Antibiotic resistance of urinary tract infection recurrences in a large U.S. integrated health care system.

BACKGROUND: Data on antibiotic resistance of uropathogens for UTI recurrences are lacking. METHODS: In a retrospective cohort of adults at Kaiser Permanente Southern California with culture-confirmed index uncomplicated UTI (uUTI) between 01/2016 and 12/2020, we examined the number and characteristics of subsequent culture-confirmed UTIs through 2021. RESULTS: We identified 148,994 individuals with a culture-confirmed index uUTI (88% female, 44% Hispanic, mean age 51 years [s.d. 19]), of whom 19% developed a subsequent culture-confirmed UTI after a median 300 days (IQR: 126-627). The proportion of UTI due to E. coli was highest for index uUTI (79%) and decreased to 73% for sixth UTI (UTI 6) (p-for trend <0.001), while the proportion due to Klebsiella spp increased from index UTI (7%) to UTI 6 (11%) (p-for-trend <0.001). Non-susceptibility to ≥1 and ≥3 antibiotic classes was observed in 57% and 13% of index uUTIs, respectively, and was higher for subsequent UTIs (65% and 20%, respectively, for UTI 6). Most commonly observed antibiotic non-susceptibility patterns included penicillins alone (12%), and penicillins, trimethoprim-sulfamethoxazole plus ≥1 additional antibiotic class (9%). CONCLUSIONS: Antibiotic non-susceptibility is common in UTIs and increases with subsequent UTIs. Continuous monitoring of UTI recurrences and susceptibility patterns are needed to guide treatment decisions.

Risk factors for recurrent urinary tract infections among women in a large integrated health care organization in the United States.

BACKGROUND: Urinary tract infections (UTIs) occur commonly and often recur. However, recent data on the epidemiology of recurrent UTI (rUTI) are scarce. METHODS: Between 01/01/2016-31/12/2020, index uncomplicated UTIs (uUTI) from office, emergency department (ED), hospital, and virtual care settings were identified from electronic health records of women at Kaiser Permanente Southern California. We defined rUTI as ≥3 UTI within 365 days or ≥2 UTI within 180 days. We determined the proportion of women with cystitis index uUTI who had rUTI and examined factors associated with rUTIs using modified multivariable Poisson regression. RESULTS: Among 374,171 women with cystitis index uUTI, 54,318 (14.5%) had rUTI. A higher proportion of women with rUTI compared to those without rUTI were age 18-27 or ≥78 years at index uUTI (19.7% vs 18.7% and 9.0% vs 6.0%, respectively), were immunocompromised, or had a positive urine culture at index uUTI. In multivariable analyses, characteristics associated with rUTI included younger or older age (48-57 vs 18-27 years aRR=0.83 [95% CI: 0.80-0.85]; ≥78 vs 18-27 years aRR=1.07 [95%CI=1.03-1.11]), Charlson Comorbidity Index (≥3 vs 0, aRR=1.12 [95%CI:1.08-1.17]), and diabetes mellitus (aRR=1.07 [95%CI:1.04-1.10]). More frequent prior year outpatient and ED encounters, oral antibiotic prescriptions, oral contraceptive prescriptions, positive culture at index uUTI, and antibiotic resistant organisms were also associated with increased risk of rUTI. CONCLUSIONS: The high risk of rUTI among women with cystitis is concerning, especially given previous reports of increasing UTI incidence. Current assessment of the epidemiology of rUTI may guide the development of preventive interventions against UTI.

Programmable, Self-Healable, and Photochromic Liquid Crystal Elastomers Based on Dynamic Hindered Urea Bonds for Biomimetic Flowers.

