Physical Organization Research Articles

Physical Therapists' Knowledge, Skills, Beliefs, and Organizations Impact Physical Activity Promotion: A Systematic Review and Meta-Analysis.

The purpose of this study was to characterize factors that influence physical therapists' physical activity (PA) promotion practices and map these factors to the Theoretical Domains Framework (TDF) to inform future implementation efforts. Six databases (MEDLINE, EMBASE, Scopus, CINAHL, PsychInfo, and Web of Science) were searched from inception to March 11, 2021. Studies were included if they reported physical therapists' PA promotion practices and factors influencing these practices. Study quality was assessed with a modified Newcastle-Ottawa Scale and the Critical Appraisal Skills Programme checklist. Studies were excluded if they did not separate physical therapist PA promotion practices and influencing factors from other health professionals. The search yielded 12,835 references and 27 included studies. Twenty studies were included in a meta-analysis of proportions, whereas 15 studies were included in a meta-analysis of correlations. Very-low to moderate-quality evidence suggests that factors at the individual and organizational levels have very small to moderate associations with PA promotion practices. Efforts to improve PA promotion by physical therapists should consider incorporating combinations of individual and organizational factors. Limitations to the body of evidence highlight the need for future research. With PA projected to decrease in the general population by an additional 20% by 2050, PA promotion is urgently needed to maximize physical therapists' impact on the health of society. This study identifies factors that may prove useful for guiding the development of strategies to encourage greater engagement in PA promotion by physical therapists.

Being an excellent scientist is not enough to succeed! Soft skills for medical physicists

PurposeTo provide a review of the literature and commentary regarding soft skills for Medical Physicists. MethodA comprehensive search in PubMed was carried out using the searchwords ‘medical physics’ coupled separately (‘AND’, both in Title) with each of the following terms: leadership, teamwork, communication, pedagog*, teach*, marketing, conflict resolution, negotiat*, qualitative research, organizational psychology. ResultsThe total number of PubMed references was extremely low (total 6 relevant articles for all of leadership, communication, pedagog*, teach*, with the rest of the searchwords giving zero hits) which is quite disturbing. For an improved perspective, we compared the search for ‘leadership AND medical physics’ to ‘leadership AND medical’ and ‘leadership AND nursing’ we only had 4 hits for Medical Physics as opposed to 564 for ‘leadership AND medical’ and 1419 for ‘leadership AND nursing’. ConclusionsIt seems that Medical Physicists give an extremely low priority to soft skills as opposed to scientific skills. In a world of austerity economics and sometimes over commoditization such a situation is not only disturbing it is actually very risky for the profession. Medical Physicists must learn to provide strategic and robust leadership, be able to market their profession to all stakeholders (in particular to decision makers, other health care professions and the general public), be able to communicate their role, negotiate effectively for their profession, and boost their abilities for teambuilding and conflict resolution. The setting up of education programmes to overcome this soft skill deficit among medical physicists by national, regional and international medical physics organizations must be given priority.

Review of Agricultural Products Marketing Activities and Services

Marketing is the performance of all physical activities, transactions and facilities, as a result of which the agricultural product is moved from the main place of production (farm), all kinds of benefits are added to them, and after reaching the last consumer, some of his needs are met. In order for objects and services to move in the marketing channel, they must legally change their ownership, resulting in a change of ownership of the exchange, so that several exchanges take place during marketing until the crop reaches the final consumer. Different activities in the marketing stage make it possible to move the material in the marketing channel. The sum of these activities is studied under the heading of marketing tasks, which are generally divided into three categories, which include exchange, physical and facilitative activities. Doing any of these activities will add value to agricultural products and facilitate the transfer of goods, and the product will be placed in the hands of the end consumer to meet some of his needs. When the product is produced and ready to be marketed for consumption until it reaches the final consumer, actions are taken on these products, which are called agricultural marketing services; Therefore, operations of agricultural products include collection, transfer and distribution of agricultural products that require various services, which include product collection, transportation, packaging, conversion or processing of products, standardization of agricultural products, grading, storage and storage of agricultural products, credit , Accept risks, pricing and advertising. Complete coherence and coordination between activities to reduce costs, normal and fast flow of products and prevent spoilage and deterioration of their quality. All of the above activities are carried out by a marketing system consisting of physical, exchange and facility organizations and institutions; Timely implementation of these activities in order to reach the product to consumers on time, good quality and reasonable price is important. The overall purpose of this issue is to identify the different marketing tasks of agricultural products in order to fully understand the various marketing activities and improve how these tasks are performed so as not to reduce the quality of agricultural products.The present research has been done by review method and using previous studies in order to review the marketing activities and services of agricultural products. In this regard, citation method and study of scientific books, articles and journals have been used to collect information and information. It came to this conclusion by reviewing and studying scientific books and articles related to the subject of marketing activities and services; All marketing activities are carried out through a marketing system consisting of individuals, physical institutions, transactions and facilities with their infrastructure, which is simultaneously responsible for increasing the high value of products and transferring them from producers to consumers to satisfy their maximum demand. Without an active and modern marketing system with telecommunication facilities, transportation, storage, refrigeration, processing, credit, generators can not make good use of production and marketing opportunities.

