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Can I how to get propecia cheap discharge this can propecia cause infertility patient?. Editor’s Choice. Although hair loss treatment has brought a number of new challenges to emergency departments (ED), it shares the same and arguably most common conundrum we face with other symptoms and diagnoses. Is it safe to send this person how to get propecia cheap home?. There are many studies now published on prediction of poor outcomes for patients with hair loss treatment, but few that address the question of whether a person who likely has hair loss treatment yet who doesn’t obviously qualify for admission (eg, an oxygen requirement) can be discharged to manage their disease at home.

A popular contender for helping with this decision has been testing oxygen saturation after a brief period of exercise in the ED. In this issue we present the results of a large, multicenter observational study (The PRIEST study) which found that post-exertion saturation provides little prognostic how to get propecia cheap information for these otherwise well-appearing patients. Perhaps this is not surprising. Many of us have used a form ‘ambulatory saturation’ testing for our asthma, COPD or pneumonia patients, where we are just not sure it is okay to discharge them. However, little evidence exists that this is a useful predictor in these diseases either.Where is your aerosol box how to get propecia cheap now?.

The aerosol or intubating box for hair loss treatment was all the rage less than a year ago after it was introduced in a high impact peer review journal. (And yes, EMJ ran a few proof of concept articles on improvements on the design—although with appropriate caveats.). However, many EDs discovered the boxes were how to get propecia cheap difficult to use, and instead worked on improving their PPE for these procedures. In this issue, Azhar and colleagues report a reassuring study in which 36 EM trainees in Malaysia simulated intubation using video laryngoscopy on airway mannikins, using Glo Germ to simulate contamination. Mannikins were intubated with and without the aerosol box.

After doffing their PPE, there were no significant differences between methods in how to get propecia cheap the median number of contamination areas but forearms were more likely to remain contaminated after doffing when the aerosol box was used. In their commentary, Brewster and colleagues present provide a summary of the evidence that suggests its time to put that box in a back closet and remember that ‘we cannot let our emotions override critical thinking when trying to protect ourselves and our patients.’Can (should?. ) point of care ultrasound be used to diagnose hair loss treatment?. From the outset of the propecia, ultrasound has been offered as a way to potentially diagnose hair loss treatment in how to get propecia cheap the absence of a reliable and quick diagnostic test, although enthusiasm has to date outstripped the evidence. Our Reader’s Choice this month presents a study of the diagnostic characteristics of lung ultrasound in patients suspected of hair loss treatment using either PCR or lung CT as the reference standard.

The sensitivity of ultrasound for hair loss treatment was 89%, with a negative predictive value of 93% (95% CI 79% to 98%), perhaps less accurate that many had hoped for. However, when confined to only those how to get propecia cheap without prior cardiopulmonary disease, the negative predictive value was 100% (95% CI 79% to 100%). The wide confidence intervals reflect a small number of patients in this single centre study, conducted at a non-Academic ED so, as the adverts say, results may vary.Novel approaches to diagnosis in paediatric EMUltrasound has a lot of advantages when it comes to paediatric patients, including lack of radiation, ability to be performed at the bedside (maybe even in Mom’s arms) and the speed of diagnosis that may shorten their ED stay. In a study by Snelling et al from Australia, nurse practitioners performed ultrasound on paediatric patients 4–16 years old with suspected, non-angulated distal forearm fractures, finding quite respectable sensitivity and specificity. There was no difference in pain reported or duration of imaging, but parents, patients and NPs all how to get propecia cheap expressed a preference for ultrasound imaging.Those of you who have implemented some form of sepsis screening at triage are aware of the poor specificity of these tools, which may result in an overuse of resources and, for providers, alert fatigue.

To avoid this, Gomes and colleagues designed and implemented a digital screening tool based on six variables in two large paediatric EDs in the UK. However, when the tool triggered an alert, instead of a rush to draw bloods and give fluids, the child underwent immediate evaluation by a physician, who could determine that no sepsis was present, or continue with sepsis treatment. Without the physician, the electronic tool had how to get propecia cheap a PPV of 2.94% (those decimals are in the right place), and missed 12 children. With physician involvement PPV increased to 46.4% with 20 children missed on initial screen, but 11 of those children were identified as septic by further physician evaluation later in the ED visit." data-icon-position data-hide-link-title="0">A proper introductionIn January, we began the hair loss treatment Top 5, a new reader service to provide updates onemerging evidence on hair loss treatment and provide critical commentary on strengths, weaknesses, and where these studies fit with what is already known. Although featured on our cover, we did not properly introduce the Top 5 in our Primary Survey.

The Top 5 was originated by the RCEM hair loss treatment CPD Journal Club, a group how to get propecia cheap of physicians who scoured the literature and presented articles of interest to RCEM members each week. They’ve kindly agreed to share their work and knowledge with all EMJ readers in a monthly format. So a proper welcome to you, Top 5 and thank you to all the contributors..

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Start Preamble https://therambarranlawfirm.com/how-to-get-a-diflucan-prescription-from-your-doctor/ Federal where can i buy propecia over the counter Transit Administration (FTA), DOT. Notice of funding opportunity. The hair loss Disease 2019 (hair loss treatment) public health emergency Start Printed Page where can i buy propecia over the counter 63654has had a significant impact on transit operations. During a series of FTA listening sessions held over the last three months, transit agencies asked FTA to support research to identify solutions to address the operational challenges that they are facing as a result of hair loss treatment. In response, FTA makes available through this Notice of Funding Opportunity (NOFO) funding to support research demonstration grants to public transit agencies to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the hair loss treatment public health emergency.

Demonstration grants under this NOFO are authorized under FTA's Public Transportation Innovation Program (49 U.S.C where can i buy propecia over the counter. 5312). Eligible projects will demonstrate innovative solutions to improve the operational efficiencies of transit systems and enhance mobility for their communities in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis where can i buy propecia over the counter. (2) exposure mitigation measures.

(3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence where can i buy propecia over the counter in transit services. The total funding available for awards under this NOFO is $10,000,000. FTA may supplement this amount if additional where can i buy propecia over the counter funding becomes available. Applicants must submit completed proposals for funding opportunity FTA-2020-015-TRI through the GRANTS.GOV “APPLY” function by 11:59 p.m.

Eastern Time on November 2, 2020. Prospective applicants should register as soon as possible on the GRANTS.GOV website to ensure they can complete the application process before the submission where can i buy propecia over the counter deadline. Application instructions are available on FTA's website at http://transit.dot.gov/​howtoapply and in the “FIND” module of GRANTS.GOV. FTA will not accept mail and fax submissions. Start Further Info Please send any questions on this notice to Jamel El-Hamri where can i buy propecia over the counter email.

Jamel.El-Hamri@dot.gov phone. 2020-366-8985. A Telecommunication Device for the Deaf (TDD) is available for individuals who where can i buy propecia over the counter are deaf or hard of hearing at 1-800-877-8339. End Further Info End Preamble Start Supplemental Information Table of Contents A. Program Description B.

Federal Award Information C where can i buy propecia over the counter. Eligibility Information D. Application and Submission Information where can i buy propecia over the counter E. Application Review Information F. Federal Award Administration Information G.

Federal Awarding Agency where can i buy propecia over the counter Contact Information A. Program Description The Public Transportation hair loss treatment Research Demonstration Grant Program is funded through the Public Transportation Innovation Program (49 U.S.C. 5312), with the goal to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the hair loss treatment public health emergency. Eligible projects will propose to develop where can i buy propecia over the counter and deploy innovative solutions in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis.

(2) exposure mitigation measures. (3) innovative mobility such as contactless where can i buy propecia over the counter payments. And (4) measures that strengthen public confidence in transit. As required where can i buy propecia over the counter by 49 U.S.C. 5312(e)(4), projects funded under this NOFO must participate in an evaluation by an independent outside entity that will conduct a comprehensive evaluation of the success or failure of the projects funded under this subsection and any plan for broad-based implementation of the innovation promoted by successful projects.

B. Federal Award where can i buy propecia over the counter Information FTA makes available $10,000,000 in fiscal year (FY) 2020 funds under the Public Transportation Innovation Program (49 U.S.C. 5312) to finance the Public Transportation hair loss treatment Research Demonstration Grant Program. FTA may supplement the total funds available if additional funding becomes available at the time project selections are made. FTA will grant pre-award authority where can i buy propecia over the counter starting on the date of the project award announcement for selected projects and should be completed within 24 months from the date of award.

Funds are available only for eligible expenses incurred after the announcement of project selections. C. Eligibility Information where can i buy propecia over the counter (1) Eligible Applicants Eligible applicants include State and local governmental authorities, direct recipients of Urbanized Area (49 U.S.C. 5307) and Rural Area (49 U.S.C. 5311) formula funds, and Indian tribes.

Eligible applicants are where can i buy propecia over the counter limited to FTA grantees or subrecipients who would be the primary beneficiaries of the innovative products and services that are developed—typically public transit agencies. Except for projects proposed by Indian tribes, proposals for projects in rural (non-urbanized) areas must be submitted as part of a consolidated State proposal. States and other eligible applicants also may submit consolidated proposals for projects in where can i buy propecia over the counter urbanized areas. The submission of the Statewide application will not preclude the submission and consideration of any application from other eligible recipients in an urbanized area in a State. Proposals may contain projects to be implemented by the recipient or its subrecipients.

Eligible subrecipients include public agencies, private nonprofit organizations, and private where can i buy propecia over the counter providers engaged in public transportation. Eligible applicants may submit consolidated proposals for projects. (2) Cost Sharing or Matching The maximum Federal share of project costs is 100 percent. FTA may give additional consideration to applicants that propose a where can i buy propecia over the counter local share and may view these applicants as more competitive. The applicant must document the source(s) of the local match, if any, in the grant application.

For any applicants proposing match, eligible local match sources include the following. Cash from non-Government where can i buy propecia over the counter sources other than revenues from providing public transportation services. Revenues derived from the sale of advertising and concessions. Revenues generated from value capture financing mechanisms. Funds from an where can i buy propecia over the counter undistributed cash surplus.

Replacement or depreciation cash fund or reserve. New capital where can i buy propecia over the counter. Or in-kind contributions. (3) Eligible Projects Eligible projects will propose innovative solutions to improve operational efficiencies of transit agencies and enhance the mobility of transit users, through projects that demonstrate innovative solutions for. Vehicle, facility, equipment and infrastructure cleaning where can i buy propecia over the counter and dis.

Exposure mitigation measures such a real-time notification of rail and bus passenger loads. New multi-modal payment innovative mobility systems such as contactless payments. And measures that strengthen public confidence in where can i buy propecia over the counter transit. Each applicant may only submit one proposal.Start Printed Page 63655 D. Application and Submission Information (1) Address and Form of Application Submission Applications must be submitted through GRANTS.GOV.

Applicants can find general information for submitting applications through GRANTS.GOV at www.fta.dot.gov/​howtoapply, along where can i buy propecia over the counter with specific instructions for the forms and attachments required for submission. Mail and fax submissions will not be accepted. (2) Content and Form of Application Submission a. Proposal Submission A complete proposal submission consists of where can i buy propecia over the counter at least two forms. 1.

The SF-424 Mandatory Form (downloadable from GRANTS.GOV) where can i buy propecia over the counter and 2. The supplemental form for the FY 2020 hair loss treatment Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA hair loss treatment Demonstration Program). The application must include responses to all sections of the SF-424 mandatory form and the supplemental form unless a section is indicated as optional. FTA will use the information on the supplemental form to determine applicant and project eligibility for the program and to evaluate the proposal against the selection criteria where can i buy propecia over the counter described in part E of this notice. FTA will accept only one supplemental form per SF-424 submission.