Recently, researchers have been exploring the use of dynamic covalent bonds (DCBs) in the construction of exchangeable liquid crystal elastomers (LCEs) for biomimetic actuators and devices. However, a significant challenge remains in achieving LCEs with both excellent dynamic properties and superior mechanical strength and stability. In this study, a diacrylate-functionalized monomer containing dynamic hindered urea bonds (DA-HUB) is employed to prepare exchangeable LCEs through a self-catalytic Michael addition reaction. By incorporating DA-HUB, the LCE system benefits from DCBs and hydrogen bonding, leading to materials with high mechanical strength and a range of dynamic properties such as programmability, self-healing, and recyclability. Leveraging these characteristics, bilayer LCE actuators with controlled reversible thermal deformation and outstanding dimensional stability are successfully fabricated using a simple welding method. Moreover, a biomimetic triangular plum, inspired by the blooming of flowers, is created to showcase reversible color and shape changes triggered by light and heat. This innovative approach opens new possibilities for the development of biomimetic and smart actuators and devices with multiple functionalities.

Recent Advances of Benzodithiophene-Based Donor Materials for Organic Solar Cells.

Recently, the power conversion efficiency (PCE) of organic solar cells (OSCs) has increased dramatically, making a big step toward the industrial application of OSCs. Among numerous OSCs, benzodithiophene (BDT)-based OSCs stand out in achieving efficient PCE. Notably, single-junction OSCs using BDT-based polymers as donor materials have completed a PCE of over 19%, indicating a dramatic potential for preparing high-performance large-scale OSCs. This paper reviews the recent progress of OSCs based on BDT polymer donor materials (PDMs). The development of BDT-based OSCs is concisely summarized. Meanwhile, the relationship between the structure of PDMs and the performance of OSCs is further described in this review. Besides, the development and prospect of single junction OSCs are also discussed.

Doping of ZnO Electron Transport Layer with Organic Dye Molecules to Enhance Efficiency and Photo-Stability of the Non-Fullerene Organic Solar Cells.

The solution-processed zinc oxide (ZnO) electron transport layer (ETL) always exhibits ubiquitous defects, and its photocatalytic activity is detrimental for the organic solar cell (OSC) to achieve high efficiency and stability. Herein, an organic dye molecule, PDINN-S is introduced, to dope ZnO, constructing a hybrid ZnO:PDINN-S ETL. This hybrid ETL exhibits improved electron mobility and conductivity, particularly post-light exposure. The catalytic activity of ZnO is also effectively suppressed.Consequently, the efficiency and photo-stability of inverted non-fullerene OSCs are synergistically enhanced. The devices based on PM6:Y6/PM6:BTP-eC9 active layer with ZnO:PDINN-S as ETL give impressive power conversion efficiencies (PCEs) of 16.78%/17.59%, significantly higher than those with pure ZnO as ETL (PCEs = 15.31%/16.04%). Moreover, ZnO:PDINN-S-based device shows exceptional long-term stability under continuous AM 1.5G illumination (T80 = 1130 h) , overwhelming the reference device (T80 = 455 h). In addition, Incorporating PDINN-S into ZnO alleviate mechanical stress within the inorganic lattice, making ZnO:PDINN-S ETL more suitable for the fabrication of flexible devices. Overall, doping ZnO with organic dye molecules offers an innovative strategy for developing multifunctional and efficient hybrid ETL of the non-fullerene OSCs with excellent efficiency and photo-stability.

Prevention of Neisseria gonorrhoeae With Meningococcal B Vaccine: A Matched Cohort Study in Southern California.

