Higgs Oscillations in a Unitary Fermi Superfluid.

Symmetry-breaking phase transitions are central to our understanding of states of matter. When a continuous symmetry is spontaneously broken, new excitations appear that are tied to fluctuations of the order parameter. In superconductors and fermionic superfluids, the phase and amplitude can fluctuate independently, giving rise to two distinct collective branches. However, amplitude fluctuations are difficult to both generate and measure, as they do not couple directly to the density of fermions and have only been observed indirectly to date. Here, we excite amplitude oscillations in an atomic Fermi gas with resonant interactions by an interaction quench. Exploiting the sensitivity of Bragg spectroscopy to the amplitude of the order parameter, we measure the time-resolved response of the atom cloud, directly revealing amplitude oscillations at twice the frequency of the gap. The magnitude of the oscillatory response shows a strong temperature dependence, and the oscillations appear to decay faster than predicted by time-dependent Bardeen-Cooper-Schrieffer theory applied to our experimental setup.

Hiperintensidad en secuencia FLAIR del LCR en el espacio subaracnoideo: diagnósticos diferenciales / FLAIR hyperintensity in the subarachnoid space: Main Differentials

La secuencia fluid attenuated inversion recovery (FLAIR) forma parte hoy en día de la gran mayoría de protocolos diagnósticos de RM cerebral. Esta secuencia de inversión-recuperación permite una supresión de la señal del líquido cefalorraquídeo, lo que facilita la detección de enfermedad que afecta al espacio subaracnoideo. Las causas de hiperintensidad del líquido cefalorraquídeo en esta secuencia pueden subdividirse en 2grandes grupos, las patológicas y las debidas a artefactos. Son bien conocidas la etiología tumoral, la inflamatoria, la vascular o las debidas a hipercelularidad del líquido cefalorraquídeo o a ocupación por contenido hemático. Sin embargo, existen numerosas condiciones no patológicas, principalmente debidas a artefactos, que se relacionan con este hallazgo constituyendo una potencial fuente de errores diagnósticos.(AU)

The fluid-attenuated inversion recovery (FLAIR) sequence forms part of the vast majority of current diagnostic protocols for brain MRI. This sequence enables the suppression of the signal from cerebrospinal fluid, facilitating the detection of disease involving the subarachnoid space. The causes of hyperintensity in the arachnoid space in this sequence can be divided into two main categories: hyperintensity due to disease and hyperintensity due to artifacts. Hyperintensity due to tumors, inflammation, vascular disease, or hypercellularity of the cerebrospinal fluid or hematic contents is well known. However, numerous other non-pathological conditions, mainly due to artifacts, that are also associated with this finding are a potential source of diagnostic errors.(AU)

FLAIR hyperintensity in the subarachnoid space: Main differentials.

The fluid-attenuated inversion recovery (FLAIR) sequence forms part of the vast majority of current diagnostic protocols for brain MRI. This sequence enables the suppression of the signal from cerebrospinal fluid, facilitating the detection of disease involving the subarachnoid space. The causes of hyperintensity in the arachnoid space in this sequence can be divided into two main categories: hyperintensity due to disease and hyperintensity due to artifacts. Hyperintensity due to tumors, inflammation, vascular disease, or hypercellularity of the cerebrospinal fluid or hematic contents is well known. However, numerous other non-pathological conditions, mainly due to artifacts, that are also associated with this finding are a potential source of diagnostic errors.

Thymic atrophy induced by Plasmodium berghei ANKA and Plasmodium yoelii 17XL infection.