FTA encourages applicants to consider submitting a single supplemental form that includes multiple activities to be evaluated as a consolidated proposal. Applicants may attach additional supporting information to the SF-424 submission, where can i buy propecia over the counter including but not limited to letters of support, project budgets, or excerpts from relevant planning documents. Supporting documentation must be described and referenced by file name in the appropriate response section of the supplemental form, or it may not be reviewed. Information such as applicant name, Federal amount requested, local match amount, description of areas served, etc., may be requested in varying degrees of detail on both the SF-424 form and supplemental form. Applicants must fill where can i buy propecia over the counter in all fields unless stated otherwise on the forms.

If applicants copy information into the supplemental form from another source, they should verify that the supplemental form has fully captured pasted text and that it has not truncated the text due to character limits built into the form. Applicants should use both the “Check Package for Errors” and the “Validate Form” validation buttons where can i buy propecia over the counter on both forms to check all required fields. Applicants should also ensure that the Federal and local amounts specified are consistent. Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S where can i buy propecia over the counter.

Initiative, the Department encourages applicants to consider how the project will address the challenges faced by rural areas. B. Application Content The where can i buy propecia over the counter SF-424 Mandatory Form and the supplemental form will prompt applicants for the required information, including. I. Applicant Name ii.

Dun and Bradstreet (D&B) Data Universal where can i buy propecia over the counter Numbering System (DUNS) number iii. Key contact information (contact name, address, email address, and phone number) iv. Congressional district(s) where project will take place v. Project Information (title, executive summary, and where can i buy propecia over the counter type) vi. A detailed description of the need for the project vii.

A detailed description of how the project will support the where can i buy propecia over the counter Program objectives viii. Evidence that the applicant can provide the local cost shares ix. A description of the technical, legal, and financial capacity of the applicant x. A detailed where can i buy propecia over the counter project budget xi. Details on the local matching funds xii.

A detailed project timeline xiii. Whether the project impacts an Opportunity Zone (3) Unique Entity Identifier and System for Award Management (SAM) Each where can i buy propecia over the counter applicant is required to. (1) Be registered in SAM before submitting an application. (2) provide a valid unique entity identifier in its application. And (3) continue to maintain an active SAM registration with current information at all times during which the applicant has an active Federal award or an application or plan under consideration where can i buy propecia over the counter by FTA.

These requirements do not apply if the applicant. (1) Is excepted from the requirements under 2 CFR 25.110(b) or (c). Or (2) has an exception approved by FTA under where can i buy propecia over the counter 2 CFR 25.110(d). FTA may not make an award until the applicant has complied with all applicable unique entity identifier and SAM requirements. If an applicant has not fully complied with the requirements by the time FTA is ready to make an award, FTA may determine that the applicant is not qualified to receive an award and use that where can i buy propecia over the counter determination as a basis for making a Federal award to another applicant.

All applicants must provide a unique entity identifier provided by SAM. Registration in SAM may take as little as 3-5 business days, but there can be unexpected steps or delays. For example, where can i buy propecia over the counter the applicant may need to obtain an Employer Identification Number. FTA recommends allowing ample time, up to several weeks, to complete all steps. For additional information on obtaining a unique entity identifier, please visit www.sam.gov.

(4) Submission Dates and Times Project proposals must where can i buy propecia over the counter be submitted electronically through GRANTS.GOV by 11:59 p.m. Eastern on November 2, 2020. Mail and fax submissions will not be accepted. FTA urges applicants to submit applications where can i buy propecia over the counter at least 72 hours prior to the due date to allow time to correct any problems that may have caused either GRANTS.GOV or FTA systems to reject the submission. Proposals submitted after the deadline will only be considered under extraordinary circumstances not within the applicant's control.

Deadlines will not be extended due to scheduled website maintenance where can i buy propecia over the counter. GRANTS.GOV scheduled maintenance and outage times are announced on the GRANTS.GOV website. Within 48 hours after submitting an electronic application, the applicant should receive two email messages from GRANTS.GOV. (1) Confirmation where can i buy propecia over the counter of successful transmission to GRANTS.GOV. And (2) confirmation of successful validation by GRANTS.GOV.

If the applicant does not receive confirmation of successful validation or receives a notice of failed validation or incomplete materials, the applicant must address the reason for the failed validation, as described in the email notice, and resubmit before the submission deadline. If making where can i buy propecia over the counter a resubmission for any reason, applicants must include all original attachments regardless of which attachments were updated and check the box on the supplemental form indicating this is a resubmission. Applicants are encouraged to begin the process of registration on the GRANTS.GOV site well in advance of the submission deadline. Registration is Start Printed Page 63656a multi-step process, which may take several weeks to complete before an application can be submitted. Registered applicants may still be required to update their registration where can i buy propecia over the counter before submitting an application.

Registration in SAM is renewed annually and persons making submissions on behalf of the Authorized Organization Representative (AOR) must be authorized in GRANTS.GOV by the AOR to make submissions. (5) Funding Restrictions Funds may be used for post-award expenditures only. Funds under this NOFO cannot be used to reimburse projects for otherwise eligible where can i buy propecia over the counter expenses incurred prior to the date of project award announcements. (6) Other Submission Requirements FTA encourages applicants to identify scaled funding options in case insufficient funding is available to fund a project at the full requested amount. If an applicant indicates that a where can i buy propecia over the counter project is scalable, the applicant must provide an appropriate minimum funding amount that will fund an eligible project that achieves the objectives of the program and meets all relevant program requirements.

The applicant must provide a clear explanation of how a reduced award would affect the project budget and scope. FTA may award a lesser amount whether or not the applicant provides a scalable option. E. Application Review Information (1) Project Evaluation Criteria Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S.

Initiative, the Department will consider how the project will address the challenges faced by rural areas. In addition, the Department will review and consider applications for funding pursuant to this Notice in accordance with the President's September 2, 2020 memorandum, entitled Memorandum on Reviewing Funding to State and Local Government Recipients of Federal Funds that Are Permitting Anarchy, Violence, and Destruction in American Cities, consistent with guidance from the Office of Management and Budget and the Attorney General and with all applicable laws. FTA will evaluate proposals submitted according to the following criteria. (a) Project Innovation and Impact. (b) Project Approach.

(c) National Applicability. (d) Commercialization and/or Knowledge Transfer. And (e) Technical, Legal and Financial Capacity. FTA encourages each applicant to demonstrate how a project supports all criteria with the most relevant information the applicant can provide, regardless of whether such information has been specifically requested or identified in this notice. A.

Project Innovation and Impact i. Effectiveness of the project in achieving and demonstrating the specific objectives of this program. Ii. Demonstration of benefits in addressing the needs of the transit agency and industry and impacts to infrastructure, equipment, transit workforce, and riders. Iii.

Degree of improvement over current and existing technologies, designs, and/or practices applicable to the transit industry. B. Project Approach i. Quality of the project approach such as existing partnerships, collaboration strategies and level of commitment of the project partners. Ii.

Proposal is realistic in its approach to fulfill the milestones/deliverables, schedule and goals. C. National Applicability i. Degree to which the project could be replicated by other transit agencies regionally or nationally. Ii.

Ability to evaluate technologies, designs and/or practices in a wide variety of conditions and locales. Iii. Degree to which the technology, designs and/or practices can be replicated by other transportation modes. D. Commercialization and/or Knowledge Transfer i.

Demonstrates a realistic plan for moving the results of the project into the transit marketplace (patents, conferences, articles in trade magazines, webinar, site visits, etc.). Ii. How the project team plans to work with the industry on improving best practices, guidance and/or standards, if applicable. Iii. Demonstrate a clear understanding and robust approach to data collection, access and management.

E. Technical, Legal and Financial Capacity Capacity of the applicant and any partners to successfully execute the project effort. There should be no outstanding legal, technical, or financial issues with the applicant that would make this a high-risk project. (2) Review and Selection Process An FTA technical evaluation committee will evaluate proposals based on the published project evaluation criteria. Members of the technical evaluation committee will rate the applications and may seek clarification about any statement in an application.

The FTA Administrator will determine the final selection and amount of funding for each project after consideration of the findings of the technical evaluation committee. Geographic diversity, diversity of the project type, the amount of local match to be provided, and the applicant's receipt and management of other Federal transit funds may be considered in FTA's award decisions. Prior fare payment innovation efforts may receive priority consideration. The FTA Administrator will consider the following key DOT objectives. A.

Utilizing alternative funding sources and innovative financing models to attract non-Federal sources of investment. B. Whether the project is located in or supports public transportation service in a qualified opportunity zone designated pursuant to 26.U.S.C. 1400Z-1. And c.

The extent to which the project addresses challenges specific to the provision of rural public transportation. (3) FAPIIS Review Prior to making a grant award, FTA is required to review and consider any information about the applicant that is in the Federal Awardee Performance and Integrity Information System (FAPIIS) accessible through SAM. An applicant may review and comment on information about itself that a Federal awarding agency previously entered. FTA will consider any comments by the applicant, in addition to the other information in FAPIIS, in making a judgment about the applicant's integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 2 CFR 200.205 Federal Awarding Agency Review of Risk Posed by Applicants. F.

Federal Award Administration Information (1) Federal Award Notices FTA will announce the final project selections on the FTA website. Project recipients should contact their FTA Regional Office for additional information regarding allocations for Start Printed Page 63657projects. At the time project selections are announced, FTA will extend pre-award authority for the selected projects. There is no blanket pre-award authority for these projects before announcement. There is no minimum or maximum grant award amount, but FTA intends to fund as many meritorious projects as possible.

FTA only will consider proposals from eligible recipients for eligible activities. Due to funding limitations, projects selected for funding may receive less than the amount originally requested. In those cases, applicants must be able to demonstrate that the proposed projects are still viable and can be completed with the amount awarded. (2) Administrative and National Policy Requirements a. Pre-Award Authority FTA will issue specific guidance to recipients regarding pre-award authority at the time of selection.

FTA does not provide pre-award authority for competitive funds until projects are selected, and there are Federal requirements that must be met before costs are incurred. For more information about FTA's policy on pre-award authority, see the FY 2020 Apportionments Notice published on June 3, 2020, at https://www.govinfo.gov/​content/​pkg/​FR-2020-06-03/​pdf/​2020-11946.pdf. b. Grant Requirements Selected applicants will submit a grant application through FTA's electronic grant management system and adhere to the customary FTA grant requirements for research project (insert Circular name). All competitive grants, regardless of award amount, will be subject to the Congressional notification and release process.

FTA emphasizes that third-party procurement applies to all funding awards, as described in FTA Circular 4220.1F, “Third Party Contracting Guidance.” However, FTA may approve applications that include a specifically identified partnering organization(s) (2 CFR 200.302(f)). When included, the application, budget, and budget narrative should provide a clear understanding of how the selection of these organizations is critical for the project and give sufficient detail about the costs involved. C. Planning FTA encourages applicants to engage the appropriate State Departments of Transportation, Regional Transportation Planning Organizations, or Metropolitan Planning Organizations in areas to be served by the project funds available under this program. D.

Standard Assurances The applicant assures that it will comply with all applicable Federal statutes, regulations, executive orders, FTA circulars, and other Federal administrative requirements in carrying out any project supported by the FTA grant. The applicant acknowledges that it is under a continuing obligation to comply with the terms and conditions of the grant agreement issued for its project with FTA. The applicant understands that Federal laws, regulations, policies, and administrative practices might be modified from time to time and may affect the implementation of the project. The applicant agrees that the most recent Federal requirements will apply to the project unless FTA issues a written determination otherwise. The applicant must submit the Certifications and Assurances before receiving a grant if it does not have current certifications on file.

E. Free Speech and Religious Liberty In connection with any program or activity conducted with or benefiting from funds awarded under this notice, recipients of funds must comply with all applicable requirements of Federal law, including, without limitation, the Constitution of the United States. Statutory, regulatory, and public policy requirements, including without limitation, those protecting free speech, religious liberty, public welfare, the environment, and prohibiting discrimination. The conditions of performance, non-discrimination requirements, and other assurances made applicable to the award of funds in accordance with regulations of the Department of Transportation. And applicable Federal financial assistance and contracting principles promulgated by the Office of Management and Budget.

