CHARACTERISTICS OF PATIENTS WITH LOW HEPATITIS C TREATMENT RATES IN URBAN MEDICAL CENTER CLINICS

The objective of this study was to determine whether there were different characteristics between HCV patients who were treated and those not treated after their first visit to a Gastroenterology (GI) or Infectious Disease (ID) clinic. This information might identify potential targets for remedial actions that could be performed to increase the number of treated patients. Data was collected from 2019 HCV patient EMR charts including patient demographics, treatment history, and laboratory studies. We defined success as receiving treatment by July 2020 (6-18 months after the first visit). We found that of 587 patients with HCV who were seen at least once in the Wayne Health system, 441 patients (441/587=75%) were not treated and only 189 (189/441= 43%) were treated by July 2020. Treated and not treated patients were similar with respect to race, gender, age, and median income defined by zip code. They were also not different with respect to the clinic seen (ID vs GI), the type of insurance, or the degree of fibrosis. However, patients with an average of 4 visits were more likely to be treated than those having 2 visits. Having 1 visit was the most dramatic factor in the lack of treatment (42% vs 8% p\u3c0.0001). PCR available at first visit was an important factor with respect to treatment (treated 38% vs not treated 25% p\u3c0.02)

A Younger Demographic Defines Hepatitis C Patient Profiles in the Recent Direct-Acting Antiviral Era

A Younger Demographic Defines Hepatitis C Patient Profiles in the Recent Direct-Acting Antiviral Era Authors: Minawala, Ria1; Naylor, Paul H.2; Ehrinpreis, Murray N.2; Mutchnick, Milton G.2 Institutions: 1. Wayne State University School of Medicine, Detroit, MI, United States. 2. Wayne State University School of Medicine, Division of Gastroenterology, Detroit, MI, United States. Background: Highly effective and safe direct-acting antivirals (DAAs) against hepatitis C virus (HCV) combined with U.S. Preventive Services Task Force recommendation to screen for HCV in individuals born between 1945 and 1965 (age cohort; 54-79 years of age in 2019) was expected to reduce the number of actively infected patients via identification and treatment. Nevertheless, HCV infections remain a significant health concern. A study of HCV infected patients in our urban internal medicine practice, during the interferon era and prior to the introduction of DAAs, demonstrated a population within the age cohort. The objective of this study was to characterize the current patient population seen in the same practice with respect to age, race, and treatment status to determine the impact of DAA therapy on patient profiles and to test the hypothesis that there would be an increase in younger population among those infected. Methods: Using electronic medical records, we identified patients who presented to our urban GI practice in 2019. Data collected from patient charts included demographics, liver function tests, HCV genotype, viral load, imaging studies, and treatment history. Results: There were 601 patients with HCV seen in 2019 and the majority were African American (AA) (85%) and male (66%). Comparison of age alongside gender and race revealed that non-AA patients (51 years, SEM = 0.9) were significantly younger than AA patients (63 years, SEM = 0.4; p Conclusion: The primary shift in patient demographics as compared to the interferon era has been toward younger, non- AA females. In contrast, the predominant AA patients are still within the age cohort. The emergence of younger patients has important implications for screening, patient outreach, and treatment plans. A more intensive evaluation for risk factors and the role of COVID-19 in treatment is warranted. Many AA and non- AA patients were not started on any treatment in 2019, signifying a need for continued follow-up after initial visit to close the linkage to care gap

FAILURE TO TREAT HCV IN PATIENTS SEEN IN A PREDOMINATELY AFRICAN AMERICAN SOCIOECONOMICALLY CHALLENGED POPULATION

The research objective of this proposal is to investigate the impediment with respect to moving a patient from initial antibody/PCR positive to successful completion of treatment. Secondary objectives include determining the most effective way for patients to progress from initial antibody/PCR positive to treatment and identifying the roadblocks for HCV antibody/PCR positive patients to be treated effectively. Data was collected from 2019 HCV patient EMR charts, including demographics, laboratory studies, and treatment history. Concerning treatment, we evaluated linkage to the care; we defined success as treatment within six months of the initial visit. Thus, data on treatment initiation was collected through the first six months of 2020

