Comparative analysis of Physician Assistant/Associate National Certifying Examination (PANCE) performance trends: pre and during COVID-19 era.

BACKGROUND: COVID-19 significantly impacted physician assistant/associate (PA) education programs. Most programs transitioned didactic and clinical education from in-person to remote, and clinical training opportunities diminished. Graduates of accredited PA programs take the Physician Assistant National Certifying Examination (PANCE), a five-hour exam with 300 multiple-choice questions, and must attain or exceed the scaled passing score of 350 (range: 200-800). We examined first-time examinees' trends in PANCE scores and passing rates three years prior to the pandemic and three years during. METHODS: We analyzed data (N = 59,459) from the National Commission on Certification of Physician Assistants. The two primary outcomes were PANCE scores and pass rates. The main exposure was the timeframe: three years pre-pandemic (2017-2019) and three years during the pandemic (2020-2022). The 2017-2018 scores were equated to the new passing standard implemented in 2019. Covariates included age, gender, years the PA program has been accredited, program region, and rural-urban setting. Analyses consisted of descriptive, bivariate, and multivariate statistics. RESULTS: The mean PANCE score and pass rate during the six-year study period were 463 and 93%, respectively. In unadjusted analyses comparing each year individually, mean PANCE score was highest in 2020 and lowest in 2022 than in all other years except for 2017. When comparing each pandemic year to the pooled three pre-pandemic years and adjusting for test-taker and PA program covariates, examinees scored significantly higher in 2020; there was no difference in 2021, and they scored lower in 2022. When controlling for covariates, examinees had 1.24 higher odds of failing in 2022 compared to the pooled pre-pandemic period. CONCLUSION: Findings suggest that PANCE scores and pass rates were impacted during the third year of the pandemic. PANCE assesses if examinees have the essential clinical knowledge to enter the PA profession. It is crucial to determine whether the pandemic affected PANCE scores and pass rates to ensure PAs provide safe and high-quality patient care.

Hematopoietic stem cell niche generation and maintenance are distinguishable by an epitranscriptomic program.

The niche is typically considered as a pre-established structure sustaining stem cells. Therefore, the regulation of its formation remains largely unexplored. Whether distinct molecular mechanisms control the establishment versus maintenance of a stem cell niche is unknown. To address this, we compared perinatal and adult bone marrow mesenchymal stromal cells (MSCs), a key component of the hematopoietic stem cell (HSC) niche. MSCs exhibited enrichment in genes mediating m6A mRNA methylation at the perinatal stage and downregulated the expression of Mettl3, the m6A methyltransferase, shortly after birth. Deletion of Mettl3 from developing MSCs but not osteoblasts led to excessive osteogenic differentiation and a severe HSC niche formation defect, which was significantly rescued by deletion of Klf2, an m6A target. In contrast, deletion of Mettl3 from MSCs postnatally did not affect HSC niche. Stem cell niche generation and maintenance thus depend on divergent molecular mechanisms, which may be exploited for regenerative medicine.

A new experimental evidence-weighted signaling pathway resource in FlyBase.

Research in model organisms is central to the characterization of signaling pathways in multicellular organisms. Here, we present the comprehensive and systematic curation of 17 Drosophila signaling pathways using the Gene Ontology framework to establish a dynamic resource that has been incorporated into FlyBase, providing visualization and data integration tools to aid research projects. By restricting to experimental evidence reported in the research literature and quantifying the amount of such evidence for each gene in a pathway, we captured the landscape of empirical knowledge of signaling pathways in Drosophila.

Public experience with and perspectives on medical care provided by PAs.

OBJECTIVE: We sought to assess public experiences with and perspectives about physician associates/assistants (PAs), who are taking on increasingly important roles in healthcare. METHODS: We conducted a survey using a Qualtrics panel assessing whether participants (N = 1,388) received care from PAs, their perceptions of the care received, and their intentions of seeking care from PAs in the future. RESULTS: About 67% of participants reported receiving care from PAs; 61.7% believed PAs have more time to communicate with patients. Most respondents were satisfied with the care received, said they were likely to see a PA again, and recommended PAs. Of those not treated by PAs, 30.6% were willing to receive care from PAs, 43.8% were willing to receive care from PAs for minor medical needs, 21.3% were unsure, and 4.3% were unwilling. Older participants and those with more education had consistently more favorable views. CONCLUSIONS: Public experiences with and perceptions of PAs are positive. Future research should employ longitudinal designs to assess trends as the PA workforce continues to grow.

