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The single stranded DNA binding protein RPA coordinates DNA metabolism using multiple protein and DNA interaction domains. Here, the authors show that the chaperone-like protein Rtt105 staples RPA domains to prevent untimely protein interactions.

Hematopoietic cell transplantation (HCT) and chimeric antigen receptor (CAR)-T cell patients are immunocompromised, remain at high risk following SARS-CoV-2 infection, and are less likely than immunocompetent individuals to respond to vaccination. As part of the safety lead-in portion of a phase 2 clinical trial in patients post HCT/CAR-T for hematological malignancies (HM), we tested the immunogenicity of the synthetic modified vaccinia Ankara-based COVID-19 vaccine COH04S1 co-expressing spike (S) and nucleocapsid (N) antigens. Thirteen patients were vaccinated 3–12 months post HCT/CAR-T with two to four doses of COH04S1. SARS-CoV-2 antigen-specific humoral and cellular immune responses, including neutralizing antibodies to ancestral virus and variants of concern (VOC), were measured up to six months post vaccination and compared to immune responses in historical cohorts of naïve healthy volunteers (HV) vaccinated with COH04S1 and naïve healthcare workers (HCW) vaccinated with the FDA-approved mRNA vaccine Comirnaty® (Pfizer, New York, NY, USA). After one or two COH04S1 vaccine doses, HCT/CAR-T recipients showed a significant increase in S- and N-specific binding antibody titers and neutralizing antibodies with potent activity against SARS-CoV-2 ancestral virus and VOC, including the highly immune evasive Omicron XBB.1.5 variant. Furthermore, vaccination with COH04S1 resulted in a significant increase in S- and N-specific T cells, predominantly CD4+ T lymphocytes. Elevated S- and N-specific immune responses continued to persist at six months post vaccination. Furthermore, both humoral and cellular immune responses in COH04S1-vaccinated HCT/CAR-T patients were superior or comparable to those measured in COH04S1-vaccinated HV or Comirnaty®-vaccinated HCW. These results demonstrate robust stimulation of SARS-CoV-2 S- and N-specific immune responses including cross-reactive neutralizing antibodies by COH04S1 in HM patients post HCT/CAR-T, supporting further testing of COH04S1 in immunocompromised populations.

Abstract Background After hospital discharge, patients can experience symptoms prompting them to seek acute medical attention. Early evaluation of patients’ post-discharge symptoms by healthcare providers may improve appropriate healthcare utilization and patient safety. Post-discharge follow-up phone calls, which are used for routine transitional care in U.S. hospitals, serve as an important channel for provider-patient communication about symptoms. This study aimed to assess the facilitators and barriers to evaluating and triaging pain symptoms in cardiovascular patients through follow-up phone calls after their discharge from a large healthcare system in Central Massachusetts. We also discuss strategies that may help address the identified barriers. Methods Guided by the Practical, Robust, Implementation and Sustainability Model (PRISM), we completed semi-structured interviews with 7 nurses and 16 patients in 2020. Selected nurses conducted (or supervised) post-discharge follow-up calls on behalf of 5 clinical teams (2 primary care; 3 cardiology). We used thematic analysis to identify themes from interviews and mapped them to the domains of the PRISM model. Results Participants described common facilitators and barriers related to the four domains of PRISM: Intervention (I), Recipients (R), Implementation and Sustainability Infrastructure (ISI), and External Environment (EE). Facilitators include: (1) patients being willing to receive provider follow-up (R); (2) nurses experienced in symptom assessment (R); (3) good care coordination within individual clinical teams (R); (4) electronic health record system and call templates to support follow-up calls (ISI); and (5) national and institutional policies to support post-discharge follow-up (EE). Barriers include: (1) limitations of conducting symptom assessment by provider-initiated follow-up calls (I); (2) difficulty connecting patients and providers in a timely manner (R); (3) suboptimal coordination for transitional care among primary care and cardiology providers (R); and (4) lack of emphasis on post-discharge follow-up call reimbursement among cardiology clinics (EE). Specific barriers for pain assessment include: (1) concerns with pain medication misuse (R); and (2) no standardized pain assessment and triage protocol (ISI). Conclusions Strategies to empower patients, facilitate timely patient-provider communication, and support care coordination regarding pain evaluation and treatment may reduce the barriers and improve processes and outcomes of pain assessment and triage.

