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Abstract Background Eliminating hepatitis C virus (HCV) infections is a goal set by the World Health Organization. This has become possible with the introduction of highly effective and safe direct-acting antivirals (DAA) but limitations remain due to undiagnosed HCV infections and loss of patients from the cascade of care at various stages, including those lost to follow-up (LTFU) before the assessment of the effectiveness of the therapy. The aim of our study was to determine the extent of this loss and to establish the characteristics of patients experiencing it. Methods Patients with chronic HCV infection from the Polish retrospective multicenter EpiTer-2 database who were treated with DAA therapies between 2015 and 2023 were included in the study. Results In the study population of 18,968 patients, 106 had died by the end of the 12-week post-treatment follow-up period, and 509 patients did not report for evaluation of therapy effectiveness while alive and were considered LTFU. Among patients with available assessment of sustained virological response (SVR), the effectiveness of therapy was 97.5%. A significantly higher percentage of men (p

The study analysed the case of a 74-year-old woman with a diagnosis of FIGO IVA vulvar carcinoma. The patient was also suffering from other diseases such as type 2 diabetes, hypertension, obesity, and permanent atrial fibrillation. Among the patient’s most significant nursing problems, self-care deficit, impaired mobility, impaired ability to perform hygiene and self-toileting, and lack of knowledge about disease were singled out. The aim of the work is to present knowledge and explain the subject of the therapeutic process and nursing problems of a patient with advanced vulvar cancer based on an individual case study. ICNP® reference terminology was used to develop care plans. The midwife’s care of a patient with advanced vulvar cancer requires special consideration of education, health promotion, and self-management activities, assisting with hygiene activities, and providing psychological support. The overarching goal in the patient’s care is to strive for the highest possible degree of self-care.

Abstract Progressive industrialisation and urbanisation in recent decades have dramatically affected the soil cover and led to significant changes in its properties, which inevitably affect the functioning of other components of the forest ecosystems. The total content of Pb, Cd, Zn, Fe, Cr, Cu, Ni, As, and Hg was studied in twenty-five plots at different heights in the topsoil (organic and humus horizons) formed from the Carpathian flysch in the area of the Silesian Beskids (Western Carpathians). The aim of this article is to analyse the spatial distribution of potentially toxic elements in the mountain forest topsoil in different types of plant communities and to determine the relationship between altitude and potentially toxic elements contamination. The soils studied are acidic or very acidic, with an average range of 3.8 (H2O) and 2.9 (KCl). Concentrations of the metals Cd, Zn, Fe, Cr, Cu, Ni, and Hg on the plots that were analysed are within the range of permissible standards for forest ecosystems in Poland, while Pb and As exceed the permissible standards for this type of ecosystem. Spearman’s rank correlation coefficient showed a high correlation between Fe–Cr (r(32) = 0.879, Pb-Hg r(32) = 0.772, Ni–Cr r(32) = 0.738, Zn-Cd r(32) = 0.734, and Cu-Hg r(32) = 0.743, and a moderate statistically significant positive correlation between Cu-Pb r(32) = 0.667 and As-Pb r(32) = 0.557. No correlation was found between altitude and the occurrence of potentially toxic elements. The geo-accumulation index (Igeo) index, on the other hand, indicates that Pb, As, and Cd have the highest impact on soil contamination in all study plots: it classifies soils from moderately to strongly polluted. The enrichment factor (EF) obtained for As and Hg indicates significant-to-very high enrichment in all areas studied. The potential ecological risk index (PLI) calculated for the sites indicates the existence of pollution in all areas examined. The highest risk categories (considerable to very high) are associated with cadmium and mercury.

Mountain societies are strongly linked to natural resources and their rational management. The growing population has led to the management of mountain areas according to emerging human needs. The study was conducted in the Urej River catchment (The Fann Mountains, Tajikistan). This paper aims to present changes in land use in 1988–2023 resulting from environmental conditions and land reform. Pasturelands predominate in the study area (93.8%), while built-up with kitchen garden and irrigated areas cover 1.8% and 4.0% of the area, respectively. Kitchen gardens and irrigated areas provide food for the residents. Significant land-use changes were observed along the Uroz River, where the irrigation system was developed in areas that have not yet been used for plant cultivation. This is typical of many areas in Tajikistan, where it is impossible to obtain crops without irrigation due to climatic conditions. Until 1988, the study area was not as intensively cultivated as it is today. Under the ongoing lease system based on the Dehkan Farm Act, grazing land is still owned by the state, but inhabitants have access to it. The leased land does little to improve the economic situation of households but contributes to preventing ecosystem degradation on the slopes caused by humans.

Conceptualizations of path creation proposed in recent years neglect the role of time and temporal mechanisms. This paper argues that a more comprehensive understanding of inter-path relations that incorporates both agency and relationships among temporal sequences can be achieved using the concept of critical conjuncture, which is overlooked in the contemporary path-creation literature. This paper draws on a case study of the industrial region of Upper Silesia, Poland, where a new regional trajectory is emerging as the result of the unpredicted critical conjuncture of the endogenously driven path of the information technology services sector and the exogenous foreign direct investment-based path of the automotive industry.

