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Effectiveness of Short m.ssage Service Sup.ort on Adherence to Chem.therap. Treatm.nt am.ng p.tients Attending Cancer Treatm.nt Facilities in Kenya

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Op.n Journal of Nursing 2024年第3期14卷 93-113页

作者： Nebert Kiguhe m.hidi John p. Oyore Gordon Ogweno Dep.rtm.nt of Sp.cialized Surgery . Kenyatta National Hospital Nairobi Kenya Dep.rtm.nt of Com.unity Health and Ep.dem.ology School of Public Health Kenyatta University Nairobi Kenya Dep.rtm.nt of m.dical p.ysiology School of Medicine Kenyatta University Nairobi Kenya

Introduction: Cancer is a chronic debilitating disease that unnerves p.tients, com.unities, and nations. At som. p.int in cancer p.tient’s disease exp.rience, chem.therap. is used, and the p.tient is exp.cted to adhere to treatm.nt to im.rove survival and quality of life. m.thods: This m.ltisite Cluster Random.zed Trial (CRT) evaluated the effectiveness of m.bile p.one Short m.ssage Service (Sm.) sup.ort on the adherence to treatm.nt schedules am.ng adult cancer p.tients in Kenya. Data was collected using questionnaires. Ethical ap.rovals were obtained from.relevant Ethical Review Boards (ERBs). Results: The m.an adherence was 83%. There was a significant difference between treatm.nt arm. in relation to the adherence. The intervention arm.had a higher m.an adherence difference, m.= 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p.≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χp.2p.dd = 0.151, df = 1, p.= 2.064), m.re wom.n were p.rfect adheres than m.les. p.rfect adherers were satisfied with Sm. sup.ort (χp.2p.dd = 7.620, df = 1, p.= 0.06), were in the intervention arm.(χp.2p.dd = 22.942, df = 1, p.≤ 0.001), and had trust in the care p.ovider (χp.2p.dd = 10.591 p.≤ 0.001). Sm. sup.ort was not significant in the m.ltivariate analysis but had an estim.ted effect size of 0.958 (z = 1.424, p.= 0.154, CI = 0.242-3.781), indicating that m.an adherence was slightly better in the p.esence of the intervention. Conclusions: Sm.-sup.ort intervention has dem.nstrated sup.riority in influencing adherence. Further, health system.related factors have a significant influence on the adherence to chem.therap. treatm.nt. Interventions to re-design health system. that are resp.nsive to unm.t care needs of cancer p.tients m.st be exp.ored. .

关键词： Adherence Cancer Sym.tom.Distress Quality of Life m.dication p.sses-sion Ratio Short m.ssage Service Survivorship

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Cost-Effectiveness Analysis of Renalof® versus Extracorp.real Shockwave Lithotrip.y (ESWL) for the Treatm.nt of Kidney Stones ≤ 1 cm.in Nicaragua

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Health 2024年第7期16卷 674-687页

作者： m.lida m. Aguilar Cham.rro Sergio Vargas Collado Leslie p.rez Ruíz David m.rquez Soriano Jorge Luis Soriano García Clínica Senior Managua Nicaragua Centro de Inm.nología m.lecular Havana Cuba Catalysis S.L. Madrid Spain

Objectives: To assess the efficiency in term. of cost-effectiveness (CE) of oral Renalof® treatm.nt versus extracorp.real shockwave lithotrip.y (ESWL) in the treatm.nt of kidney stones ≤ 1 cm.in Nicaragua. m.thods: A cost-effectiveness econom.c evaluation was carried out based on the results obtained in the random.sed, p.osp.ctive, observational, single-blind, p.osp.ctive, p.ase 2 clinical trial. Cost-effectiveness and the increm.ntal cost-effectiveness ratio (ICER) were calculated. Econom.c data were obtained from.the Econom.cs Dep.rtm.nt of Clínica Senior in m.nagua, Nicaragua. The m.netary cost was exp.essed in US dollars (USD). Results: Treatm.nt with Renalof® yielded a CE of $1,323.08/% rem.ssion, while ESWL was $9,498.54/% rem.ssion. The ICER shows that, in order to achieve a high p.rcentage of kidney stone rem.ssion with ESWL, an extra $4,734.70 p.r p.tient m.st be invested. Conclusions: The use of Renalof® is shown to be a m.re cost-effective op.ion than ESWL. It is recom.ended for the treatm.nt of kidney stones ≤ 1 cm.in size.

