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People who inject drugs (PWIDs) experience high rates of hepatitis C virus (HCV) infection, primarily due to needle sharing and limited healthcare access, resulting in a disproportionate disease burden within this population. This prospective study evaluated treatment outcomes in 432 adult patients with chronic hepatitis C (CHC) treated with direct-acting antivirals (DAAs) at the University Clinical Center of Serbia. Patients were categorized into two groups based on a history of drug addiction: PWIDs (163, 37.7%) and non-PWIDs (269, 62.3%). The PWID group was further categorized into subpopulations of problematic PWIDs (39, 23.9%), ex-PWIDs (124, 76.1%), and PWIDs on OST (96, 58.9%). The PWID group demonstrated significantly lower treatment adherence, with an intention-to-treat (ITT) rate of 82.8%, compared to 96.3% in the control group (p < 0.001). In contrast, no significant differences were observed in per-protocol (PP) outcomes between the two groups. Additionally, PWIDs were significantly younger (p < 0.001) and had higher rates of psychiatric disorders (p < 0.001), alcohol abuse (p < 0.001), and HCV genotype 1a (p < 0.001). Advanced fibrosis was predictor of PP treatment failure among PWIDs, while mood disorders and alcohol use disorder were associated with interruptions before the scheduled completion time. For non-PWIDs, older age and advanced fibrosis emerged as key predictors of PP treatment failure. The loss to follow-up was most commonly observed in the problematic PWID subgroup (p = 0.001). These findings highlight the importance of addressing barriers in PWIDs through integrated care strategies that concurrently manage addiction and HCV.

This study, conducted at two university-based infectious disease clinics, included 216 patients with chronic hepatitis C. The primary objective was to assess the positive and negative predictive values, sensitivity, and specificity of achieving a sustained virological response (SVR) at 4 weeks compared to 12 weeks post-therapy. The results demonstrated a maximum sensitivity of 100% for achieving SVR at 12 weeks after reaching SVR at 4 weeks for all analyzed genotypes, except for genotype 1b treated with EBR/GZR therapy, where the specificity was 75%. Additionally, younger age and less advanced liver fibrosis were identified as independent predictors of achieving a sustained virological response at both 4 and 12 weeks. The significant normalization of various biochemical parameters was observed after treatment, indicating an overall improvement in liver function. This study suggests that shortening the monitoring period to 4 weeks might be effective for younger patients without significant fibrosis, potentially reducing loss to follow-up, which is a critical issue in HCV treatment. These findings align with the “test and treat” approach. Further research is needed to confirm these findings and incorporate them into official guidelines, which could simplify and enhance the effectiveness of HCV treatment protocols, aiding global efforts to eliminate HCV as a public health issue by 2030.

Background: Atrial fibrillation (AF) is associated with the development and progression of chronic kidney disease (CKD). This study evaluated the impact of long-term rhythm outcome after catheter ablation (CA) of AF on renal function. Methods and results: The study group included 169 consecutive patients (the mean age was 59.6 ± 10.1 years, 61.5% were males) who underwent their first CA of AF. Renal function was assessed by eGFR (using the CKD-EPI and MDRD formulas), and by creatinine clearance (using the Cockcroft–Gault formula) in each patient before and 5 years after index CA procedure. During the 5-year follow-up after CA, the late recurrence of atrial arrhythmia (LRAA) was documented in 62 patients (36.7%). The mean eGFR, regardless of which formula was used, significantly decreased at 5 years following CA in patients with LRAA (all p < 0.05). In the arrhythmia-free patients, the mean eGFR at 5 years post-CA remained stable (for the CKD-EPI formula: 78.7 ± 17.3 vs. 79.4 ± 17.4, p = 0.555) or even significantly improved (for the MDRD formula: 74.1 ± 17.0 vs. 77.4 ± 19.6, p = 0.029) compared with the baseline. In the multivariable analysis, the independent risk factors for rapid CKD progression (decline in eGFR > 5 mL/min/1.73 m2 per year) were the post-ablation LRAA occurrence (hazard ratio 3.36 [95% CI: 1.25–9.06], p = 0.016), female sex (3.05 [1.13–8.20], p = 0.027), vitamin K antagonists (3.32 [1.28–8.58], p = 0.013), or mineralocorticoid receptor antagonists’ use (3.28 [1.13–9.54], p = 0.029) after CA. Conclusions: LRAA after CA is associated with a significant decrease in eGFR, and it is an independent risk factor for rapid CKD progression. Conversely, eGFR in arrhythmia-free patients after CA remained stable or even improved significantly.