The purpose of the article was to conduct an in-depth literature review on the possibilities of managing combustion by-products (mainly fly ash) in the context of a closed-loop economy. First, information on the chemical composition of fly ash in Poland was collected and compared with the composition of fly ash in other European countries. The authors concentrated on describing methods for synthesizing geopolymers and zeolites using fly ash as a substrate. By-products of zeolite synthesis, which are strongly alkaline solutions, can be used as a substrate in the synthesis of geopolymers. A concept has been proposed to combine the synthesis of zeolites and geopolymers into a single process to close the material loop. The search for comprehensive technological solutions that take into account the ideas of a closed-loop economy is essential in an era of resource depletion, and this literature review encapsulates this topic area.

Abstract Background COVID-19, caused by a novel coronavirus SARS-CoV 2 has rapidly developed into pandemic. This infectious disease affecting mainly respiratory system may cause multiple systemic disorders. With increasing number of new infected patients there are more and more cases with neurological complications secondary to COVID-19. Case presentation Here we present a case of 67-years old Polish male with previously no comorbidities, who has developed bilateral paralysis of peroneal nerve after SARS-CoV 2 infection. Prior to the hospitalization he presented cough and fever and weakness. RT-PCR was reported positive for COVID-19 infection. Then he developed pneumonia and respiratory failure with bilateral lung consolidations on radiological examination. Laboratory findings revealed elevated levels of D-dimer, CRP, AspAT, GGTP, PCT and serum glucose. After discharge from hospital he was diagnosed with thrombophlebitis and prediabetes on follow-up visits. Due to problems with walking, numbness of toes and involuntary muscle spasms in hands, the patient went to the Neurological Outpatient Clinic. After neurological examination bilateral paralysis of peroneal nerve was revealed. Conclusions In this report we want to highlight one of the unexpected presentations of SARS-CoV 2 infection and emphasize the importance of neurological examination in COVID-19 patients.

To date, the effectiveness of direct‐acting antivirals (DAAs) discontinued before 4 weeks has not been analysed in routine clinical practice. The study aimed to determine whether such a short therapy will enable achieving a sustained virological response under real‐world experience. The study population of 97 patients who discontinued DAA therapy and had data enabling analysis of patient and disease characteristics, and assessment of treatment effectiveness was selected from 16,815 patients registered in the EpiTer‐2 database. The most common reason for discontinuation was hepatic decompensation (20.6%) or the patient's personal decision (18.6%). Patients who discontinued treatment were significantly older, more frequently therapy‐experienced, more likely to have cirrhosis, a history of decompensation and a Child–Pugh B or C classification than those who completed treatment. SVR was achieved by 93.5% of patients who discontinued treatment after 4 weeks, 60.9% if discontinued at 3 or 4 week and 33.3% at Week 1 or 2. Patients receiving pangenotypic but not genotype‐specific treatment who discontinued after 4 weeks were as likely to achieve SVR as those who completed therapy. Patients who responded to treatment that lasted no longer than 2 weeks had a low baseline viral load (<400,000 IU/mL). Despite discontinuation of therapy after Week 4, the chances of SVR are high. Very early discontinuation does not preclude therapeutic success, especially in patients with low baseline viral load. [ABSTRACT FROM AUTHOR]

Introduction Multimorbidity, the coexistence of two or more chronic conditions, has been extensively studied in certain disease states. Bronchiectasis aetiology is complex and multimorbidity is insufficiently understood. We performed a scoping review, summarising the existing literature and identifying deficits. Method A literature search of the electronic databases PubMed, CINAHL and EMBASE was conducted following PRISMA guidelines. Observational, interventional, qualitative, randomised control trials and systematic reviews were included. The main objective was to identify prevalence, prognosis, symptoms, quality of life and management in bronchiectasis multimorbidity. Key findings were analysed descriptively. Results 40 studies (200 567 patients) met the inclusion criteria, the majority (68%) being cohort studies. Study size ranged from 25 to 57 576 patients, with mean age 30–69 years. 70% of studies investigated the prognosis of comorbidities and 68% prevalence; 70% analysed multiple comorbidities in bronchiectasis. The most frequent comorbid diseases evaluated were COPD (58%), cardiovascular disease (53%) and asthma (40%). COPD and hypertension were the most prevalent conditions (pooled mean 35% and 34% respectively). Multimorbidity was associated with increased mortality, exacerbations and hospitalisation rates. It had a negative impact on lung function. Mortality increased in the following comorbidities: COPD, gastro-oesophageal reflux disease and rheumatoid arthritis. Conclusion Bronchiectasis multimorbidity is common. Research focuses on a few key aspects and favoured comorbidities (e.g. COPD). There is a deficit of research into symptoms, quality of life, interactions and management. High-resolution computed tomography diagnosis is not consistent, and there is no agreed multimorbidity screening questionnaire. Bronchiectasis multimorbidity is of importance; it is associated with morbidity and mortality.