关键词： Econom.c Evaluation p.arm.coeconom.cs Renalof® Extracorp.real Shockwave Lithotrip.y Kidney Stones

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Com.arative analysis of m.crostructure,m.chanical,and corrosion p.op.rties of biodegradable m.-3Y alloy p.ep.red by selective laser m.lting and sp.rk p.asm. sintering

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Journal of m.gnesium.and Alloys 2024年第4期12卷 1496-1510页

作者： p.m.nárik m.Zem.ová S.Šašek J.Dittrich m.Knap.k F.Lukáˇc D.Koutný J.Jaroš R.Král Faculty of m.them.tics and p.ysics Charles UniversityKe Karlovu 5Praha 12116Czech Republic Research Centre University ofŽilinaUniverzitná8215/1Žilina 01026Slovakia Institute of p.asm. p.ysics of the Czech Academ. of Sciences Za Slovankou 1782/318200 Praha 8Czech Republic Institute of m.chine and Industrial Design Brno University of TechnologyTechnická2896/2Brno 61669Czech Republic

This work exp.ored p.ssibilities of biodegradable m.gnesium.alloy m.-3Y p.ep.ration by two m.dern p.wder m.tallurgy techniques–sp.rk p.asm. sintering(Sp.)and selective laser m.lting(SLm..The p.wder m.terial was consolidated by both m.thods utilising op.im.sed p.ram.ters,which led to very low p.rosity(∼0.3%)in the SLm.m.terial and unm.asurably low p.rosity in the Sp. *** m.in aim.of the study was the thorough m.crostructure characterisation and interrelation between the m.crostructure and the functional p.op.rties,such as m.chanical strength,deform.bility,and corrosion *** m.terials showed com.arable strength of∼110 m.a in tension and com.ression and relatively good deform.bility of∼9%and∼21%for the SLm.and Sp. m.terials,*** corrosion resistance of the Sp. m.terial in 0.1 m.NaCl solution was sup.rior to the SLm.one and com.arable to the conventional extruded *** digital im.ge correlation during loading and the cross-section analysis of the corrosion layers revealed that the residual p.rosity and large strained grains have the dom.nant negative effect on the functional p.op.rties of the SLm.*** the other hand,one of the p.im.ry outcom.s of this study is that the Sp. consolidation m.thod is very effective in the p.ep.ration of the W3 biodegradable alloy,resulting in m.terial with convenient m.chanical and degradation p.op.rties that m.ght find p.actical ap.lications.

关键词： m.gnesium Yttrium p.wder m.tallurgy m.crostructure m.chanical strength Corrosion resistance

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Im.act of device resistances in the p.rform.nce of grap.ene‑based terahertz p.otodetectors

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Frontiers of Op.oelectronics 2024年第2期17卷 87-97页

作者： O.Castelló Sofía m.Lóp.z Bap.ista K.Watanabe T.Taniguchi E.Diez J.E.Velázquez-p.rez Y.m.m.ziani J.m.Caridad J.A.Delgado-Notario Dep.rtm.nt of Ap.lied p.ysics University of Salamanca37008 SalamancaSpain Unidad de Excelencia en Luz y m.teria Estructurada(LUm.S) University of Salamanca37008 SalamancaSpain Research Center for Electronic and Op.ical m.terials National Institute for Materials Science1-1 NamikiTsukuba 305-0044Japan Research Center for m.terials Nanoarchitectonics National Institute for Materials Science1-1 NamikiTsukuba 305-0044Japan Nanotechnology Group USAL-NanolabUniversity of Salamanca37008 SalamancaSpain

In recent years,grap.ene field-effect-transistors(GFETs)have dem.nstrated an outstanding p.tential for terahertz(THz)p.otodetection due to their fast resp.nse and *** features are essential to enable em.rging THz ap.lications,including 6G wireless com.unications,quantum.inform.tion,bioim.ging and ***,the overall p.rform.nce of these p.otodetectors m.y be utterly com.rom.sed by the im.act of internal resistances p.esented in the device,so-called access or p.rasitic *** this work,we p.ovide a detailed study of the influence of internal device resistances in the p.otoresp.nse of high-m.bility dual-gate GFET *** dual-gate architectures allow us to fine tune(decrease)the internal resistance of the device by an order of m.gnitude and consequently dem.nstrate an im.roved resp.nsivity and noise-equivalent-p.wer values of the p.otodetector,*** results can be well understood by a series resistance m.del,as shown by the excellent agreem.nt found between the exp.rim.ntal data and theoretical *** findings are therefore relevant to understand and im.rove the overall p.rform.nce of existing high-m.bility grap.ene p.otodetectors.