The thymus is the anatomical site where T cells undergo a complex process of differentiation, proliferation, selection, and elimination of autorreactive cells which involves molecular signals in different intrathymic environment. However, the immunological functions of the thymus can be compromised upon exposure to different infections, affecting thymocyte populations. In this work, we investigated the impact of malaria parasites on the thymus by using C57BL/6 mice infected with Plasmodium berghei ANKA and Plasmodium yoelii 17XL; these lethal infection models represent the most severe complications, cerebral malaria, and anemia respectively. Data showed a reduction in the thymic weight and cellularity involving different T cell maturation stages, mainly CD4-CD8- and CD4+CD8+ thymocytes, as well as an increased presence of apoptotic cells, leading to significant thymic cortex reduction. Thymus atrophy showed no association with elevated serum cytokines levels, although increased glucocorticoid levels did. The severity of thymic damage in both models reached the same extend although it occurs at different stages of infection, showing that thymic atrophy does not depend on parasitemia level but on the specific host-parasite interaction.

Evaluation of the goat cellular immune response to rBtuB-Hia-FlgK peptides from Brucella melitensis.

Brucellosis is a zoonosis caused by Brucella; B. melitensis is the most prevalent species in goats and humans. Previously, three B. melitensis peptides, rBtuB-Hia-FlgK showed antigen-specific immune responses in rodent models. The goal of this study was to evaluate the goat Th1/Th2 immune response to B. melitensis peptides. Twenty-eight animals were separated into four groups and were immunized with the rBtuB-Hia-FlgK peptides cocktail, adjuvant, PBS and Rev-1 vaccine, respectively. Peripheral blood samples were collected on days 0, 15, and 80 post-inoculation. The CD4+ and CD8+ T cells proliferation, and cytokine production of the Th-1 (IL-2, IL-12, TNF-α, and IFN-γ) and Th-2 profiles (IL-4, IL-5, and IL-10) were evaluated. An increase of CD4+/CD8+ at 15 days post-vaccination was observed and continued until the 80th. In addition, the IFN-γ, TNF-α, and IL-2 mRNA expression were typically induced by the 15th day, but only IFN-γ levels were observed at day 80 post-immunization. Brucella pathogenesis is distinguished by the presence of a large amount of Th-1 cytokines. Although a reduced amount of IFN-γ in the culture supernatant was accurately detected compared with Rev-1 after 15 days, it could be influenced by the sampling schedule, as a higher cytokine production might be induced as early as the first-week post-vaccination. The results indicate that rBtuB-Hia-FlgK induced an immune response similar to the Rev-1 vaccine. The possible use of inert molecules with the unique ability to typically induce cellular response similar to attenuated vaccine represents an attractive option that should not be ruled out.

Dynamics of a Fermi Gas Quenched to Unitarity.

We present an experimental study of a two component Fermi gas following an interaction quench into the superfluid phase. Starting with a weakly attractive gas in the normal phase, interactions are ramped to unitarity at a range of rates and we measure the subsequent dynamics as the gas approaches equilibrium. Both the formation and condensation of fermion pairs are mapped via measurements of the pair momentum distribution and can take place on very different timescales, depending on the adiabaticity of the quench. The contact parameter is seen to respond very quickly to changes in the interaction strength, indicating that short-range correlations, based on the occupation of high-momentum modes, evolve far more rapidly than the correlations in low-momentum modes necessary for pair condensation.

[Proposals by the Spanish Society of Quality in Healthcare (SECA) for the recovery of the National Health Service after the COVID-19 pandemic]. / Propuestas de la SECA para la recuperación del Sistema Nacional de Salud tras la pandemia por SARS-CoV-2.

