In 1834, Dr. Henry Orton immigrated to Guelph, seeking to escape the English class system and attracted by the prospect of land ownership. The analysis of his letters and memoirs offers a rich trove of information about the strategies he pursued to survive in his new home. Joining the scholarly literature based on the analysis of medical casebooks, diaries, and letters, this study seeks to increase understanding of how colonial practitioners made a living. In common with other doctors, Orton describes gruelling work providing poorly paid medical services, competition by alternative practitioners, and seeking financial remuneration through land transactions. Relying on funds from family members in England, he details his partnership in a medical practice, commercial investments, and using his connections as a property owner to obtain paid political and civic offices. In the process, assisted by the emerging liberalism of his adopted country, Henry Orton reveals his contribution to Guelph\'s development as a middle-class community.
Résumé. En 1834, cherchant à échapper au système anglais des classes sociales et attiré par la perspective de posséder des terres, le Dr Henry Orton immigrait à Guelph. L’analyse de ses lettres et de ses mémoires nous offre un trésor sur les stratégies qu’il a employées pour survivre dans son nouvel environnement. Dans l’esprit des travaux savants qui analysent les recueils de cas médicaux, les journaux intimes et les lettres, cette étude cherche à étoffer nos connaissances sur la manière dont les médecins gagnaient leur vie dans les colonies. Comme d’autres de ses confrères, Orton décrit le travail épuisant et les revenus médiocres que représentent les soins médicaux, la concurrence entre praticiens et ses efforts pour augmenter ses ressources financières au moyen de transactions foncières. Dépendant de l’argent que sa famille lui fait parvenir d’Angleterre, il expose en détail son partenariat avec un cabinet de médecins, ses investissements commerciaux et le recours à ses relations avec d’autres propriétaires terriens pour obtenir des charges politiques et civiles rémunérées. Ce faisant, porté par le libéralisme émergent de son pays d’adoption, Henry Orton nous révèle sa contribution au développement de la classe moyenne dans la collectivité de Guelph.

UNASSIGNED: Gender-affirming hormones (hormones)-the use of sex hormones to induce desired secondary sex characteristics in transgender and nonbinary (TGNB) individuals-are vital health care for many TGNB people. Some hormone providers require a letter from a mental health provider before hormone initiation. We explore the perspectives of TGNB individuals regarding the impact of the letter requirement on their experience of care.
UNASSIGNED: We conducted semistructured interviews with 21 TGNB individuals who have sought or are receiving hormones. We purposively sampled respondents who were (n=12) and were not (n=8) required to provide a letter. An Advisory Board of transgender individuals guided the methodology. Interviews were transcribed verbatim and coded both inductively and deductively.
UNASSIGNED: We identified three themes related to the letter requirement: (1) Mental health: While participants appreciated the importance of therapy, the letter requirement did not serve this purpose; (2) Trans identity: The process of obtaining a letter created doubt in participants\' own transness, along with a resistance to the pathologization and conflation of mental illness with transness; and (3) Care relationships: The letter requirement negatively impacted the patient-provider relationship. Participants felt the need to self-censor or to perform a version of transness they thought the provider expected; this process decreased their trust in care professionals.
UNASSIGNED: A letter requirement did not improve mental health and had several negative consequences. Removal of this requirement will improve access to hormones and may paradoxically improve mental health.

BACKGROUND: Artificial intelligence (AI) is progressively influencing healthcare sectors, including pediatric neurology. This paper aims to investigate the potential and limitations of using ChatGPT, a large language model (LLM) developed by OpenAI, in an outpatient pediatric neurology clinic. The analysis focuses on the tool\'s capabilities in enhancing clinical efficiency, productivity, and patient education.
METHODS: This is an opinion-based exploration supplemented with practical examples. We assessed ChatGPT\'s utility in administrative and educational tasks such as drafting medical necessity letters and creating patient educational materials.
RESULTS: ChatGPT showed efficacy in streamlining administrative work, particularly in drafting administrative letters and formulating personalized patient education materials. However, the model has limitations in performing higher-order tasks like formulating nuanced differential diagnoses. Additionally, ethical and legal concerns, including data privacy and the potential dissemination of misinformation, warrant cautious implementation.
CONCLUSIONS: The integration of AI tools like ChatGPT in pediatric neurology clinics has demonstrated promising results in boosting efficiency and patient education, despite present limitations and ethical concerns. As technology advances, we anticipate future applications may extend to more complex clinical tasks like precise differential diagnoses and treatment strategy guidance. Careful, patient-centered implementation is essential for leveraging the potential benefits of AI in pediatric neurology effectively.