Parking search reduces the quality of parking service, as well as traffic network level of service, due to additionally generated traffic. Parking search also entails other negative effects, primarily ecological, social and economic. Even though the importance of this problem has been noted in the past, there is an impression that this issue has not been sufficiently researched and should be additionally analysed in order to properly understand this phenomenon. Therefore, the aim of this paper is to study the factors affecting parking search time that can be influenced through a set of parking management measures. In this paper, an ordinal regression model was developed to estimate these parameters and it was fitted using empirical data collected by interviewing drivers. Main model results show that parking occupancy has the highest impact upon the value of parking search time, indicating the significance of defining proper policies and measures aimed at reaching targeted parking occupancy. Parking frequency is the second parameter observed to be significant, demonstrating the importance of implementing proper parking information systems.

The present study aimed to create a more sustainable and controlled delivery system based on natural biopolymer bacterial nanocellulose (BNC) and bacterial natural product actinomycin (Act), with the applicative potential in the biomedical field. In order to provide improved interaction between BNC and the active compound, and thus to modulate the release kinetics, the TEMPO oxidation of BNC support was carried out. A mix of actinomycins from bacterial fermentation (ActX) were used as natural antimicrobial agents with an established bioactivity profile and clinical use. BNC and TEMPO-oxidized BNC films with incorporated active compounds were obtained and analyzed by FTIR, SEM, XPS, and XRD. The ActX release profiles were determined in phosphate-buffer solution, PBS, at 37 °C over time. FTIR analysis confirmed the improved incorporation and efficiency of ActX adsorption on oxidized BNC due to the availability of more active sites provided by oxidation. SEM analysis indicated the incorporation of ActX into the less-dense morphology of the TEMPO-oxidized BNC in comparison to pure BNC. The release kinetics of ActX were significantly affected by the BNC structure, and the activated BNC sample indicated the sustained release of active compounds over time, corresponding to the Fickian diffusion mechanism. Antimicrobial tests using Staphylococcus aureus NCTC 6571 confirmed the potency of this BNC-based system for biomedical applications, taking advantage of the capacity of modified BNC to control and modulate the release of bioactive compounds.

BackgroundTreatment burden (TB) is defined as the patient’s workload of healthcare and its impact on patient functioning and wellbeing. High TB can lead to non-adherence, a higher risk of adverse outcomes and lower quality of life (QoL). We have previously reported a higher TB in patients with atrial fibrillation (AF) vs. those with other chronic conditions. In this analysis, we explored sex-related differences in self-reported TB in AF patients.Materials and methodsA single-center, prospective study included consecutive patients with AF under drug treatment for at least 6 months before enrollment from April to June 2019. Patients were asked to voluntarily and anonymously answer the Treatment Burden Questionnaire (TBQ). All patients signed the written consent for participation.ResultsOf 331 patients (mean age 65.4 ± 10.3 years, mean total AF history 6.41 ± 6.62 years), 127 (38.4%) were females. The mean TB was significantly higher in females compared to males (53.7 vs. 42.6 out of 170 points, p < 0.001), and females more frequently reported TB ≥ 59 points than males (37.8% vs. 20.6%, p = 0.001). In females, on multivariable analysis of the highest TB quartile (TB ≥ 59), non-vitamin K Antagonist Oral Anticoagulant (NOAC) use [Odds Ratio (OR) 0.319; 95% Confidence Interval (CI) 0.12–0.83, P = 0.019], while in males, catheter ablation and/or ECV of AF (OR 0.383; 95% CI 0.18–0.81, P = 0.012) were negatively associated with the highest TB quartile.ConclusionOur study was the first to explore the sex-specific determinants of TB in AF patients. Females had significantly higher TB compared with males. Approximately 2 in 5 females and 1 in 5 males reported TB ≥ 59 points, previously shown to be an unacceptable burden of treatment for patients. Using a NOAC rather than vitamin K antagonist (VKA) in females and a rhythm control strategy in males could decrease TB to acceptable values.