Mental contrasting and implementation of physical activity intentions in Ugandan primary care patients with mental health problems: A real-world intervention involving support partners

This study explored the efficacy of lay health worker (LHW)-led physical activity (PA) counselling for primary care patients with mental health problems (PCMH) and their support partners. Forty-nine (41♀, median age=47, interquartile range=22) PCMH and 49 support partners [9♀, 31(9)years] participated in once weekly counselling based on the mental contrasting and implementation of intentions framework for 8 weeks. All participants completed the Simple Physical Activity Questionnaire (SIMPAQ) and World Health Organization Disability Assessment Schedule 2 (WHODAS 2), while PCMH completed the Multidimensional Scale for Perceived Social Support (MSPSS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Alcohol Use Disorders Identification Test (AUDIT) pre- and immediately post-intervention. In PCMH significant (P<0.001) increases in walking, exercising and incidental PA (SIMPAQ) levels, reductions in depressive (PHQ-9) and anxiety (GAD-7) symptoms and improvements in mobility and participation (WHODAS 2) were observed. Perceived support from significant others (MSPSS) significantly increased. In support partners, a significant reduction in time spent sedentary, increase in incidental PA (SIMPAQ) and improvement in the perception of getting alone with others (WHODAS 2) was seen. Our study demonstrates that LHW-led PA counselling is beneficial for PCMH and their support partners. Randomized controlled trials are warranted to confirm these positive findings.

The (Un)governable City: Productive Failure in the Making of Colonial Delhi, 1858-1911 by Raghav Kishore

Delhi has always been a crucible of political disquiet, and the seat of manifold state and aesthetic desires to order, control and design the city. Even at this moment, we find ourselves before a ubiquitous impulse to change the appearance of the city through the Central Vista Project which proposes to cater to needs of increase in government office space. There are layers to the city and obvious enough, it is not monolithic. The vestiges and architectural remnants of subsequent ages narrate the relentless saga of power, domination and settlement. A historical analysis of the spatial structures reflects the reasons behind its physical organization. To talk about colonial designs within this very broad spectrum is but, only a brief moment in a longue duree of human settlement in this region. Yet, it is necessary to understand the spatial synchrony, for much of it is what we have inherited today and this is what shapes our experiences of this city even at present. Raghav Kishore’s The (Un)governable City (2020), makes an intervention in this corpus of historical analysis with his impeccable research and endless forays into the archives. This is a welcome addition to studies in the field of urban development of Delhi, with Pilar Maria Guerrieri’s Maps of Delhi (2017) being one precursor, which painstakingly curates maps of Delhi from the precolonial times, to the modern municipal Master Plans to contemporary digital mappings. Kishore unearths curious details from local sources and twines those with debates among colonial policy makers and personnel to highlight issues of political ideology, statecraft and governmentality. This volume juxtaposes notions of policing, control and accessibility with debates and discussions on sanitation, traffic, communication, railways and the building of military cantonments, which are significant if we think of the British rule in India as a garrison state, heavily dependent on the easy mobility of its military forces. The success of the control was conditional on the ability to gather up huge military forces to curb parallel sporadic outbursts at their very onset. The broadening of roads, regulation of quarters and delimiting encroachments and concerns over connectivity, were carefully thought out strategisations towards the goal of containment and territorialisation.

Combining research and design: A mixed methods approach aimed at understanding and optimising inpatient medication storage systems.