In complying with these requirements, recipients must ensure that no concession agreements are denied or other contracting decisions made on the basis of speech or other activities protected by the First Amendment. If the Department determines that a recipient has failed to comply with applicable Federal requirements, the Department may terminate the award of funds and disallow previously incurred costs, requiring the recipient to reimburse any expended award funds. (3) Reporting The post-award reporting requirements include submission of the Federal Financial Report (FFR) and Milestone Progress Report in TrAMS. An evaluation of the grant will occur at various points in the demonstration process and at the end of the project. In addition, FTA is responsible for producing an Annual Report to Congress that compiles evaluation of selected projects, including an evaluation of the performance measures identified by the applicants.

All applicants must develop an evaluation plan to measure the success or failure of their projects and describe any plans for broad-based implementation of successful projects. FTA may request data and reports to support the evaluation and Annual Report. A. Independent Evaluation To achieve a comprehensive understanding of the impacts and implications of each proposed hair loss treatment Research Demonstration Program, projects funded under this announcement will require the recipient to conduct a third party independent evaluation of their project. Recipients will be required to contract with a third party independent evaluator to assist in developing an evaluation plan, and collecting, storing and managing data required to fulfill the evaluation requirement.

No more than 10 percent of the Federal share of the project may be used to hire the third-party independent evaluator and the inclusion of a third-party independent evaluation should be described in the grant application. If the project duration is more than two years, an interim evaluation report would need to be submitted to FTA, otherwise the evaluation report should be included as part of the final project report. B. hair loss treatment Research Demonstration Grant Program Evaluation Projects funded under this announcement will be required to establish a set of performance metrics set by the third-party independent evaluator and shared with FTA. G.

Federal Awarding Agency Contacts Information For questions about applying, please contact Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone. 202-366-8985. A TDD is available at 1-800-877-8339 (TDDFIRS). To ensure that applicants receive accurate information about eligibility or the program, applicants are encouraged to contact FTA directly with questions, rather than through intermediaries or third parties.Start Printed Page 63658 FTA staff also may conduct briefings on the competitive grants selection and award process upon request.

Start Signature K. Jane Williams, Deputy Administrator. End Signature End Supplemental Information [FR Doc. 2020-22316 Filed 10-7-20. 8:45 am]BILLING CODE 4910-57-PStart Preamble Office of the Secretary, Department of Health and Human Services.

Notice. The Department of Health and Human Services (HHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP) in the Office of the Assistant Secretary for Health (OASH) announces the draft Viral Hepatitis National Strategic Plan. A Roadmap to Elimination (2021-2025) (Hepatitis Plan) available for public comment. The draft Hepatitis Plan may be reviewed at www.hhs.gov/​hepatitis. All comments must be received by 5:00 p.m.

ET on October 8, 2020 to ensure consideration. All comments must be submitted electronically to HepatitisPlanComments@hhs.gov. Start Further Info Carol Jimenez, OIDP, Carol.Jimenez@hhs.gov. 202-401-5131. End Further Info End Preamble Start Supplemental Information Viral hepatitis is a significant public health threat that puts people who are infected at increased risk for serious disease and death.

In the United States, new hepatitis A and hepatitis C s have increased dramatically in recent years, little progress has been made on preventing hepatitis B s, and, as of 2016, an estimated 3.3 million people were chronically infected with hepatitis B and hepatitis C.1-3 Collectively, viral hepatitis costs people, health systems, states, and the federal government billions of dollars each year 4 5 and contributes to substantial health disparities, stigma, and discrimination. Reversing the rates of viral hepatitis, preventing new s, and improving care and treatment require a strategic and coordinated approach by federal partners in collaboration with state and local health departments, tribal communities, community-based organizations, and other nonfederal partners and stakeholders. To spur action to reduce new viral hepatitis s and their adverse public health impact, OASH through OIDP, in collaboration with federal partners throughout HHS and other departments, led and coordinated development of the Hepatitis Plan. Opportunities for public input were provided, and public comments received were reviewed and analyzed and helped inform the components of the Hepatitis Plan. The Hepatitis Plan focuses on hepatitis A, hepatitis B, and hepatitis C—the hepatitis propeciaes that most significantly affect the health of the nation.

It is an elimination plan, with the overarching goal of eliminating viral hepatitis as a public health threat in the United States by 2030. The Hepatitis Plan is intended to serve as a roadmap for all stakeholders at all levels to eliminate hepatitis in this nation. The Hepatitis Plan presents a strategic framework for integrating and leveraging synergistic policies, programs, and resources. It sets forth a vision and five goals for the nation, with objectives and strategies for each goal. The objectives and strategies offered in this plan are interrelated and may be used to make progress toward more than one goal.

The Hepatitis Plan identifies disproportionately impacted populations based on national hepatitis incidence, prevalence, and mortality data, to help federal and other stakeholders focus their efforts to realize the greatest impact. The Hepatitis Plan also includes indicators to measure progress and quantitative targets for each indicator. Although it is a 5-year plan, it sets 10-year quantitative targets for each indicator—reflecting the reality that it will take more than 5 years to eliminate viral hepatitis as a public health threat. The order in which the goals, objectives, strategies, and indicators are presented is not associated with any prioritization. The following are the Hepatitis Plan's vision and goals.

Vision. The United States will be a place where new viral hepatitis s are prevented, every person knows their status, and every person with viral hepatitis has high-quality health care and treatment and lives free from stigma and discrimination. This vision includes all people, regardless of age, sex, gender identity, sexual orientation, race, ethnicity, geographic location, or socioeconomic circumstance. Goals. 1.

Prevent New Viral Hepatitis s 2. Improve Viral Hepatitis—Related Health Outcomes of People with Viral Hepatitis 3. Reduce Viral Hepatitis—Related Disparities and Health Inequities 4. Improve Viral Hepatitis Surveillance and Data Usage 5. Achieve Integrated, Coordinated Efforts That Address the Viral Hepatitis Epidemics among All Partners and Stakeholders A roadmap for stakeholders at all levels and sectors, the Hepatitis Plan envisions a whole-of-nation response to preventing and controlling viral hepatitis in the United States.

The Hepatitis Plan assumes the active participation of state, local, and tribal health departments and organizations, health plans and health care providers, schools and other academic institutions, community- and faith-based organizations, scientists, researchers, and the public in this effort. The priority populations, indicators, and quantitative targets, especially the methods used to determine them, are intended to help focus efforts and limited resources to realize the most impact. Stakeholders are encouraged to focus on activities that resonate the most with the needs of the populations they serve and services they provide, and, using the Hepatitis Plan as a framework, develop their own plans to eliminate viral hepatitis and improve the health of their communities, states, tribal nations, and the nation. Information Needs The draft Hepatitis Plan may be reviewed at. Www.hhs.gov/​hepatitis.

OIDP seeks to obtain feedback from external stakeholders on the following. 1. Do the draft plan's goals, objectives, and strategies appropriately address the viral hepatitis epidemics?. 2. Are there any critical gaps in the Hepatitis Plan's goals, objectives, and strategies?.

If so, please specify the gaps. 3. Do any of the Hepatitis Plan's goals, objectives and strategies cause concern?. If so, please specify the goal, objective or strategy, and describe the concern regarding it. Each commenter is limited to a maximum of seven pages.

Start Authority 77 FR 15761 (March 16, 2012). End Authority Start Signature Dated. September 22, 2020. B. Kaye Hayes, Acting Director, Office of Infectious Disease and HIV/AIDS Policy.

End Signature Footnotes 1. Centers for Disease Control and Prevention. Viral Hepatitis Surveillance—Start Printed Page 60814United States, 2018. U.S. Department of Health and Human Services.

2020. Accessed August 9, 2020. Https://www.cdc.gov/​hepatitis/​statistics/​2018surveillance/​index.htm. 2. Hofmeister MG, Rosenthal EM, Barker LK, et al.

Estimating prevalence of hepatitis C propecia in the United States, 2013-2016. Hepatology. 2019 Mar;69(3):1020-1031. Doi. 10.1002/hep.30297.

3. LeFevre ML. Screening for hepatitis B propecia in nonpregnant adolescents and adults. US Preventive Services Task Force recommendation statement. Annals Internal Med.

2014;161(1):58-66. 4. Morey RJ, Collier MG, Nelson NP. The financial burden of public health responses to hepatitis A cases among food handlers, 2012-2014. Public Health Rep.

2017;132(4):443-447. Doi:10.1177/0033354917710947. 5. Wittenborn J, Brady J, Dougherty M, Rein D. Potential epidemiologic, economic, and budgetary impacts of current rates of hepatitis C treatment in Medicare and non-Medicare populations.

Hepatol Commun. 2017;1(2):99-109. Doi:10.1002/hep4.1031. End Supplemental Information [FR Doc. 2020-21288 Filed 9-25-20.

Start Preamble how to get propecia cheap Federal Transit Administration (FTA), DOT https://therambarranlawfirm.com/how-to-get-a-diflucan-prescription-from-your-doctor/. Notice of funding opportunity. The hair loss Disease 2019 (hair loss treatment) public health emergency Start Printed Page 63654has had a significant impact on transit operations how to get propecia cheap. During a series of FTA listening sessions held over the last three months, transit agencies asked FTA to support research to identify solutions to address the operational challenges that they are facing as a result of hair loss treatment. In response, FTA makes available through this Notice of Funding Opportunity (NOFO) funding to support research demonstration grants to public transit agencies to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the hair loss treatment public health emergency.

Demonstration grants under this NOFO how to get propecia cheap are authorized under FTA's Public Transportation Innovation Program (49 U.S.C. 5312). Eligible projects will demonstrate innovative solutions to improve the operational efficiencies of transit systems and enhance mobility for their communities in four major areas. (1) Vehicle, facility, equipment how to get propecia cheap and infrastructure cleaning and dis. (2) exposure mitigation measures.

(3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence how to get propecia cheap in transit services. The total funding available for awards under this NOFO is $10,000,000. FTA may supplement this how to get propecia cheap amount if additional funding becomes available. Applicants must submit completed proposals for funding opportunity FTA-2020-015-TRI through the GRANTS.GOV “APPLY” function by 11:59 p.m.

Eastern Time on November 2, 2020. Prospective applicants should register as soon as possible on the GRANTS.GOV website to ensure how to get propecia cheap they can complete the application process before the submission deadline. Application instructions are available on FTA's website at http://transit.dot.gov/​howtoapply and in the “FIND” module of GRANTS.GOV. FTA will not accept mail and fax submissions. Start Further how to get propecia cheap Info Please send any questions on this notice to Jamel El-Hamri email.

Jamel.El-Hamri@dot.gov phone. 2020-366-8985. A Telecommunication Device for the Deaf (TDD) is available how to get propecia cheap for individuals who are deaf or hard of hearing at 1-800-877-8339. End Further Info End Preamble Start Supplemental Information Table of Contents A. Program Description B.

Federal Award how to get propecia cheap Information C. Eligibility Information D. Application and how to get propecia cheap Submission Information E. Application Review Information F. Federal Award Administration Information G.

Federal Awarding Agency how to get propecia cheap Contact Information A. Program Description The Public Transportation hair loss treatment Research Demonstration Grant Program is funded through the Public Transportation Innovation Program (49 U.S.C. 5312), with the goal to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the hair loss treatment public health emergency. Eligible projects how to get propecia cheap will propose to develop and deploy innovative solutions in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis.

(2) exposure mitigation measures. (3) innovative mobility such how to get propecia cheap as contactless payments. And (4) measures that strengthen public confidence in transit. As required by how to get propecia cheap 49 U.S.C. 5312(e)(4), projects funded under this NOFO must participate in an evaluation by an independent outside entity that will conduct a comprehensive evaluation of the success or failure of the projects funded under this subsection and any plan for broad-based implementation of the innovation promoted by successful projects.