BACKGROUND: Neisseria gonorrhoeae is acquiring increasing resistance to available oral antibiotics, and current screening and treatment approaches have not decreased gonorrhea incidence. Although a gonorrhea-specific vaccine does not exist, N. gonorrhoeae shares much of its genome with Neisseria meningitidis, notably critical antigenic determinants including outer membrane vesicles (OMV). Prior observational studies have suggested that OMV-based meningococcal serogroup B vaccines confer protection against gonorrhea. METHODS: We conducted a matched cohort study from 2016 to 2020 to examine the association of OMV-containing recombinant meningococcal serogroup B vaccine (4CMenB) with gonorrhea infection among teens and young adults at Kaiser Permanente Southern California. Recipients of 4CMenB were matched in a ratio of 1:4 to recipients of non-OMV-containing polysaccharide-conjugate vaccine targeting serotypes A, C, W, and Y (MenACWY) who had not received 4CMenB and were followed for incident gonorrhea. We used Cox proportional hazards regression to compare gonorrhea rates among recipients of 4CMenB vs MenACWY, adjusting for potential confounders. We conducted the same analysis with chlamydia as a negative control outcome. RESULTS: The study included 6641 recipients of 4CMenB matched to 26 471 recipients of MenACWY. During follow-up, gonorrhea incidence rates per 1000 person-years (95% confidence intervals [CIs]) were 2.0 (1.3-2.8) for recipients of 4CMenB and 5.2 (4.6-5.8) for recipients of MenACWY. In adjusted analyses, gonorrhea rates were 46% lower among recipients of 4CMenB vs MenACWY (hazard ratio [HR], 0.54; 95% CI, .34-.86), but chlamydia rates were similar between vaccine groups (HR, 0.98; 95% CI, .82-1.17). CONCLUSIONS: These results suggest cross-protection of 4CMenB against gonorrhea, supporting the potential for vaccination strategies to prevent gonorrhea.

N-Type Small Molecule Electron Transport Layers with Excellent Surface Energy and Moisture Resistance Siloxane for Non-Fullerene Organic Solar Cells.

Electron transport layers (ETLs) generally contain polar groups for enhancing performance and reducing the work function. Nevertheless, the polar group with high surface energy may cause inferior interfacial compatibility, which challenges the ETLs to balance stability and performance. Here, two conjugated small molecules of ETLs with low surface energy siloxane, namely PDI-Si and PDIN-Si, are synthesized. The siloxane with low surface energy not only enhances the interfacial compatibility between ETLs and active layers but also improves the moisture-proof stability of the device. Impressively, the amine-functionalized PDIN-Si can simultaneously exhibit conspicuous n-type self-doping properties and outstanding moisture-proof stability. The optimization of interfacial contact and morphology enables the PM6:Y6-based OSC with PDIN-Si to achieve a power conversion efficiency (PCE) of 15.87%, which is slightly superior to that of classical ETL PDINO devices (15.27%), and when the PDIN-Si film thickness reaches 28 nm, the PCE remains at 13.19% (≈83%), which indicates that PDIN-Si has satisfactory thickness insensitivity to facilitate roll-to-roll processing. Excitingly, after 120 h of storage in an environment with humidity above 45%, the unencapsulated device with PDIN-Si as ETL remains at 75% of the initial PCE value, while the device with PDINO as ETL is only 50%.

Revealing the Enhanced Thermoelectric Properties of Controllably Doped Donor-Acceptor Copolymer: The Impact of Regioregularity.

Albeit considerable attention to the fast-developing organic thermoelectric (OTE) materials due to their flexibility and non-toxic features, it is still challenging to design an OTE polymer with superior thermoelectric properties. In this work, two "isomorphic" donor-acceptor (D-A) conjugated polymers are studied as the semiconductor in OTE devices, revealing for the first time the internal mechanism of regioregularity on thermoelectric performances in D-A type polymers. A higher molecular structure regularity can lead to higher crystalline order and mobility, higher doping efficiency, order of energy state, and thermoelectric (TE) performance. As a result, the regioregular P2F exhibits a maximum power factor (PF) of up to 113.27 µW m-1  K-2 , more than three times that of the regiorandom PRF (35.35 µW m-1  K-2 ). However, the regular backbone also implies lower miscibility with a dopant, negatively affecting TE performance. Therefore, the trade-off between doping efficiency and miscibility plays a vital role in OTE materials, and this work sheds light on the molecular design strategy of OTE polymers with state-of-the-art performances.

