HepCare Europe: a service innovation project. HepCheck: enhancing HCV identification and linkage to care for vulnerable populations through intensified outreach screening. A prospective multisite feasibility study.

OBJECTIVES: Hepatitis C is one of the main causes of chronic liver diseases worldwide. One of the major barriers to effecting EU- and WHO-mandated HCV elimination by 2030 is underdiagnosis. Community-based screening strategies have been identified as important components of HCV models of care. HepCheck Europe is a large-scale intensified screening initiative aimed at enhancing identification of HCV infection among vulnerable populations and linkage to care. METHODS: Research teams across four European countries were engaged in the study and rolled out screening to high-risk populations in community addiction, homeless and prison services. Screening was offered to 2822 individuals and included a self-administered questionnaire, HCV antibody and RNA testing, liver fibrosis assessment and referral to specialist services. RESULTS: There was a 74% (n=2079) uptake of screening. The majority (85.8%, n=1783) were male. In total 44.6% (n=927) of the sample reported ever injecting drugs, 38.4% (n=799) reported ever being homeless and 27.9% (n=581) were prisoners. In total 397 (19%) active HCV infections were identified and 136 (7% of total sample and 34% of identified active infections) were new cases. Of those identified with active HCV infection, 80% were linked to care, which included liver fibrosis assessment and referral to specialist services. CONCLUSIONS: HepCheck's screening and linkage to care is a clear strategy for reaching high-risk populations, including those at highest risk of transmission who are not accessing any type of care in the community. Elimination of HCV in the EU will only be achieved by such innovative, patient-centred approaches.

A Microvascular System Self-Healing Approach on Polymeric Composite Materials.

The paper addresses the synthesis of a nano-fibre network by coaxial electrospinning, embedding the healing agent dicyclopentadiene (DCPD) in polyacrylonitrile (PAN) fibres. Compared to other encapsulation methods, the use of nano-fibres filled with healing agent have no effect on the mechanical properties of the matrix and can address a larger healing area. Additionally, carbon nanotubes were added as nanofillers to enhance the reactivity between DCPD and the epoxydic matrix. The self-healing capability of the nano-fibre network was carried out by flexural tests, at epoxy resin level and composite level. Results obtained from Fourier transform infrared (FTIR) spectrometry, thermogravimetric analysis (TGA) and scanning electron microscopy (SEM) confirmed the successful encapsulation of DCPD healing agent in PAN fibres. Flexural tests indicate that after 48 h, the epoxy resin has recovered 84% of its flexural strength while the composite material recovered 93%.

Korsakoff syndrome: An overlook (Review).

This review aimed to analyze the latest neurobiological findings regarding Korsakoff syndrome, since alcoholism is the most prevalent addiction worldwide. In addition, we analyzed the optimal treatment that can be administered in order to minimize the symptoms and improve the outcome of these patients. The disruption of memory circuits within the brain of alcoholic patients results in the amnestic syndrome known as Korsakoff syndrome. It is generally characterized by a chronic neuropsychiatric syndrome caused by vitamin B1 (thiamine) deficiency. Other categories of patients can develop Korsakoff syndrome without consuming alcohol such as AIDS patients, terminally ill cancer patients, or patients with chronic infections and malnutrition. Vitamin B1 is required in the Krebs cycle for production of adenosine triphosphate (ATP). It is also a cofactor in the production of acetylcholine and certain neurotransmitters. Alcohol consumption can decrease the intake, gastrointestinal absorption and cellular utilization of vitamin B1. Treatment of alcohol withdrawal along with high doses of vitamin B1 can improve the general outcome of patients. A small percentage of patients can recover from Wernicke's encephalopathy with no permanent brain damage. The onset of Korsakoff syndrome darkens the prognosis. Alcohol abstinence is an absolute recommendation and prevents the extension of neural damage.

Manufacturing of Closed Impeller for Mechanically Pump Fluid Loop Systems Using Selective Laser Melting Additive Manufacturing Technology.

In the space industry, the market demand for high-pressure mechanically pumped fluid loop (MPFL) systems has increased the interest for integrating advanced technologies in the manufacturing process of critical components with complex geometries. The conventional manufacturing process of a closed impeller encounters different technical challenges, but using additive manufacturing (AM) technology, the small component is printed, fulfilling the quality requirements. This paper presents the Laser Powder Bed Fusion (LPBF) process of a closed impeller designed for a centrifugal pump integrated in an MPFL system with the objective of defining a complete manufacturing process. A set of three closed impellers was manufactured, and each closed impeller was subjected to dimensional accuracy analysis, before and after applying an iterative finishing process for the internal surface area. One of the impellers was validated through non-destructive testing (NDT) activities, and finally, a preliminary balancing was performed for the G2.5 class. The process setup (building orientation and support structure) defined in the current study for a pre-existing geometry of the closed impeller takes full advantages of LPBF technology and represents an important step in the development of complex structural components, increasing the technological readiness level of the AM process for space applications.

HepCare Europe-A service innovation project. HepCheck: Characteristics of the patient population with active infection as defined by HCV RNA.

BACKGROUND: Hepatitis C virus (HCV) is a main cause of chronic liver disease worldwide and is consistently under-diagnosed. Community-based screening initiatives, such as HepCheck, have been identified as important components of HCV care. HepCheck focuses on screening and identifying HCV RNA-positive cases in high-risk populations and linking them to care as part of a larger European project to improve HCV care (HepCare). METHODS: HCV testing with a self-administered questionnaire was offered to 2822 individuals. RESULTS: There were 2079 patients screened. Overall, 397 (19%) of the total screened cohort were identified as having active HCV infections as measured by HCV RNA PCR. The patients were mostly male (84%), white (88%), and had a history of injecting drug use (IDU) (86%), homelessness (58%), and tattooing (42%). There were 136 new cases (7% of the total sample and 34% of identified active infections). Romania had the highest proportion of newly identified cases with 87%, then Ireland with 60%, and Spain with 43%; the UK had the lowest proportion of new cases at 10%. CONCLUSIONS: For those lost to follow-up, a major strategy is re-engagement. For those newly diagnosed, the 'seek and treat' approach is a key strategy. Thus, different priorities are defined for different countries.