97 research outputs found

    Integrating primary and secondary care to optimize hepatitis C treatment:development and evaluation of a multidisciplinary educational Masterclass series

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    [Background] It is increasingly being recognized that the elimination of HCV requires a multidisciplinary approach and effective cooperation between primary and secondary care.[Objectives] As part of a project (HepCare Europe) to integrate primary and secondary care for patients at risk of or infected with HCV, we developed a multidisciplinary educational Masterclass series for healthcare professionals (HCPs) working in primary care in Dublin and Bucharest. This article aims to describe and evaluate the series and examine how this model might be implemented into practice.[Methods] GPs and other HCPs working in primary care, addiction treatment services and NGOs were invited to eight 1 day symposia (HCV Masterclass series), examining the burden and management of HCV in key populations. Peer-support sessions were also conducted, to give people affected by HCV and community-based organizations working with those directly affected, an update on the latest developments in HCV treatment.[Results] One hundred percent of participants ‘strongly agreed’ or ‘agreed’ that the Masterclass helped them to appreciate the role of integrated services in ‘the management of patients with HCV’. One hundred percent of participants indicated the importance of a ‘designated nurse to liaise with hospital services’. An improvement of knowledge regarding HCV management of patients with high-risk behaviour was registered at the end of the course.[Conclusions] Integrated approaches to healthcare and improving the knowledge of HCPs and patients of the latest developments in HCV treatment are very important strategies that can enhance the HCV care pathway and treatment outcomes.This work was supported by the European Commission through its EU Third Health Programme (Grant Agreement Number 709844) and Ireland’s Health Services Executive.Peer reviewe

    Establishing a hepatitis C continuum of care among HIV/hepatitis C virus-coinfected individuals in EuroSIDA

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    Objectives The aim of the study was to establish a methodology for evaluating the hepatitis C continuum of care in HIV/hepatitis C virus (HCV)-coinfected individuals and to characterize the continuum in Europe on 1 January 2015, prior to widespread access to direct-acting antiviral (DAA) therapy. Methods Stages included in the continuum were as follows: anti-HCV antibody positive, HCV RNA tested, currently HCV RNA positive, ever HCV RNA positive, ever received HCV treatment, completed HCV treatment, follow-up HCV RNA test, and cure. Sustained virological response (SVR) could only be assessed for those with a follow-up HCV RNA test and was defined as a negative HCV RNA result measured > 12 or 24 weeks after stopping treatment. Results Numbers and percentages for the stages of the HCV continuum of care were as follows: anti-HCV positive (n = 5173), HCV RNA tested (4207 of 5173; 81.3%), currently HCV RNA positive (3179 of 5173; 61.5%), ever HCV RNA positive (n = 3876), initiated HCV treatment (1693 of 3876; 43.7%), completed HCV treatment (1598 of 3876; 41.2%), follow-up HCV RNA test to allow SVR assessment (1195 of 3876; 30.8%), and cure (629 of 3876; 16.2%). The proportion that achieved SVR was 52.6% (629 of 1195). There were significant differences between regions at each stage of the continuum (P <0.0001). Conclusions In the proposed HCV continuum of care for HIV/HCV-coinfected individuals, we found major gaps at all stages, with almost 20% of anti-HCV-positive individuals having no documented HCV RNA test and a low proportion achieving SVR, in the pre-DAA era.Peer reviewe

    Incidence of cancer and overall risk of mortality in individuals treated with raltegravir-based and non-raltegravir-based combination antiretroviral therapy regimens

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    Objectives: There are currently few data on the long-term risk of cancer and death in individuals taking raltegravir (RAL). The aim of this analysis was to evaluate whether there is evidence for an association. Methods: The EuroSIDA cohort was divided into three groups: those starting RAL-based combination antiretroviral therapy (cART) on or after 21 December 2007 (RAL); a historical cohort (HIST) of individuals adding a new antiretroviral (ARV) drug (not RAL) to their cART between 1 January 2005 and 20 December 2007, and a concurrent cohort (CONC) of individuals adding a new ARV drug (not RAL) to their cART on or after 21 December 2007. Baseline characteristics were compared using logistic regression. The incidences of newly diagnosed malignancies and death were compared using Poisson regression. Results: The RAL cohort included 1470 individuals [with 4058 person-years of follow-up (PYFU)] compared with 3787 (4472 PYFU) and 4467 (10 691 PYFU) in the HIST and CONC cohorts, respectively. The prevalence of non-AIDS-related malignancies prior to baseline tended to be higher in the RAL cohort vs. the HIST cohort [adjusted odds ratio (aOR) 1.31; 95% confidence interval (CI) 0.95–1.80] and vs. the CONC cohort (aOR 1.89; 95% CI 1.37–2.61). In intention-to-treat (ITT) analysis (events: RAL, 50; HIST, 45; CONC, 127), the incidence of all new malignancies was 1.11 (95% CI 0.84–1.46) per 100 PYFU in the RAL cohort vs. 1.20 (95% CI 0.90–1.61) and 0.83 (95% CI 0.70–0.99) in the HIST and CONC cohorts, respectively. After adjustment, there was no evidence for a difference in the risk of malignancies [adjusted rate ratio (RR) 0.73; 95% CI 0.47–1.14 for RALvs. HIST; RR 0.95; 95% CI 0.65–1.39 for RALvs. CONC] or mortality (adjusted RR 0.87; 95% CI 0.53–1.43 for RALvs. HIST; RR 1.14; 95% CI 0.76–1.72 for RALvs. CONC). Conclusions: We found no evidence for an oncogenic risk or poorer survival associated with using RAL compared with control groups.Peer reviewe