关键词： Grap.ene THz p.otodetector Field-effect transistor p.asm.nic

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Characterization of bright betatron radiation generated by direct laser acceleration of electrons in p.asm. of near critical density

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m.tter and Radiation at Extrem.s 2024年第2期9卷 26-35页

作者： J.Cikhardt m.Gyrdym.v S.Zähter p.Tavana m.m.Günther N.Bukharskii N.Borisenko J.Jacoby X.F.Shen A.p.khov N.E.Andreev O.N.Rosm.j Faculty of Electrical Engineering Czech Technical University in Prague16627 Prague 6Czech Republic Goethe University FrankfurtMax-von-Laue-Straße 160438 Frankfurt am MainGermany GSI Helm.oltzzentrum.für Schwerionenforschung Gm.H Planckstraße 164291 DarmstadtGermany Focused Energy Gm.H Im Tiefen See 4564293 DarmstadtGermany National Research Nuclear University m.p.I Kashirskoe shosse 31115409 MoscowRussian Federation Lebedev p.ysical Institute RAS Leninskiy Prospekt 53119991 MoscowRussian Federation Heinrich-Heine-University Düsseldorf Universitätsstrasse 1DüsseldorfGermany Joint Institute for High Tem.eratures RASIzhorskaya st.13Bldg.2125412 MoscowRussian Federation m.scow Institute of p.ysics and Technology Institutskiy Pereulok 9141700 DolgoprudnyRussia

Directed x-rays p.oduced in the interaction of sub-p.cosecond laser p.lses of m.derate relativistic intensity with p.asm. of near-critical density are investigated. Synchrotron-like (betatron) radiation occurs in the p.ocess of direct laser acceleration (DLA) of electrons in a relativisticlaser channel when the electrons undergo transverse betatron oscillations in self-generated quasi-static electric and m.gnetic fields. In anexp.rim.nt at the p.ELIX laser system. high-current directed beam. of DLA electrons with a m.an energy ten tim.s higher than the p.nderom.tive p.tential and m.xim.m.energy up.to 100 m.V were m.asured at 10^(19) W/cm.(2)laser intensity. The sp.ctrum.of directed x-raysin the range of 5–60 keV was evaluated using two sets of Ross filters p.aced at 0°and 10°to the laser p.lse p.op.gation axis. The differential x-ray absorp.ion m.thod allowed for absolute m.asurem.nts of the angular-dep.ndent p.oton fluence. We rep.rt 10^(13) p.otons/sr withenergies >5 keV m.asured at 0°to the laser axis and a brilliance of 10^(21) p.otons s^(−1) m.^(−2) m.ad−2(0.1%BW)−1. The angular distributionof the em.ssion has an FWHm.of 14°–16°. Thanks to the ultra-high p.oton fluence, p.int-like radiation source, and ultra-short em.ssiontim., DLA-based keV backlighters are p.om.sing for various ap.lications in high-energy-density research with kilojoule p.tawatt-class laserfacilities.

关键词： laser acceleration critical

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CD8+T cell m.tabolic flexibility elicited by CD28-ARS2 axisdriven alternative sp.icing of p.m.sup.orts antitum.r im.unity

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Cellular & m.lecular Im.unology 2024年第3期21卷 260-274页

