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assessment highlighted desired changes by TOC patients. Long-term outcomes will need to be studied to determine if the implemented changes at this site are sustainable.

Triaging in community pharmacies can lower the burden of minor health disorders on other primary health care settings. The netCare service, introduced in 2012 by the Swiss association of pharmacists, provides community pharmacists with 27 decision trees for the triage of minor health disorders.

(1) to describe the utilization and symptom resolving rate of decision trees in community pharmacies; (2) to identify the need for additional decision trees.

A descriptive, explorative analysis was conducted of netCare consultations between January 2019 and March 2020, as documented in phS-net, a service platform for public pharmacies. Client characteristics, weekdays, recommended course of action, availability of a general practitioner, and hypothetical course of action if netCare would not have been available were investigated. Follow-up information was assessed for resolution of symptoms and prevention of needing additional services. Data from consultations with empty assessment forms were used to identify minal for pharmacists to minimize the demand on other primary health care providers.

In 2017, Oregon passed legislation that authorized pharmacists to autonomously prescribe specified medications or devices that were included on the Formulary and Protocol Compendia (FPC). Factors that impact pharmacists' intention to prescribe from the FPC are not currently known.

Identify factors that influence pharmacists' intention to prescribe.

The Theory of Planned Behavior (TPB) served as the framework. Three focus groups were conducted with Oregon pharmacists between May and June 2019 to elicit salient beliefs about prescribing related to TPB constructs, including attitudes, subjective norms, perceived behavioral control, and perceived obligation. Two investigators conducted a qualitative content analysis and reached agreement on names of categories during consensus meetings. Talazoparib order A codebook was created after analysis of the first focus group and used to guide the remaining analysis. Participants reported background information and awareness of prescribing rules via a questionnaire; descriptive statiswill enable stakeholders to develop interventions to improve uptake of prescribing via the FPC.

TPB was useful for exploring pharmacists' beliefs related to their intention to prescribe using the FPC. Determining the relative importance of these factors in a broader population will enable stakeholders to develop interventions to improve uptake of prescribing via the FPC.As the COVID-19 pandemic ravages the whole world, frontline doctors are tirelessly fighting to contain and manage the disastrous effects of the virus. However, thoracic surgeons will also become frontline doctors, because everyone around them is likely to be infected after the closed-loop management of the hospital. Stress, difficulty, fears, physical and psychological burnout and lowered morale are some side effects. We feature the perspectives of thoracic surgeons at the epicenter of the COVID-19 fight in Fudan University Shanghai Cancer Center, which highlight the emotions, measures, motivation and belief of thoracic surgeons while they work on frontlines.

What are the hormonal and ovarian histological effects of a gender affirming hormonal therapy in assigned female at birth (AFAB) transgender people?

Prospective observational study of 70 AFAB transgender people taking testosterone therapy before gender-affirming surgery (hystero-oophorectomy). A gynaecological ultrasonographic scan was undertaken and serum hormone concentrations measured, including anti-Müllerian hormone (AMH) and androgenic profile. Histological ovarian evaluation was assessed in both ovaries, including the developmental stages of the follicles.

The mean age of the population was 27.7+/-5.14 years. The main biochemical parameters were total testosterone levels 781.5 ± 325.9 ng/dl; AMH levels 3.2 ± 1.4 ng/ml; FSH and LH levels 4.9 ± 2.5 IU/l and 3.9 ± 2.9 IU/l, respectively; and oestradiol values 47.6 ± 13.7 pg/ml. Fifty-five AFAB underwent gynaecological ultrasound before surgery and antral follicles were found in 43 out of 47 ultrasounds (91.5%) (without the presence of a dominant fol changes have been observed.

To determine if building a digital technology supported infrastructure improves general surgery residents' confidence to conduct clinical research.

We developed and introduced a multimodal virtual Surgery Resident Research Forum (SuRRF) in July 2019. An anonymized survey asked residents to rate their confidence using a five-point Likert scale in various fields pre- and post-intervention. Fields included finding a research mentor, developing a project, conducting research, performing an effective literature search, navigating internal and external resources, and ability to complete a research project.

Northwell Health - North Shore University Hospital / Long Island Jewish Medical Center academic tertiary care centers.

All 58 residents in our general surgery program, including research residents, were eligible to participate in our study.

Survey response rate was 55% (28 clinical residents, 4 research fellows). Post-implementation of SuRRF, all respondents (PGY1-5) reported an increase in awareness ofants.

