SCREENING FOR HEPATITIS C Response from Hepatitis C Trust, BASL, BIA, BVHG, BSG, and BHIVA to article asking whether widespread screening for hepatitis C is justified

This is the peer reviewed published version of the following article: Response from Hepatitis C Trust, BASL, BIA, BVHG, BSG, and BHIVA to article asking whether widespread screening for hepatitis C is justified, which has been published in final form at 10.1136/bmj.h998. This article may be used for non-commercial purposes in accordance with BMJ's Terms and Conditions for Self-Archiving.This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/ by/4.0

Reconstructing 3D x-ray CT images of polymer gel dosimeters using the zero-scan method

In this study x-ray CT has been used to produce a 3D image of an irradiated PAGAT gel sample, with noise-reduction achieved using the ‘zero-scan’ method. The gel was repeatedly CT scanned and a linear fit to the varying Hounsfield unit of each pixel in the 3D volume was evaluated across the repeated scans, allowing a zero-scan extrapolation of the image to be obtained. To minimise heating of the CT scanner’s x-ray tube, this study used a large slice thickness (1 cm), to provide image slices across the irradiated region of the gel, and a relatively small number of CT scans (63), to extrapolate the zero-scan image. The resulting set of transverse images shows reduced noise compared to images from the initial CT scan of the gel, without being degraded by the additional radiation dose delivered to the gel during the repeated scanning. The full, 3D image of the gel has a low spatial resolution in the longitudinal direction, due to the selected scan parameters. Nonetheless, important features of the dose distribution are apparent in the 3D x-ray CT scan of the gel. The results of this study demonstrate that the zero-scan extrapolation method can be applied to the reconstruction of multiple x-ray CT slices, to provide useful 2D and 3D images of irradiated dosimetry gels

Controlling Light Through Optical Disordered Media : Transmission Matrix Approach

We experimentally measure the monochromatic transmission matrix (TM) of an optical multiple scattering medium using a spatial light modulator together with a phase-shifting interferometry measurement method. The TM contains all information needed to shape the scattered output field at will or to detect an image through the medium. We confront theory and experiment for these applications and we study the effect of noise on the reconstruction method. We also extracted from the TM informations about the statistical properties of the medium and the light transport whitin it. In particular, we are able to isolate the contributions of the Memory Effect (ME) and measure its attenuation length

Hepatitis B testing and treatment in HIV patients in The Gambia - compliance with international guidelines and clinical outcomes

Background Compliance with WHO guidelines on HBV screening and treatment in HIV-coinfected patients is often challenging in resource limited countries and has been poorly assessed in sub-Saharan Africa. Methods Between 2015 and 2016, we assessed physician’s compliance with WHO guidelines on HIV-HBV coinfection in the largest HIV clinic in The Gambia, and the hepatic outcomes in HIV-HBV coinfected patients as compared to randomly selected HIV-monoinfected controls. Results 870 HIV-infected patients regularly seen in this clinic agreed to participate in our study. Only 187 (21.5%, 95% CI 18.8–24.3) had previously been screened for HBsAg, 23 (12.3%, 95% CI 8.0–17.9) were positive of whom none had liver assessment and only 6 (26.1%) had received Tenofovir. Our HBV testing intervention was accepted by all participants and found 94/870 (10.8%, 95% CI 8.8–13.1) positive, 78 of whom underwent full liver assessment along with 40 HBsAg-negative controls. At the time of liver assessment, 61/78 (78.2%) HIV-HBV coinfected patients received ART with 7 (11.5%) on Tenofovir and 54 (88.5%) on Lamivudine alone. HIV-HBV coinfected patients had higher APRI score compared to controls (0.58 vs 0.42, p = 0.002). HBV DNA was detectable in 52/53 (98.1%) coinfected patients with 14/53 (26.4%) having HBV DNA >20,000 IU/L. 10/12 (83.3%) had at least one detectable 3TC-associated HBV resistance, which tended to be associated with increase in liver fibrosis after adjusting for age and sex (p = 0.05). Conclusions Compliance with HBV testing and treatment guidelines is poor in this Gambian HIV programme putting coinfected patients at risk of liver complications. However, the excellent uptake of HBV screening and linkage to care in our study suggests feasible improvements

New Partnerships for a New Generation

Objective:This poster will demonstrate how partnering with civic and community organizations to host a traveling exhibit helps the library reach beyond its primary clientele to: 1) heighten awareness of the historical roles of women physicians, 2) encourage young women to enter the medical fields, 3) promote medical librarians and library services, and 4) increase visibility of the medical school. Method:In the summer of 2004, a core group of library staff gathered to prepare the application to host the ALA/NLM traveling exhibit, “Changing the Face of Medicine: Celebrating America’s Women Physicians.” Once selected as a host site, the group reached out to a diverse mix of academic and administrative staff from across the Medical School, as well as members of the local community. This group became the formal steering committee to plan programming to accompany the exhibit, helping meet the educational and promotional goals set forth in the initial application. Some outreach events included movie nights at the public library, an essay contest for grade school students, a career day with Girl Scouts, a review of research in women’s health (WHI), etc. Promotional methods/vehicles included “save the date” postcards, flyers, posters, and coverage through area radio, television, and newspapers. Results:Seventeen events were held in conjunction with the Library’s hosting of the exhibit. During the six-week period, approximately 60,000 individuals visited the Library, more than 750 specifically devoted to viewing the display. Two hundred people from the medical school community and the public at large attended the opening ceremony, 100 area Girl Scout members participated in multiple educational events, local middle and high school students took part in an essay contest, and more than 100 people attended book signings, film screenings, and a dramatic performance about Elizabeth Blackwell. Six groups provided financial support of the exhibit, totaling more than $7,000. Conclusion:The exhibit encouraged new experiences for Library staff including collaboration, marketing and outreach to a wider audience. It introduced many first-time Library visitors to a valued local resource, helped develop relationships between medical school students and the public, and introduced a different and important historical perspective on medicine to all. Presented at the Medical Library Association Annual Meeting on May 20, 2007, in Philadelphia, PA

