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LOS ANGELES Jeff Samardzija Jersey , Sept. 26 (Xinhua) -- The death toll from an outbreak of Hepatitis A in San Diego County in the U.S. state of California has reached 17, the latest update released by the county's Health and Human Services Agency revealed on Tuesday.

Seventeen people have died of the highly contagious virus in San Diego, the southernmost county in the state of California. Among the 461 cases that have been confirmed, the number of hospitalizations stands at 315, the update showed.

A third of the cases involved people who used illicit drugs and are considered homeless. Local authorities have installed new bathrooms for transient laborers in San Diego County to help curb the spread of the virus.

As of Sept. 23, more than 42,000 vaccines had been administered in the county and the Board of Supervisors has decided to keep a local public health emergency in place. The emergency was first announced on Sept. 1 and was scheduled to be reviewed every two weeks.

Hepatitis A, most commonly spread person-to-person through the fecal-oral route, is an infectious disease that can sometimes cause liver failure and even deaths.

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TORONTO, Nov. 11 (Xinhua) -- Canada's main stock market in Toronto fell sharply to close the week due to falling commodity prices and the uncertainty of future policies set by U.S. president-elect Donald Trump.

The Toronto Stock Exchange's benchmark Standard & Poor'sTSX Composite Index fell 188.84 points, or 1.28 percent, to end the day at 14,555.41 points. All of the ten sub-sectors finished the session in negative territory.

Friday's slide was the largest single-day drop for Toronto stocks since Sep. 13 when it retreated 248.04 points.

Gold prices tumbled to a six-month low, as Globex prices retreated 3.07 percent to 1229.70 U.S. dollars an ounce. Silver did not fare any better, sinking 7.28 percent to 17.45 U.S. dollars an ounce. Subsequently, the TSX Materials group, which feature miners of gold and other precious metals, slumped 4.33 percent on the session.

Gold miners B2Gold Corp. and Yamana Gold Inc. shares were among the most actively traded during the session and dipped 7.85 percent and 9.15 percent, respectively. Meanwhile, shares of Toronto-based Barrick Gold Corporation, the world's largest gold miner, fell 5.47 percent to 20.06 Canadian dollars (14.81 U.S. dollars).

Energy sub-sector performed poorly, declining 1.29 percent as crude oil reached a three-month low. A barrel of Brent in London for January delivery slid 2.26 percent to close at 44.64 U.S. dollars. Calgary-based energy firms Baytex Energy Corp. and Encana Corporation shares descended 3.42 percent and 3.07 percent, respectively.

Utilities and Consumer Discretionary groups also finished in the red, giving back 1.15 percent and 1.02 percent, respectively.

Industrials sub-sector fell 1.04 percent despite Bombardier Inc. shares rising 3.57 percent to 2.03 Canadian dollars (1.50 U.S. dollars) a day after the Montreal-based manufacturer of planes and automobiles reported better than expected quarterly earnings.

The Canadian dollar dipped to an 8-month low to close at 0.7382 U.S. dollars, compared to Thursday's closing rate of 0.7457.

In choosing an EMR system for an ophthalmology practice, a major factor to consider is the system s ability to handle high resolution images.

At our practice we have a multi sub specialty which includes glaucoma and retina, which require that electronic images are viewable from devices such as both digital fluorescein cameras and ocular coherence tomography, GDx and HRT.

Many EMR systems have viewing modules built in. Some practices may want to consider a solution which has more robust capability, such as the ability to view multiple images at the same time, meanwhile scrolling through other reports, along with the ability to view images over a WAN between office locations.

I recently spoke with Steve Thomas, CRA of Florida Opthalmic Consultants, an independent imaging consultant for ophthalmologists. I asked him about the key factors that a practice needs to consider when selecting an imaging system. His responses:

1. Durability. This is based on the reputation of the manufacturer and the average amount of use. Can you get it fixed fast if it breaks? Who provides the technical support?

2. Expandability. After the system has been in use for a number of years, will you need additional computer resources to manage the increasing patient image information? How do you backup this information to protect loss?

3. Affordability. This is based on your patient volume how many fluorescein angiograms (FA) and fundus photos (FP) are typically performed? Based on the revenue from this volume what does the system cost to run and maintain?

4. Licensing. Is the system licensed per practice, per doctor, or per user? If it is per user, does the system limit how many users can be logged on at any one time? Can you network the system into all your exam rooms without having to purchase additional licenses?

5. Interoperability. Is it a self contained system? Will it dovetail easily with your existing EMR system? Or is the digital part from a third party manufacturer, complicating service issues when the system goes down?

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