BACKGROUND: The SARS-CoV-2 pandemic has demanded responses for which the National Health System (NHS) was not prepared. The Spanish Society for Quality in Healthcare (SECA) has the mission of promoting quality in healthcare and contributing to its proper functioning. OBJECTIVE: To present SECA recommendations to ensure the quality and safety of patients in the recovery of the NHS following the impact of the SARS-CoV-2 pandemic and the possibility of a resurgence. METHODS: Qualitative study to seek consensus with the participation of 49 representatives of the different stakeholders (patients, managers, professionals, academics and researchers). The areas to be explored were: lessons learned, management of new care demands from COVID-19 patients, recompositing of templates, strengthening the resilience of professionals, new role of patients and contingency plans. RESULTS: Four hundred and twenty-eight proposals were submitted. Once duplicates were deleted and similar proposals were merged, their number was reduced to 120. Of these, 60 proposals were prioritized and grouped into two categories of measures: (1) to recover the Health System (equity, accessibility, effectiveness, efficiency, safety, patient experience and work morale) and (2) to deal with possible outbreaks. CONCLUSION: SECA responds to its commitment to society with recommendations to ensure quality of healthcare and patient safety in the COVID-19 Era.

Enfoque clínico-radiológico de la mielopatía no traumática / Clinical-radiological approach to nontraumatic myelopathy

Las enfermedades de la médula espinal tienen con frecuencia consecuencias devastadoras y su estudio radiológico es indispensable para su diagnóstico. La técnica de imagen fundamental para su valoración es la resonancia magnética espinal y el enfoque diagnóstico debe basarse en el contexto clínico, el tiempo de evolución y los hallazgos radiológicos, por lo que es necesario en algunos casos la ampliación del estudio a la región cerebral. El primer paso en el algoritmo diagnóstico debe ser excluir la compresión medular antes de valorar otras causas de mielopatía, entre las que se incluyen múltiples etiologías. Este artículo incluye una amplia revisión de las diferentes patologías que pueden producir mielopatías, sus manifestaciones radiológicas, diagnósticos diferenciales y algoritmos diagnósticos. Un adecuado enfoque por parte del radiólogo repercutirá en un mejor manejo y pronóstico de estos pacientes

Diseases of the spinal cord often have devastating consequences and imaging studies are indispensable for their diagnosis. The fundamental imaging technique to evaluate these diseases is magnetic resonance imaging of the spine. The diagnostic approach must be based on the clinical context, the time elapsed since the onset of symptoms and signs, and the imaging findings; for this reason, it sometimes necessary to broaden the study to include the brain. The first step in the diagnostic algorithm is to rule out spinal cord compression before evaluating other causes of myelopathy, which sometimes has multiple causes. This paper includes a broad review of the different diseases that can cause myelopathy, their imaging manifestations, their differential diagnoses, and diagnostic algorithms. Using an appropriate radiological approach will result in better management and prognosis of these patients

Clinical-radiological approach to nontraumatic myelopathy. / Enfoque clínico-radiológico de la mielopatía no traumática.

Diseases of the spinal cord often have devastating consequences and imaging studies are indispensable for their diagnosis. The fundamental imaging technique to evaluate these diseases is magnetic resonance imaging of the spine. The diagnostic approach must be based on the clinical context, the time elapsed since the onset of symptoms and signs, and the imaging findings; for this reason, it sometimes necessary to broaden the study to include the brain. The first step in the diagnostic algorithm is to rule out spinal cord compression before evaluating other causes of myelopathy, which sometimes has multiple causes. This paper includes a broad review of the different diseases that can cause myelopathy, their imaging manifestations, their differential diagnoses, and diagnostic algorithms. Using an appropriate radiological approach will result in better management and prognosis of these patients.

High-Frequency Sound in a Unitary Fermi Gas.

We present an experimental and theoretical study of the phonon mode in a unitary Fermi gas. Using two-photon Bragg spectroscopy, we measure excitation spectra at a momentum of approximately half the Fermi momentum, both above and below the superfluid critical temperature T_{c}. Below T_{c}, the dominant excitation is the Bogoliubov-Anderson (BA) phonon mode, driven by gradients in the phase of the superfluid order parameter. The temperature dependence of the BA phonon is consistent with a theoretical model based on the quasiparticle random phase approximation in which the dominant damping mechanism is via collisions with thermally excited quasiparticles. As the temperature is increased above T_{c}, the phonon evolves into a strongly damped collisional mode, accompanied by an abrupt increase in spectral width. Our study reveals strong similarities between sound propagation in the unitary Fermi gas and bosonic liquid helium.