Effects of ketorolac on complications and postoperative pancreatic fistula in patients undergoing pancreatectomy.

BACKGROUND: There are conflicting data on the risk of postoperative pancreatic fistula (POPF) associated with postoperative NSAID use. The primary objective of this multi-center retrospective study was to assess the relationship between ketorolac use and POPF. The secondary objective was to assess for effect of ketorolac use on overall complication rate. METHODS: Retrospective chart review of patients undergoing pancreatectomy from January 1, 2005-January 1, 2016 was performed. Data on patient factors (age, sex, comorbidities, previous surgical history etc.), operative factors (surgical procedure, estimated blood loss, pathology etc.), and outcomes (morbidities, mortality, readmission, POPF) were collected. The cohort was compared based on ketorolac use. RESULTS: The study included 464 patients. Ninety-eight (21%) patients received ketorolac during the study period. Ninety-six (21%) patients were diagnosed with POPF within 30 days. There was a significant association between ketorolac use and clinically relevant POPF (21.4 vs. 12.7%) (p = 0.04, 95% CI [1.76, 1.04-2.97]). There was no significant difference in overall morbidity or mortality between the groups. DISCUSSION: Though there was no overall increase in morbidity, there was a significant association between POPF and ketorolac use. The use of ketorolac after pancreatectomy should be judicious.

Regulating the Sequence Structure of Conjugated Block Copolymers Enables Large-Area Single-Component Organic Solar Cells with High Efficiency and Stability.

Single-component organic solar cells (SCOSCs) based on conjugated block copolymers (CBCs) by covalently bonding a polymer donor and polymer acceptor become more and more appealing due to the formation of a favorable and stable morphology. Unfortunately, a deep understanding of the effect of the assembly behavior caused by the sequence structure of CBCs on the device performance is still missing. Herein, from the aspect of manipulating the sequence length and distribution regularity of CBCs, we synthesized a series of new CBCs, namely D18(20)-b-PYIT, D18(40)-b-PYIT and D18(60)-b-PYIT by two-pot polymerization, and D18(40)-b-PYIT(r) by traditional one-pot method. It is observed that precise manipulation of sequence length and distribution regularity of the polymer blocks fine-tunes the self-assembly of the CBCs, optimizes film morphology, improves optoelectronic properties, and reduces energy loss, leading to simultaneously improved efficiency and stability. Among these CBCs, the D18(40)-b-PYIT-based device achieves a high efficiency of 13.4 % with enhanced stability, which is an outstanding performance among SCOSCs. Importantly, the regular sequence distribution and suitable sequence length of the CBCs enable a facile film-forming process of the printed device. For the first time, the blade-coated large-area rigid/flexible SCOSCs are fabricated, delivering an impressive efficiency of 11.62 %/10.73 %, much higher than their corresponding binary devices.

Rational Regulation of the Molecular Aggregation Enables A Facile Blade-Coating Process of Large-area All-Polymer Solar Cells with Record Efficiency.

Developing robust materials is very critical and faces a big challenge for high-performance large-area all-polymer solar cells (all-PSCs) by printing methods. Herein, the authors combine the advantages of the terpolymerization strategy with the non-conjugated backbone strategy to regulate the molecular aggregation rationally during the film-forming printing process, facilitating a facile printing process for large-area all-PSCs. A series of terpolymer acceptors PYSe-Clx (x = 0, 10, 20, and 30) is also developed, which can effectively fine-tune the morphology and photoelectric properties of the active layer. The PBDB-T: PYSe-Cl20-based all-PSC delivers a significantly improved power cconversion efficiency (PCE) than the one with PBDB-T: PYSe (14.21% vs 12.45%). By addition of a small amount of non-conjugated polymer acceptor PTClo-Y, the ternary all-PSC reaches a PCE of 15.26%. More importantly, the regulation of molecular aggregation enables a facile blade-coating process of the large-area device. A record PCE of 13.81% for large-area devices (1.21 cm2 ) is obtained, which is the highest value for large-area all-PSCs fabricated by blade-coating. The environmentally friendly solvent processed large-area device also obtains an excellent performance of 13.21%. This work provides a simple and effective molecular design strategy of robust materials for high-performance large-area all-PSCs by a printing process.