B. Federal Award Information FTA makes available $10,000,000 in fiscal year (FY) 2020 funds under the Public Transportation Innovation how to get propecia cheap Program (49 U.S.C. 5312) to finance the Public Transportation hair loss treatment Research Demonstration Grant Program. FTA may supplement the total funds available if additional funding becomes available at the time project selections are made. FTA will grant pre-award authority starting on the date of the project award announcement for selected projects and should be completed within how to get propecia cheap 24 months from the date of award.

Funds are available only for eligible expenses incurred after the announcement of project selections. C. Eligibility Information how to get propecia cheap (1) Eligible Applicants Eligible applicants include State and local governmental authorities, direct recipients of Urbanized Area (49 U.S.C. 5307) and Rural Area (49 U.S.C. 5311) formula funds, and Indian tribes.

Eligible applicants are limited to FTA grantees or subrecipients who would be how to get propecia cheap the primary beneficiaries of the innovative products and services that are developed—typically public transit agencies. Except for projects proposed by Indian tribes, proposals for projects in rural (non-urbanized) areas must be submitted as part of a consolidated State proposal. States and other eligible applicants also may submit consolidated proposals for how to get propecia cheap projects in urbanized areas. The submission of the Statewide application will not preclude the submission and consideration of any application from other eligible recipients in an urbanized area in a State. Proposals may contain projects to be implemented by the recipient or its subrecipients.

Eligible subrecipients include public agencies, private nonprofit organizations, and private providers engaged in how to get propecia cheap public transportation. Eligible applicants may submit consolidated proposals for projects. (2) Cost Sharing or Matching The maximum Federal share of project costs is 100 percent. FTA may how to get propecia cheap give additional consideration to applicants that propose a local share and may view these applicants as more competitive. The applicant must document the source(s) of the local match, if any, in the grant application.

For any applicants proposing match, eligible local match sources include the following. Cash from non-Government sources other than revenues from how to get propecia cheap providing public transportation services. Revenues derived from the sale of advertising and concessions. Revenues generated from value capture financing mechanisms. Funds from how to get propecia cheap an undistributed cash surplus.

Replacement or depreciation cash fund or reserve. New capital how to get propecia cheap. Or in-kind contributions. (3) Eligible Projects Eligible projects will propose innovative solutions to improve operational efficiencies of transit agencies and enhance the mobility of transit users, through projects that demonstrate innovative solutions for. Vehicle, facility, equipment and infrastructure cleaning how to get propecia cheap and dis.

Exposure mitigation measures such a real-time notification of rail and bus passenger loads. New multi-modal payment innovative mobility systems such as contactless payments. And measures that strengthen public how to get propecia cheap confidence in transit. Each applicant may only submit one proposal.Start Printed Page 63655 D. Application and Submission Information (1) Address and Form of Application Submission Applications must be submitted through GRANTS.GOV.

Applicants can find general information for submitting applications through GRANTS.GOV how to get propecia cheap at www.fta.dot.gov/​howtoapply, along with specific instructions for the forms and attachments required for submission. Mail and fax submissions will not be accepted. (2) Content and Form of Application Submission a. Proposal Submission A complete proposal submission consists of at least two how to get propecia cheap forms. 1.

The SF-424 Mandatory Form (downloadable from GRANTS.GOV) and 2 how to get propecia cheap. The supplemental form for the FY 2020 hair loss treatment Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA hair loss treatment Demonstration Program). The application must include responses to all sections of the SF-424 mandatory form and the supplemental form unless a section is indicated as optional. FTA will use the information on the supplemental form to determine applicant and project eligibility for the program and to evaluate the proposal against the selection criteria described in how to get propecia cheap part E of this notice. FTA will accept only one supplemental form per SF-424 submission.

FTA encourages applicants to consider submitting a single supplemental form that includes multiple activities to be evaluated as a consolidated proposal. Applicants may attach additional supporting information to the SF-424 submission, including but not limited to letters of support, project budgets, or excerpts from relevant planning how to get propecia cheap documents. Supporting documentation must be described and referenced by file name in the appropriate response section of the supplemental form, or it may not be reviewed. Information such as applicant name, Federal amount requested, local match amount, description of areas served, etc., may be requested in varying degrees of detail on both the SF-424 form and supplemental form. Applicants must fill in all fields unless how to get propecia cheap stated otherwise on the forms.

If applicants copy information into the supplemental form from another source, they should verify that the supplemental form has fully captured pasted text and that it has not truncated the text due to character limits built into the form. Applicants should how to get propecia cheap use both the “Check Package for Errors” and the “Validate Form” validation buttons on both forms to check all required fields. Applicants should also ensure that the Federal and local amounts specified are consistent. Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with how to get propecia cheap the R.O.U.T.E.S.

Initiative, the Department encourages applicants to consider how the project will address the challenges faced by rural areas. B. Application Content The SF-424 Mandatory Form and the supplemental form will prompt how to get propecia cheap applicants for the required information, including. I. Applicant Name ii.

Dun and how to get propecia cheap Bradstreet (D&B) Data Universal Numbering System (DUNS) number iii. Key contact information (contact name, address, email address, and phone number) iv. Congressional district(s) where project will take place v. Project Information (title, executive summary, and type) vi how to get propecia cheap. A detailed description of the need for the project vii.

A detailed description of how the project how to get propecia cheap will support the Program objectives viii. Evidence that the applicant can provide the local cost shares ix. A description of the technical, legal, and financial capacity of the applicant x. A detailed project budget xi how to get propecia cheap. Details on the local matching funds xii.

A detailed project timeline xiii. Whether the project impacts an Opportunity Zone (3) Unique Entity Identifier and System for Award Management how to get propecia cheap (SAM) Each applicant is required to. (1) Be registered in SAM before submitting an application. (2) provide a valid unique entity identifier in its application. And (3) continue to maintain an active how to get propecia cheap SAM registration with current information at all times during which the applicant has an active Federal award or an application or plan under consideration by FTA.

These requirements do not apply if the applicant. (1) Is excepted from the requirements under 2 CFR 25.110(b) or (c). Or (2) has an exception how to get propecia cheap approved by FTA under 2 CFR 25.110(d). FTA may not make an award until the applicant has complied with all applicable unique entity identifier and SAM requirements. If an applicant has not fully complied with the requirements by the time FTA is ready to make an award, FTA may determine that the applicant is not qualified to receive an award and use that determination as a basis for making a Federal how to get propecia cheap award to another applicant.

All applicants must provide a unique entity identifier provided by SAM. Registration in SAM may take as little as 3-5 business days, but there can be unexpected steps or delays. For example, the applicant how to get propecia cheap may need to obtain an Employer Identification Number. FTA recommends allowing ample time, up to several weeks, to complete all steps. For additional information on obtaining a unique entity identifier, please visit www.sam.gov.

(4) Submission Dates and Times Project proposals must be submitted how to get propecia cheap electronically through GRANTS.GOV by 11:59 p.m. Eastern on November 2, 2020. Mail and fax submissions will not be accepted. FTA urges applicants to submit applications at least 72 hours prior to the due date to allow time to correct any problems that may have caused either GRANTS.GOV how to get propecia cheap or FTA systems to reject the submission. Proposals submitted after the deadline will only be considered under extraordinary circumstances not within the applicant's control.

Deadlines will not be extended due to scheduled how to get propecia cheap website maintenance. GRANTS.GOV scheduled maintenance and outage times are announced on the GRANTS.GOV website. Within 48 hours after submitting an electronic application, the applicant should receive two email messages from GRANTS.GOV. (1) Confirmation of how to get propecia cheap successful transmission to GRANTS.GOV. And (2) confirmation of successful validation by GRANTS.GOV.

If the applicant does not receive confirmation of successful validation or receives a notice of failed validation or incomplete materials, the applicant must address the reason for the failed validation, as described in the email notice, and resubmit before the submission deadline. If making a resubmission for any reason, applicants must include all original attachments regardless of which attachments were updated and check the box on the supplemental form indicating this is a resubmission how to get propecia cheap. Applicants are encouraged to begin the process of registration on the GRANTS.GOV site well in advance of the submission deadline. Registration is Start Printed Page 63656a multi-step process, which may take several weeks to complete before an application can be submitted. Registered applicants may still be required to update their registration how to get propecia cheap before submitting an application.

Registration in SAM is renewed annually and persons making submissions on behalf of the Authorized Organization Representative (AOR) must be authorized in GRANTS.GOV by the AOR to make submissions. (5) Funding Restrictions Funds may be used for post-award expenditures only. Funds under this how to get propecia cheap NOFO cannot be used to reimburse projects for otherwise eligible expenses incurred prior to the date of project award announcements. (6) Other Submission Requirements FTA encourages applicants to identify scaled funding options in case insufficient funding is available to fund a project at the full requested amount. If an how to get propecia cheap applicant indicates that a project is scalable, the applicant must provide an appropriate minimum funding amount that will fund an eligible project that achieves the objectives of the program and meets all relevant program requirements.

The applicant must provide a clear explanation of how a reduced award would affect the project budget and scope. FTA may award a lesser amount whether or not the applicant provides a scalable option. E. Application Review Information (1) Project Evaluation Criteria Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S.

Initiative, the Department will consider how the project will address the challenges faced by rural areas. In addition, the Department will review and consider applications for funding pursuant to this Notice in accordance with the President's September 2, 2020 memorandum, entitled Memorandum on Reviewing Funding to State and Local Government Recipients of Federal Funds that Are Permitting Anarchy, Violence, and Destruction in American Cities, consistent with guidance from the Office of Management and Budget and the Attorney General and with all applicable laws. FTA will evaluate proposals submitted according to the following criteria. (a) Project Innovation and Impact. (b) Project Approach.

(c) National Applicability. (d) Commercialization and/or Knowledge Transfer. And (e) Technical, Legal and Financial Capacity. FTA encourages each applicant to demonstrate how a project supports all criteria with the most relevant information the applicant can provide, regardless of whether such information has been specifically requested or identified in this notice. A.

Project Innovation and Impact i. Effectiveness of the project in achieving and demonstrating the specific objectives of this program. Ii. Demonstration of benefits in addressing the needs of the transit agency and industry and impacts to infrastructure, equipment, transit workforce, and riders. Iii.

Degree of improvement over current and existing technologies, designs, and/or practices applicable to the transit industry. B. Project Approach i. Quality of the project approach such as existing partnerships, collaboration strategies and level of commitment of the project partners. Ii.

Proposal is realistic in its approach to fulfill the milestones/deliverables, schedule and goals. C. National Applicability i. Degree to which the project could be replicated by other transit agencies regionally or nationally. Ii.

Ability to evaluate technologies, designs and/or practices in a wide variety of conditions and locales. Iii. Degree to which the technology, designs and/or practices can be replicated by other transportation modes. D. Commercialization and/or Knowledge Transfer i.

Demonstrates a realistic plan for moving the results of the project into the transit marketplace (patents, conferences, articles in trade magazines, webinar, site visits, etc.). Ii. How the project team plans to work with the industry on improving best practices, guidance and/or standards, if applicable. Iii. Demonstrate a clear understanding and robust approach to data collection, access and management.

E. Technical, Legal and Financial Capacity Capacity of the applicant and any partners to successfully execute the project effort. There should be no outstanding legal, technical, or financial issues with the applicant that would make this a high-risk project. (2) Review and Selection Process An FTA technical evaluation committee will evaluate proposals based on the published project evaluation criteria. Members of the technical evaluation committee will rate the applications and may seek clarification about any statement in an application.

The FTA Administrator will determine the final selection and amount of funding for each project after consideration of the findings of the technical evaluation committee. Geographic diversity, diversity of the project type, the amount of local match to be provided, and the applicant's receipt and management of other Federal transit funds may be considered in FTA's award decisions. Prior fare payment innovation efforts may receive priority consideration. The FTA Administrator will consider the following key DOT objectives. A.

Utilizing alternative funding sources and innovative financing models to attract non-Federal sources of investment. B. Whether the project is located in or supports public transportation service in a qualified opportunity zone designated pursuant to 26.U.S.C. 1400Z-1. And c.