A new experimental evidence-weighted signaling pathway resource in FlyBase.

Research in model organisms is central to the characterization of signaling pathways in multicellular organisms. Here, we present the systematic curation of 17 Drosophila signaling pathways using the Gene Ontology framework to establish a comprehensive and dynamic resource that has been incorporated into FlyBase, providing visualization and data integration tools to aid research projects. By restricting to experimental evidence reported in the research literature and quantifying the amount of such evidence for each gene in a pathway, we captured the landscape of empirical knowledge of signaling pathways in Drosophila . Summary statement: Comprehensive curation of Drosophila signaling pathways and new visual displays of the pathways provides a new FlyBase resource for researchers, and new insights into signaling pathway architecture.

The association of physician assistant/associate demographic and practice characteristics with perceptions of value of certification.

BACKGROUND: To determine physician assistant/associate (PA) perceptions of the value of certification and explore how they vary across demographic and practice characteristics. METHODS: We conducted a cross-sectional online survey between March and April 2020 with PAs participating in the longitudinal pilot program for recertification administered by the National Commission on Certification of Physician Assistants (NCCPA). The survey was distributed to 18,147 PAs, of which 10,965 participated (60.4% response rate). In addition to descriptive statistics, chi-square tests were conducted on demographics and specialty to examine if perceptions of value of certification (1 global and 10 items measuring specific domains) were associated with a particular PA profile. A series of fully adjusted multivariate logistic regressions were performed, exploring the relationship between PA characteristics and the value of certification items. RESULTS: Most PAs strongly agreed/agreed that certification helps with fulfilling licensure requirements (9,578/10,893; 87.9%), helps with updating medical knowledge (9,372/10,897; 86.0%), and provides objective evidence of continued competence (8,875/10,902; 81.4%). The items receiving the lowest percentage of responses for strongly agreeing/agreeing were for certification providing no value (1,925/10,887; 17.7%), helping with professional liability insurance (5,076/10,889; 46.6%), and competing with other providers for clinical positions (5,661/10,905; 51.9%). Age 55 and older and practicing in dermatology and psychiatry were among the strongest predictors of less favorable views. PAs from underrepresented in medicine (URiM) backgrounds had more positive perceptions. CONCLUSIONS: Overall, the findings indicate that PAs value certification; however, perceptions varied by demographics and specialties. PAs who were younger, from URiM backgrounds, and practicing in primary care specialties had among the most favorable perspectives. Continued feedback monitoring is critical in ensuring certification is relevant and meaningful in supporting PAs across demographics and specialties. Measuring PA perceptions of the value of certification is essential to understanding how to support the PA profession's current and future credentialing needs and those who license and hire PAs.

FlyBase: a guided tour of highlighted features.

FlyBase provides a centralized resource for the genetic and genomic data of Drosophila melanogaster. As FlyBase enters our fourth decade of service to the research community, we reflect on our unique aspects and look forward to our continued collaboration with the larger research and model organism communities. In this study, we emphasize the dedicated reports and tools we have constructed to meet the specialized needs of fly researchers but also to facilitate use by other research communities. We also highlight ways that we support the fly community, including an external resources page, help resources, and multiple avenues by which researchers can interact with FlyBase.

First do no harm: Principles of care for clients with sexual identity confusion and/or conflict.

Individuals who experience sexual identity confusion and/or conflict face unique stressors and life circumstances for which they may seek psychotherapy; however, little specific guidance exists for therapists working with clients who experience sexual identity confusion and/or conflict. To meet this need, we present a framework for therapists whose clients experience distress related to sexual identity confusion and/or conflict. We first define and describe sexual identity confusion and conflict, situating both in developmental theories of sexual identity. We then review clinical approaches that have been used historically to inform treatment with clients experiencing sexual identity confusion and/or conflict. Next, we discuss guiding ethical and clinical principles to inform such a clinical approach. Then, we provide assessment and treatment recommendations. We conclude by discussing considerations for working with clients who are diverse in gender identity, race/ethnicity, age, sexual orientation, and religious affiliation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Self-defining memories-Narrative features in relation to adaptive and maladaptive personality traits (replication and extension of Blagov & Singer, 2004).