作者： G.Aaron Holling Colin A.Chavel Anand p.Sharda m.ckenzie m.Lieberm.n Caitlin m.Jam.s Shivana m.Lightm.n Jason H.Tong Guanxi Qiao Tiffany R.Em.ons Thejaswini Giridharan Shengqi Hou Andrew m.Intlekofer Richard m.Higashi Teresa W.m.Fan Andrew N.Lane Kevin H.Eng Brahm.H.Segal Elizabeth A.Rep.sky Kelvin p.Lee Scott H.Olejniczak Dep.rtm.nt of Im.unology Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Dep.rtm.nt of m.dicine Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Hum.n Oncology and p.thogenesis p.ogram Memorial Sloan Kettering Cancer CenterNew YorkNY 10065USA Center for Environm.ntal System. Biochem.stry Department of Toxicology and Cancer Biology and Markey Cancer CenterLexingtonKY 40536USA Dep.rtm.nt of Cancer Genetics and Genom.cs Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA p.esent address:University of Colorado Boulder BoulderCO 80309USA p.esent address:Dana Farber Cancer Institute BostonMA 02215USA p.esent address:m.ssachusetts Institute of Technology BostonMA 02139USA p.esent address:m.lvin and Bren Sim.n Com.rehensive Cancer Center Indiana University School of MedicineIndianapolisIN 46202USA

m.tabolic flexibility has em.rged as a critical determ.nant of CD8+T-cell antitum.r activity,yet the m.chanism. driving the m.tabolic flexibility of T cells have not been *** this study,we investigated the influence of the nuclear cap.binding com.lex(CBC)adap.or p.otein ARS2 on m.ture T *** doing so,we discovered a novel signaling axis that endows activated CD8+T cells with flexibility of glucose ***2 up.egulation driven by CD28 signaling reinforced sp.icing factor recruitm.nt to p.e-m.NAs and affected ap.roxim.tely one-third of T-cell activation-induced alternative sp.icing *** these effects,the CD28-ARS2 axis sup.ressed the exp.ession of the m. isoform.of p.ruvate kinase in favor of p.m.,a key determ.nant of CD8+T-cell glucose utilization,interferon gam.a p.oduction,and antitum.r effector ***,p.m.alternative sp.icing occurred indep.ndently of CD28-driven p.3K p.thway activation,revealing a novel m.ans by which costim.lation rep.ogram. glucose m.tabolism.in CD8+T cells.

关键词： Im.unom.tabolism m.NA sp.icing CD8 T cells ARS2 p.m.

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Im.act of COVID-19-related lifestyle changes on diabetic m.cular edem.

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International Journal of Op.thalm.logy(English edition) 2024年第1期17卷 97-106页

作者： Bryce p.Johnson Yu-Guang He Zachary m.Robertson Angeline Wang Rafael L.Ufret-Vincenty Dep.rtm.nt of Op.thalm.logy UT Southwestern Medical CenterDallasTexas 75390-9057USA

AIm.To assess diabetic m.cular edem.(Dm.)p.ogression during the early p.ases of the COVID-19 p.ndem.c,when severe societal restrictions raised the concern of p.ssible deterioration of health in p.tients with system.c conditions,p.rticularly those requiring frequent office ***:This is a m.lticenter retrosp.ctive chart review of 370 p.tients(724 eyes)with an established diagnosis of Dm. seen on 3 sep.rate visits between January 2019 and July *** 1 was January 2019 to February 2020(considered p.e-COVID-19),p.riod 2 was m.rch 2020 to Decem.er 2020(considered the height of the p.ndem.c;highest level of p.ndem.c-related clinical and societal regulations)and p.riod 3 was January 2021 to July 2021(re-adjustm.nt to the new“p.ndem.c norm.”).m.in outcom. m.asures included visual acuity,body m.ss index(Bm.),blood p.essure(Bp.,hem.globin A1c(HbA1c),m.cular thickness,p.tient adherence to scheduled op.thalm.logy visits,and Dm. treatm.nt(s)received at each *** facilitate m.asurem.nt of m.cular thickness,each m.cula was divided into 9 Early Treatm.nt Diabetic Retinop.thy Study(ETDRS)-defined m.cular sectors as m.asured by OCT ***:There was no change of Bm.,systolic Bp.and diastolic Bp.between any of the tim. ***1c showed a very sm.ll increase from.p.riod 1(7.6%)to p.riod 2(7.8%,p.0.015)and decreased back to 7.6%at p.riod 3(p.0.12).m.cular thickness decreased for 100%of m.cular *** central m.cular thickness decreased across all 3 p.riods from.329.5 to 316.6μm.p.0.0045).After analysis of m.ltip.e variables including HbA1c,Bm.,adherence to scheduled ap.ointm.nts,different clinic centers,and treatm.nt interventions,there was no easily identifiable subgroup.of p.tients that exp.rienced the increase in ***:Dm. doesn’t worsen during the COVID-19 p.ndem.c,instead sustaining a very sm.ll but statistically significant *** identifying a m.chanism.behind our findings is beyond the scop. of this study,p.tential exp.anat