The extent to which the project addresses challenges specific to the provision of rural public transportation. (3) FAPIIS Review Prior to making a grant award, FTA is required to review and consider any information about the applicant that is in the Federal Awardee Performance and Integrity Information System (FAPIIS) accessible through SAM. An applicant may review and comment on information about itself that a Federal awarding agency previously entered. FTA will consider any comments by the applicant, in addition to the other information in FAPIIS, in making a judgment about the applicant's integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 2 CFR 200.205 Federal Awarding Agency Review of Risk Posed by Applicants. F.

Federal Award Administration Information (1) Federal Award Notices FTA will announce the final project selections on the FTA website. Project recipients should contact their FTA Regional Office for additional information regarding allocations for Start Printed Page 63657projects. At the time project selections are announced, FTA will extend pre-award authority for the selected projects. There is no blanket pre-award authority for these projects before announcement. There is no minimum or maximum grant award amount, but FTA intends to fund as many meritorious projects as possible.

FTA only will consider proposals from eligible recipients for eligible activities. Due to funding limitations, projects selected for funding may receive less than the amount originally requested. In those cases, applicants must be able to demonstrate that the proposed projects are still viable and can be completed with the amount awarded. (2) Administrative and National Policy Requirements a. Pre-Award Authority FTA will issue specific guidance to recipients regarding pre-award authority at the time of selection.

FTA does not provide pre-award authority for competitive funds until projects are selected, and there are Federal requirements that must be met before costs are incurred. For more information about FTA's policy on pre-award authority, see the FY 2020 Apportionments Notice published on June 3, 2020, at https://www.govinfo.gov/​content/​pkg/​FR-2020-06-03/​pdf/​2020-11946.pdf. b. Grant Requirements Selected applicants will submit a grant application through FTA's electronic grant management system and adhere to the customary FTA grant requirements for research project (insert Circular name). All competitive grants, regardless of award amount, will be subject to the Congressional notification and release process.

FTA emphasizes that third-party procurement applies to all funding awards, as described in FTA Circular 4220.1F, “Third Party Contracting Guidance.” However, FTA may approve applications that include a specifically identified partnering organization(s) (2 CFR 200.302(f)). When included, the application, budget, and budget narrative should provide a clear understanding of how the selection of these organizations is critical for the project and give sufficient detail about the costs involved. C. Planning FTA encourages applicants to engage the appropriate State Departments of Transportation, Regional Transportation Planning Organizations, or Metropolitan Planning Organizations in areas to be served by the project funds available under this program. D.

Standard Assurances The applicant assures that it will comply with all applicable Federal statutes, regulations, executive orders, FTA circulars, and other Federal administrative requirements in carrying out any project supported by the FTA grant. The applicant acknowledges that it is under a continuing obligation to comply with the terms and conditions of the grant agreement issued for its project with FTA. The applicant understands that Federal laws, regulations, policies, and administrative practices might be modified from time to time and may affect the implementation of the project. The applicant agrees that the most recent Federal requirements will apply to the project unless FTA issues a written determination otherwise. The applicant must submit the Certifications and Assurances before receiving a grant if it does not have current certifications on file.

E. Free Speech and Religious Liberty In connection with any program or activity conducted with or benefiting from funds awarded under this notice, recipients of funds must comply with all applicable requirements of Federal law, including, without limitation, the Constitution of the United States. Statutory, regulatory, and public policy requirements, including without limitation, those protecting free speech, religious liberty, public welfare, the environment, and prohibiting discrimination. The conditions of performance, non-discrimination requirements, and other assurances made applicable to the award of funds in accordance with regulations of the Department of Transportation. And applicable Federal financial assistance and contracting principles promulgated by the Office of Management and Budget.

In complying with these requirements, recipients must ensure that no concession agreements are denied or other contracting decisions made on the basis of speech or other activities protected by the First Amendment. If the Department determines that a recipient has failed to comply with applicable Federal requirements, the Department may terminate the award of funds and disallow previously incurred costs, requiring the recipient to reimburse any expended award funds. (3) Reporting The post-award reporting requirements include submission of the Federal Financial Report (FFR) and Milestone Progress Report in TrAMS. An evaluation of the grant will occur at various points in the demonstration process and at the end of the project. In addition, FTA is responsible for producing an Annual Report to Congress that compiles evaluation of selected projects, including an evaluation of the performance measures identified by the applicants.

All applicants must develop an evaluation plan to measure the success or failure of their projects and describe any plans for broad-based implementation of successful projects. FTA may request data and reports to support the evaluation and Annual Report. A. Independent Evaluation To achieve a comprehensive understanding of the impacts and implications of each proposed hair loss treatment Research Demonstration Program, projects funded under this announcement will require the recipient to conduct a third party independent evaluation of their project. Recipients will be required to contract with a third party independent evaluator to assist in developing an evaluation plan, and collecting, storing and managing data required to fulfill the evaluation requirement.

No more than 10 percent of the Federal share of the project may be used to hire the third-party independent evaluator and the inclusion of a third-party independent evaluation should be described in the grant application. If the project duration is more than two years, an interim evaluation report would need to be submitted to FTA, otherwise the evaluation report should be included as part of the final project report. B. hair loss treatment Research Demonstration Grant Program Evaluation Projects funded under this announcement will be required to establish a set of performance metrics set by the third-party independent evaluator and shared with FTA. G.

Federal Awarding Agency Contacts Information For questions about applying, please contact Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone. 202-366-8985. A TDD is available at 1-800-877-8339 (TDDFIRS). To ensure that applicants receive accurate information about eligibility or the program, applicants are encouraged to contact FTA directly with questions, rather than through intermediaries or third parties.Start Printed Page 63658 FTA staff also may conduct briefings on the competitive grants selection and award process upon request.

Start Signature K. Jane Williams, Deputy Administrator. End Signature End Supplemental Information [FR Doc. 2020-22316 Filed 10-7-20. 8:45 am]BILLING CODE 4910-57-PStart Preamble Office of the Secretary, Department of Health and Human Services.

Notice. The Department of Health and Human Services (HHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP) in the Office of the Assistant Secretary for Health (OASH) announces the draft Viral Hepatitis National Strategic Plan. A Roadmap to Elimination (2021-2025) (Hepatitis Plan) available for public comment. The draft Hepatitis Plan may be reviewed at www.hhs.gov/​hepatitis. All comments must be received by 5:00 p.m.

ET on October 8, 2020 to ensure consideration. All comments must be submitted electronically to HepatitisPlanComments@hhs.gov. Start Further Info Carol Jimenez, OIDP, Carol.Jimenez@hhs.gov. 202-401-5131. End Further Info End Preamble Start Supplemental Information Viral hepatitis is a significant public health threat that puts people who are infected at increased risk for serious disease and death.

In the United States, new hepatitis A and hepatitis C s have increased dramatically in recent years, little progress has been made on preventing hepatitis B s, and, as of 2016, an estimated 3.3 million people were chronically infected with hepatitis B and hepatitis C.1-3 Collectively, viral hepatitis costs people, health systems, states, and the federal government billions of dollars each year 4 5 and contributes to substantial health disparities, stigma, and discrimination. Reversing the rates of viral hepatitis, preventing new s, and improving care and treatment require a strategic and coordinated approach by federal partners in collaboration with state and local health departments, tribal communities, community-based organizations, and other nonfederal partners and stakeholders. To spur action to reduce new viral hepatitis s and their adverse public health impact, OASH through OIDP, in collaboration with federal partners throughout HHS and other departments, led and coordinated development of the Hepatitis Plan. Opportunities for public input were provided, and public comments received were reviewed and analyzed and helped inform the components of the Hepatitis Plan. The Hepatitis Plan focuses on hepatitis A, hepatitis B, and hepatitis C—the hepatitis propeciaes that most significantly affect the health of the nation.

It is an elimination plan, with the overarching goal of eliminating viral hepatitis as a public health threat in the United States by 2030. The Hepatitis Plan is intended to serve as a roadmap for all stakeholders at all levels to eliminate hepatitis in this nation. The Hepatitis Plan presents a strategic framework for integrating and leveraging synergistic policies, programs, and resources. It sets forth a vision and five goals for the nation, with objectives and strategies for each goal. The objectives and strategies offered in this plan are interrelated and may be used to make progress toward more than one goal.

The Hepatitis Plan identifies disproportionately impacted populations based on national hepatitis incidence, prevalence, and mortality data, to help federal and other stakeholders focus their efforts to realize the greatest impact. The Hepatitis Plan also includes indicators to measure progress and quantitative targets for each indicator. Although it is a 5-year plan, it sets 10-year quantitative targets for each indicator—reflecting the reality that it will take more than 5 years to eliminate viral hepatitis as a public health threat. The order in which the goals, objectives, strategies, and indicators are presented is not associated with any prioritization. The following are the Hepatitis Plan's vision and goals.

Vision. The United States will be a place where new viral hepatitis s are prevented, every person knows their status, and every person with viral hepatitis has high-quality health care and treatment and lives free from stigma and discrimination. This vision includes all people, regardless of age, sex, gender identity, sexual orientation, race, ethnicity, geographic location, or socioeconomic circumstance. Goals. 1.

Prevent New Viral Hepatitis s 2. Improve Viral Hepatitis—Related Health Outcomes of People with Viral Hepatitis 3. Reduce Viral Hepatitis—Related Disparities and Health Inequities 4. Improve Viral Hepatitis Surveillance and Data Usage 5. Achieve Integrated, Coordinated Efforts That Address the Viral Hepatitis Epidemics among All Partners and Stakeholders A roadmap for stakeholders at all levels and sectors, the Hepatitis Plan envisions a whole-of-nation response to preventing and controlling viral hepatitis in the United States.

The Hepatitis Plan assumes the active participation of state, local, and tribal health departments and organizations, health plans and health care providers, schools and other academic institutions, community- and faith-based organizations, scientists, researchers, and the public in this effort. The priority populations, indicators, and quantitative targets, especially the methods used to determine them, are intended to help focus efforts and limited resources to realize the most impact. Stakeholders are encouraged to focus on activities that resonate the most with the needs of the populations they serve and services they provide, and, using the Hepatitis Plan as a framework, develop their own plans to eliminate viral hepatitis and improve the health of their communities, states, tribal nations, and the nation. Information Needs The draft Hepatitis Plan may be reviewed at. Www.hhs.gov/​hepatitis.

OIDP seeks to obtain feedback from external stakeholders on the following. 1. Do the draft plan's goals, objectives, and strategies appropriately address the viral hepatitis epidemics?. 2. Are there any critical gaps in the Hepatitis Plan's goals, objectives, and strategies?.

If so, please specify the gaps. 3. Do any of the Hepatitis Plan's goals, objectives and strategies cause concern?. If so, please specify the goal, objective or strategy, and describe the concern regarding it. Each commenter is limited to a maximum of seven pages.

Start Authority 77 FR 15761 (March 16, 2012). End Authority Start Signature Dated. September 22, 2020. B. Kaye Hayes, Acting Director, Office of Infectious Disease and HIV/AIDS Policy.

End Signature Footnotes 1. Centers for Disease Control and Prevention. Viral Hepatitis Surveillance—Start Printed Page 60814United States, 2018. U.S. Department of Health and Human Services.

2020. Accessed August 9, 2020. Https://www.cdc.gov/​hepatitis/​statistics/​2018surveillance/​index.htm. 2. Hofmeister MG, Rosenthal EM, Barker LK, et al.

Estimating prevalence of hepatitis C propecia in the United States, 2013-2016. Hepatology. 2019 Mar;69(3):1020-1031. Doi. 10.1002/hep.30297.

3. LeFevre ML. Screening for hepatitis B propecia in nonpregnant adolescents and adults. US Preventive Services Task Force recommendation statement. Annals Internal Med.

2014;161(1):58-66. 4. Morey RJ, Collier MG, Nelson NP. The financial burden of public health responses to hepatitis A cases among food handlers, 2012-2014. Public Health Rep.