OBJECTIVE: Self-defining memories (SDMs) are units of life-story analysis, whose features resemble elements from narrative identity's factorial structure. To bridge narrative-identity and personality-trait domains, we conducted a replication and extension of prior research. METHOD: We linked four SDM features - affect, specificity, meaning making, and content - to the Big Three trait domains of personality and psychopathology in a small sample that was well-powered for multilevel modeling (133 participants, 1330 SDMs). RESULTS: Affect SDM affect correlated with indices of Positive Emotionality and Negative Emotionality, and narrative themes of contamination were associated with Negative Emotionality. Specificity SDM specificity vs. overgenerality related to Constraint and Negative Emotionality indices, lending support to the executive dysfunction and emotional disorder theories of overgeneral autobiographical memory. (Tests of the avoidance thesis of overgeneral memory were inconclusive.) Meaning making Explicit meaning making in SDMs reflected adaptive personality. It moderated (or buffered) the link between SDMs' affect and chronic emotional distress. Content The links between SDM content and traits suggest that SDMs reflect personal goals, whose fulfillment or frustration relate to psychological health. CONCLUSIONS: This research serves replication purposes as well as the purpose of connecting two major domains of personality: narrative identity and adaptive and maladaptive traits.

Inequality in household adaptation to schooling shocks: Covid-induced online learning engagement in real time.

We use high frequency internet search data to study in real time how US households sought out online learning resources as schools closed due to the Covid-19 pandemic. By April 2020, nationwide search intensity for both school- and parent-centered online learning resources had roughly doubled relative to pre-Covid levels. Areas of the country with higher income, better internet access and fewer rural schools saw substantially larger increases in search intensity. The pandemic will likely widen achievement gaps along these dimensions given schools' and parents' differing engagement with online resources to compensate for lost school-based learning time. Accounting for such differences and promoting more equitable access to online learning could improve the effectiveness of education policy responses to the pandemic. The public availability of internet search data allows our analyses to be updated when schools reopen and to be replicated in other countries.

Learning is inhibited by heat exposure, both internationally and within the United States.

Human capital generally, and cognitive skills specifically, play a crucial role in determining economic mobility and macroeconomic growth. While elevated temperatures have been shown to impair short-run cognitive performance, much less is known about whether heat exposure affects the rate of skill formation. We combine standardized achievement data for 58 countries and 12,000 US school districts with detailed weather and academic calendar information to show that the rate of learning decreases with an increase in the number of hot school days. These results provide evidence that climatic differences may contribute to differences in educational achievement both across countries and within countries by socioeconomic status and that may have important implications for the magnitude and functional form of climate damages in coupled human-natural systems.

FlyBase: updates to the Drosophila melanogaster knowledge base.

FlyBase (flybase.org) is an essential online database for researchers using Drosophila melanogaster as a model organism, facilitating access to a diverse array of information that includes genetic, molecular, genomic and reagent resources. Here, we describe the introduction of several new features at FlyBase, including Pathway Reports, paralog information, disease models based on orthology, customizable tables within reports and overview displays ('ribbons') of expression and disease data. We also describe a variety of recent important updates, including incorporation of a developmental proteome, upgrades to the GAL4 search tab, additional Experimental Tool Reports, migration to JBrowse for genome browsing and improvements to batch queries/downloads and the Fast-Track Your Paper tool.

Reducing Internalized Homonegativity: Refinement and Replication of an Online Intervention for Gay Men.