Prolactin selectively inhibits the LPS-induced chemokine secretion of human foetal membranes.

Background: Inflammation is a condition that jeopardizes the continuity of pregnancy because it increases the secretion of chemokines that favor the migration of leukocytes from maternal and fetal circulations to the cervix, placenta, and the chorioamniotic membranes. During pregnancy, the level of prolactin (PRL) in the amniotic fluid is high; there is evidence to suggest that PRL contributes to maintain a privileged immune environment in the amniotic cavity. We test the effect of prolactin on the secretion profile of chemokines in human fetal membranes.Methods: Nine fetal membranes collected from healthy nonlabouring cesarean deliveries at term. We placed whole membrane explants in a two-chamber culture system. Choriodecidua and amniotic chambers were pretreated with 250, 500, 1000, or 4000 ng/ml of PRL for 24 h, then choriodecidua was cotreated with 500 ng/ml of lipopolysaccharide (LPS) and PRL for 24 h. We used ELISA to measure secreted levels of four chemokines (RANTES, monocyte chemoattractant protein 1 (MCP-1), MIP-1α, and IL-8) in both amnion and choriodecidua regions.Results: In comparison with basal conditions, LPS treatment induced significantly higher secretion of RANTES, MCP-1, and MIP-1α, but not of IL-8. RANTES was mainly produced by choriodecidua and cotreatment with PRL significantly decreased its LPS-induced secretion. MCP-1 was primarily produced by the amnion and its secretion was only inhibited by 4000 ng/ml of PRL. Both membrane regions produced MIP-1α, which was significantly inhibited at 1000 and 4000 ng/ml PRL concentrations. IL-8 showed no significant changes regardless of PRL concentration.Conclusion: PRL inhibits the differential secretion of proinflammatory chemokines by human fetal membranes.

Propuestas de la SECA para la recuperación del Sistema Nacional de Salud tras la pandemia por SARS-CoV-2 / Proposals by the Spanish Society of Quality in Healthcare (SECA) for the recovery of the National Health Service after the COVID-19 pandemic

JUSTIFICACIÓN: La pandemia por SARS-CoV-2 ha exigido respuestas para las que el Sistema Nacional de Salud (SNS) no estaba preparado. La Sociedad Española de Calidad Asistencial (SECA) tiene la misión de impulsar la calidad en el ámbito sanitario y de contribuir a su adecuado funcionamiento. OBJETIVO: Presentar recomendaciones de la SECA para asegurar la calidad y la seguridad de los pacientes en la recuperación del SNS tras el impacto de la pandemia por SARS-CoV-2 y ante la posibilidad de un rebrote. MÉTODO: Estudio cualitativo de búsqueda de consenso con participación de 49 representantes de los diferentes grupos de interés (pacientes, directivos, profesionales, académicos e investigadores). Las áreas a explorar fueron: lecciones aprendidas, gestión de nuevas demandas asistenciales de pacientes COVID-19, recomposición de plantillas, fortalecimiento de la resiliencia de los profesionales, nuevo rol del paciente y planes de contingencia. RESULTADOS: Se aportaron 428 recomendaciones. Una vez eliminadas las duplicidades y unificado similitudes se redujeron a 120. De estas, se priorizaron 60 recomendaciones que fueron agrupadas en 2 bloques: 1) para la recuperación del SNS (equidad, accesibilidad, efectividad, eficiencia, seguridad, experiencia de pacientes y moral laboral) y 2) para afrontar posibles rebrotes. CONCLUSIÓN: La SECA responde a su compromiso con la sociedad con recomendaciones para asegurar la calidad y seguridad de pacientes en la era COVID-19