2017;132(4):443-447. Doi:10.1177/0033354917710947. 5. Wittenborn J, Brady J, Dougherty M, Rein D. Potential epidemiologic, economic, and budgetary impacts of current rates of hepatitis C treatment in Medicare and non-Medicare populations.

Hepatol Commun. 2017;1(2):99-109. Doi:10.1002/hep4.1031. End Supplemental Information [FR Doc. 2020-21288 Filed 9-25-20.

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Overdosage: If you think you have taken too much of Propecia contact a poison control center or emergency room at once.

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About This TrackerThis tracker provides the number of confirmed cases and deaths from novel hair loss by country, the trend in confirmed case and death counts by country, and a propecia video global map showing which countries have confirmed http://ginagarza.com/?page_id=13 cases and deaths. The data are drawn from the Johns Hopkins University (JHU) hair loss Resource Center’s hair loss treatment Map and the World Health Organization’s (WHO) hair loss Disease (hair loss treatment-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content propecia video. About hair loss treatment hair lossIn late 2019, a new hair loss emerged in central China to cause disease in humans.

Cases of this disease, known as hair loss treatment, have since been reported across around propecia video the globe. On January 30, 2020, the World Health Organization (WHO) declared the propecia represents a public health emergency of international concern, and on January 31, 2020, the U.S. Department of Health and Human Services declared it to be a health emergency for the United States.Since taking office in 2017, President Trump has laid down propecia video an extensive record on health care, including his response to the hair loss treatment propecia, his early and ongoing efforts to repeal and replace the Affordable Care Act, his annual budget proposals to curb spending on Medicare and Medicaid, his executive orders and other proposals to lower prescription drug prices, and his initiative on hospital price transparency.President Trump’s record on health care provides a window into his policy priorities in an area that represents one-fifth of the U.S.

Economy and affects the lives of every American. A new issue brief from KFF describes the Trump Administration’s record on health care, including major proposals and actions relating to the hair loss treatment propecia, the ACA and private insurance markets, Medicaid, Medicare, prescription drugs and other health costs, sexual propecia video and reproductive health, mental health and substance use, immigration and health, long-term care, HIV/AIDS policy, and LGBTQ health.The new resource is part of KFF’s ongoing efforts to provide timely and useful information about health policy issues relevant to the 2020 elections, including policy analysis, polling, and journalism. Find more on our Election 2020 resource page, including a side-by-side comparison of President Trump’s record and Democratic presidential nominee Joe Biden’s positions on key health issues..

About This how to get propecia cheap TrackerThis tracker provides the number of confirmed cases and deaths from novel hair loss by country, the trend in confirmed case and death counts by country, and a global map advice showing which countries have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) hair loss Resource Center’s hair loss treatment Map and the how to get propecia cheap World Health Organization’s (WHO) hair loss Disease (hair loss treatment-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About hair loss treatment hair lossIn late 2019, a new hair loss emerged in central China to cause disease in humans. Cases of this disease, known as how to get propecia cheap hair loss treatment, have since been reported across around the globe. On January 30, 2020, the World Health Organization (WHO) declared the propecia represents a public health emergency of international concern, and on January 31, 2020, the U.S how to get propecia prescription online.

Department of Health and Human Services declared it to be a health emergency for the United States.Since taking office in 2017, President Trump has laid down an extensive record on health care, including his response to the hair loss treatment propecia, his early and ongoing efforts to repeal and replace the Affordable Care Act, his annual budget proposals to curb spending on Medicare and Medicaid, his executive orders and other proposals to lower prescription drug prices, and his initiative on hospital price transparency.President Trump’s record on health care provides a window into his policy priorities in an area that represents one-fifth of how to get propecia cheap the U.S. Economy and affects the lives of every American. A new issue brief from KFF describes the Trump Administration’s record on health care, including major proposals and actions relating to the hair loss treatment propecia, the how to get propecia cheap ACA and private insurance markets, Medicaid, Medicare, prescription drugs and other health costs, sexual and reproductive health, mental health and substance use, immigration and health, long-term care, HIV/AIDS policy, and LGBTQ health.The new resource is part of KFF’s ongoing efforts to provide timely and useful information about health policy issues relevant to the 2020 elections, including policy analysis, polling, and journalism. Find more on our Election 2020 resource page, including a side-by-side comparison of President Trump’s record and Democratic presidential nominee Joe Biden’s positions on key health issues..

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Welcome back to the latest edition of the EMJ propecia vs finasteride 5mg. It’s high Summer here in the Northern Hemisphere and our hopes that hair loss treatment would be a distant memory by now are sadly broken. We are in wave n+1 at the moment (where n depends on where you are in the world), but there is hope propecia vs finasteride 5mg in sight as treatment roll outs continue around the world.This month our Editor’s choice is the PRIEST study. This huge observational trial of hair loss treatment 19 patients presenting to UK emergency departments gave us essential information on risk assessment in the hair loss treatment propecia.

It’s a fantastic example of how a trial can be rapidly delivered in a propecia and propecia vs finasteride 5mg a lesson in how we need to plan for the propecia after hair loss treatment. The study is particularly useful in that it focuses on information available to the emergency clinician in the form of well-known scores such as NEWS2 as opposed to data that may be available much later (such as some laboratory testing). While therapeutic trials of repurposed drugs such as the RECOVERY and REMAP-CAP trials have received much of the publicity in the wake of hair loss treatment we must remember that as emergency clinicians it is diagnosis, prognosis, risk assessment and disposition decisions that propecia vs finasteride 5mg are at the core of our specialty. The PRIEST study is a great example of how this can be done in a propecia.Keeping with a hair loss treatment theme Richards et al examined the evidence for prone positioning for non-intubated hypoxic hair loss treatment patients.

Despite the millions of cases worldwide and the enthusiasm for this technique the evidence base from 31 trials is actually very poor. There are theoretical physiological advantages of course, and anecdotally short-term improvement can be seen propecia vs finasteride 5mg. However, it is still not clear whether this translates into important patient related outcomes. It’s clear from this study that we need more data to support clinical practice and from well-designed clinical trials.Leading a cardiac arrest is a complex task that even experienced propecia vs finasteride 5mg clinicians can find cognitively overwhelming.

There is the ‘in the moment’ task of sticking to an algorithm while at the same time trying to figure out a more strategic plan for the patient. Few individuals can propecia vs finasteride 5mg do both effectively which is why my colleagues have been teaching the concept of splitting roles to cognitively offload the strategic leader to strategically direct the arrest. I was therefore delighted to see this concept tested in the CANLEAD trial using a simulated model of cardiac arrest and nursing team leaders to run the ALS algorithm. In 20 simulations involving propecia vs finasteride 5mg 120 participants they found improved overall team performance.

Whether this would translate to better outcomes for patients in real world settings remains to be seen, but it has face validity and this study supports further work. It’s also a welcome reminder that nurses are perfectly capable of running cardiac arrests, and some of the best resuscitationists I know work with nurses in exactly this manner.Cardiac arrest is a condition (among others) where debriefing is important and so it’s good to see a study of the use of a structured debrief tool from Sugarman et al who report a quality improvement project looking at implementing the ‘TAKE STOCK’ tool, adapted from the Stop5 tool. QIP reports are relatively new to propecia vs finasteride 5mg the journal, and we hope to highlight effective and interesting projects that can make a real difference to clinical care. The QIP shows a broad welcoming of a structured approach to debriefing from all staff members, and articulates a path for their introduction.

If you are not already using a debriefing tool then propecia vs finasteride 5mg this QIP may well help your department embed this important task.As I write this there is a lot of media attention in the UK regarding the number of paediatric attendances to UK emergency departments with colleagues such as Damian Roland from Leicester working hard to educate the public on what fever really means in the paediatric population. While most fevers are benign we all know that it can also be a marker of and so we have two paediatric studies looking at this in August. Chong et propecia vs finasteride 5mg al looked at children under 3 months which are a notoriously difficult group to differentiate serious from benign disease. In their cohort the incidence of severe disease was high (33%), but there are clues in the heart rate variability, temperature, and gender may help.

In a less risky group Mallet et al have looked at the prescription of antibiotics in paediatric sore throat finding a fair amount of variability between clinician choice and more formalised scoring mechanisms. It’s a good story to remind us that research findings (in this case scoring systems) rarely perform or penetrate clinical practice in the way that we would hope or anticipate.Sticking with paediatrics I was interested to read a paper that made me stop and think about my own propecia vs finasteride 5mg practice for Toddler’s fractures. My approach has been symptom led varying from the rare use of plaster of Paris through splints, and often very little indeed if the patient is not distressed or in pain. This month we have a randomised controlled trial from Australia comparing above knee propecia vs finasteride 5mg POP to a controlled ankle motion boot.

They found that a controlled motion boot is easier to live with and allows a faster return to activities of daily living and without any healing problems. However, I’m still left wondering if either of these levels of intervention are necessary for all patients.There’s lots more in this month’s edition but I’ll end with a reminder that our propecia vs finasteride 5mg perceptions of emergency care may differ from those of our patients. Bull et al.’s systematic review of patient experience in the emergency department is enlightening with two major themes, one of the interactions between patients and staff and the other with the environment of the emergency department. There is much to reflect on here and perhaps time to look at our departments from the patient perspective.Ethics statementsPatient consent for publicationNot required..

Welcome back to the latest edition of the EMJ how to get propecia cheap http://begopa.de/google-maps/anfahrt-begopa-bochum/. It’s high Summer here in the Northern Hemisphere and our hopes that hair loss treatment would be a distant memory by now are sadly broken. We are in wave n+1 at the moment (where n depends on where you are in the world), but there is hope in sight as treatment roll outs how to get propecia cheap continue around the world.This month our Editor’s choice is the PRIEST study.

This huge observational trial of hair loss treatment 19 patients presenting to UK emergency departments gave us essential information on risk assessment in the hair loss treatment propecia. It’s a fantastic example of how a trial can be rapidly delivered in a propecia and a lesson in how we need to plan how to get propecia cheap for the propecia after hair loss treatment. The study is particularly useful in that it focuses on information available to the emergency clinician in the form of well-known scores such as NEWS2 as opposed to data that may be available much later (such as some laboratory testing).

While therapeutic trials of repurposed drugs such how to get propecia cheap as the RECOVERY and REMAP-CAP trials have received much of the publicity in the wake of hair loss treatment we must remember that as emergency clinicians it is diagnosis, prognosis, risk assessment and disposition decisions that are at the core of our specialty. The PRIEST study is a great example of how this can be done in a propecia.Keeping with a hair loss treatment theme Richards et al examined the evidence for prone positioning for non-intubated hypoxic hair loss treatment patients. Despite the millions of cases worldwide and the enthusiasm for this technique the evidence base from 31 trials is actually very poor.

There are theoretical physiological advantages of course, and anecdotally short-term improvement can be how to get propecia cheap seen. However, it is still not clear whether this translates into important patient related outcomes. It’s clear from this study that we need more data to support clinical practice and from well-designed clinical trials.Leading a cardiac arrest is a complex task that even how to get propecia cheap experienced clinicians can find cognitively overwhelming.

There is the ‘in the moment’ task of sticking to an algorithm while at the same time trying to figure out a more strategic plan for the patient. Few individuals can do both effectively which is why my colleagues have been teaching the concept of splitting roles to cognitively how to get propecia cheap offload the strategic leader to strategically direct the arrest. I was therefore delighted to see this concept tested in the CANLEAD trial using a simulated model of cardiac arrest and nursing team leaders to run the ALS algorithm.

In 20 simulations involving 120 participants they found improved how to get propecia cheap overall team performance. Whether this would translate to better outcomes for patients in real world settings remains to be seen, http://www.snackoverflow.uk/2015/11/toffee-apple-cake/ but it has face validity and this study supports further work. It’s also a welcome reminder that nurses are perfectly capable of running cardiac arrests, and some of the best resuscitationists I know work with nurses in exactly this manner.Cardiac arrest is a condition (among others) where debriefing is important and so it’s good to see a study of the use of a structured debrief tool from Sugarman et al who report a quality improvement project looking at implementing the ‘TAKE STOCK’ tool, adapted from the Stop5 tool.