Recent Advances and Prospects of Small Molecular Organic Thermoelectric Materials.

Thermoelectric (TE) materials possess unique energy conversion capabilities between heat and electrical energy. Small organic semiconductors have aroused widespread attention for the fabrication of TE devices due to their advantages of low toxicity, large area, light weight, and easy fabrication. However, the low TE properties hinder their large-scale commercial application. Herein, the basic knowledge about TE materials, including parameters affecting the TE performance and the remaining challenges of the organic thermoelectric (OTE) materials, are initially summarized in detail. Second, the optimization strategies of power factor, including the selection and design of dopants and structural modification of the dope-host are introduced. Third, some achievements of p- and n-type small molecular OTE materials are highlighted to briefly provide their future developing trend; finally, insights on the future development of OTE materials are also provided in this study.

Antidepressant medication use and prostate cancer recurrence in men with depressive disorders.

PURPOSE: Whether treating prostate cancer survivors with a depressive disorder with antidepressants can affect their cancer outcomes is unknown. We evaluated the association between antidepressant use and prostate cancer recurrence, in survivors with comorbid depressive disorders. METHODS: We conducted a longitudinal cohort study of 10,017 men with prostate cancer (stages I-II) diagnosed who also had a comorbid depressive disorder followed a maximum of 22 years, and examined rates of biochemical recurrence by antidepressant medication use. We conducted multivariable Cox models based on time-dependent antidepressant drug use status, and examined the risk of biochemical recurrence by cumulative duration of antidepressant use. RESULTS: Of these 10,017 survivors, 1842 (18%) experienced biochemical recurrence over 69,500 person-years of follow-up. The prostate cancer biochemical recurrence rate was greater with antidepressant non-use (31.3/1000 person-years) compared to antidepressant use (23.5/1000 person-years). In Cox proportional hazards multivariable adjusted models, non-use of antidepressants was associated with a 34% increased risk of biochemical recurrence compared to antidepressant use (HR = 1.34, 95% CI: 1.24-1.44). Longer use of antidepressants was associated with a lower biochemical recurrence risk (P trend test < 0.001). CONCLUSION: Untreated depressive disorders in prostate cancer patients may be associated with an increased risk of biochemical recurrence.

Thermoresponsive ionogels with switchable adhesion in air and aqueous environments induced by LCST phase behavior.

The rapid development of wearable devices is in urgent demand for materials with switchable adhesion both in air and aqueous environments. Herein, we report a thermoresponsive ionogel with switchable adhesion against various substrates both in air and aqueous environments. The switchable adhesion of ionogels is realized by a phase separation induced collapse of the polymer network and the subsequent extrusion of ionic liquids (ILs) on ionogel surfaces. The hydrophobic poly(butyl acrylate) (PBA) network and ILs endow the ionogels with excellent water-resistance ability, which enables the application of ionogels in aqueous environments. As a result, the adhesion strength of ionogels against rubber can reach an on/off ratio of 75-fold (45 kPa versus 0.6 kPa) and 7.7-fold (21 kPa versus 2.7 kPa) in air and aqueous environments, respectively. By varying the ratio of two structurally similar ILs in their blends, the responsive temperature of ionogels can be tuned within a wide temperature range from 32 °C to 100 °C. Furthermore, we show a demonstration of an underwater on demand capture and release by taking advantage of the switchable adhesion of ionogels. These nonvolatile ionogels with tunable responsive temperatures and high on/off adhesion strength ratio both in air and aqueous environments show broad applications in the fields related to wearable devices, soft robots and submersible sensors.