BACKGROUND: The SARS-CoV-2 pandemic has demanded responses for which the National Health System (NHS) was not prepared. The Spanish Society for Quality in Healthcare (SECA) has the mission of promoting quality in healthcare and contributing to its proper functioning. OBJECTIVE: To present SECA recommendations to ensure the quality and safety of patients in the recovery of the NHS following the impact of the SARS-CoV-2 pandemic and the possibility of a resurgence. METHODS: Qualitative study to seek consensus with the participation of 49 representatives of the different stakeholders (patients, managers, professionals, academics and researchers). The areas to be explored were: lessons learned, management of new care demands from COVID-19 patients, recompositing of templates, strengthening the resilience of professionals, new role of patients and contingency plans. RESULTS: Four hundred and twenty-eight proposals were submitted. Once duplicates were deleted and similar proposals were merged, their number was reduced to 120. Of these, 60 proposals were prioritized and grouped into two categories of measures: (1) to recover the Health System (equity, accessibility, effectiveness, efficiency, safety, patient experience and work morale) and (2) to deal with possible outbreaks. CONCLUSION: SECA responds to its commitment to society with recommendations to ensure quality of healthcare and patient safety in the COVID-19 Era

Assessing sustainability performance in the educational sector. A high school case study.

This paper provides a detailed assessment of the environmental performance of a High school student in the city of Madrid, as well as the associated external costs. Life Cycle Assessment was used to evaluate the potential environmental impacts. Environmental external costs were also estimated using a simplified application of the impact pathway approach. The inventory of environmental loads included the consumption of resources in the school building operation and maintenance (O&M) activities, in the educational activities and in the transport activities. The activity of one student in one school year is the functional unit. The results showed that the emissions contributing to Climate Change are quantified in 461 kg CO2 eq·year-1·student-1, being the transport responsible for the 69% of the total impact, the O&M of the school building for the 20% and the educational activities for the remaining 11%. According to the results, the O&M of the facilities is the largest contributor to ozone depletion and water resource depletion. The educational activity is the main contributor to human toxicity, freshwater eutrophication and ecotoxicity, land use and resource depletion. Transport activities are responsible for most of the impacts related to the exposure to particular matter, ionizing radiation, and those impacts related to photochemical ozone formation, acidification, and terrestrial and marine eutrophication. Furthermore, the quantification of the external costs showed that these costs could reach a value of 34 euro·year-1·student-1 being transport the main contributor with a 52% of the external costs.

Prolactin decreases LPS-induced inflammatory cytokines by inhibiting TLR-4/NFκB signaling in the human placenta.

Prolactin (PRL) plays an important role in trophoblast growth, placental angiogenesis and immunomodulation within the feto-maternal interface, where different cell types secrete PRL and express its receptor. During pregnancy, inflammatory signalling is a deleterious event that has been associated with poor fetal outcomes. The placenta is highly responsive to the inflammatory stimulus; however, the actions of PRL in placental immunity and inflammation remain largely unknown. The aim of this study was to evaluate PRL effects on the TLR4/NFkB signalling cascade and associated inflammatory targets in cultured explants from healthy term human placentas. An in utero inflammatory scenario was mimicked using lipopolysaccharides (LPS) from Escherichia coli. PRL significantly reduced LPS-dependent TNF-α, IL-1ß and IL-6 secretion and intracellular levels. Mechanistically, PRL prevented LPS-mediated upregulation of TLR-4 expression and NFκB phosphorylation. In conclusion, PRL limited inflammatory responses to LPS in the human placenta, suggesting that this hormone could be critical in inhibiting exacerbated immune responses to infections that could threaten pregnancy outcome. This is the first evidence of a mechanism for anti-inflammatory activity of PRL in the human placenta, acting as a negative regulator of TLR-4/NFkB signaling.

[Primary care specific scorecards as management tools]. / Cuadros de mando específicos de atención primaria como herramienta de gestión.