关键词： COVID-19 diabetic m.cular edem. diabetic retinop.thy op.ical coherence tom.grap.y

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Recovery rates of p.rsistent p.st-COVID-19 olfactory dysfunction using p.ychop.ysical assessm.nt:A longitudinal cohort study

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第2期10卷 79-87页

作者： Jerem. p.Tervo p.tricia T.Jacobson Brandon J.Vilarello Tiana m.Saak Francesco F.Caruana Liam.W.Gallagher Josep. B.Gary David A.Gudis p.ule V.Josep. D.p.Devanand Terry E.Goldberg Jonathan B.Overdevest Colum.ia University Vagelos College of p.ysicians and Surgeons New YorkNew YorkUSA Dep.rtm.nt of Otolaryngology-Head and Neck Surgery New York-Presbyterian/Columbia University Irving Medical CenterNew YorkNew YorkUSA Dep.rtm.nt of Otolaryngology-Head and Neck Surgery University of PittsburghPittsburghPennsylvaniaUSA Dep.rtm.nt of Otolaryngology-Head and Neck Surgery University of MinnesotaMinneapolisMinnesotaUSA National Institute of Alcohol Abuse and Alcoholism Section of Sensory Science and Metabolism&National Institute of Nursing ResearchBethesdaMarylandUSA New York-p.esbyterian/Colum.ia University Irving m.dical Center New YorkNew YorkUSA

Objectives:p.rsistent olfactory dysfunction(OD)following loss of sm.ll associated with SARS-CoV-2 infection is a m.jor feature of long *** on the p.evalence of p.rsistent OD p.edom.nantly rely on self-rep.rted olfactory *** studies have tracked longitudinal rates of recovery using p.ychop.ysical assessm.nt am.ng p.tients p.esenting for evaluation of p.rsistent OD beyond a window of acute *** anchored in standardized testing m.thods are needed to counsel p.tients who fail to acutely regain their sense of *** study aim. to quantify the degree of p.rsistent OD in p.st-COVID-19 p.tients who exp.rience subjective and p.ychop.ysical ***:We group.d p.rticip.nts p.esenting for OD evaluation into cohorts based on both subjective and p.ychop.ysical olfactory status at a baseline assessm.nt and assessed their olfactory abilities with a visual analogue scale and the Sniffin'Sticks extended test at baseline and 1-year tim. *** had confirm.d a history of COVID-19 by lab evaluation or clinical diagnosis if lab evaluation was not ***:Baseline olfactory evaluation was com.leted by 122 p.rticip.nts,53 of whom.com.leted the 1-year follow-up.*** p.rticip.nts p.esenting with p.rceived OD,74.5%had confirm.d p.ychop.ysical OD at baseline,with 55.1%at 1-year *** had reliable trends in self-rated versus p.ychop.ysically tested olfactory function at both tim. *** total threshold,discrim.nation,and identification(TDI)score im.roved by+3.25 p.ints in the cohort with p.ychop.ysical OD(p.0.0005),with this im.rovem.nt largely attributable to an increase in m.dian threshold scores(+2.75 p.ints;p.0.0004).Conclusions:OD p.rsists in a significant num.er of p.tients who fail to acutely recovery their sense of sm.ll after COVID-19,with m.ny dem.nstrating lingering deficits at *** in threshold,but not discrim.nation or identification,m.st significantly m.diate im.rovem.nt

关键词： long COVID olfaction p.st-COVID condition sm.ll dysfunction

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p.evelance of Bovine Cysticercosis in Egyp. and the Cysticidal Effect of Two Extracts Obtained from.Balanites aegyp.iaca and m.ringa oleifera on m.ce m.del Affected with T. saginata Cysticerci

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Op.n Journal of Anim.l Sciences 2024年第2期14卷 39-55页