Oligomer-Assisted Photoactive Layers Enable >18 % Efficiency of Organic Solar Cells.

Although ternary organic solar cells (OSCs) have unique advantages in improving device performance, the morphology assembly in the ternary-phase would be more uncertain or complex than that in the binary-phase. Here, we propose a new concept of oligomer-assisted photoactive layers for high-performance OSCs. The formed alloy-like phase of the oligomer : host polymer blend enabled the oligomer-assisted OSCs to fuse the advantages of both binary and ternary devices, exhibiting substantially enhanced performance and stability compared to the control devices. With the addition of oligomers, outstanding efficiencies of 17.33 % for a PM6 : Y6 device, 18.32 % for a PM6 : BTP-eC9 device, and 17.13 % for a PM6/Y6 pseudo-bilayer device were achieved, all of which are one of the highest values in their corresponding fields. The improved performance originated from the downshift energy levels, enhanced light absorption, optimized blend morphology, favorable charge dynamics, and reduced non-radiative energy loss.

Ferroelectric Polymer Drives Performance Enhancement of Non-fullerene Organic Solar Cells.

Enhancing the built-in electric field to promote charge dynamitic process is of great significance to boost the performance of the non-fullerene organic solar cells (OSCs), which has rarely been concerned. In this work, we introduced a cheap ferroelectric polymer as an additive into the active layers of non-fullerene OSCs to improve the device performance. An additional and permanent electrical field was produced by the polarization of the ferroelectric dipoles, which can substantially enhance the built-in electric field. The promoted exciton separation, significantly accelerated charge transport, reduced the charge recombination, as well as the optimized film morphology were observed in the device, leading to a significantly improved performance of the PVDF-modified OSCs with various active layers, such as PM6 : Y6, PM6 : BTP-eC9, PM6 : IT-4F and PTB7-Th : Y6. Especially, a record efficiency of 17.72 % for PM6 : Y6-based OSC and an outstanding efficiency of 18.17 % for PM6 : BTP-eC9-based OSC were achieved.

Do Inpatient Antimicrobial Stewardship Programs Help Us in the Battle Against Antimicrobial Resistance?

BACKGROUND: Antibiotic stewardship programs (ASPs) have demonstrated success at reducing costs, yet there is limited quality evidence of their effectiveness in reducing infections of high-profile drug-resistant organisms. METHODS: This retrospective, cohort study included all Kaiser Permanente Southern California (KPSC) members aged ≥18 years hospitalized in 9 KPSC hospitals from 1 January 2008 to 31 December 2016. We measured the impact of staggered ASP implementation on consumption of 18 ASP-targeted antibiotics using generalized linear mixed-effects models. We used multivariable generalized linear mixed-effects models to estimate the adjusted effect of an ASP on rates of infection with drug-resistant organisms. Analyses were adjusted for confounding by time, cluster effects, and patient- and hospital-level characteristics. RESULTS: We included 765 111 hospitalizations (288 257 pre-ASP, 476 854 post-ASP). By defined daily dose, we found a 6.1% (-7.5% to -4.7%) overall decrease antibiotic use post-ASP; by days of therapy, we detected a 4.3% (-5.4% to -3.1%) decrease in overall use of antibiotics. The number of prescriptions increased post-ASP (1.04 [1.03-1.05]). In adjusted analyses, we detected an overall increase in vancomycin-resistant enterococci infections post-ASP (1.37 [1.10-1.69]). We did not detect a change in the rates of extended-spectrum beta-lactamase, carbapenem-resistant Enterobacteriaceae, and multidrug-resistant Pseudomonas aeruginosa infections post-ASP. CONCLUSIONS: ASPs with successful reductions in consumption of targeted antibiotics may not see changes in infection rates with antibiotic-resistant organisms in the 2 to 6 years post-implementation. There are likely differing timescales for reversion to susceptibility across organisms and antibiotics, and unintended consequences from compensatory prescribing may occur.