INTRODUCTION: Specific Scorecards are a key element to improve strategic lines aimed at enhancing intermediate health outcomes. Their implementation, involving professionals, requires identifying indicators linked to the outcomes of healthcare actions that the scientific literature may endorse. In addition, the inclusion of objectives that can be defined by parameterized by indicators of intermediate results in the health centre program contract, conveys the relevance of health actions and their impact on health. OBJECTIVE: To describe the design, development and outcomes of the specific scorecards of indicators of intermediate health outcomes in the Primary Care information system (eSOAP) in order to promote the involvement of professionals in strategic management from clinical management. METHODS: Phase 1: description of the process (preparation and publication of 147 indicators, 46 of them of chronicity). Phase 2: observational descriptive study on the use of professionals and managers and data on the intermediate health outcomes obtained. RESULTS: A total of 268,849 reports were generated in 2017, with 35,835 reports of specific balanced scorecard (20%) being downloaded in just 6 months. One-quarter (25%) of the indicators of the Centre program contract are intermediate results. The percentage of diabetic patients controlled was 39.2%, and has improved significantly (P<.05) in 5 years. DISCUSSION: The specific scorecards with indicators of intermediate outcomes linked to strategic lines and their inclusion in the program contracts enables professionals to become involved in clinical and strategic management and improves the decision making of professionals and managers.

The cytokine profile of women with severe anxiety and depression during pregnancy.

BACKGROUND: Controversial findings regarding the association between pro-inflammatory cytokines and depression have been reported in pregnant subjects. Scarce data about anxiety and its relationships with cytokines are available in pregnant women. To understand the association between anxiety and cytokines during pregnancy, we conducted the present study in women with or without depression. METHODS: Women exhibiting severe depression (SD) and severe anxiety (SA) during the 3rd trimester of pregnancy (n = 139) and control subjects exhibiting neither depression nor anxiety (n = 40) were assessed through the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). Serum cytokines were measured by a multiplex bead-based assay. Correlation tests were used to analyze the data and comparisons between groups were performed. A general linear model of analysis of variance was constructed using the group as a dependent variable, interleukin concentrations as independent variables, and HDRS/HARS scores and gestational weeks as covariables. RESULTS: The highest levels of Th1- (IL-6, TNF-α, IL-2, IFN-γ), Th17- (IL-17A, IL-22), and Th2- (IL-9, IL-10, and IL-13) related cytokines were observed in women with SD + SA. The SA group showed higher concentrations of Th1- (IL-6, TNF-α, IL-2, IFN-γ) and Th2- (IL-4, and IL-10) related cytokines than the controls. Positive correlations were found between HDRS and IL-2, IL-6, and TNF-α in the SA group (p < 0.03), and between HDRS and Th1- (IL-2, IL-6, TNF-α), Th2- (IL-9, IL-10, IL-13) and Th17- (IL-17A) cytokines (p < 0.05) in the SD + SA group. After controlling the correlation analysis by gestational weeks, the correlations that remained significant were: HDRS and IL-2, IL-6, IL-9, and IL-17A in the SD + SA group (p < 0.03). HARS scores correlated with IL-17A in the SA group and with IL-17A, IL-17F, and IL-2 in the SD + SA group (p < 0.02). The linear model of analysis of variance showed that HDRS and HARS scores influenced cytokine concentrations; only IL-6 and TNF-α could be explained by the group. CONCLUSIONS: We found that the cytokine profiles differ when comparing pregnant subjects exhibiting SA with comorbid SD against those showing only SA without depression.

The BeWo cell line derived from a human placental choriocarcinoma is permissive for respiratory syncytial virus infection.