The COVID-19 pandemic significantly altered the residency application and interview process. Due to social distancing concerns, residency programs have had to virtually showcase their program to applicants, many utilizing social media. Similarly, applicants have had to devise novel ways of assessing "goodness of fit", one of the top factor's applicants use when ranking programs (1). Whether or not these attempts made an impact on an applicant's decision-making process has yet to be determined.

Residency candidates interviewing for a diagnostic and/or interventional radiology residency position at our institution completed an online survey. The goal of the survey was to assess the potential influence of virtual interviews, social media, and virtual events on an applicant's decision to apply to, interview at, and rank residency programs.

78/156 (50%) candidates completed the survey. Thirty-five percent reported applying to more programs and 58% reported accepting more interviews than they would have if interviews were not virtual. Forty-two percent reported that social media played a vital role during the application season and 71% reported using social media to learn more about the program. Sixty-nine percent attended a virtual open house, 57% of whom reported that attending the open house influenced their decision to apply to a program. Sixty-three percent reported that attending a virtual reception influenced a program's ranking.

Social media has had a growing role in the medical community, and the COVID-19 pandemic likely accelerated an inevitable shift in residency program "branding" and how applicants perceive overall "goodness of fit".

Social media has had a growing role in the medical community, and the COVID-19 pandemic likely accelerated an inevitable shift in residency program "branding" and how applicants perceive overall "goodness of fit".Ageing is perceived to be the common culprit behind the most prevalent noncommunicable chronic diseases (NCD) such as cardiovascular disease (CVD). Treating ageing as a means to prevent its downstream pathologies has become the logical extension of this idea, and the defining criterion of anti-ageing medicine (evidence-based early detection, prevention, and treatment of age-related diseases). Challenging the underlying rationale, we here argue that the disease's late-in-life occurrence is proof of a genetically conserved robustness that helps us resist disease long enough for it to masquerade as a consequence of living long rather than of living wrong. Robustness is an acknowledged hallmark phenomenon of all complex systems (while there exists no universally adopted definition, a hallmark of complex systems is that they consist of many networked components whose interactions may give rise to system behaviors which cannot be derived or predicted from a reductionist knowledge of the interacting parts, even if this knowledge is complete) and a key concept in the complexity sciences (a relatively new branch of science that attempts to find and understand the common mechanisms and patterns shared by all complex systems). link2 To reconceptualise the age-relatedness of chronic diseases in this sense has important implications for medical research and practice. The goal of our essay is to open a discussion that may enhance the overall understanding of robustness and prevent a misguided redirection of funding away from established disease specific research and towards anti-ageing medicine. This essay is timely, as the forthcoming 11th version of the International Classification of Diseases (ICD) will be the first to recognise ageing as a condition, thereby legitimising anti-ageing medical research. On a more pragmatic note, and for the benefit of people alive today, we propose a practical strategy to remedy the mismatch between heritable robustness and the lifestyle challenges that gradually overwhelm it.

To compare short- and long-term outcomes after transcatheter aortic valve implantation (TAVI) in the public and private hospital setting.

Propensity-matched, retrospective analysis of a prospective registry.

Patients with severe aortic stenosis who underwent TAVI at a tertiary public hospital (n=507) and an experienced private hospital (n=436).

The primary endpoint was all-cause mortality.

Patients that underwent TAVI in the public hospital were younger than patients in the private hospital (82±8 years vs 84±6 years, p<0.001), with lower estimated short-term mortality risk (Society of Thoracic Surgeons Predicted Risk of Mortality [STS-PROM] score >4.0% 43% vs 56%, p<0.001). There was no difference between public and private hospitals in 30-day mortality (1.5% vs 1.2%, p=1.0), and the rate of complications was similar. Long-term survival was similar in propensity-matched public (n=344) and private (n=344) patient cohorts. The 1-year, 2-year, 5-year and 7-year survival rates were 95%, 90%, 67% and 47% in public patients, and 92%, 86%, 67% and 51% in private patients (p=0.94). In multivariable analysis, the hospital setting was not a predictor of mortality.

Despite increased age and predicted mortality in private hospital patients, short- and long-term outcomes after TAVI were comparable between public and private hospital settings. link3 This study demonstrates the feasibility of performing TAVI in a private hospital with a dedicated and experienced team and questions the current restricted access to TAVI in the private sector.

Despite increased age and predicted mortality in private hospital patients, short- and long-term outcomes after TAVI were comparable between public and private hospital settings. This study demonstrates the feasibility of performing TAVI in a private hospital with a dedicated and experienced team and questions the current restricted access to TAVI in the private sector.

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