Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia

Introduction: Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods: A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results: There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion: Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping accurate inventory control procedures were recommended.Key words: Logistics management information system, stock outs, laboratory commoditie

Moduli of Abelian varieties, Vinberg theta-groups, and free resolutions

We present a systematic approach to studying the geometric aspects of Vinberg theta-representations. The main idea is to use the Borel-Weil construction for representations of reductive groups as sections of homogeneous bundles on homogeneous spaces, and then to study degeneracy loci of these vector bundles. Our main technical tool is to use free resolutions as an "enhanced" version of degeneracy loci formulas. We illustrate our approach on several examples and show how they are connected to moduli spaces of Abelian varieties. To make the article accessible to both algebraists and geometers, we also include background material on free resolutions and representation theory.Comment: 41 pages, uses tabmac.sty, Dedicated to David Eisenbud on the occasion of his 65th birthday; v2: fixed some typos and added reference

Annealing study and thermal investigation on bismuth sulfide thin films prepared by chemical bath deposition in basic medium

This is a post-peer-review, pre-copyedit version of an article published in Applied Physics A 124.2 (2018): 166. The final authenticated version is available online at: http://doi.org/10.1007/s00339-018-1584-7Bismuth sulfide thin films were prepared by chemical bath deposition using thiourea as sulfide ion source in basic medium. First, the effects of both the deposition parameters on films growth as well as the annealing effect under argon and sulfur atmosphere on as-deposited thin films were studied. The parameters were found to be influential using the Doehlert matrix experimental design methodology. Ranges for a maximum surface mass of films (3 mg cm-2) were determined. A well crystallized major phase of bismuth sulfide with stoichiometric composition was achieved at 190°C for 3 hours. The prepared thin films were characterized using Grazing Incidence X-ray diffraction (GIXRD), Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray analysis (EDX). Second, the band gap energy value was found to be 1.5 eV. Finally, the thermal properties have been studied for the first time by means of the electropyroelectric (EPE) technique. Indeed, the thermal conductivity varied in the range of 1.20 - 0.60 W m-1 K-1 while the thermal diffusivity values increased in terms of the annealing effect ranging from 1.8 to 3.5 10-7 m2s-1This work was financially supported by the Tunisian Ministry of Higher Education and Scientific Research and by the WINCOST (ENE2016-80788-C5-2-R) project funded by the Spanish Ministry of Economy and Competitivenes

HIV testing in patients who are HCV positive: Compliance with CDC guidelines in a large healthcare system.

BackgroundThere are approximately 300,000 people in the United States who are co-infected with HIV and HCV. Several organizations recommend that individuals who are HCV infected, as well as persons over the age of 13, should be HIV tested. Comorbidities associated with HCV can be reduced with early identification of HIV. Our objective was to determine whether providers routinely followed HIV testing guidelines for patients who tested HCV positive (HCV+).MethodsA retrospective chart review was conducted of all patients in primary care at an academic health system from 7/2015-3/2017 who tested HCV+. As part of a primary database, HCV testing data was collected; HIV testing data was abstracted manually. We collected and described the intervals between HCV and HIV tests. To determine associations with HIV testing univariable and multivariable analyses were performed.ResultsWe identified 445 patients who tested HCV+: 56.6% were tested for HIV, the mean age was 57 ± 10.9 years, 77% were from the Birth Cohort born 1945-1965 (BC); 61% were male; and 51% were Black/AA. Patients in the BC were more likely to be HIV tested if they were: male (p = 0.019), Black/AA (pConclusionAs demonstrated, providers did not routinely follow CDC recommendations as almost half of the HCV+ patients were not correctly tested for HIV. It is important to emphasize that six persons were tested HIV positive simultaneously with their HCV+ diagnosis. If providers did not follow the CDC guidelines, then these patients may not have been identified. Improvements in EHR clinical decision support tools and provider education can help improve the HIV testing rate among individuals who are HCV+

Leveraging the electronic health record to eliminate hepatitis C: Screening in a large integrated healthcare system.

Highly efficacious and tolerable treatments that cure hepatitis C viral (HCV) infection exist today, increasing the feasibility of disease elimination. However, large healthcare systems may not be fully prepared for supporting recommended actions due to knowledge gaps, inadequate infrastructure and uninformed policy direction. Additionally, the HCV cascade of care is complex, with many embedded barriers, and a significant number of patients do not progress through the cascade and are thus not cured. The aim of this retrospective cohort study was to evaluate a large healthcare system's HCV screening rates, linkage to care efficiency, and provider testing preferences. Patients born during 1945-1965, not previously HCV positive or tested from within the Electronic Health Record (EHR), were identified given that three-quarters of HCV-infected persons in the United States are from this Birth Cohort (BC). In building this HCV testing EHR prompt, non-Birth Cohort patients were excluded as HCV-specific risk factors identifying this population were not usually captured in searchable, structured data fields. Once completed, the BC prompt was released to primary care locations. From July 2015 through December 2016, 11.5% of eligible patients (n = 9,304/80,556) were HCV antibody tested (anti-HCV), 3.8% (353/9,304) anti-HCV positive, 98.1% (n = 311/317) HCV RNA tested, 59.8% (n = 186/311) HCV RNA positive, 86.6% (161/186) referred and 76.4% (n = 123/161) seen by a specialist, and 34.1% (n = 42/123) cured of their HCV. Results from the middle stages of the cascade in this large healthcare system are encouraging; however, entry into the cascade-HCV testing-was performed for only 11% of the birth cohort, and the endpoint-HCV cure-accounted for only 22% of all infected. Action is needed to align current practice with recommendations for HCV testing and treatment given that these are significant barriers toward elimination