BackgroundAlmost every patient admitted to hospital will receive medication during their stay. Medication errors are an important cause of patient morbidity and mortality, as well as an economic burden for healthcare institutions. Research suggests that current methods of storing medication on hospital wards are not fit for purpose, contributing to inefficiency and error.AimTo improve medication storage in inpatient areas, by exploring variation and challenges related to medication storage and designing a prototype solution.MethodsSet in four hospitals in an English teaching hospital trust, the study used a mixed methods approach comprising a quantitative descriptive survey of storage facilities and practices followed by mixed methods observations of medication rounds and interviews with patients, nurses and pharmacy staff. Quantitative data were presented descriptively and qualitative data analysed thematically and using a human-centered design approach.ResultsWe identified wide variation in medication storage facilities and practices across 77 wards. Observations and staff interviews in six wards revealed five problem areas: poor management of multiple storage facilities; lack of visibility and organisation of medication within trolleys; inadequate size of storage; lack of ownership and knowledge of standard practice; and use of key locks. Patients were largely satisfied with receiving their medication. Systematic and consistent physical organisation of medication in medication trolleys, and integrating and implementing principles of best practice, were identified as areas for intervention.Discussion and conclusionVariation in medication storage facilities and practices existed both across the organization and on individual wards. Multiple challenges were identified in how medication was stored, which if addressed may improve the efficiency and safety of medication administration and in turn, staff and patient experience. The use of design principles alongside a research approach resulted in a rapid, iterative process for developing and refining potential solutions to improve inpatient medication storage.

Making it \u201cwork\u201d: mothers\u2019 perceptions of workplace breastfeeding and pumping at Dutch universities

BackgroundDutch breastfeeding rates are below World Health Organization’s recommendations and targets despite the benefits for individuals and society. Increasing the rates is complex due to multiple breastfeeding determinants, of which maternal education and employment are dominant. This study aimed to identify the perceptions and experiences of mothers employed at Dutch universities regarding barriers and enablers to workplace breastfeeding and pumping.MethodsThe study adopted a descriptive, qualitative research design. Thirteen semi-structured online interviews, underpinned by the Social Ecological Model, were conducted in 2020 with three experts and ten academic employees from five universities who had breastfed or pumped at work within the past five years. Qualitative data were examined through a thematic analysis.ResultsFour main themes were identified: physical work environment, social support, work culture and organisation, policies and legal rights. Most mothers had more negative than positive experiences combining breastfeeding with work. They were unable to exercise their rights as a breastfeeding employee due to inappropriate and inaccessible lactation rooms, a lack of communication and information-provision, other people’s lack of awareness, inflexible working hours and unadjusted workloads, especially for teaching positions. All participants found the duration of Dutch maternity leave too short.ConclusionsUniversities need to increase institutional efforts at multiple levels and meet their legal obligations to support breastfeeding employees. Workplace interventions should be combined with more political commitment to normalise breastfeeding, monitor compliance with maternity protection provisions at work and prolong parental leave to encourage breastfeeding continuation.

VJ21.089The subcompartmented oxphosomic model of the phosphorylating system organization in mitochondria.

The oxidative phosphorylation (OXPHOS) system of mitochondria supports all the vitally important energy-consuming processes in eukaryotic cells, providing them with energy in the form of ATP. OXPHOS enzymes (complexes I–V) are located in the inner mitochondrial membrane, mainly in the cristae subcompartment. At present, there is a large body of data evidencing that the respiratory complexes I, III2 and IV under in vivo conditions can physically interact with each other in diverse stoichiometry, thereby forming supercomplexes. Despite active accumulation of knowledge about the structure of the main supercomplexes of the OXPHOS system, its physical and functional organization in vivo remains unclear. Contemporary models of the OXPHOS system’s organization in the inner membrane of mitochondria are contradictory and presume the existence of either highly organized respiratory strings, or, by contrast, a set of randomly dispersed respiratory supercomplexes and complexes. Furthermore, it is assumed that ATP-synthase (complex V) does not form associations with respiratory enzymes and operates autonomously. Our latest data obtained on mitochondria of etiolated shoots of pea evidence the possibility of physical association between the respiratory supercomplexes and dimeric ATP-synthase. These data have allowed us to reconsider the contemporary concept of the phosphorylation system organization and propose a new subcompartmented oxphosomic model. According to this model, a substantial number of the OXPHOS complexes form oxphosomes, which in a def inite stoichiometry include complexes I–V and are located predominantly in the cristae subcompartment of mitochondria in the form of highly organized strings or patches. These suprastructures represent “mini-factories” for ATP production. It is assumed that such an organization (1) contributes to increasing the eff iciency of the OXPHOS system operation, (2) involves new levels of activity regulation, and (3) may determine the inner membrane morphology to some extent. The review discusses the proposed model in detail. For a better understanding of the matter, the history of development of concepts concerning the OXPHOS organization with the emphasis on recent contemporary models is brief ly considered. The principal experimental data accumulated over the past 40 years, which conf irm the validity of the oxphosomic hypothesis, are also provided.