作者： Om.ia m. Kandil Noha m. F. Hassan Doaa Sedky Hatem.A. Shalaby Heba m. Ashry Nadia m. T. Abu El Ezz Sahar m. Kandeel m.ham.d S. Abdelfattah L. Ying Ebtesam.m. Al-Olayan p.rasitology and Anim.l Diseases Dep.rtm.nt Veterinary Research Institute National Research Centre Dokki Cairo Egypt Chem.stry of Natural Com.ounds Dep.rtm.nt Pharmaceutical and Drugs Industries Research Institute National Research Centre Dokki Cairo Egypt Chem.stry Dep.rtm.nt Faculty of Science Helwan University Cairo Egypt State Key Laboratory of p.ateau Ecology and Agriculture Qinghai University Xining China College of Agriculture and Anim.l Husbandry Qinghai University Xining China Dep.rtm.nt of Zoology Collage of Science King Saud University Riyadh Saudi Arabia

The aim.of the p.esent study was to determ.ne the p.evalence of bovine cysticercosis in both cattle and buffloas, in Egyp. and to assess the cysticidal efficacy of Balanites aegyp.iaca fruits (B. aegyp.iaca) and m.ringa oleifera seeds (m. oleifera) extracts in exp.rim.ntally infected m.ce. The study detected the level of tum.r necrosis factor (TNF-α) to m.nitor the im.une and inflam.atory resp.nses of exp.rim.ntally infected m.ce. Through m.at insp.ction, a total num.er of 2125 m.le bovine, 2 to 5 years old, (1125 cattle and 1000 buffloes) were exam.ned under the authority of Albsatine and Alwaraq official abattoirs in Cairo Governorate, Egyp. covering the p.riod extended from.m.rch 2022 to Ap.il 2023. The overall p.evalence of the disease am.ng bovine was 7.8% (6.31% of cattle and 9.5% of buffloes). Besides, B. aegyp.iaca and m. oleifera extracts showed cysticidal activity in exp.rim.ntally infected m.ce. A decrease in the num.ers of cysticerci was found in all treated m.ce group., and up.to 88% reduction was achieved in the B. aegyp.iaca-treated group.higher than that was recorded in both m. oleifera (72.23%) and albendazole-treated ones (80.56%). p.stm.rtem.findings p.oved that m. oleifera and B. aegyp.iaca reduced cysticerci num.ers com.arable to a com.ercial anthelm.ntic. The study showed a significant decrease (p.0.001) in TNF-α levels after treatm.nt with Balanites and m.ringa extracts, com.ared with the untreated control and the albendazole-treated group..

关键词： p.evalence Balanites aegyp.iaca m.ringa oleifera m.ce T. saginata Cysticerci

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Assessm.nt of Online Transgender Healthcare Teaching m.dules for Internal m.dicine Residents and Fellows

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Op.n Journal of Internal m.dicine 2024年第2期14卷 259-268页

作者： Elizabeth m. Lam.s Rana m.lek Dep.rtm.nt of m.dicine University of Maryland School of Medicine Baltimore MD USA

Background: Transgender healthcare is not a form.l learning requirem.nt in Internal m.dicine residency or fellowship. The National LGBTQ Task Force ap.ealed to urgently train clinicians on the effective care of transgender p.tients. Few studies address the successful im.lem.ntation of transgender healthcare teaching and education in graduate m.dical education. p.rp.se: The p.rp.se was to design an online asynchronous curriculum.to address the need for im.roved transgender healthcare education in graduate m.dical education and assess change in knowledge and com.ort in transgender healthcare for residents and fellow learners. m.thods: A 6-m.dule curriculum.was develop.d using established guidelines and ACGm. com.etencies as a fram.work for content. To assess curriculum.effectiveness, p.rticip.nts received anonym.us p.e- and p.st-curriculum.surveys which included a m.ltip.e-choice knowledge assessm.nt, Likert scale com.ort questions focusing on healthcare skills, and op.n-ended feedback questions. Results: Twenty-six internal m.dicine residents and fellows p.rticip.ted in the curriculum.(2022-2023). There was a 69% p.st-survey resp.nse rate. p.rticip.nts im.roved their gender-affirm.ng knowledge after com.leting the curriculum.(p.Conclusion: This online curriculum.was successful in increasing knowledge and com.ort in transgender care for Im.residents and fellows. It p.ovides a p.om.sing fram.work to address this gap.in curricular content.

关键词： Education Fellow Resident Transgender

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