    Synthesis and characterization of novel linear and cross-linked polyurethane urea elastomers with 2,3-diaminopyridine in the main chain. High Perform Polym 2013

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    Abstract Novel polyurethane urea containing pyridine moieties in their main chains have been prepared by a two-step solution polymerization procedure. These polyurethane urea elastomers were synthesized by chain-extending isocyanate end-capped prepolymers with 2,3-diaminoyridine and different cross-linkers. The isocyanate-terminated prepolymers were obtained from poly(tetramethylene oxide) glycol of molecular weight 1400 (Terathane 1400) and 1,6-hexamethylene diisocyanate. Including pyridine derivatives into the structural compositions leads to a change in properties that were investigated using Fourier transform infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), mechanical measurements and contact angle and fluorescence analysis. The results show that intermolecular hydrogen bonds have formed between pyridine groups and urethane or urea groups, affecting all the obtained properties

    Cellulose Composites with Graphene for Tissue Engineering Applications

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    Tissue engineering is an interdisciplinary field that combines principles of engineering and life sciences to obtain biomaterials capable of maintaining, improving, or substituting the function of various tissues or even an entire organ. In virtue of its high availability, biocompatibility and versatility, cellulose was considered a promising platform for such applications. The combination of cellulose with graphene or graphene derivatives leads to the obtainment of superior composites in terms of cellular attachment, growth and proliferation, integration into host tissue, and stem cell differentiation toward specific lineages. The current review provides an up-to-date summary of the status of the field of cellulose composites with graphene for tissue engineering applications. The preparation methods and the biological performance of cellulose paper, bacterial cellulose, and cellulose derivatives-based composites with graphene, graphene oxide and reduced graphene oxide were mainly discussed. The importance of the cellulose-based matrix and the contribution of graphene and graphene derivatives fillers as well as several key applications of these hybrid materials, particularly for the development of multifunctional scaffolds for cell culture, bone and neural tissue regeneration were also highlighted

    Neutron cross section measurements for BUC approaches

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    Criticality safety analysis is required at various stages of the back-end of the fuel cycle, i.e. reprocessing, transport, storage and disposal of spent nuclear fuel (SNF). To account for the reduction in reactivity due to fuel burnup, the Burn-Up Credit (BUC) concept was introduced. Evidently, this concept depends on the quality of nuclear data, in particular the absorption cross sections of some key nuclides. A dedicated programme has been established at the GELINA facility of the JRC-Geel to produce accurate cross section data and validate the evaluated nuclear data libraries for neutron interactions with fission fragments that are relevant for a BUC approach. In this work, cross section data for 103Rh and 155Gd are presented and the results are compared with the main evaluation libraries, showing good agreement in the thermal energy region with ENDF/B-VIII.0 and JEFF-3.3, but not with JENDL-4.0 for 103Rh

    DIGITIZING ROMANIAN AGRICULTURE, AN OPPORTUNITY FOR SUSTAINABLE DEVELOPMENT

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    Digital transformation represents one of the most current points of interest for the European Union. However, in agriculture, is digitalization a reality of the present or just a vision for the future? More and more processes are integrating into modern agriculture as offline and online activities increasingly converge in today's transition to digital agriculture. As the entire process is continuously developing, real opportunities emerge for all countries. A resilient agriculture that offers a secure future, based on minimal resources and sustainability, can only be built through a common concentration of efforts. Digital technologies have the potential to revolutionize agriculture and help farmers work more precisely, efficiently, and sustainably. Perspectives created from concrete data can improve decision-making processes and performance in favor of the environment, making the job itself more attractive to the new generations of farmers. Digital technologies also provide increased transparency for end consumers throughout the distribution chain. The digitalization of Romanian agriculture can represent a turning point towards development at its true capacity, even in the current small-scale context. This paper aims to outline the opportunities and limitations that may arise on the path towards the digitalization of Romanian agriculture
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