Ultraviolet Emission Line Ratios of Cataclysmic Variables

We present a statistical analysis of the ultraviolet emission lines of cataclysmic variables (CVs) based on $\approx 430$ ultraviolet spectra of 20 sources extracted from the International Ultraviolet Explorer Uniform Low Dispersion Archive. These spectra are used to measure the emission line fluxes of N V, Si IV, C IV, and He II and to construct diagnostic flux ratio diagrams. We investigate the flux ratio parameter space populated by individual CVs and by various CV subclasses (e.g., AM Her stars, DQ Her stars, dwarf novae, nova-like variables). For most systems, these ratios are clustered within a range of $\sim 1$ decade for log Si IV/C IV $\approx -0.5$ and log He II/C IV $\approx -1.0$ and $\sim 1.5$ decades for log N V/C IV $\approx -0.25$. These ratios are compared to photoionization and collisional ionization models to constrain the excitation mechanism and the physical conditions of the line-emitting gas. We find that the collisional models do the poorest job of reproducing the data. The photoionization models reproduce the Si IV/C IV line ratios for some shapes of the ionizing spectrum, but the predicted N V/C IV line ratios are simultaneously too low by typically $\sim 0.5$ decades. Worse, for no parameters are any of the models able to reproduce the observed He II/C IV line ratios; this ratio is far too small in the collisional and scattering models and too large by typically $\sim 0.5$ decades in the photoionization models.Comment: LaTeX format, uses aaspp4.sty, 28 pages, 11 Postscript figures, accepted for publication in The Astrophysical Journal 10/16/9

Observing Extended Sources with the \Herschel SPIRE Fourier Transform Spectrometer

The Spectral and Photometric Imaging Receiver (SPIRE) on the European Space Agency's Herschel Space Observatory utilizes a pioneering design for its imaging spectrometer in the form of a Fourier Transform Spectrometer (FTS). The standard FTS data reduction and calibration schemes are aimed at objects with either a spatial extent much larger than the beam size or a source that can be approximated as a point source within the beam. However, when sources are of intermediate spatial extent, neither of these calibrations schemes is appropriate and both the spatial response of the instrument and the source's light profile must be taken into account and the coupling between them explicitly derived. To that end, we derive the necessary corrections using an observed spectrum of a fully extended source with the beam profile and the source's light profile taken into account. We apply the derived correction to several observations of planets and compare the corrected spectra with their spectral models to study the beam coupling efficiency of the instrument in the case of partially extended sources. We find that we can apply these correction factors for sources with angular sizes up to \theta_{D} ~ 17". We demonstrate how the angular size of an extended source can be estimated using the difference between the sub-spectra observed at the overlap bandwidth of the two frequency channels in the spectrometer, at 959<\nu<989 GHz. Using this technique on an observation of Saturn, we estimate a size of 17.2", which is 3% larger than its true size on the day of observation. Finally, we show the results of the correction applied on observations of a nearby galaxy, M82, and the compact core of a Galactic molecular cloud, Sgr B2.Comment: Accepted for publication by A&

Hopes and Fears: Community cohesion and the ‘White working class’ in one of the ‘failed spaces’ of multiculturalism

Since 2001, community cohesion has been an English policy concern, with accompanying media discourse portraying a supposed failure by Muslims to integrate. Latterly, academia has foregrounded White majority attitudes towards ethnic diversity, particularly those of the ‘White working class’. Whilst questioning this categorisation, we present data on attitudes towards diversity from low income, mainly White areas within Dewsbury, West Yorkshire, a town portrayed in media discourse as one of the ‘failed spaces’ of multiculturalism. Drawing on mixed methods research, we present and discuss data that provide a complex message, seemingly confirming pessimistic analyses around ethnic diversity and predominantly White neighbourhoods but also highlighting an appetite within the same communities for greater and more productive inter-ethnic contact. Furthermore, anxieties about diversity and integration have largely failed to coalesce into broad support for organised anti-minority politics manifest in groups such as the English Defence League

Experience-based VAS values for EQ-5D-3L health states in a national general population health survey in China

Purpose: To investigate the feasibility of deriving experience-based visual analogue scale (VAS) values for EQ-5D-3L health states using national general population health survey data in China. Methods: The EQ-5D-3L was included in the National Health Services Survey (n = 120,709, aged 15–103 years) to measure health-related quality of life. The respondents reported their current health status on a VAS and completed the EQ-5D-3L questionnaire, enabling modelling of the association between the experience-based VAS values and self-reported problems on EQ-5D dimensions and severity levels. Results: VAS values were generally negatively associated with problems reported on the EQ-5D dimensions, and the anxiety/depression dimension had the greatest impact on VAS values. A previously obtained value for dead allowed the values for all 243 EQ-5D-3L health states to be transformed to the 0–1 scale (0 = dead, 1 = full health). Conclusions: This study presents the feasibility of deriving an experience-based VAS values for EQ-5D-3L health states in China. The analysis of these VAS data raises more fundamental issues concerning the universal nature of the classification system and the extent to which Chinese respondents utilise the same concepts of health as defined by this classification system

Variations in the pre-operative status of patients coming to primary hip replacement for osteoarthritis in European orthopaedic centres.

addresses: Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Headington, Oxford, UK. [email protected]: PMCID: PMC2654855types: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't© 2009 Dieppe et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Total hip joint replacement (THR) is a high volume, effective intervention for hip osteoarthritis (OA). However, indications and determinants of outcome remain unclear. The 'EUROHIP consortium' has undertaken a cohort study to investigate these questions. This paper describes the variations in disease severity in this cohort and the relationships between clinical and radiographic severity, and explores some of the determinants of variation