Objective: To examine the effect of motion-controlled commercial video games compared with traditional occupational and physiotherapy methods for hand and arm function in persons of all ages with cerebral palsy. Data sources: A systematic literature search was conducted in Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, OTseeker and PEDro for randomized controlled trials involving persons with cerebral palsy using motion-controlled commercial video games as a training method for hand and arm function, compared with traditional therapy. Study selection and data extraction: Screening, data-extraction, risk of bias and quality assessment was carried out independently by 2 of the authors. The risk of bias of each study was assessed using the Cochrane Collaborations Risk of Bias Tool. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Data synthesis: Eight randomized controlled trials, with a total of 262 participants, were included. A random effects meta-analysis showed a statistically significant difference compared to traditional therapy methods in favour of motion-controlled commercial video games. The quality of the evidence was, however, rated as very low. Conclusion: Despite a significantly greater improvement in hand and arm function in favour of motion-controlled commercial video games, the results of this review should be interpreted with caution with regards to high risk of bias and the low strength of evidence. There is a need for high-powered studies on the effectiveness of training with motion-controlled commercial video games for persons with cerebral palsy, especially in adults.

Parking charge is a powerful tool for solving parking and traffic congestion problems. In order to achieve the expected effects without any adverse impact it is necessary to understand well the users’ responses to this policy. This paper, based on a sample of interviewed parking garage users, has developed binary logit model for identification and quantification of characteristics of users and trips, on which the acceptance of parking price is dependent. In addition, multinomial logit model has been made in order to predict what the users will opt for when faced with an increase in parking price. For the first time the parameter “shorten duration” has been introduced which has shown to be the most significant in making behaviour-related decisions. The results show that the users with the purpose work are the most sensitive to an increase in parking charge, what can be deemed positive for policy makers. However, great sensitivity of the users with the purpose shopping should cause their concern. The results of the multinomial model show that they would not discontinue coming into the area after all.

Vehicle parking standards are related exclusively to parking in connection with: planning, construction, development and/or extension and change of use of the existing developments. On the other hand, vehicle parking standards are the key measure for managing the level of traffic and they should be an integral part of the urban transport policy. This would allow the parking standards to be applied also to the land use management in accordance with accessibility to the urban zones by means of travel other than by car. This implies that in the course of producing vehicle parking standards the level of parking restrictions is to be defined depending on the Public Transport Accessibility Level. If Public Transport Accessibility Level of a zone the subject development belongs to is high, the number of parking spaces to be provided is restricted and customers are encouraged to shift to alternative transport modes. Thus defined parking standards assist in the development of sustainable transport system. This paper will present the methodology for calculation of parking standards depending on the accessibility of the zone the subject development is located within. Santrauka Transporto priemonių stovėjimo vietų standartai numato naujų automobilių aikštelių planavimą ir statybą, esamų statinių išplėtimą ar pakeitimą. Kita vertus, automobilių aikštelių standartai yra pagrindinė priemonė, padedanti valdyti transporto srauto lygi. Jie tūretų būti neatsiejami nuo miesto transporto politikos. Tai leistų įvairias miesto zonas vykti ne automobiliais. Tai reiškia, kad automobilių aikštelių apribojimai turi būti suderinti su miesto viešojo transporto sistema. Jei viešojo transporto prieinamumo lygis konkrečioje miesto zonoje yra aukštas, automobiliu aikšteliu skaičius turi būti ribojamas, o miestiečiai turi būti skatinami naudotis alternatyviomis transporto rūšimis. Taip automobilių aikštelių standartai padeda pletoti darnia transporto sistema. Šiame straipsnyje pateikiama automobilių aikštelių skaičiavimo metodologija, įvertinanti atskirų miesto zonų pasiekiamumą. First published online: 10 Feb 2010 Reikšminiai žodžiai: automobilių aikštelių standartas, viešojo transporto prieinamumo lygis, patrauklumo lygis, darni transporto sistema, žemenauda, Belgradas