MySQL database, 2) a set of standard Java data access objects that pull data from the database, and 3) a set of dynamic web pages the user interacts with. HIV-1 data from external sources such as the Protein Data Bank, NCBI, Los Alamos, etc. was collected, curated, and stored in the HIVToolbox database. Additional data, such as homology and position statistics matrices, was generated from existing data. Since version 1, drug binding site and drug resistant mutation data has also been added.ResultsHIVToolbox was used to create several new hypotheses about HIV-1 integrase, including predicting the location of a CK2 phosphorylation site, which was later confirmed by experiment. A new version of HIVToolbox support display of the 3D locations of drug resistant mutations on surface plots of HIV proteins and the drug binding sites for structures of complexes of HIV proteins with drugs.ConclusionHIVToolbox is an open-access web application that allows virologists and structural biologists to access detailed information about HIV-1 proteins, such as sequence, structure, functional sites and relationships, homology, drug binding sites, and drug resistant mutations, and to immediately see the relationships between any or all of them. Weblink: [http://hivtoolbox.bio-toolkit.com]
Eating patterns that emphasize healthy, plant-predominant foods, as opposed to animal-derived products, are associated with reductions in cardiovascular (CV) risk and should be promoted to patients. We created a hospital initiative to educate the multidisciplinary staff to serve as advocates for healthy eating to our patients. Housestaff engagement may be a promising mechanism to educate patients and encourage food and nutrition changes across a health system.
Introduction: Due to reduction in cardiovascular risk, healthy, plant-based foods, as opposed to animal-derived products should be promoted to patients. We created a hospital initiative on the cardiac floors to educate the multidisciplinary staff to serve as advocates for healthy eating. Methods: Housestaff participated in education sessions on the benefits of plant-predominant meals and patient counseling. More plant-predominant options were added to the menu and several unhealthy items were eliminated. Food orders were assessed pre-intervention (February 2020) and post-staged interventions (October 2020 and April 2022). Food choices were assessed using the healthful and unhealthful diet index. Press Ganey scores were obtained and housestaff comfort with diet counseling was also assessed. Results: Resident perception of their own knowledge went from “poor” to “good” post-intervention. Confidence in talking to patients about plant-based diets went from “not confident at all” to “fairly confident". After analysis of diet orders, a 52% decrease was noted in animal-based products (chicken, beef, pork and turkey), 35% decrease in unhealthful food items (refined grains, processed foods, potatoes and sweetened beverages), and 25% decrease in plant-predominant food items (whole grains, fruits, vegetables, nuts, salads, legumes and fish), but this time period occurred in the setting of high COVID-19 rates. A subsequent analysis of a single cardiac unit after the COVID-19 surges and after select unhealthy items were removed from the menu showed notable improvements in each parameter when adjusted for discharges; a 2% increase in plant-based, 37% decrease in animal based and 4% decrease in unhealthy items. Press Ganey ratings for the quality of food increased post-initiative by at least 27%. Conclusions: This quality initiative was a local pilot to increase our understanding of interventions that may have a meaningful impact on healthy eating for patients. Interpretation of results is limited due to the COVID-19 pandemic, which may have impacted food choices of admitted patients. Although further research is needed, housestaff engagement may be a promising mechanism to educate patients and encourage food and nutrition changes in a health system.
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