We refined and replicated an efficacious brief intervention to reduce internalized homonegativity (IH) with a sample of gay and exclusively same-sex attracted men recruited from outside of LGBT community networks using Amazon Mechanical Turk. We sought to 1) determine if levels of IH differed between the original study's community-based sample and our non-community-based sample, 2) examine the efficacy of the replicated intervention, and 3) assess for longitudinal effects of the intervention at a 30-day follow-up. Four hundred eighty-four participants completed either the intervention or a stress management control condition. Mean levels of IH were higher in the current sample compared with the earlier study's community sample. The intervention was efficacious at reducing global IH, reducing personal homonegativity, and increasing gay affirmation. Ninety-six participants completed the follow-up; follow-up results were not significant and may have been affected by high rates of attrition. Implications for research and practice are discussed.

Fighting for Fat: Gluttonous Tumors and Starved T Cells.

In this issue of Cell, Ringel et al. reveal a link between lipid utilization in the tumor microenvironment and anti-tumor immunity in obese mice. These findings provide one explanation for how obesity worsens cancer outcomes and may point to a new metabolic approach to treating some cancers.

L or G or B or T: Matching Sexual and Gender Minorities with Subpopulation-Specific Interventions.

Sexual and gender minorities (SGM) may benefit from psychological interventions tailored to specific subpopulations (e.g., lesbians, gay men, bisexual people, transgender people) given differing experiences with stigma. However, determining the inclusion/exclusion process for subpopulation-specific interventions is challenging and recommendations for this process are scarce. We developed and evaluated a matching procedure to place 1183 SGM participants into four targeted online interventions designed to reduce internalized stigma for lesbian, gay, bisexual, and transgender people. We evaluated participant attrition, efficacy, satisfaction with placement, and qualitative feedback across the four interventions. Results indicated that our matching procedure was time-efficient and largely successful in terms of low attrition, high satisfaction, and reaching segments of the SGM population not usually captured with the LGBT acronym. Based on these findings, we offer six practical guidelines for devising the inclusion/exclusion process or matching procedure for future subpopulation-specific SGM interventions studies.

An online intervention to promote predictors of supportive parenting for sexual minority youth.

This article presents the Parent Resource for Increasing Sexual Minority Support (PRISMS), an interactive online intervention designed by the authors to promote parental self-efficacy and behavioral intentions for supporting a sexual minority child. The intervention was developed based upon psychological literature about parent support and feedback from parents of sexual minority youth and psychologists, and contains 5 interactive online modules: normalizing parent experiences, psychoeducation, reflection upon existing support, rehearsal of support, and affirmation. We assessed the feasibility and acceptability of PRISMS and collected pilot data to assess its efficacy. One hundred eighty-four U.S. parents of sexual minority youth Ages 13 to 18 were recruited from Amazon Mechanical Turk and were randomly assigned to complete either PRISMS (n = 92) or a control: an existing resource with psychoeducation about sexual orientation (n = 92). Analyses revealed that PRISMS was highly acceptable to participants and established the noninferiority of the intervention relative to the control in terms of credibility and affect at posttest. Two analyses of covariance did not establish significant associations between PRISMS and parental self-efficacy or behavioral intentions for supportive parenting, although we found small effect sizes (d = .31 and .21). Post hoc exploratory analyses offered preliminary support for the efficacy of PRISMS with parents who were highly distressed about their child's sexual orientation, suggesting that this might be an important population for future research. We discuss implications for research and practice, including the importance of interventions for parents of sexual minority youth. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

FlyBase 2.0: the next generation.

FlyBase (flybase.org) is a knowledge base that supports the community of researchers that use the fruit fly, Drosophila melanogaster, as a model organism. The FlyBase team curates and organizes a diverse array of genetic, molecular, genomic, and developmental information about Drosophila. At the beginning of 2018, 'FlyBase 2.0' was released with a significantly improved user interface and new tools. Among these important changes are a new organization of search results into interactive lists or tables (hitlists), enhanced reference lists, and new protein domain graphics. An important new data class called 'experimental tools' consolidates information on useful fly strains and other resources related to a specific gene, which significantly enhances the ability of the Drosophila researcher to design and carry out experiments. With the release of FlyBase 2.0, there has also been a restructuring of backend architecture and a continued development of application programming interfaces (APIs) for programmatic access to FlyBase data. In this review, we describe these major new features and functionalities of the FlyBase 2.0 site and how they support the use of Drosophila as a model organism for biological discovery and translational research.