Is 70% Achievable? Hospital-Level Variation in Rates of Cardiac Rehabilitation Use Among Medicare Beneficiaries.

Background: Despite national goals to enroll 70% of cardiac rehabilitation (CR)-eligible patients, enrollment remains low.

Objectives: The purpose of this study was to evaluate how the treating hospital influences CR enrollment nationally.

Methods: We included Fee-for-Service Medicare beneficiaries aged ≥66 years who were hospitalized for acute myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, or heart valve repair/replacement.

Salmonella Typhimurium screen identifies shifts in mixed-acid fermentation during gut colonization.

How enteric pathogens adapt their metabolism to a dynamic gut environment is not yet fully understood. To investigate how Salmonella enterica Typhimurium (S.Tm) colonizes the gut, we conducted an in vivo transposon mutagenesis screen in a gnotobiotic mouse model.

Surface Cross-Linking by Macromolecular Tethers Enhances Virus-like Particles' Resilience to Mucosal Stress Factors.

Virus-like particles (VLPs) are emerging as nanoscaffolds in a variety of biomedical applications including delivery of vaccine antigens and cargo such as mRNA to mucosal surfaces. These soft, colloidal, and proteinaceous structures (capsids) are nevertheless susceptible to mucosal environmental stress factors. We cross-linked multiple capsid surface amino acid residues using homobifunctional polyethylene glycol tethers to improve the persistence and survival of the capsid to model mucosal stressors.

Bacterial genome-wide association study substantiates papGII of Escherichia coli as a major risk factor for urosepsis.

Background: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, often caused by uropathogenic Escherichia coli. Multiple bacterial virulence factors or patient characteristics have been linked separately to progressive, more invasive infections. In this study, we aim to identify pathogen- and patient-specific factors that drive the progression to urosepsis by jointly analysing bacterial and host characteristics.

The Effect of Rural Underserved Opportunities Program Participation on Medical Graduates' Decision to Work in Rural Areas.

Purpose: There is a persistent rural physician shortage in the United States. Policies to scale up the health workforce in response to this shortage must include measures to draw and maintain existing and newly trained health care workers to rural regions. Prior studies have found that experience in community medicine in rural practice settings increases the likelihood of medical graduates practicing in those regions but have not accounted for selection bias.

Positive yet problematic: Lived experiences of racial and ethnic minority medical students during rural and urban underserved clinical rotations.

Purpose Of Study: Medical students who identify as Black, Indigenous, and People of Color (BIPOC) regularly experience mistreatment and discrimination. This study sought to understand these student experiences during rotations in rural and urban underserved community teaching sites.

Methods: Self-identified BIPOC medical students who completed the University of Washington School of Medicine's Rural Underserved Opportunities Program from 2019 through 2021 were invited to participate in a 60- to 90-minute focus group discussion via Zoom.

Mechanical tuning of virus-like particles.

Hypothesis: Virus-like particles (VLPs) are promising scaffolds for developing mucosal vaccines. For their optimal performance, in addition to design parameters from an immunological perspective, biophysical properties may need to be considered.

Experiments: We investigated the mechanical properties of VLPs scaffolded on the coat protein of Acinetobacter phage AP205 using atomic force microscopy and small angle X-ray scattering.

Interprofessional Primary Care Course Impact on Knowledge, Attitudes, and Careers.

Background And Objectives: Our innovative, highly rated, interprofessional Primary Care Course (PCC) engaged learners in dentistry, medicine, nursing, physician assistants, pharmacy, public health, and social work. PCC used a low-resource, flexible classroom format, earned 99% high student ratings, and increased PC career plans in 56% of students. This study assessed changes in PC knowledge and attitudes and tracked PC career outcomes over 5 years.

Factors influencing pharmacy faculty behavior, perceptions, and challenges with determining authorship credit.

Introduction: This study aimed to identify challenges in determining authorship and author order, factors and criteria that influence behavior in determining authorship and author order, and beliefs about authorship and familiarity with guidelines among pharmacy faculty.

Methods: An online survey was emailed to faculty from three groups of schools categorized by degree of external research funding. Academic discipline and rank, tenure status, years in rank, and gender were queried.

Biosynthesis of Glycoconjugate Virus-like Particles (VLPs).

The outermost surface of bacterial pathogens consists primarily of complex carbohydrate structures-polysaccharides, glycolipids, and glycoproteins. To raise a long-lasting and effective immune response against carbohydrate antigens, they generally require covalent attachment to an immunogenic carrier protein-a so-called glycoconjugate vaccine. One hurdle to the development of glycoconjugate vaccines is that carbohydrate antigens remain inaccessible to recombinant production.

Cytoplasmic glycoengineering enables biosynthesis of nanoscale glycoprotein assemblies.

Glycosylation of proteins profoundly impacts their physical and biological properties. Yet our ability to engineer novel glycoprotein structures remains limited. Established bacterial glycoengineering platforms require secretion of the acceptor protein to the periplasmic space and preassembly of the oligosaccharide substrate as a lipid-linked precursor, limiting access to protein and glycan substrates respectively.

Premedical Student Exposure to Pharmaceutical Marketing: Too Much, Too Soon?