Physician-pharmacy integration and oral cancer drug use and quality.

39 Background: Public reports suggest increasing integration of in-house specialty pharmacies by independent and system-based oncology practices. Understanding the impact of such integration has important implications for state-level regulations limiting physicians’ ability to launch pharmacies in certain states and policies governing pharmacy network design. In this analysis, I document the growth of in-house pharmacies and estimate the impact of this growth on oral cancer drug use and quality. Methods: I used 2006-2017 data from Medicare Fee-for-Service and Part D claims, pharmacy names and characteristics from health plan pharmacy network lists and the National Plan and Provider Enumeration System, and a unique Health System and Practice Dataset, developed by National Bureau of Economic Research and Harvard University researchers, that tracks practice ownership relationships. I first linked physician organizations and pharmacies that they operate using a novel claims-based algorithm combining information on pharmacy characteristics, similarities in names of practices and pharmacies, and the share of total pharmacy spending attributable to a single practice or system. I then used an event study approach to compare oral oncolytic use and quality at practices launching a pharmacy between 2009 to 2014 compared with matched controls. Outcomes included total spending on oral oncolytics, use of oral drugs when an intravenous equivalent exists (capecitabine and 5-fluoruracil), timeliness of new prescription fills (# days from first fill to last office visit), medication adherence, and early discontinuation of lenalidomide, tyrosine kinase inhibitors, aromatase inhibitors, tamoxifen, enzalutamide, and abiraterone. Results: The number of independent or system-based oncology practices with an in-house pharmacy filling any oncology prescriptions increased from 135 in 2006 to 442 in 2017. In that time, the share of Medicare Part D spending on oral oncolytics filled at in-house pharmacies increased from 4% in 2006 to 27% in 2017. The launch of an in-house pharmacy was not associated with an overall increase in spending on oral oncolytics, but was associated with a 4.5 percentage point (p =.01) increase in the use of capecitabine relative to 5-fluorouracil, within 2 years of launch. In-house pharmacies were associated with a modest decrease in the time to fill an initial prescription (2.4 days, p &lt;.001) within 2 years of launch, but no improvements in adherence or reductions in early discontinuation. Conclusions: There has been substantial growth in the use of in-house pharmacies in oncology in recent years. Having an in-house pharmacy only had modest effects on cost and quality. Policymakers should therefore approach claims that in-house pharmacies meaningfully impact cost and quality with caution.

Implementation of the Core Outcome Measures CPG: Assessing the Know-Do Gap

<h3>Research Objectives</h3> To assess the Know-Do Gap of physical therapist use of the clinical practice guideline recommended core set of outcome measures (OMs) for neurologic conditions. <h3>Design</h3> Mixed-methods knowledge translation study implementing the Knowledge to Action (KTA) Cycle. <h3>Setting</h3> One neurologic outpatient physical therapy organization with three clinical sites that primarily serves patients with neurologic conditions. <h3>Participants</h3> 19 physical therapists. <h3>Interventions</h3> Retrospective medical record review of initial evaluation and discharge documentation from a five month period (October 2019 - February 2020). <h3>Main Outcome Measures</h3> Frequency of use of outcome measures, including the six core outcome measures recommended in the neurological outcome measures clinical practice guideline. <h3>Results</h3> 225 notes were reviewed (evaluation = 134; discharge = 91), performed by 19 physical therapists. 39 unique OMs were used during the 5 month reporting period. Results of the six core OMs were performed at the following frequencies: Six Minute Walk Test 82.2% (n = 185); Berg Balance Scale 43.1% (n = 97); 5 Times Sit-to-Stand 16.9% (n = 38); 10 meter Walk Test 14.7% (n = 33); Functional Gait Assessment 3.1% (n = 7); and the Activities-Specific Balance Confidence Scale 1.8% (n =4). <h3>Conclusions</h3> Implementation of the six core OMs in this outpatient physical therapy organization was variable. This assessment of the know-do gap is the first step in the KTA Cycle. Future steps include continuing to utilize the KTA Cycle to increase uptake of the core set of OMs. <h3>Author(s) Disclosures</h3> Dr. Yorke has no disclosures. Dr. Trojanowski has no disclosures. Dr. Fritz serves on the MS scientific advisory board for Helius Medical.