Alkylsilyl Fused Ring-Based Polymer Donor for Non-Fullerene Solar Cells with Record Open Circuit Voltage and Energy Loss.

The energy loss (Eloss ), especially the nonradiative recombination loss and energetic disorder, needs to be minimized to improve the device performance with a small voltage (VOC ) loss. Urbach energy (EU ) of organic photovoltaic materials is related to energetic disorder, which can predict the Eloss of the corresponding device. Herein, a polymer donor (PBDS-TCl) with Si and Cl functional atoms for organic solar cells (OSCs) is synthesized. It can be found that the VOC and Eloss can be well manipulated by regulation of the energy level of the polymer donor and EU , which is dominated by the morphology. A low energetic disorder with an EU of 23.7 meV, a low driving force of 0.08 eV, and a low Eloss of 0.41 eV are achieved for the PBDS-TCl:Y6-based OSCs. Consequently, an impressive open circuit voltage (VOC ) of 0.92 V is obtained. To the best of knowledge, the VOC value and Eloss are both the record values for the Y6-based device. These results demonstrate that fine-tuning the polymer donor by functional atom modification on the side chain is a promising way to reduce EU and energy loss, as well as obtain small driving force and high VOC for highly efficient OSCs.

Silicon Naphthalocyanine Tetraimides: Cathode Interlayer Materials for Highly Efficient Organic Solar Cells.

Naphthalocyanine derivatives (SiNcTI-N and SiNcTI-Br) were firstly used as excellent cathode interlayer materials (CIMs) in organic solar cells, via introducing four electron-withdrawing imide groups and two hydrophilic alkyls. Both of them showed deep LUMO energy levels (below -3.90 eV), good thermal stability (Td >210 °C), and strong self-doping property. The SiNcTI-Br CIM displayed high conductivity (4.5×10-5  S cm-1 ) and electron mobility (7.81×10-5  cm2 V-1 s-1 ), which could boost the efficiencies of the PM6:Y6-based OSCs over a wide range of CIM layer thicknesses (4-25 nm), with maximum efficiency of 16.71 %.

S-Acylation controls functional coupling of BK channel pore-forming α-subunits and ß1-subunits.

The properties and physiological function of pore-forming α-subunits of large conductance calcium- and voltage-activated potassium (BK) channels are potently modified by their functional coupling with regulatory subunits in many tissues. However, mechanisms that might control functional coupling are very poorly understood. Here we show that S-acylation, a dynamic post-translational lipid modification of proteins, of the intracellular S0-S1 loop of the BK channel pore-forming α-subunit controls functional coupling to regulatory ß1-subunits. In HEK293 cells, α-subunits that cannot be S-acylated show attenuated cell surface expression, but expression was restored by co-expression with the ß1-subunit. However, we also found that nonacylation of the S0-S1 loop reduces functional coupling between α- and ß1-subunits by attenuating the ß1-subunit-induced left shift in the voltage for half-maximal activation. In mouse vascular smooth muscle cells expressing both α- and ß1-subunits, BK channel α-subunits were endogenously S-acylated. We further noted that S-acylation is significantly reduced in mice with a genetic deletion of the palmitoyl acyltransferase (Zdhhc23) that controls S-acylation of the S0-S1 loop. Genetic deletion of Zdhhc23 or broad-spectrum pharmacological inhibition of S-acylation attenuated endogenous BK channel currents independently of changes in cell surface expression of the α-subunit. We conclude that functional effects of S-acylation on BK channels depend on the presence of ß1-subunits. In the absence of ß1-subunits, S-acylation promotes cell surface expression, whereas in its presence, S-acylation controls functional coupling. S-Acylation thus provides a mechanism that dynamically regulates the functional coupling with ß1-subunits, enabling an additional level of conditional, cell-specific control of ion-channel physiology.