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Urban walkability is influenced both by built environment features and by pedestrian demographics. Research has shown that factors influencing women’s walking differ from those affecting men’s. Using a mixed-method approach, this study creates a new women-specific, GIS-based walkability index using San Francisco as a case study, and answers two questions: Which variables most influence women’s propensity to walk? And Does the leading walkability index, Walk Score, reflect women’s walkability? Focus group participants (n=17) ranked crime, homelessness and street/sidewalk cleanliness as the three most influencing factors on women’s walkability, accounting for 58% to 67% of the Women’s Walkability Index’s total score. The least walkable areas in San Francisco, according to this index, are rated as some of the most walkable neighborhoods in the city by Walk Score, despite high crime and homelessness density. Walk Score is negatively correlated with the new Women’s Walkability Index (Spearman’s rho = -0.585) and inaccurately represents women’s walkability. If the new index accurately captures the reality of women’s walking, then some of the most widely accepted conventions about what kind of areas promote walking could be inaccurate when it comes to women.

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Background The benefits of Point of Care Ultrasound (POCUS) are well established in the literature. As it is an operator-dependent modality, the operator is required to be skilled in obtaining and interpreting images. Physicians who are not trained in POCUS attend courses to acquire the basics in this field. The effectiveness of such short POCUS courses on daily POCUS utilization is unknown. We sought to measure the change in POCUS utilization after practicing physicians attended short POCUS courses. Methods A 13-statements questionnaire was sent to physicians who attended POCUS courses conducted at the Soroka University Medical Center between the years 2014–2018. Our primary objective was to compare pre-course and post-course POCUS utilization. Secondary objectives included understanding the course graduates’ perceived effect of POCUS on diagnosis, the frequency of ultrasound utilization and time to effective therapy. Results 212 residents and specialists received the questionnaire between 2014–2018; 116 responded (response rate of 54.7%). 72 (62.1%) participants were male, 64 (55.2%) were residents, 49 (42.3%) were specialists, 3 (2.5%) participants did not state their career status. 90 (77.6%) participants declared moderate use or multiple ultrasound use six months to four years from the POCUS course, compared to a rate of ‘no use at all’ and ‘minimal use of 84.9% before the course. 98 participants [84.4% CI 77.8%, 91.0%] agree and strongly agree that a short POCUS course may improve diagnostic skills and 76.7% [CI 69.0%, 84.3%] agree and strongly agree that the POCUS course may shorten time to diagnosis and reduce morbidity. Conclusions Our short POCUS course significantly increases bedside ultrasound utilization by physicians from different fields even 4 years from course completion. Course graduates strongly agreed that incorporating POCUS into their clinical practice improves patient care. Such courses should be offered to residents and senior physicians to close the existing gap in POCUS knowledge among practicing physicians.

Describes the development of the hybrid library at the University of Haifa Library. This is an attempt to integrate disparate library resources such as the OPAC, online and networked databases, and electronic journals into a united system. Instead of separate terminals and workstations, access to library resources is facilitated through one Web interface allowing horizontal as well as vertical navigation. Additionally, linking from the library catalogue was realized. This article focuses on the goals, technology, and implementation of this scheme. The pilot project was a success, although a number of problems were detected. As a result, all workstations are being converted to the new framework.

Introduction: Secondary prevention of cardiovascular events among patients with diagnosed cardiovascular disease and high ischemic risk poses a signi cant challenge in clinical practice. The combinations of aspirin with low dose (LD) Ticagrelor or LD-Rivaroxaban have shown superiority in preventing major adverse cardiovascular events (MACE) than aspirin treatment alone. The comparative value for money of these two regimens remains unexplored.Methods: We analyzed each regimen's annual cost needed to treat (CNT) by multiplying the annualized number needed to treat (aNNT) by the annual cost of each drug. The aNNTs were based on outcome data from PEGASUS TIMI-54 and COMPASS trials. Scenario analyses were performed to overcome variances in terms of population risk. Costs were based on 2021 US prices. The primary outcome was de ned as CNT to prevent one MACE across the two regimens. Secondary value analysis was performed for myocardial infarction (MI), stroke, and CV death as separate outcomes.

Funding Acknowledgements Type of funding sources: None. Background Atrial fibrillation (AF) is associated with an increased risk of stroke and mortality. Pulmonary vein isolation (PVI) is the most effective treatment to reduce AF burden and is associated with a reduced risk of stroke and death. Differences in long-term clinical outcomes following PVI between sexes are debatable. Purpose We aimed to explore the sex differences in outcomes following PVI in a contemporary population of AF patients. Methods This is a historical population-based study including all adult patients of the largest health maintenance organization in Israel who were first diagnosed with AF between January 1st, 2010, and January 1st, 2020. Patients with congenital heart disease, significant mitral stenosis, or who underwent valvular surgery were excluded. The primary outcomes were stroke and all-cause death after PVI. Early (30-day) outcomes were compared using logistic regression, and late (3-year) outcomes were assessed using multivariable survival analyses with Cox regression. Results Of 94,612 patients diagnosed with incident AF during the study period, 4593 (4.85%) underwent PVI, of whom 1892 (38.2%) were women. Women were older (65±12 vs. 63±13) and less likely to be smokers (15.0% vs. 33.0%). Women had higher body-mass-index (30.26±6.58 vs. 29.14±4.86) and higher rates of hypertension (66.4% vs. 63.2%) but had lower rates of known coronary or peripheral vascular disease and congestive heart failure (p<0.05 for all). The CHA2DS2-VASc score was higher among women compared to men [median 3 (IQR 2-4) vs. median 2 IQR (1-3), p<0.001). Compared to men, women were treated more often with beta-blockers (74.5% vs. 69.4%), non-dihydropyridine calcium channel blockers (6.5% vs. 3.0%), and class 1c antiarrhythmic drugs (19.4% vs. 12.8%; p<0.001 for all), but were treated less with amiodarone (14.2% vs. 18.1%, p<0.001). In the 30 days following CA, stroke occurred in 8 (0.2%) patients, and 26 (0.6%) patients died (p>0.1 for both). Three-year mortality was lower in women than in men (6.2%% vs. 8.6%, p=0.003), while stroke rates were similar in women (1.0%) and men (1.5%, p>0.1). In multivariable survival models, adjusting for potential confounders, women had a lower risk of mortality [aHR 0.72 95%CI (0.56-0.92), p=0.009]. Conversely, the risk of stroke was similar in women and men [aHR 0.62 95%CI (0.33-1.12), p=0.114]. The results were similar in propensity-adjusted models accounting for all differences between men and women. Conclusions In this contemporary AF population, short-term stroke and mortality rates after PVI were very low and similar in men and women. The risk of long-term stroke following PVI was relatively low and similar across sex criteria. Women had a lower risk of long-term mortality than men following PVI despite undergoing the procedure at an older age and after adjusting for comorbidities and background medical therapy, suggesting possible sex differences in long-term mortality after PVI.