RESUMO
Natural selection often acts on multiple traits simultaneously. For example, the virus HIV-1 faces pressure to evade host immunity while also preserving replicative fitness. While past work has studied selection during HIV-1 evolution, it is challenging to quantitatively separate different contributions to fitness. This task is made more difficult because a single mutation can affect both immune escape and replication. Here, we develop an evolutionary model that disentangles the effects of escaping CD8+ T cell-mediated immunity, which we model as a binary trait, from other contributions to fitness. After validation in simulations, we applied this model to study within-host HIV-1 evolution in a clinical data set. We observed strong selection for immune escape, sometimes greatly exceeding past estimates, especially early in infection. Conservative estimates suggest that roughly half of HIV-1 fitness gains during the first months to years of infection can be attributed to T cell escape. Our approach is not limited to HIV-1 or viruses, and could be adapted to study the evolution of quantitative traits in other contexts.
RESUMO
OBJECTIVE: The purpose of the study on the one hand is to see different hospital organization commitment have difference, including the overall score and various dimensions, on the other hand, due to the different hospital type, its function orientation is different, the factors of the doctor organization commitment may also exist differences, so the study of another purpose is to determine for different types of hospital doctor organization commitment the focus and key groups, provide reference for the doctor incentive strategy. METHODS: A total of 292 doctors in four large public hospitals in Beijing were investigated. Physicians' perceived organizational commitment was investigated using self-made electronic questionnaires. Data were analyzed by factor analysis, descriptive statistics, t-test, ANOVA, and multiple linear regression. RESULTS: In the large public hospital doctor perception of the hospital commitment status, Specialized hospitals had higher overall commitment behavior scores, it is 3.47 ± 0.86; General hospital commitment behavior scored low at 3.39 ± 0.91. In the regression results, department category, working years, administrative position, and entry mode are the influencing factors of the organizational commitment of doctors in general hospitals, while in specialized hospitals, in addition to whether to hold an administrative position, entry mode, and working hours, the influencing factors also include gender, professional title and overseas learning background. CONCLUSION: There are differences in the perceived organizational commitment by doctors in different types of public hospitals, and different factors influencing their organizational commitment.Hospital type directly influences physicians' organizational commitment and plays a moderating role in influencing other factors. A possible solution is general hospital specialization, encouraging general hospitals to develop the dominant discipline. These findings can help healthcare service hospital executives or government policymakers understand the impact of hospital specialization strategies and develop more efficient medical staff incentive systems.