The respiratory syncytial virus (RSV) is the main pathogen associated with upper respiratory tract infections during early childhood. Vertical transmission of this virus has been suggested in humans, based on observations recorded during animal studies that revealed an association of RSV with persistent structural and functional changes in the developing lungs of the offspring. However, human placentas have not yet been evaluated for susceptibility to RSV infection. In this study, we examined the capacity of RSV to infect a human trophoblast model, the BeWo cell line. Our results suggest that BeWo cells are susceptible to RSV infection since they allow RNA viral replication, viral protein translation, leading to the production of infectious RSV particles. In this report, we demonstrate that a human placenta model system, consisting of BeWo cells, is permissive to RSV infection. Thus, the BeWo cell line may represent a useful model for studies that aim to characterize the events of a possible RSV infection at the human maternal-fetal interface.

Quantum Anomaly and 2D-3D Crossover in Strongly Interacting Fermi Gases.

We present an experimental investigation of collective oscillations in harmonically trapped Fermi gases through the crossover from two to three dimensions. Specifically, we measure the frequency of the radial monopole oscillation or breathing mode in highly oblate gases with tunable interactions. The breathing mode frequency is set by the adiabatic compressibility and probes the thermodynamic equation of state. In 2D, a dynamical scaling symmetry for atoms interacting via a δ potential predicts the breathing mode to occur at exactly twice the harmonic confinement frequency. However, a renormalized quantum treatment introduces a new length scale which breaks this classical scale invariance resulting in a so-called quantum anomaly. Our measurements deep in the 2D regime lie above the scale-invariant prediction for a range of interaction strengths providing evidence for the quantum anomaly and signifying the breakdown of an elementary δ-potential model of atomic interactions. By varying the atom number we can tune the chemical potential and see the breathing mode frequency evolve smoothly between the 2D to 3D thermodynamic limits.

A versatile apparatus for two-dimensional atomtronic quantum simulation.

We report on the implementation of a novel optical setup for generating high-resolution customizable potentials to address ultracold bosonic atoms in two dimensions. Two key features are developed for this purpose. The customizable potential is produced with a direct image of a spatial light modulator, conducted with an in-vacuum imaging system of high numerical aperture. Custom potentials are drawn over an area of 600×400 µm with a resolution of 0.9 µm. The second development is a two-dimensional planar trap for atoms with an aspect ratio of 900 and spatial extent of Rayleigh range 1.6 × 1.6 mm, providing near-ballistic in-planar movement. We characterize the setup and present a brief catalog of experiments to highlight the versatility of the system.

Audio-computer-assisted survey interview and patient navigation to increase chronic viral hepatitis diagnosis and linkage to care in urban health clinics.

Intravenous drug use and sexual practices account for 60% of hepatitis C (HCV) and B (HBV) infection. Disclosing these activities can be embarrassing and reduce risk reporting, blood testing and diagnosis. In diagnosed patients, linkage to care remains a challenge. Audio-computer-assisted survey interview (Audio-CASI) was used to guide HCV and HBV infection testing in urban clinics. Risk reporting, blood testing and serology results were compared to historical controls. A patient navigator (PN) followed up blood test results and provided patients with positive serology linkage to care (LTC). Of 1932 patients surveyed, 574 (30%) were at risk for chronic viral hepatitis. A total of 254 (44.3%) patients were tested, 34 (13.5%) had serology warranting treatment evaluation, and 64% required HBV vaccination. Of 16 patients with infection, seven HCV and three HBV patients started treatment following patient LTC. Of 146 HBV-naïve patients, 70 completed vaccination. About 75% and 49% of HCV antibody and HBV surface antigen-positive patients were born between 1945 and 1965. Subsequently, automated HCV testing of patients born between 1945 and 1965 was built into our hospital electronic medical records. Average monthly HCV antibody testing increased from 245 (January-June) to 1187 (July-October). Patient navigator directed LTC for HCV antibody-positive patients was 61.6%. In conclusion, audio-CASI can identify patients at risk for HCV or HBV infection and those in need of HBV vaccination in urban medical clinics. Although blood testing once a patient is identified at risk for infection needs to increase, a PN is useful to provide LTC of newly diagnosed patients.