QIP reports are how to get propecia cheap relatively new to the journal, and we hope to highlight effective and interesting projects that can make a real difference to clinical care. The QIP shows a broad welcoming of a structured approach to debriefing from all staff members, and articulates a path for their introduction. If you how to get propecia cheap are not already using a debriefing tool then this QIP may well help your department embed this important task.As I write this there is a lot of media attention in the UK regarding the number of paediatric attendances to UK emergency departments with colleagues such as Damian Roland from Leicester working hard to educate the public on what fever really means in the paediatric population.

While most fevers are benign we all know that it can also be a marker of and so we have two paediatric studies looking at this in August. Chong et how to get propecia cheap al looked at children under 3 months which are a notoriously difficult group to differentiate serious from benign disease. In their cohort the incidence of severe disease was high (33%), but there are clues in the heart rate variability, temperature, and gender may help.

In a less risky group Mallet et al have looked at the prescription of antibiotics in paediatric sore throat finding a fair amount of variability between clinician choice and more formalised scoring mechanisms. It’s a good story to remind us that research how to get propecia cheap findings (in this case scoring systems) rarely perform or penetrate clinical practice in the way that we would hope or anticipate.Sticking with paediatrics I was interested to read a paper that made me stop and think about my own practice for Toddler’s fractures. My approach has been symptom led varying from the rare use of plaster of Paris through splints, and often very little indeed if the patient is not distressed or in pain.

This month how to get propecia cheap we have a randomised controlled trial from Australia comparing above knee POP to a controlled ankle motion boot. They found that a controlled motion boot is easier to live with and allows a faster return to activities of daily living and without any healing problems. However, I’m still left wondering if either of these levels how to get propecia cheap of intervention are necessary for all patients.There’s lots more in this month’s edition but I’ll end with a reminder that our perceptions of emergency care may differ from those of our patients.

Bull et al.’s systematic review of patient experience in the emergency department is enlightening with two major themes, one of the interactions between patients and staff and the other with the environment of the emergency department. There is much to reflect on here and perhaps time to look at our departments from the patient perspective.Ethics statementsPatient consent for publicationNot required..

Propecia reviews 2020

One year after the first patient propecia reviews 2020 with hair loss treatment was diagnosed in the U.S., the world is still searching for safe and effective drugs to http://www.posrcumlad.si/buy-levitra-20mg-online/ treat the hair loss. UC Davis School of Medicine researchers have partnered with many drug developers to propecia reviews 2020 test potential therapies and treatments. Currently, they are recruiting for more than 12 clinical trials to find potent hair loss treatments. Participants in clinical trials save lives and push science forward“Fighting the hair loss treatment propecia demands the collaboration of drug developers, academic medical and research centers as well as supportive propecia reviews 2020 funding agencies,” said Allison Brashear, the dean of the UC Davis School of Medicine.

€œUC Davis School of Medicine, renowned for its research expertise, is a trusted partner on many hair loss treatment clinical trials at the forefront of efforts to cure this terrible disease.”Treating hair loss treatment with stem cellsChristian Sandrock, director of critical care and professor of internal medicine, is leading a phase 2 study to evaluate injections of stromal cells (called PLX-PAD) in the muscle for the treatment of severe hair loss treatment patients. The trial, sponsored by Pluristem Therapeutics, will test if PLX-PAD can help patients intubated and on ventilators due to hair loss treatment to recover faster with propecia reviews 2020 fewer complications. PLX-PAD cells, extracted from the human placenta, have regenerative potential that might help reduce tissue damage caused by hyperimmune reaction to hair loss.Stuart Cohen, chief of infectious diseases, is testing how well a treatment with natural killer cells (CYNK-001) works in people with hair loss treatment. The study is propecia reviews 2020 sponsored by Celularity Incorporated.

Natural killer cells from the human placenta are immune cells known to kill some types of cancers without hurting normal healthy tissues.A study led by the chair of internal medicine, Timothy Albertson, evaluates the intravenous (IV) infusion of CAP-1002 as a treatment for patients with hair loss treatment. CAP-1002, produced propecia reviews 2020 by Capricor Therapeutics, consists of stem cells extracted from the cardiac tissue.Albertson is also co-managing a stem-cell trial with Rachael Callcut,associate professor of surgery and vice chair of clinical sciences. The trial, sponsored by the Department of Defense, aims to see how effective mesenchymal stromal cells are in reducing inflammation associated with acute respiratory distress syndrome (ARDS) and in helping damaged lungs to repair themselves. ARDS is one of the severe complications of hair loss treatment .Treating hair loss treatment with monoclonal antibodiesAntibodies are proteins made by the body’s immune cells propecia reviews 2020 to fight s.

Monoclonal antibodies are laboratory-produced molecules that act as substitute antibodies. Their role is to restore, enhance or mimic the immune system's attack on cells.Albertson is testing Regeneron’s combined monoclonal propecia reviews 2020 antibodies as a treatment of hospitalized and non-hospitalized patients with hair loss treatment. The experimental drug targets the propecia that causes hair loss treatment, making it harder for the propecia to infect people. These monoclonal propecia reviews 2020 antibodies are also being tested for household members of patients with hair loss treatment.UC Davis Health is testing VIR-7831, a monoclonal antibody by Vir Biotechnology and GlaxoSmithKline.

George Thompson, associate professor of medicine, is studying the safety and effectiveness of VIR-7831 as an early treatment of hair loss treatment in non-hospitalized patients.Other antiviral clinical trialsAlbertson is leading a phase 1b trial to evaluate the safety and efficacy of a Pfizer antiviral protease inhibitor (C4611001). This study is available to hospitalized patients and administered via a 5-day propecia reviews 2020 continuous IV infusion.Thompson is also leading a trial of Remdesivir, an antiviral drug given intravenously, as a treatment of hair loss treatment in an outpatient setting. Remdesivir was initially developed by Gilead Sciences to combat Ebola.Another phase 2/3 clinical study led by Thompson evaluates the efficacy and safety of molnupiravir (MK-4482) in hospitalized and non-hospitalized adults with hair loss treatment. Molnupiravir, by Ridgeback Biotherapeutics and Merck propecia reviews 2020 &.

Co, is taken orally, making it easier to use and distribute.Thompson is also testing the orally administered AT-527 for moderate hair loss treatment in hospitalized patients. AT-527, an experimental antiviral drug by propecia reviews 2020 Atea Pharmaceuticals in collaboration with Roche, is designed to prevent viral replication.The adaptive I-SPY and ACTIV-3 hair loss treatment trialsOn Jan. 22, UC Davis Health was approved for patient recruitment to the I-SPY hair loss treatment trial (An Adaptive Platform Trial for Critically Ill Patients). The trial, part of the Quantum Leap Healthcare Collaborative, is co-led by Albertson and propecia reviews 2020 Angela Haczku, professor of pulmonology and associate dean for translational research.

It is an adaptive platform trial that aims to rapidly screen promising drugs for the treatment of critically ill hair loss treatment patients.Similar to the I-SPY trial, the ACTIV-3 study is an adaptive study testing a host of monoclonal antibodies that target various propecia functions. The study, also led by Albertson and propecia reviews 2020 funded by the National Institutes of Health, is enrolling hospitalized patients who are not mechanically ventilated.“We take this opportunity to thank all the participants who volunteer in our clinical trials,” Albertson said. €œTheir contribution helps to save lives and push science forward.”.

One year after the first patient with hair loss treatment was diagnosed in how to get propecia cheap the U.S., the world is still searching for safe and effective drugs to treat the hair loss. UC Davis School of Medicine researchers have partnered with many drug how to get propecia cheap developers to test potential therapies and treatments. Currently, they are recruiting for more than 12 clinical trials to find potent hair loss treatments.

Participants in clinical trials save lives and push science forward“Fighting the hair loss treatment propecia demands the collaboration of drug developers, how to get propecia cheap academic medical and research centers as well as supportive funding agencies,” said Allison Brashear, the dean of the UC Davis School of Medicine. €œUC Davis School of Medicine, renowned for its research expertise, is a trusted partner on many hair loss treatment clinical trials at the forefront of efforts to cure this terrible disease.”Treating hair loss treatment with stem cellsChristian Sandrock, director of critical care and professor of internal medicine, is leading a phase 2 study to evaluate injections of stromal cells (called PLX-PAD) in the muscle for the treatment of severe hair loss treatment patients. The trial, sponsored by Pluristem Therapeutics, will test if PLX-PAD can help patients intubated and on ventilators due to hair loss treatment how to get propecia cheap to recover faster with fewer complications.

PLX-PAD cells, extracted from the human placenta, have regenerative potential that might help reduce tissue damage caused by hyperimmune reaction to hair loss.Stuart Cohen, chief of infectious diseases, is testing how well a treatment with natural killer cells (CYNK-001) works in people with hair loss treatment. The study is how to get propecia cheap sponsored by Celularity Incorporated. Natural killer cells from the human placenta are immune cells known to kill some types of cancers without hurting normal healthy tissues.A study led by the chair of internal medicine, Timothy Albertson, evaluates the intravenous (IV) infusion of CAP-1002 as a treatment for patients with hair loss treatment.

CAP-1002, produced by Capricor Therapeutics, consists of stem cells extracted from the cardiac tissue.Albertson is also co-managing a stem-cell how to get propecia cheap trial with Rachael Callcut,associate professor of surgery and vice chair of clinical sciences. The trial, sponsored by the Department of Defense, aims to see how effective mesenchymal stromal cells are in reducing inflammation associated with acute respiratory distress syndrome (ARDS) and in helping damaged lungs to repair themselves. ARDS is one of the how to get propecia cheap severe complications of hair loss treatment .Treating hair loss treatment with monoclonal antibodiesAntibodies are proteins made by the body’s immune cells to fight s.

Monoclonal antibodies are laboratory-produced molecules that act as substitute antibodies. Their role is to restore, enhance or mimic the immune system's attack on cells.Albertson is testing Regeneron’s combined monoclonal antibodies as a treatment of hospitalized and non-hospitalized how to get propecia cheap patients with hair loss treatment. The experimental drug targets the propecia that causes hair loss treatment, making it harder for the propecia to infect people.

These monoclonal antibodies are also being tested for household members of patients with hair loss treatment.UC how to get propecia cheap Davis Health is testing VIR-7831, a monoclonal antibody by Vir Biotechnology and GlaxoSmithKline. George Thompson, associate professor of medicine, is studying the safety and effectiveness of VIR-7831 as an early treatment of hair loss treatment in non-hospitalized patients.Other antiviral clinical trialsAlbertson is leading a phase 1b trial to evaluate the safety and efficacy of a Pfizer antiviral protease inhibitor (C4611001). This study how to get propecia cheap is available to hospitalized patients and administered via a 5-day continuous IV infusion.Thompson is also leading a trial of Remdesivir, an antiviral drug given intravenously, as a treatment of hair loss treatment in an outpatient setting.

Remdesivir was initially developed by Gilead Sciences to combat Ebola.Another phase 2/3 clinical study led by Thompson evaluates the efficacy and safety of molnupiravir (MK-4482) in hospitalized and non-hospitalized adults with hair loss treatment. Molnupiravir, by how to get propecia cheap Ridgeback Biotherapeutics and Merck &. Co, is taken orally, making it easier to use and distribute.Thompson is also testing the orally administered AT-527 for moderate hair loss treatment in hospitalized patients.

AT-527, an how to get propecia cheap experimental antiviral drug by Atea Pharmaceuticals in collaboration with Roche, is designed to prevent viral replication.The adaptive I-SPY and ACTIV-3 hair loss treatment trialsOn Jan. 22, UC Davis Health was approved for patient recruitment to the I-SPY hair loss treatment trial (An Adaptive Platform Trial for Critically Ill Patients). The trial, part of the how to get propecia cheap Quantum Leap Healthcare Collaborative, is co-led by Albertson and Angela Haczku, professor of pulmonology and associate dean for translational research.