Telehealth provides health care services to clients through telecommunications. Rehabilitation services such as occupational therapy, physical therapy, and speech-language therapy can be delivered via telehealth. The aim of this study was to evaluate patients’ reports of their satisfaction with telehealth compared to standard in-person therapy for patients living in rural areas. Four databases were utilized for this systematic review. The following words were searched: telehealth, rural, and patient satisfaction. Abstract searches identified 251 articles, and 55 were read in full text. Four articles met inclusion criteria. There was high satisfaction for patients in all studies regarding the use of telehealth. Findings showed that overall, telehealth supported increased rates of patient satisfaction for OT, PT, and SLP services delivered to rural communities.

Objective:To examine the attitudes of students majoring in occupational therapy (OT) and physical therapy (PT) on evidence-based practice (EBP) and the possible impact of professional education in China.Methods:A cross-sectional survey of the Evidence-Based Practice Process Assessment Scale (EBPPAS) was administered to OT and PT students from four universities in China.Results:The total mean score of the students’attitudes toward all EBP subscales which included familiarity, attitude, intention, and engagement was 3.18 on a 5-point Likert scale. Significant differences in overall attitude were found between 2nd& 3rdyear students and 1styear and 4thyear students indicating professional education may have impact on students’attitudes (P=0.031 and P

