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Introduction: Adherence to direct-acting antivirals (DAAs) could be a predictor of chronic viral hepatitis C (HCV) therapeutic failure. We examined the perceptions of patients receiving DAAs to determine how cognitive factors influence their decision to maintain adherence. Also, we explored the threshold of DAAs adherence for obtaining sustained virologic response (SVR) among patients with HCV, in order to better implement a strategy that improves the DAAs adherence in the future clinical practice. Methods: A single-arm prospective study was performed. Patients with HCV that started and completed DAAs treatment in the County Hospital of Craiova, Dolj, Romania, were enrolled. Patients' medication adherence was assessed using the HCV-AD10 questionnaire, and the cognitive emotion regulation was measured with CERQ questionnaire (five positive/adaptive cognitive emotion-regulation domains and four negative/maladaptive domains). Spearman correlation analysis was conducted to explore the relationships between adherence and different factors. ROC-curves were used to evaluate the adherence threshold to achieve SVR. A linear regression model was performed to analyze the primary outcome (DAAs adherence) to be the target variable based on given independent variables (age, treatment duration, severity of HCV, the nine adaptive and maladaptive strategies). Results: 368 patients (mean age: 61 years) with HCV diagnosed 4.05 ± 6.38 (average) years ago were enrolled. Mean (±SD) adherence via HCV-AD10 was 91.51 ± 8.34, and the proportion of the participants achieving SVR was 96%. Patients with an adherence less than 84% (5 patients, 1.36%) was considered nonadherent and they have a high probability of not achieving response (sensitivity and specificity of 83% and 80%, respectively). We obtained significantly higher values of three adaptive strategies between adherent and nonadherent patients following DAAs treatment: in positive refocusing (p -value = 0.044), refocus on planning (p -value = 0.037), and positive reappraisal (p -value = 0.047). Discussion: The interplay between the three adaptive strategies of the cognitive emotion regulation and the enhancement of DAAs adherence contributes to a more holistic comprehension of patient behavior in the context of HCV treatment. Increasing refocusing and planning using goal setting and assisting patients in establishing specific, achievable goals can be crucial strategies for clinicians aiming to improve adherence among their patients. [ABSTRACT FROM AUTHOR]

In the framework of wave propagation, finite difference time domain (FDTD) algorithms, yield high computational time. We propose to use morphing algorithms to deduce some approximate wave pictures of their interactions with fluid-solid structures of various shapes and different sizes deduced from FDTD computations of scattering by solids of three given shapes: triangular, circular and elliptic ones. The error in the L2 norm between the FDTD solution and approximate solution deduced via morphing from the source and destination images are typically less than 1% if control points are judiciously chosen. We thus propose to use a morphing algorithm to deduce approximate wave pictures: at intermediate time steps from the FDTD computation of wave pictures at a time step before and after this event, and at the same time step, but for an average frequency signal between FDTD computation of wave pictures with two different signal frequencies. We stress that our approach might greatly accelerate FDTD computations as discretizations in space and time are inherently linked via the Courant–Friedrichs–Lewy stability condition. Our approach requires some human intervention since the accuracy of morphing highly depends upon control points, but compared to the direct computational method our approach is much faster and requires fewer resources. We also compared our approach to some neural style transfer (NST) algorithm, which is an image transformation method based on a neural network. Our approach outperforms NST in terms of the L2 norm, Mean Structural SIMilarity, expected signal to error ratio.

Background: In upper gastrointestinal bleeding (UGIB), admissions after normal working hours and during weekends may be associated with increased mortality.Aim: To assess the evolution of the after-hours and weekend effects during the COVID-19 pandemic as a result of progressive improved management despite management challenges during the pandemic.Methods: We performed an observational study of patients admitted for UGIB at a tertiary academic center between March 2020 and December 2021, compared to the corresponding timeframe before the pandemic. Admissions were assessed based on regular hours versus after-hours and weekdays versus weekends. We stratified patients based on demographic data, etiology, prognostic scores, the time between symptom onset and admission, as and between admission and endoscopy. The outcomes included mortality, rebleeding rate, the requirement for surgery and transfusion, and hospitalization days.Results: 802 cases were recorded during the pandemic, and 1006 cases before the pandemic. The overall mortality rate was 12.33%. Patients admitted after hours and during weekends had a higher mortality rate compared to those admitted during regular hours and weekdays (15.18% versus 10.22%, and 15.25% versus 11.16%), especially in cases of non-variceal bleeding. However, the difference in mortality rates was reduced by 2/3 during the pandemic, despite the challenges posed by COVID-19 infection. This suggests that there was an equalization effect of care in UGIB, regardless of the admission time. The differences observed in mortality rates for after-hours and weekend admissions seem to be primarily related to a higher proportion of patients who did not undergo endoscopy, while the proportion of severe cases remained similar. Blood requirements, hospital days, and rebleeding rate were similar between the two groups.Conclusion: Admissions during weekends and after-hours have been associated with increased mortality, particularly in cases of non-variceal bleeding. However, the impact of this association was significantly reduced during the pandemic. [ABSTRACT FROM AUTHOR]

This observational study included all patients undergoing HCV treatment with direct-acting antiviral (DAA)-based therapy between May 2020 and September 2023 at the Dolj County Hospital, Romania. The aim was to investigate adherence to DAAs among HCV patients and the effect of this treatment on their health-related quality of life (HRQoL). Chronic HCV-infected patients were prospectively evaluated at baseline (T0), before the beginning of treatment, and 12 weeks after completing DAAs treatment (T1). The HCV-AD10 questionnaire was used to measure DAAs adherence, and HRQoL was assessed with the 15D instrument. The 15D questionnaire was administered at two time points: T0 and T1, during which the Sustained Virologic Response (SVR) was also measured. The primary outcome was DAAs adherence, with secondary outcomes including quality of life (QoL), and sustained virologic response (SVR). DAAs based therapy was initiated for 368 patients, all of whom were health insured. HRQoL and psychological state of HCV patients clinically improved. The DAAs adherence was very good (mean±SD, 91.51±8.34), being influenced by age (younger patients were much adherent, rho=-0.112, p-value=0.031) and the severity of the disease (patients with more severe hepatitis were less adherent, rho=-0.167, p-value=0.001). DAAs had a significant effect on improving HRQoL of HCV patients, but did not influence medication adherence. [ABSTRACT FROM AUTHOR]

We outline some recent research advances on the control of elastic waves in thin and thick plates, that have occurred since the large scale experiment [S. Brûlé, Phys. Rev. Lett. 112, 133901 (2014)] that demonstrated significant interaction of surface seismic waves with holes structuring sedimentary soils at the meter scale. We further investigate the seismic wave trajectories of compressional body waves in soils structured with buildings. A significant substitution of soils by inclusions, acting as foundations, raises the question of the effective dynamic properties of these structured soils. Buildings, in the case of perfect elastic conditions for both soil and buildings, are shown to interact and strongly influence elastic body waves; such site-city seismic interactions were pointed out in [Guéguen et al., Bull. Seismol. Soc. Am. 92, 794–811 (2002)], and we investigate a variety of scenarios to illustrate the variety of behaviours possible.