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Introduction Malaysia has been actively battling hepatitis C since 2016, primarily through partnerships with access-oriented nonprofit organizations and drug price control by compulsory licensing of sofosbuvir, a patented direct-acting antiviral. This study evaluated the impact of such initiatives on the treatment coverage, health expenditure of the government, and clinical outcomes of patients. Methods The data contributed by 144 public hospitals across the country was used to assess the trend changes in the number of hepatitis C patients treated and the corresponding drug expenditure between 2013 and 2019 (before and after government-driven interventions). The information on the effectiveness of the sofosbuvir-daclatasvir regimen was also gathered from medical records of hepatitis C patients, who sought care from 16 selected hospitals between April 2018 and March 2020. Results While the number of hepatitis C patients receiving treatment increased by >10 times (from 299 in 2013 to 3,116 in 2019; pConclusion The findings demonstrate the sustainability and scalability of the existing hepatitis C care model in Malaysia, along with the great real-world effectiveness of the treatment. [Disclaimer: Abstract text might vary slightly from what is displayed in the e-poster], This poster was submitted to the 14th National Conference for Clinical Research (NCCR) in August 18-20, 2021. https://nccrconference.com.my/ This poster is also shortlisted for 14th Dr Wu Lien-Teh Youth Investigator Awards. Following are the links for the presentation slides on Zenodo Repository and Slideshare: Zenodo Repository : https://zenodo.org/record/5348475 Slideshare : https://www.slideshare.net/ICRInstituteForClini/midterm-outcome-evaluation-of-governmentled-endeavors-to-eliminate-hepatitis-c-as-a-public-health-threat-by-2030-in-malaysia

Background: Malaysia has been fully committed to the global endeavor to eliminate hepatitis C virus (HCV) infection by 2030. In early 2018, the Ministry of Health (MOH) embarked on a “one-size-fits-all strategy” by introducing generic versions of sofosbuvir and daclatasvir as the standard treatment for HCV infection in public hospitals nationwide. Objectives: To evaluate the outcomes of such an initiative in multiple aspects, including the number and characteristics of patients treated, the extent of evidence-based drug use, the treatment completion status, individual responses to treatment, common side effects of treatment, and its economic implications. Methods: The findings were generated from the data compiled by the MOH, capturing the information regarding the treatment provided to adult HCV-infected patients in 16 selected hospitals between April 2018 and March 2020, along with the drug costs incurred. Results: A total of 1,797 patients were treated, nearly four times more than the patients receiving interferon-based treatment across the country in the preceding two years. Approximately one-third of them had liver cirrhosis, and the main HCV genotypes were 3 (46.9%) and 1a (20.0%). Dosing, treatment duration and the addition of ribavirin to the treatment generally agreed with the recommendations of the MOH. More than 90% of the patients completed the treatment course, and a sustained virologic response (SVR) rate of 95.4% (95% CI: 94.2, 96.7%) was recorded in those with a known treatment outcome (n = 1,163). The SVR achievement did not vary across HCV genotypes and cirrhosis status, but those ≥ 50 years of age (adjusted OR: 2.13; 95% CI: 1.16, 3.92) were more likely to fail the treatment. Side effects were rare. Anemia and fatigue caused treatment discontinuation in only 0.3% of the patients. The total drug expenditure reached US$678,258.20, and the mean cost of a 12-week treatment course of sofosbuvir and daclatasvir (US$235.16) was lower than the cost expected by the MOH (US$300). Conclusions: The findings demonstrate a high degree of real-world effectiveness, safety, and affordability of the standard treatment, suggesting that such a government-led initiative was reasonable and timely and could be extended to include more public health institutions.

