De Novo Designed Peptide and Protein Hairpins Self-Assemble into Sheets and Nanoparticles.

The design and assembly of peptide-based materials has advanced considerably, leading to a variety of fibrous, sheet, and nanoparticle structures. A remaining challenge is to account for and control different possible supramolecular outcomes accessible to the same or similar peptide building blocks. Here a de novo peptide system is presented that forms nanoparticles or sheets depending on the strategic placement of a "disulfide pin" between two elements of secondary structure that drive self-assembly. Specifically, homodimerizing and homotrimerizing de novo coiled-coil α-helices are joined with a flexible linker to generate a series of linear peptides. The helices are pinned back-to-back, constraining them as hairpins by a disulfide bond placed either proximal or distal to the linker. Computational modeling indicates, and advanced microscopy shows, that the proximally pinned hairpins self-assemble into nanoparticles, whereas the distally pinned constructs form sheets. These peptides can be made synthetically or recombinantly to allow both chemical modifications and the introduction of whole protein cargoes as required.

Cervical cancer screening guidelines: An update.

ABSTRACT: Cervical cancer screening practices in the United States have been inefficient, with variable screening rates. Some women are screened too frequently, overmanaged, lost to follow-up, or are at risk and should be screened but are not. Timely screening, identification, and management of abnormal cervical cells is vital in order to prevent progression to cervical cancer. Educating, counseling, screening, and offering the human papillomavirus vaccine continue to be the primary methods of cervical cancer prevention practices. Guidelines and primary screening methods have been updated because of supporting evidence, and clinicians must stay up-to-date in order to provide effective patient care.

Financial analysis of PA lifetime earnings and debt.

ABSTRACT: This economic analysis of physician assistant/associate (PA) career earnings sought to assess the increasing effect of student debt, its potential effect on job selection, and whether such financial obligations may influence graduates to select higher-paying specialties. The model was a 30-year-old newly graduated PA who begins working in family medicine. A simulation included wages, student debt, national household expenditures, and real estate statistics. The scenario consisted of a high and middle cost of living in two geographic areas, a family of four, and an average life expectancy. Using a validated economic program, a series of calculations produced the financial effect on moderate-income levels and expenditures based on median PA earnings. On the deficit side is education debt, loan repayment, financing a house, college for children, retirement, and discretionary spending. Weighted variables were used to maximize the sensitivity effect of the simulation. A Monte Carlo probabilistic program predicted the likely outcome of income, expenses, inflation, and investments. Furthermore, the lifetime earnings of a PA who retires at age 67 years and lives to age 85 years falls in the 75th percentile of income of all Americans. The conclusion is that a full-time PA career in any clinical role is as economically rewarding as it is satisfying.

Financial analysis of PA lifetime earnings and debt.

ABSTRACT: This economic analysis of physician assistant/associate (PA) career earnings sought to assess the increasing effect of student debt, its potential effect on job selection, and whether such financial obligations may influence graduates to select higher-paying specialties. The model was a 30-year-old newly graduated PA who begins working in family medicine. A simulation included wages, student debt, national household expenditures, and real estate statistics. The scenario consisted of a high and middle cost of living in two geographic areas, a family of four, and an average life expectancy. Using a validated economic program, a series of calculations produced the financial effect on moderateincome levels and expenditures based on median PA earnings. On the deficit side is education debt, loan repayment, financing a house, college for children, retirement, and discretionary spending. Weighted variables were used to maximize the sensitivity effect of the simulation. A Monte Carlo probabilistic program predicted the likely outcome of income, expenses, inflation, and investments. Furthermore, the lifetime earnings of a PA who retires at age 67 years and lives to age 85 years falls in the 75th percentile of income of all Americans. The conclusion is that a full-time PA career in any clinical role is as economically rewarding as it is satisfying.

Impact of Integrated Pharmacology Instruction by Principal Faculty Pharmacists in Two Physician Assistant Programs: A Retrospective Study.