This review article describes the patterns and trends of early rehabilitation (ER), occupational therapy (OT) and physical therapy (PT), and the specific roles of rehabilitation therapists, particularly occupational therapists (OTs) and physical therapists (PTs) in acute care hospitals in the United States (U. S.). First, a broad overview of the research literature related to the consequences of bed rest and immobility is presented along with the techniques used by OTs and PTs to minimize negative outcomes and optimize function through ER. Occupation-based and mobility-focused practices are then outlined to describe rehabilitation therapy's role in decreasing readmissions and improving patient and family satisfaction. Finally, traditional OT and PT practices in acute care settings in China, including the challenges of implementing ER and the implications for contemporary practice, are discussed. ER refers to the initiation of therapy services in an expedited manner for patients who have rehabilitative, safety, or community support needs in the acute care hospital. That is, after experiencing an injury, illness, or disease, patients'occupational performance and ability to participate in activities and mobility can be improved, or prevented from worsening, with ER. The goals of OT and PT in an accelerated and fast-past hospital environment are to facilitate a patient's functional performance and outcomes to improve function recovery and to prevent further disability and loss of function. Currently in U. S., federal regulations, health care policies, financial constraints, and the demanded shortened hospital stays require therapists to be both comprehensive and efficient and to continue advancing ER practices. Early rehabilitation must be well-timed and intensive enough to bring about positive changes. Additionally, ensuring patients'active engagement and addressing therapy goals that patients and families identified as essential are imperative to achieve patients'successful transition to home or to another setting. Through ER, not only can a patient's functional abilities improve, but ER reduces the risk of undesirable and unintended health consequences. Such hospital-acquired conditions (HAC) are conditions which occur during a patient's hospitalization and are not present at admission. The risk of developing HAC increases if the patient is limited from active engagement in activity and mobility as a result of bed rest, immobility, or deconditioning. Systemic deconditioning, which can result from a prolonged critical illness, a trauma, or a surgery, reduces the patient's functional capacity, impairs cognitive abilities, diminishes psychological coping, and increases rates of depression and anxiety. With ER, the specific OT and PT rehabilitative interventions minimize the risk for negative health conditions, impairments, and disability while simultaneously promoting functional recovery. Specific to each rehabilitation profession's roles and responsibilities in the U. S., OTs promote the patients'occupational performance and participation in daily occupations, roles, habits, and routines. Through facilitating the patient's engagement in typical activities of daily living, OT improves patient's overall health, well-being, and independence at home and in the community. In addition to direct therapy service to patients, OTs also assess and recommend specific task and environmental modifications. Occupational therapists'intervention may focus on compensatory (i.e., facilitating occupation through modifying the task or environment) or remediation (i.e., rehabilitative) techniques for patients to achieve a greater level of independence. In PT, the emphasis is on promoting and progressing patients'mobility and movement to increase performance and to enhance function, well-being, overall health and quality of life. PTs promote optimal mobility to enable patients to achieve a greater level of independence, autonomy, and to return to previous or enhanced level of function. Any patient who has or may develop impairments, activity limitations, and participation restrictions related to musculoskeletal, neuromuscular, cardiovascular, pulmonary, and integumentary systems can be treated by PT. Therefore, PTs are well-suited to promote early rehabilitation (ER) in the acute care setting. In the U. S., currently, however, acute care hospitals are not often designed to support patients and meet their intensive rehabilitation needs. Consequently, patients who require assistance with daily occupations or mobility or who have ongoing rehabilitation needs often result in relocating, or transferring to another health care facility, i.e., post-acute care, for continued recovery of medical issues and rehabilitative deficits. Multiple levels of post-acute care are available in the U. S.including skilled nursing facilities, rehabilitation hospitals, long-term acute care hospitals, nursing homes, outpatient clinics, home health, and private caregiver services. Currently, in the Chinese acute care hospital, patients have the option to stay for an extended period of time which provides the opportunity for OTs and PTs to provide multiple rehabilitation visits. Typically, the outcomes of OT and PT services are to restore physical mobility, increase active range of motion, and improve function in order for the patient to return home with family. It seems, due to the Chinese culture, tradition and custom, less emphasis is on improving independence with self-care activities. It is expected that family members take on the responsibilities to provide care to a family member who is ill or has disabilities. As such, in China there is typically a supportive family dynamic, meaning the family is present daily during rehabilitative intervention, helping provide therapeutic exercises and physical agent modalities for their loved ones. The burden of care on the family members worsens at discharge, especially if the patient and family have not received therapy or patient education to improve the patient's function and independence. Currently, the profession of rehabilitation including occupational therapy and physical therapy in China is in an excellent position of growth and advancement. Understanding the unique roles of OT and PT in acute care from an international perspective will improve global health not only through rehabilitative services, but also through focusing on health and wellness for the patient, family, and community. Early rehabilitation in the acute care setting is an effective way to improve the health and well-being of patients and enable them to return to their home and community in a timely manner. OTs and PTs play instrumental roles in early rehabilitation in the acute care settings.

The purpose of the study was to assess the impact of an international doctoral capstone on occupational therapy clinicians’ current practice. The study used a cross-sectional descriptive online survey design with qualitative elements with 26 occupational therapy graduates. All participants identified as female and the majority were 25-34 years old. Participants reported that the international doctorate capstone experience positively impacted their cultural competence and professional growth. Qualitative outcomes supported these findings through three themes on culture, building rapport with patients, and professional growth. This study suggests that an international doctoral capstone experience is an important way for occupational therapy students to be prepared to become culturally competent clinicians and advance their professional skills. Limitations of the study included a convenience sample of occupational therapy alumni who graduated from Creighton University and using a non-validated survey instrument. Future studies need to use a representative sample and examine the cultural competence and professional growth of occupational therapy students who did not complete an international capstone project.

With the rapid development of rehabilitation in China, professional education in occupational therapy(OT)has witnessed significant expansion and changes in recent years. Professional doctorates in OT and other health care professions have gained increasing attention and popularity in China. Confusion exists for emerging professional doctorates in China and the international community. The purpose of this article is to introduce and describe the concept of professional doctorates, with an emphasis on doctor of occupational therapy(OTD)degree. Training and education of a professional doctorate in OT is illustrated via an OTD program in the USA. And the increased residency/fellow program after post OTD graduation was explaind and discussed. This review will provide guidance for the development of OT education in China.