The moral technical imaginaries of internet convergence in an American television network

How emergent technologies are imagined, discussed, and implemented reveals social morality about how society, politics, and economics should be organized. For the television industry in the United States, for instance, the development of internet “convergence” provoked the rise of a new discourse about participatory democracy as well as the hopes for lucrative business opportunities. The simultaneity of technical, moral, and social ordering defines the “moral technical imaginary.” Populating this concept with ethnographic and historical detail, this article expands the theory of the moral technical imaginary with information from six years of participant observation, interviews, and employment with Current TV, an American-based television news network founded by Vice President Al Gore to democratize television production. This chapter explores the limits of political participation and morality when faced with neoliberal capitalism

COMPARISON OF TWO ELLIPTICAL MOTION RUNNING MACHINES AND TREADMILL RUNNING

INTRODUCTION: One of the major problems associated with rehabilitation from impact- associated running injuries is maintaining cardiovascular fitness. Recently, elliptical motion exercise machines have been developed in an attempt to simulate running while minimizing impact forces. These machines have been shown to maintain cardiovascular fitness. However, they have not yet been shown to truly simulate the running motion. The purpose of this study was to provide a quantitative comparison of two elliptical motion exercise machines (C1 and C2) and treadmill running (C3). METHODS: Both of the elliptical motion machines fixed stride length, although one allowed a greater stride length (C1). Eight subjects were tested in each of three submaximal exercise conditions during a 15 minute bout. Subjects performed at a stride frequency that resulted in a heart rate of 65% of their age-predicted maximum heart rate. Five 60 Hz digital cameras were used to collect lower extremity kinematic data. Pre-amplified surface electrodes measured the muscle activity of seven lower extremity muscles. Impact forces were assessed using a 1.7g PCB accelerometer placed on the distal medial aspect of the tibia. Both the accelerometer and EMG data were collected concurrently on a microcomputer sampling at 600 Hz. Lower extremity joint and segment parameters, onset and offset of muscles during stride, peak impact force and time to peak impact force were calculated. An analysis of variance was used to compare the measured parameters between each machine condition and to identify whether the duration of the exercise bout had an effect. RESULTS: There were no significant differences in stride duration with controlled stride frequency. The results of the analysis of the kinematic data showed that the majority of the differences between the machines and treadmill running occurred at the ankle and knee joints. At the ankle and knee joints, the touchdown angle was greater for the two machines (C1 and C2) than for treadmill running (ankle: 11.97 o and 22.14 o versus 2.23o; knee: 34.94 o and 33.89 o versus 12.05 o). At the ankle joint, the maximum plantar flexion angle was greatest in treadmill running, while there were no significant differences in any knee angles subsequent to touchdown. There were no differences in any of the hip angles at any time in the stride. Impact values on the two machines were 30% of those measured during treadmill running, and the time of occurrence of the impact was substantially longer into the stride. The results of the EMG data showed that the duration of muscle activity throughout the stride was different in the triceps surae, rectus femoris and vastus lateralis. In each case, the duration of the stride in which these muscles were active was least in treadmill running. CONCLUSIONS: In conclusion, while there are a few differences between the elliptical machines and running, it appears that the machines could be considered representative of running with distinctly less impact. Thus, these machines could be used as rehabilitation tools for runners recovering from impact-related injuries

A Web of Expectations: Evolving Relationships in Community Participatory Geoweb Projects.

This article was first published in ACME: An International Journal for Critical Geographies in 2015, available online: http://ojs.unbc.ca/index.php/acme/article/view/1235/1030.New forms of participatory online geospatial technology have the potential to support citizen engagement in governance and community development. The mechanisms of this contribution have predominantly been cast in the literature as ‘citizens as sensors’, with individuals acting as a distributed network, feeding academics or government with data. To counter this dominant perspective, we describe our shared experiences with the development of three community-based Geospatial Web 2.0 (Geoweb) projects, where community organizations were engaged as partners, with the general aim to bring about social change in their communities through technology development and implementation. Developing Geoweb tools with community organizations was a process that saw significant evolution of project expectations and relationships. As Geoweb tool development encountered the realities of technological development and implementation in a community context, this served to reduce organizational enthusiasm and support for projects as a whole. We question the power dynamics at play between university researchers and organizations, including project financing, both during development and in the long term. How researchers managed, or perpetuated, many of the popular myths of the Geoweb, namely that it is inexpensive and easy to use (thought not to build, perhaps) impacted the success of each project and the sustainability of relationships between researcher and organization. Ultimately, this research shows the continuing gap between the promise of online geospatial technology, and the realities of its implementation at the community level.Peer-reviewe