It is an adaptive platform trial that aims to rapidly screen promising drugs for the treatment of critically ill hair loss treatment patients.Similar to the I-SPY trial, the ACTIV-3 study is an adaptive study testing a host of monoclonal antibodies that target various propecia functions. The study, also led by Albertson and funded by the National Institutes of Health, is enrolling hospitalized patients who are not mechanically ventilated.“We take this opportunity to how to get propecia cheap thank all the participants who volunteer in our clinical trials,” Albertson said. €œTheir contribution helps to save lives and push science forward.”.

Propecia helped my acne

We are http://www.physio-hanko.at/therapieangebot/sportphysiotherapie/ social epidemiologists propecia helped my acne and community advocates focused on addressing social determinants of health inequities. While we appreciate O’Neill et al’s effort to link multiple provincial-level administrative data sets to examine homicide victimisation by immigration status in Ontario, Canada, we have concerns about the framing and interpretation of findings and their potential impact on immigrants and refugees.1FRAMING AND APPROACHWhile O’Neill et al’s data and sample size are strengths, the attention to the context of being an immigrant to Canada, theoretical framework and motivation for examining immigrants in relation to homicide victimisation are not fully developed. O’Neill et al do not propecia helped my acne acknowledge having done any community engagement which is critical and ethical2 given the long history of exclusion, exploitation, racism and discrimination, and the current global climate of increasing criminalisation of migrants.

Meaningful community engagement offers important context. Helps shape the research purpose, questions, approach, interpretation propecia helped my acne and recommendations. And can reduce the potential for harm.Though criminalisation of migration under security pretexts is an infringement of international law,3 and contradicts evidence that immigration is related to a reduction in crime,4 many high-income countries, including Canada, are framing harmful immigration policy (eg, restricting entry, detaining immigrants) as an urgent need to protect against threats of safety and security,4 5 disproportionately targeting racialised and Muslim immigrants and refugees.

Within this policy context, along with political rhetoric to generate support for it, hate crimes are at record highs in Canada, with approximately 85% of these crimes motivated by racism and ethnic or religious discrimination.6Not only does this paper fail to consider propecia helped my acne this context, the statements that immigrant communities are ‘predisposed to violence’ without evidence to support this claim. The conflation of perpetrating and dying by homicide, by alternating between the use of ‘homicide’ and ‘homicide victimisation’. And the suggestion that ‘cultural views on gender’ increase risk of violence and homicide victimisation against immigrant women, are particularly harmful.RESULTS AND INTERPRETATIONThe authors’ emphasis on the increased risk of homicide victimisation of female and male refugees compared to long-term residents is misleading given that these propecia helped my acne results are not statistically significant.

The authors argue that the findings are important regardless of significance, because of large effect sizes. But for many researchers, effect sizes of 1.31 and 1.23, respectively, would be considered small to medium and would lead to a much more cautious interpretation.The authors’ interpretation that non-refugee immigrants have a lower risk of homicide victimisation because Canada’s immigration policies select for highly educated and healthy immigrants reflects problems with the theory informing this research, since homicide victimisation is propecia helped my acne not within the control of an individual. Social epidemiology was buy brand propecia online founded on the need to theorise political, economic and cultural context over and above individual characteristics.7 A concerning omission is that there is no mention of the potential for hate crimes6 to be at least partially responsible for homicide victimisation among refugees and immigrants.

Additionally, in the text, it is left unclear how a refugee’s history of ‘violence, trauma and torture’ and ‘depression and psychosocial illness’ are linked to homicide victimisation propecia helped my acne. Such unsupported statements omit essential consideration that Canadian neighbourhoods are heterogeneous combinations of refugees, non-refugees and long-term residents and that violence occurs within a social context which includes racism, xenophobia and Islamophobia.8With the study’s low counts of homicide victimisations among refugees (31 among females and 89 among males over 20 years), 90% of all homicide victimisations in the same time period occurring among long-term residents (table 1 of paper), and no clear data pointing to specific factors to intervene upon, we argue that this potential in excess homicide victimisation does not warrant targeted homicide prevention strategies, as the authors suggest. Broader prevention strategies targeting the entire population (eg, a national ban on handguns and assault weapons,9 10 implementing Canada’s Anti-Racism Strategy8) may be more beneficial in reducing homicide victimisation.POTENTIAL IMPACTWe are concerned that the paper’s framing, approach and interpretation could negatively impact immigrant and refugee communities targeted by significant racism, anti-immigrant sentiment and Islamophobia at policy, practice, community and individual levels.6 11 Community engagement from propecia helped my acne the start, and comprehensive multi-level, multistage social determinants of immigrant health framework,11 could have prevented misinterpretations of the findings and this potential for harm.

It could have also shifted the approach from a deficit- to an asset-based one that recognises the leadership and impacts of women who founded groups such as Mothers for Peace12 and Mending a Crack in the Sky.13 These groups combat the stigmatisation of mothers and families that have lost children to violence. Support mothers and families experiencing ongoing trauma due to violence propecia helped my acne. And advocate for policy and programme change to reduce poverty, violence and homicide for all people in Canada, a more inclusive public health approach.We thank Wanigaratne and Mawani et al for taking the time to write this Commentary,1 which we have read with great interest.

We agree that the framing and propecia helped my acne interpretation of findings about immigrant and refugee communities is of great importance and appreciate the opportunity to provide clarification. We would first like to acknowledge the valuable expertise of the authors as well as their strong relationships and vital advocacy work within communities.The primary aim of our study was to provide descriptive epidemiology of homicide in Ontario.2 Very few population-level descriptive studies have been published characterising homicides, particularly regarding trends in homicide victimisation between and across population subgroups. Our study team includes epidemiologists, professional and academics who work at the intersection of public health and violence, experience with implementing violence prevention programmes in marginalised populations around the world and expertise in working with large linked health administrative data.The linked health and administrative databases we used help fill the data gap with respect to understanding the victims of violence, including but not limited to propecia helped my acne refugee status.3 This aim is consistent with other descriptive database studies published about health and health system outcomes among immigrant and refugee populations in Ontario.4–11 The motivation for this study was to provide descriptive data that can be used by communities and researchers to better understand the distribution of health outcomes across populations.

Our study found differences in risk of homicide across several social and economic indicators, including lower socioeconomic ….

We are social epidemiologists and community advocates how to get propecia cheap focused on addressing social determinants of health inequities. While we appreciate O’Neill et al’s effort to link multiple provincial-level administrative data sets to examine homicide victimisation by immigration status in Ontario, Canada, we have concerns about the framing and interpretation of findings and their potential impact on immigrants and refugees.1FRAMING AND APPROACHWhile O’Neill et al’s data and sample size are strengths, the attention to the context of being an immigrant to Canada, theoretical framework and motivation for examining immigrants in relation to homicide victimisation are not fully developed. O’Neill et al do not acknowledge having how to get propecia cheap done any community engagement which is critical and ethical2 given the long history of exclusion, exploitation, racism and discrimination, and the current global climate of increasing criminalisation of migrants.

Meaningful community engagement offers important context. Helps shape the research purpose, questions, approach, how to get propecia cheap interpretation and recommendations. And can reduce the potential for harm.Though criminalisation of migration under security pretexts is an infringement of international law,3 and contradicts evidence that immigration is related to a reduction in crime,4 many high-income countries, including Canada, are framing harmful immigration policy (eg, restricting entry, detaining immigrants) as an urgent need to protect against threats of safety and security,4 5 disproportionately targeting racialised and Muslim immigrants and refugees.

Within this policy context, along with political rhetoric to generate support for it, hate crimes are at record highs how to get propecia cheap in Canada, with approximately 85% of these crimes motivated by racism and ethnic or religious discrimination.6Not only does this paper fail to consider this context, the statements that immigrant communities are ‘predisposed to violence’ without evidence to support this claim. The conflation of perpetrating and dying by homicide, by alternating between the use of ‘homicide’ and ‘homicide victimisation’. And the suggestion that ‘cultural views on gender’ increase risk of violence and homicide victimisation against immigrant women, are particularly harmful.RESULTS AND INTERPRETATIONThe authors’ emphasis on the increased risk of homicide victimisation of female and male refugees compared how to get propecia cheap to long-term residents is misleading given that these results are not statistically significant.

The authors argue that the findings are important regardless of significance, because of large effect sizes. But for many researchers, effect sizes of 1.31 and 1.23, respectively, would be considered small to medium and would lead to a much more cautious interpretation.The authors’ interpretation that non-refugee immigrants have a lower risk of homicide victimisation because Canada’s immigration policies select for highly educated and healthy immigrants reflects problems with the theory informing this research, since homicide victimisation is not how to get propecia cheap within the control of an individual. Social epidemiology was founded on the need to theorise political, economic and cultural context over and above individual characteristics.7 A concerning omission is that there is no mention of the potential for hate crimes6 to be at least partially responsible for homicide victimisation among refugees and immigrants.

Additionally, in the text, it is left unclear how a refugee’s history of ‘violence, trauma and how to get propecia cheap torture’ and ‘depression and psychosocial illness’ are linked to homicide victimisation. Such unsupported statements omit essential consideration that Canadian neighbourhoods are heterogeneous combinations of refugees, non-refugees and long-term residents and that violence occurs within a social context which includes racism, xenophobia and Islamophobia.8With the study’s low counts of homicide victimisations among refugees (31 among females and 89 among males over 20 years), 90% of all homicide victimisations in the same time period occurring among long-term residents (table 1 of paper), and no clear data pointing to specific factors to intervene upon, we argue that this potential in excess homicide victimisation does not warrant targeted homicide prevention strategies, as the authors suggest. Broader prevention strategies targeting the entire population (eg, a national ban on handguns and assault weapons,9 10 implementing Canada’s Anti-Racism Strategy8) may be more beneficial in reducing homicide victimisation.POTENTIAL IMPACTWe are concerned that the paper’s framing, approach and interpretation could negatively impact immigrant and refugee communities targeted by significant racism, anti-immigrant sentiment and Islamophobia at policy, practice, community and individual levels.6 11 Community engagement from the start, and comprehensive multi-level, multistage social how to get propecia cheap determinants of immigrant health framework,11 could have prevented misinterpretations of the findings and this potential for harm.

It could have also shifted the approach from a deficit- to an asset-based one that recognises the leadership and impacts of women who founded groups such as Mothers for Peace12 and Mending a Crack in the Sky.13 These groups combat the stigmatisation of mothers and families that have lost children to violence. Support mothers and families experiencing ongoing trauma due to violence how to get propecia cheap. And advocate for policy and programme change to reduce poverty, violence and homicide for all people in Canada, a more inclusive public health approach.We thank Wanigaratne and Mawani et al for taking the time to write this Commentary,1 which we have read with great interest.

We agree that the framing and interpretation of how to get propecia cheap findings about immigrant and refugee communities is of great importance and appreciate the opportunity to provide clarification. We would first like to acknowledge the valuable expertise of the authors as well as their strong relationships and vital advocacy work within communities.The primary aim of our study was to provide descriptive epidemiology of homicide in Ontario.2 Very few population-level descriptive studies have been published characterising homicides, particularly regarding trends in homicide victimisation between and across population subgroups. Our study team includes epidemiologists, professional and academics who work at the intersection of public health how to get propecia cheap and violence, experience with implementing violence prevention programmes in marginalised populations around the world and expertise in working with large linked health administrative data.The linked health and administrative databases we used help fill the data gap with respect to understanding the victims of violence, including but not limited to refugee status.3 This aim is consistent with other descriptive database studies published about health and health system outcomes among immigrant and refugee populations in Ontario.4–11 The motivation for this study was to provide descriptive data that can be used by communities and researchers to better understand the distribution of health outcomes across populations.

Our study found differences in risk of homicide across several social and economic indicators, including lower socioeconomic ….