Background And Objectives: Direct pharmaceutical marketing to physicians by pharmaceutical representatives is effective in changing behavior of health care providers, resulting in less evidence-based prescribing. Although much has been written about pharmaceutical marketing exposures among medical students, less is known about direct marketing exposures before students matriculate. This study examined the types of pharmaceutical representative direct marketing exposures for premedical students and where they occurred.

Carious lesion management in children and adolescents by Australian dentists.

Background: The management of carious lesions in children and adolescents can have lifelong implications for the patient. The aim of this study was to assess the decision-making process of dentists when managing carious lesions in children and adolescents.

Methods: Approximately, 11 000 dentists listed as members of the Australian Dental Association Inc.

Interprofessional Primary Care Course Curriculum and Evaluation.

Background And Objectives: Primary care (PC) requires interprofessional teamwork and training. Although clinical training in PC settings is well developed in some professions, classroom teaching on the principles and practice of PC provides additional opportunities for interprofessional education.

Methods: We offered an elective one-credit classroom course on PC over 3 years, 2013 through 2015, enrolling students from dentistry, medicine, nursing, pharmacy, physician assistant, public health, social work, and other fields.

A biosynthetic route for polysialylating proteins in Escherichia coli.

Polysialic acid (polySia) is a posttranslational modification found on only a handful of proteins in the central nervous and immune systems. The addition of polySia to therapeutic proteins improves pharmacokinetics and reduces immunogenicity. To date, polysialylation of therapeutic proteins has only been achieved in vitro by chemical or chemoenzymatic strategies.

Exploring and Exploiting Acceptor Preferences of the Human Polysialyltransferases as a Basis for an Inhibitor Screen.

α2,8-Linked polysialic acid (polySia) is an oncofoetal antigen with high abundance during embryonic development. It reappears in malignant tumours of neuroendocrine origin. Two polysialyltransferases (polySTs) ST8SiaII and IV are responsible for polySia biosynthesis.

Big Pharma on the Farm: Students Are Exposed to Pharmaceutical Marketing More Often in Rural Clinics.

Background And Objectives: Pharmaceutical marketing techniques are effective in changing the behavior of health care providers in ways that deviate from evidence-based practices. To mitigate the influence of pharmaceutical marketing on learners, academic medical centers (AMCs) have adopted policies to limit student/industry interaction. Many clinical experiences occur outside of the AMC.

Transcriptome analysis of bladder biopsy from interstitial cystitis/bladder pain syndrome patients.

Interstitial cystitis and bladder pain syndrome (IC/BPS) are terms used to describe a heterogeneous chronic pelvic and bladder pain disorder. Despite its significant prevalence, the disease etiology is not well understood and providing diagnosis and treatment can be challenging. In our study, published recently in the Journal of Urology (Colaco et al.

Dissection of hexosyl- and sialyltransferase domains in the bifunctional capsule polymerases from Neisseria meningitidis W and Y defines a new sialyltransferase family.

Crucial virulence determinants of disease causing Neisseria meningitidis species are their extracellular polysaccharide capsules. In the serogroups W and Y, these are heteropolymers of the repeating units (→6)-α-d-Gal-(1→4)-α-Neu5Ac-(2→)n in NmW and (→6)-α-d-Glc-(1→4)-α-Neu5Ac-(2→)n in NmY. The capsule polymerases, SiaDW and SiaDY, which synthesize these highly unusual polymers, are composed of two predicted GT-B fold domains separated by a large stretch of amino acids (aa 399-762).

Correlation of gene expression with bladder capacity in interstitial cystitis/bladder pain syndrome.

Purpose: Interstitial cystitis and bladder pain syndrome are terms used to describe a heterogeneous chronic pelvic and bladder pain disorder. Despite its significant prevalence, our understanding of disease etiology is poor. We molecularly characterized interstitial cystitis/bladder pain syndrome and determined whether there are clinical factors that correlate with gene expression.

Engineering the product profile of a polysialyltransferase.

Oligo- and polysaccharides have myriad applications as therapeutic reagents from glycoconjugate vaccines to matrices for tissue engineering. Polysaccharide length may vary over several orders of magnitude and is a critical determinant of both their physical properties and biological activities. Therefore, the tailored synthesis of oligo- and polysaccharides of defined size is a major goal for glycoengineering.

Preschool center quality and school readiness: quality effects and variation by demographic and child characteristics.

This article examines associations between observed quality in preschool center classrooms for approximately 6,250 three- to five-year-olds and their school readiness skills at kindergarten entry. Secondary analyses were conducted using data from four large-scale studies to estimate the effects of preschool center quality and interactions between quality and demographic characteristics and child entry skills and behaviors. Findings were summarized across studies using meta-analytic methods.

A single amino acid toggles Escherichia coli polysialyltransferases between mono- and bifunctionality.

The enteropathogenic Escherichia coli K92 synthesizes a unique capsule consisting of polysialic acid (polySia) with alternating α2,8- and α2,9-linkages. The fact that a single enzyme is responsible for the synthesis of these alternating regioisomeric linkages raises questions as to how this controlled bifunctionality is achieved mechanistically. Aiming to identify the sequence elements responsible for dual regiospecificity, we have utilized a high-throughput polysialyltransferase (polyST) activity screen to explore the relevant sequence space between this enzyme and its close monofunctional homolog from E.