Accredited occupational therapy education programs are required to include telehealth technology in their curricula as outlined by the Accreditation Council for Occupational Therapy Education. An innovative Doctor of Occupational Therapy program piloted a telehealth module with first- and second-year students. Both dynamic lecture content and active learning lab exercises were created to advance student knowledge in the use of telehealth technology and to inform occupational therapy telehealth education. The teaching approaches in lecture and lab were assessed using a mixed methods approach. A quantitative pre and posttest assessment of student self-efficacy and knowledge was collected at three time points. At the final timepoint, a post survey was also completed to collect qualitative perspectives of student experiences after the lecture content and lab exercise, to further explain quantitative findings. Results indicated that the students’ knowledge significantly improved after the module. In addition, engaging in lab after lecture did add a significant improvement in self-efficacy of students’ perception of their knowledge regarding telehealth as well as confidence in their ability to use telehealth. The outcomes of this study assist and inform occupational therapy education programs in determining an effective teaching format for instruction on the use of telehealth technology in practice.

For decades, biologists and biochemists have taken advantage of atomic resolution structural models of proteins from X-ray crystallography, nuclear magnetic resonance spectroscopy, and more recently cryo-electron microscopy. However, not all proteins relent to structural analyses using these approaches, and as the depth of knowledge increases, additional data elucidating a mechanistic understanding of protein function is desired. Flavin-based electron bifurcating enzymes, which are responsible for producing high energy compounds through the simultaneous endergonic and exergonic reduction of two intercellular electron carriers (i.e., NAD+ and ferredoxin) are one class of proteins that have challenged structural biologists and in which there is great interest to understand the mechanism behind electron gating. A limited number of X-ray crystallography projects have been successful; however, it is clear that to understand how these enzymes function, techniques that can reveal detailed in solution information about protein structure, dynamics, and interactions involved in the bifurcating reaction are needed. In this review, we cover a general set of mass spectrometry-based techniques that, combined with protein modeling, are capable of providing information on both protein structure and dynamics. Techniques discussed include surface labeling, covalent cross-linking, native mass spectrometry, and hydrogen/deuterium exchange. We cover how biophysical data can be used to validate computationally generated protein models and develop mechanistic explanations for regulation and performance of enzymes and protein complexes. Our focus will be on flavin-based electron bifurcating enzymes, but the broad applicability of the techniques will be showcased.

The protocol detailed here describes a way to perform hydrogen deuterium exchange coupled to mass spectrometry (HDX-MS) on oxygen sensitive proteins. HDX-MS is a powerful tool for studying the protein structure-function relationship. Applying this technique to anaerobic proteins provides insight into the mechanism of proteins that perform oxygen sensitive chemistry. A problem when using HDX-MS to study anaerobic proteins is that there are many parts that require constant movement into and out of an anaerobic chamber. This can affect the seal, increasing the likelihood of oxygen exposure. Exposure to oxygen causes the cofactors bound to these proteins, a common example being FeS clusters, to no longer interact with the amino acid residues responsible for coordinating the FeS clusters, causing loss of the clusters and irreversible inactivation of the protein. To counteract this, a double vial system was developed that allows the preparation of solutions and reaction mixtures anaerobically, but also allows these solutions to be moved to an aerobic environment while shielding the solutions from oxygen. Additionally, movement isn’t limited like it is in an anaerobic chamber, ensuring more consistent data, and fewer errors during the course of the reaction.

Laura E. Anderson's book, "When Religion Hurts You: Healing From Trauma and the Impact of High Control Religion," offers a comprehensive exploration of trauma associated with high-control religions (HCRs). Drawing on her personal experiences, clinical practice, and research, Anderson explains how religious abuse and trauma manifest and provides insights into the healing process. The book covers various topics, including the impact of HCRs on different aspects of life, such as self-trust, boundaries, grief, and sexuality. It serves as a valuable resource for both professionals and individuals seeking to heal from HCR experiences, offering a hopeful perspective on the journey towards healing. [Extracted from the article]