PURPOSE: In recent years, there has been a growing trend toward integrating pharmacology instruction into physician assistant (PA) programs by dedicated PA faculty pharmacists. Pharmacists train to become medication experts. Incorporating pharmacist instruction in a PA program during the didactic year provides PA students with an early opportunity to experience interprofessional education and interdisciplinary synergy through clinical application. METHODS: This article presents a retrospective study that aims to evaluate the impact of integrated pharmacology instruction by principal PA faculty pharmacists on student satisfaction and standardized assessment metrics. Student satisfaction was measured by course evaluations and exit/alumni surveys. Standardized metrics included Physician Assistant Clinical Knowledge Rating and Assessment Tool and Physician Assistant National Certifying Exam assessments. RESULTS: The findings indicate that having a principal faculty member with specialized expertise in pharmacology has improved the overall course satisfaction, knowledge, and competence of PA students and perceptions of the relevance and effectiveness of pharmacology instruction in their clinical practice. CONCLUSION: The results of this study support the value of using pharmacist faculty members in PA programs to enhance the quality of pharmacology instruction and ultimately contribute to the success of PA students in their professional careers.

Academic Rank Disparities in Minoritized and Racialized Physician Assistant Educators.

PURPOSE: The aim of this study was to investigate the disparities in career progression and the need for inclusive mentorship in the physician assistant (PA) profession, specifically focusing on racial/ethnic minority faculty. METHODS: Pooled data from the Physician Assistant Education Association Program Survey in 2015, 2017, and 2019 were analyzed to examine the effect of PA faculty race/ethnicity on academic rank promotion. Logistic regression models were used to assess the association between faculty race/ethnicity and the likelihood of being in a middle/late-career (associate/professor) or early-career status (instructor/assistant), adjusting for confounding factors. RESULTS: The analysis revealed significant disparities in career progression, particularly for Black/African American and Hispanic faculty members, who were 44% less likely to be in late-career positions compared with White faculty. These disparities persisted even after accounting for gender, highest degree, region, and years in rank. The slower career progression experienced by minoritized faculty can have negative impacts, such as lower salaries, impostorism, reduced social capital, isolation, marginalization, burnout, and attrition. CONCLUSION: The findings highlight the urgent need for increased efforts to promote diversity and inclusion in the PA profession. Creating a more equitable academic environment requires addressing systemic biases, implementing inclusive mentorship initiatives, and promoting diversity in hiring and promotion decisions. By prioritizing equity, diversity, and inclusion, the PA profession can foster a more diverse, innovative, and satisfied workforce while reducing turnover. Continued research and evidence-based strategies are essential to effectively address these disparities and create a more inclusive and equitable environment in the PA profession.

What do we know about retired physician assistants? A preliminary study.

Retirement generally means the complete end of employment. Retirement is a new phenomenon for physician assistants (PAs), as those trained in the 1970s exit their careers. To better understand retirement patterns of PAs, we undertook a survey in 2011 using a national database. A cadre of 625 respondents met the criteria of being retired and living; the mean age of PA retirement was 61 years (range 47-75 years). Duration of a PA career was 29 years on average (range, 10-40 years). Forty-three percent of respondents retired from family/general medicine and 11% from emergency medicine. Almost all reported receiving Social Security and Medicare; most had some form of a pension. Fewer than one-fifth retired for health reasons. When asked about the timeliness of retiring, 20% wished they had retired later in life; 4% of the men and 7% of the women thought they should have retired earlier; 74% of the men and 73% of the women said they had retired at the right time. Reasons for retiring varied widely. Approximately one-quarter reported volunteering in a medically-related capacity. We suggest that retirement is a concept undergoing evolution in American society and that PAs represent a health profession that reflects the complexity of this evolution.

A survey of fellow members of the Society of Dermatology Physician Assistants.

Income and productivity data of physician assistants (PAs) practicing in dermatology were measured by a survey instrument developed by the authors. The median income for PAs in dermatology was $100,000, and the median annual production was $500,000. PAs in dermatology appear to generate adequate revenue to be profitable to a dermatology practice.

The changing physician assistant profession: a gender shift.

The physician assistant (PA) movement originally served as an avenue for male veterans to transition into the civilian workforce. After a half-century of development, the profession in the United States is now predominantly female and nonveteran. Using archival data and other resources, this article documents the influences on gender and age shifts in the PA profession with related policy perspectives. Now entering its sixth decade, the profession continues to evolve as demand for PA services outpaces supply.