The engineer and technical writer Frederick Walter Simms (1803–65) ranked as a leading authority on tunnel construction for railways. After working for a time at the Royal Observatory, Simms assisted Henry Robinson Palmer and later Sir William Cubitt on the South Eastern Railway. He was awarded the Telford medal by the Institution of Civil Engineers in 1842 for his articles on tunnelling, and further employment on railways in England and France was followed by engineering consultancies to the East India Company and the London, Chatham and Dover Railway. He gained greatest recognition, however, as the author of authoritative engineering textbooks, notably this work, first published in 1844. Considered the standard textbook on the subject at the time, it sets out the approved practices of the day, using the Bletchingley and Saltwood tunnels, whose construction Simms supervised, as key examples. A number of technical illustrations accompany the text.

The main aim of this work was to develop a method of screening HgCdTe materials for carrier concentration and mobility using Faraday rotation θ and absorption α. Faraday rotation provides N/m*2, where N is the carrier concentration and m* is the effective mass. Since m* was not known in HgCdTe, a Faraday rotation spectrometer was developed to systematically measure it as a function of temperature and Cd mole fraction. Effective masses in n-InSb, and n-GaAs were measured and compared with known values in the literature to validate the method. Mobility is proportional to θ/α. The proportionalities were determined in HgCdTe, n-InSb, and n-GaAs at infrared wavelengths.

Young stars surrounded by disks with very low mass accretion rates are likely in the final stages of inner disk evolution and therefore particularly interesting to study. We present ultraviolet (UV) observations of the ~5-9 Myr old stars RECX-1 and RECX-11, obtained with the Cosmic Origins Spectrograph and Space Telescope Imaging Spectrograph on the Hubble Space Telescope, as well as optical and near-infrared spectroscopic observations. The two stars have similar levels of near-UV emission, although spectroscopic evidence indicates that RECX-11 is accreting and RECX-1 is not. The line profiles of Hα and He I λ10830 in RECX-11 show both broad and narrow redshifted absorption components that vary with time, revealing the complexity of the accretion flows. We show that accretion indicators commonly used to measure mass accretion rates, e.g., U-band excess luminosity or the Ca II triplet line luminosity, are unreliable for low accretors, at least in the middle K spectral range. Using RECX-1 as a template for the intrinsic level of photospheric and chromospheric emission, we determine an upper limit of 3 × 10^(–10) M_☉ yr–1 for RECX-11. At this low accretion rate, recent photoevaporation models predict that an inner hole should have developed in the disk. However, the spectral energy distribution of RECX-11 shows fluxes comparable to the median of Taurus in the near-infrared, indicating that substantial dust remains. Fluorescent H2 emission lines formed in the innermost disk are observed in RECX-11, showing that gas is present in the inner disk, along with the dust.

Summary Using a more sensitive fluorimeter than has previously been described in this country, a method is given for estimating riboflavine in malted preparations which gives much better agreement with microbiological assays than had previously been obtained. These preparations when oxidised with permanganate during the purification procedure exhibit a non-specific blue fluorescence which interferes with the fluorimetric assay. In old samples of malt extract this blue fluorescence is quite marked before permanganate treatment. The behaviour of the fluorescent substance with Florisil and its low solubility in chloroform show it not to be lumichrome. It is most effectively separated from riboflavine by adsorption on Florisil and careful elution with 1 per cent. pyridine, the process being observed continuously under the ultra-violet lamp. Spectroscopic studies indicated Wratten 47 as a satisfactory primary filter. Comparison of fluorimetric and microbiological results confirmed this. When calculating the results of riboflavine fluorimetric assays a method based on the assumption that the net fluorescence is proportional to the concentration, and using solvent blanks to determine the net fluorescence, is preferable to the method more usual in this country of using calibration curves obtained by plotting gross fluorescence against concentration. We are indebted to Mr. E. J. Bowen, F.R.S., for advice, to Miss Janet Horsford and Mr. R. Evans for technical assistance, to Mr. G. Slaughter for the fluorescence spectrum of riboflavine, to Messrs.*** Hilger and Watts, Ltd., and Messrs. Kodak, Ltd., for data on the transmission of filters.