Letters to the editor are an important part of democratic societies. In academic journals, letters serve as a form of postpublication review and thus permit continued discussion and debate of scientific ideas. However, letters and their importance are rarely taught to university students. Therefore, the aim of the present paper is to propose a lecture and an assignment that introduce the exercise physiology student to letters. The lecture includes an overview of the history of letters, the definition and purposes of letters, letter themes, examples of letters published in exercise physiology journals, and a search method for discovering letters. The student is then assigned a project comprised of two parts. Part 1 requires the student to independently discover a letter exchange in a scientific journal, including the original research article, the letter commenting on the article, and the reply to the letter. The student then writes a report that summarizes the exchange. The report includes an analysis of the letter\'s themes and the validity of the arguments made. Part 2 of the assignment requires the student to independently discover an article published in the past year that they believe requires comment. The student then writes a letter, commenting on the article. Students who write convincing letters can be encouraged to submit their letter to the journal. The assignment should help prepare the next generation of journal editors, reviewers, and readers for the task of preserving and participating in a practice that serves to refine knowledge.NEW & NOTEWORTHY Letters to the editor are a form of postpublication review and thus help to refine knowledge through discussion and debate, yet exercise physiology students are rarely introduced to letters in their formal education. Here, the author proposes a lecture and an assignment that the university educator can use to help students understand the importance of letters. In the assignment, the student, among other tasks, critiques an existing letter exchange and writes a letter for potential publication.

Older adults living in long term care (LTC) facilities may experience increased isolation and loneliness. This was compounded with the Coronavirus Disease 2019 (COVID-19) pandemic. Loneliness and isolation increase the risk for physical, psychological, and social decline. This case report discusses the effect of a letter writing initiative on feelings of loneliness and connection in a long-term care resident. Personalized care is the standard in the long-term care setting and letter writing between two people can contribute to personalized meaningful care as evidenced by the example provided. Further research is needed to explore social connection and loneliness and methods to combat these issues with a personalized approach for different populations within LTC facilities.

The covid-19 global syndemic has upended societies worldwide and concomitantly united the world in a shared experience of lockdowns, social distancing, and economic upheaval. In the face of great uncertainty, dystopian realities, and binding government edicts, people\'s everyday lives, sense of agency, actions, and interactions changed forcibly. Importantly, it has disrupted many practices and routines essential for (re)constituting a sense of belonging, an important element of personhood and individual wellbeing. Using the \"Letters from the Future\" method, we investigate how individuals imagine and present themselves in the future to navigate this social change. We ask \"How do letter writers construct a sense of belonging in a future of their own imagining?\" To answer this question, we combine discourse- and text analysis with network analysis to examine 47 letters that Greek participants wrote during the Spring 2020 lockdown. We explore how individuals present and introduce their future self, what topos this self inhabits and what expressions, values, and practices they perform and negotiate as they reflect on and navigate their relational worlds. By and large, Greek letter writers recognize that inequities and injustices paved the way for the syndemic and express a pressing need for societal transformation.

The Correspondence of Charles Darwin will be completed in 2022. This essay looks briefly at the history of editing Darwin and compares the modern edition with the Victorian practice of narrating an exemplary life through letters, with commemorative volumes produced by a family member or friend and private material carefully selected to document personal character. How is a scientific life composed? What kind of character is expressed in scientific work?

The letters of S. P. Botkin from Bulgaria (1877) to his wife, E. A. Botkina (née Princess Obolenskaya), were published as travel diary in the journal \"Vestnik Evropy\" in 1892 and as separate book in 1893. The family events related to publication of epistolary were restored. For publication, material of private nature was abridged by E. A. Botkina. Then, passages with compromising criticism were removed by editor of the journal. In spite of good quality of prepared text, publication was postponed by E. A. Botkina herself and afterwards it was lingered on because of claims of censorial department. The role of N. A. Belogolovy, public figure and friend of S. P. Botkin of many years and M. M. Stasyulevich, a publisher, in final decision to publish epistolary is emphasized. The comparison of original and printed matter carried out for the first time, established that cuts made up to more than one third of author\'s text.

Antony van Leeuwenhoek\'s entire output is contained in the hundreds of letters that he wrote from 1673 to 1723. This article discusses the content, features, and circumstances of the letters and their contemporary publishing history, especially in the Royal Society\'s Philosophical Transactions, as well as a brief history of the project begun in 1932 to publish a complete edition of Leeuwenhoek\'s letters in Dutch and English translation with linguistic, scientific, and historical annotations.

UNASSIGNED: Our objective was to assess the impact of mass mailing and the inclusion of Best Practice Advisory (BPA) \"Pop-Up\" tool in the electronic medical record (EMR) on HCV screening rates.
UNASSIGNED: Between June 2015 and March 2020, two interventions were developed for primary care physicians (PCP). An educational letter along with a blood requisition form, signed on behalf of the PCPs, was sent to patients. We also developed a BPA \"Pop-Up\" screening tool to alert PCPs to order HCV screening tests on patients with no previous screening. Data were collected and analyzed prospectively.
UNASSIGNED: When we started the screening program in June 2015, 33,736 baby boomers were eligible for screening, and the hospital system added an additional 26,027 baby boomers between June 2015 and March 2020. Of the 89 primary care providers employed by the hospital, 75 agreed to participate at different time periods. We screened 23,291 (43.5%) of 53,526 eligible patients during study period. Of these, 399 (1.7%) had HCV antibody, but HCV RNA was positive in only 195 (1%). HCV antibody positivity rates were higher in men, blacks, and in 1951-1960 birth cohorts. Spontaneous clearance rates appeared to be lower in men (OR 0.59, 95% CI 0.39-0.90, P = 0.015) and in blacks (OR 0.31, 95% CI 0.20-0.50, P < 0.001).
UNASSIGNED: Although a formal screening program increased screening rates for HCV among baby boomers, about 50% of baby boomers remained unscreened. In this community screening program, we found that men and blacks are less likely to have spontaneous HCV clearance.