Gender Disparities in Physician Assistant Educator Promotion and Compensation: A Mixed Methods Approach.

INTRODUCTION: The gender wage gap is well documented in many industries. A disparity in salary between female and male physician assistant (PA) educators has been demonstrated, but disparities in academic rank have not been shown. The purpose of this study was to re-examine gender disparities in compensation to PA educators and to explore whether gender-based disparities exist in promotion to higher academic rank in this field. METHODS: An explanatory sequential mixed-methods design was used to determine differences in salary and rank by gender. PA Education Association Faculty and Directors Survey data from 2014, 2017, and 2019 were analyzed. A focus group was conducted to explain the findings and understand the barriers to promotion for female faculty. RESULTS: Female PA faculty members earn $7573 less than their male colleagues when controlling for all other variables. Female faculty members have an increased likelihood (RR 1.150) for being in early career stage versus late career stage. Obtaining a doctoral degree decreased the risk for being in an early career stage (RR 0.567) with men twice as likely to have a doctoral degree as women. DISCUSSION: Rank and salary disparities exist in PA faculty by gender. Female faculty are less likely to hold doctoral degrees or to be promoted to higher academic ranks, and they earn less than men. Degree level and career track are themes unique to the PA education profession, and further research is needed to understand their impact. With more women entering PA education, pay equity and promotion need to be addressed.

Professionalism in Physician Assistant Education as a Predictor of Future Licensing Board Disciplinary Actions.

PURPOSE: The purpose of this study was to evaluate associations between postgraduate disciplinary actions (PGDA) by state licensing boards and physician assistant (PA) school documented professionalism violations (DPV) and academic probation. METHODS: This was a retrospective cohort study comprising PA graduates from 2001 to 2011 at 3 institutions (n = 1364) who were evaluated for the main outcome of PGDA and independent variable of DPV and academic probation. Random-effects multiple logistic regression and accelerated failure time parametric survival analysis were used to investigate the association of PGDA with DPV and academic probation. RESULTS: Postgraduate disciplinary action was statistically significant and positively associated with DPV when unadjusted (odds ratio [OR] = 5.15; 95% CI: 1.62-16.31; P = .01) and when adjusting for age, sex, overall PA program GPA (GPA), and Physician Assistant National Certifying Exam Score (OR = 5.39; 95% CI: 1.54-18.85; P = .01) (fully adjusted). Academic probation increased odds to 8.43 times (95% CI: 2.85-24.92; P < .001) and 9.52 times (95% CI: 2.38-38.01; P < .001) when fully adjusted. CONCLUSION: Students with professionalism violation or academic probation while in the PA school had significant higher odds of receiving licensing board disciplinary action compared with those who did not. Academic probation had a greater magnitude of effect and could represent an intersection of professionalism and academic performance.

Kinetic studies of unmodified individual Escherichia coli beta-galactosidase molecules in free solution.

Assays were performed on individual Escherichia coli beta-galactosidase molecules at 2 different concentrations of the substrate DDAO-beta-D-galactoside using a free zone capillary electrophoresis-based protocol with an in-laboratory-constructed instrument utilizing laser-induced fluorescence detection. In a typical run, 2 enzyme molecules were injected into the capillary. They were separated from each other by a brief period of electrophoresis and incubated on the capillary in the presence of the substrate. They were then mobilized on the capillary into a zone of substrate at a different concentration, re-incubated, and the product peaks mobilized past the detector . The relative change in activity as the concentration was increased differed between molecules, suggesting differences in Km. In a different experiment, the capillary was filled with on average 13 enzyme molecules per run, incubated, and the activities of the individual molecules determined. The shapes of the distribution curves of single molecule activities obtained at different concentrations of the substrate resorufin-beta-D-galactoside were indistinguishable, suggesting a homogeneous Km. To explain why individual enzyme molecules behaved as if they were heterogeneous with respect to Km but the population behaved as if it were homogeneous, theoretical Michaelis-Menten curves were constructed. The curves for populations with heterogeneous Km values were found to be indistinguishable from that of a homogeneous population.