As copper and its compounds are of fundamental importance for the development of innovative materials, the synthesis of composites intended for water purification was undertaken in which submicron copper containing particles were dispersed within the matrix of a strongly basic anion exchanger, with a macroporous and gel-like structure. Due to their trimethylammonium functional groups, the host materials alone exhibited an affinity to anionic water contaminants and antimicrobial properties. The introduction of such particles as CuO, Cu2O, metallic Cu, CuO/FeO(OH), Cu4O3, Cu(OH)2, Cu4(OH)6SO4, Cu2(OH)3Cl increased these properties and demonstrated new properties. The composites were obtained unconventionally, in ambient conditions, using eco-friendly reagents. Alternative synthesis methods were compared and optimized, as a result of which a new group of hybrid ion exchangers was created (HIXs) containing 3.5–12.5 wt% of Cu. As the arrangement of the inorganic phase in the resin matrix was atypical, i.e., close to the surface of the beads, the obtained HIXs exhibited excellent kinetic properties in the process of oxidation and adsorption of As(III), as well as catalytic properties for the synthesis of triazoles via click reaction, and also antimicrobial properties in relation to Gram-positive Enterococcus faecalis and Gram-negative Pseudomonas aeruginosa and Escherichia coli, preventing biofilm formation. Using thermogravimetry, the effect of the inorganic phase on decomposition of the polymeric phase was evaluated for the first time and comprehensively, confirming the relationship and finding numerous regularities. It was also found that, depending on the oxidation state (CuO, Cu2O, Cu), copper-containing particles affected the textural properties of the polymeric phase endowing a tighter structure, limiting the porosity and reducing the affinity for water.

Abstract In the DECODE project, data were collected from 3,114 surveys filled by symptomatic patients RT-qPCR tested for SARS-CoV-2 in a single university centre in March-September 2020. The population demonstrated balanced sex and age with 759 SARS-CoV-2( +) patients. The most discriminative symptoms in SARS-CoV-2( +) patients at early infection stage were loss of taste/smell (OR = 3.33, p 38℃ with cough was most frequent in men (20%), while loss of taste/smell with cough in women (17%). For younger people, taste/smell impairment is sufficient to characterise infection, whereas in older patients co-occurrence of fever and cough is necessary. The presented study objectifies the single symptoms and interactions significance in COVID-19 diagnoses and demonstrates diverse symptomatology in patient groups.

Purpose: Results of the low-dose radiation therapy (LDRT) in patients with pneumonia due to COVID-19 has been presented. Methods: Fifteen patients received a single-fraction radiation dose of 1 Gy to the bilateral lungs due to pre-ARDS pneumonia in the course of COVID-19. Follow-up was performed on days 1, 3, 5, 7, 14 after LDRT. Results: Eleven patients (73%) were released up until day 28. Median hospitalization was 20 days; 28-day mortality was 13%. Median O2 saturation improved within 24 h after LDRT in 14/15, with median SpO2 values of 84.5% vs. 87.5% p = 0.016, respectively. At day 14 of hospitalization, 46% did not require oxygen supplementation. Significant decline in CRP and IL-6 was observed within 24 h post LDRT. No organ toxicities were noted. Conclusion: LDRT is feasible, well tolerated and may translate to early clinical recovery in patients with severe pneumonia. Further studies are needed to determine optimal candidate, time and dose of LDRT for COVID-19 patients with pneumonia.

Introduction Pseudomonas aeruginosa increases morbidity and mortality in respiratory disease. To date the long-term ventilation population does not have clear guidelines regarding its management. Method We undertook a retrospective observational study in a regional long-term ventilation population (837 patients). We defined the primary outcome as P. aeruginosa isolation. In addition positive cultures for copathogens (Serratia, Proteus species, Stenotrophomonas, Burkholderia cepacia complex and nontuberculous mycobacteria) were recorded. Logistic regression and odds ratios were calculated. Results 17.6% of the cohort isolated P. aeruginosa, and this pathogen was cultured more frequently in patients with a tracheostomy (logistic regression coefficient 2.90, p≤0.0001) and cystic fibrosis/bronchiectasis (logistic regression coefficient 2.48, p≤0.0001). 6.3% of patients were ventilated via tracheostomy. In the P. aeruginosa positive cohort 46.9% of patients were treated with a long-term macrolide, 36.7% received a nebulised antibiotic and 21.1% received both. Tracheostomised P. aeruginosa positive patients received a nebulised antibiotic more frequently (OR 2.63, 95% CI 1.23–5.64, p=0.013). Copathogens were isolated in 33.3% of the P. aeruginosa cohort. In this cohort patients with a tracheostomy grew a copathogen more frequently than those without (OR 2.75, 95% CI 1.28–5.90). Conclusions P. aeruginosa isolation is common within the adult long-term ventilation population and is significantly associated with tracheostomy, cystic fibrosis and bronchiectasis. Further research and international guidelines are needed to establish the prognostic impact of P. aeruginosa and to guide on antimicrobial management. The increased risk of P. aeruginosa should be considered when contemplating long-term ventilation via tracheostomy.