Mental health in mine workers: a literature review.

The mining environment is hazardous for worker’s health. It can affect the mental health, triggering symptoms and diseases, such as anxiety, job stress, depression, sleep disorders, mental fatigue and other. The aim of this study was to describe and analyze the scientific literature about the mental health in mine workers and to summarize the findings. The method used was scoping review. The principal outcomes were the following: evidence in the last 12 years in the topic was focused in four themes 1) Psychological problems & personal factors (38.2%); 2) Psychosocial problems & health related factor (23.6%); 3) Well-being (21.1%) and 4) Physical problems & organization factors (17.1%). Several affections, symptoms, characteristics or disorders were inquired about mine worker’s mental health, such as job strain, unsafety experiences, poor quality of sleep, non-subjective well-being, job unsatisfaction, social-relations conflict, risk of accidents and injuries, musculoskeletal disorders (MSDs), substance abuse, dangerous working conditions and demanding job organization, and so on. For those factors, Mining could expose to serious mental health problems to a part of their workers. It’s necessary to deepen the elaboration of international policies and carry out more scientific research and suggestions to make programs on the topic.

Метаболічні та психологічні рестрикти корекції харчування дітей із надлишковою масою тіла

Публікація присвячена огляду сучасних уявлень про психологічні та метаболічні регулятори голоду/насичення та їх вплив на формування порушень харчової поведінки в дітей із надмірною масою тіла. В умовах епідемії ожиріння у світі рекомендовані заходи, що спрямовані на запобігання її поширенню, включають у себе підвищення рівня фізичної активності та правильну організацію харчування дітей. У той же час ефективність цих немедикаментозних інтервенцій є вкрай низькою внаслідок психосоціальної дисфункції. Аналіз механізмів виникнення надлишкового споживання їжі показує, що порушення харчової поведінки при надмірній масі тіла в дітей мають метаболічну нейроентероендокринну основу з безпосереднім впливом на центри голоду/насичення. Постійна стимуляція гедонічних центрів із формуванням фізичної залежності у дітей зі зниженими вольовими якостями, що підтримуються батьківським ставленням, є основою вкрай низької ефективності корекції харчування при надлишковій вазі. З метою підвищення ефективності програм корекції ваги в дітей паралельно з ендокринологічним/педіатричним консультуванням необхідно широко впроваджувати сімейно-орієнтовані просвітницькі програми та соціально-психологічні інтервенції.

Tough Hydrogels with Dynamic H-Bonds: Structural Heterogeneities and Mechanical Performances

The recently developed tough and self-healing hydrogels, containing a large number of physical bonds, have found widespread applications in bioengineering and soft electronics. Owing to the sophisticated physical interactions and organization, these hydrogels often demonstrate structural heterogeneities, which strongly influence their mechanical performances. Using poly(N,N-dimethyl acrylamide-co-methacrylic acid) hydrogels (P(DMAA-co-MAAc)) with dynamic hydrogen bonds (H-bonds) as a model system, the structural characterization has been carried out in this study using small-angle X-ray scattering (SAXS) and small-angle neutron scattering (SANS) analyses, along with exploring the influence of the structure on the mechanical properties. By systematically tuning the polymer composition, including the monomer fraction and chemical cross-linking density, two different hydrogel regions with distinct mechanical properties were observed: the swollen regions and shrunk regions. The former was mechanically weak, whereas the latter exhibited a tough behavior. Both types of hydrogels were noted to be highly heterogeneous, which results from the nanoscale spatial polymer concentration fluctuations at ∼100 nm scale. Combined with the contrast variation utilizing SANS, the structure parameters, including the polymer volume fraction of the dense and sparse regions, volume fraction occupied in the space, and average correlation length of the long-range and short-range heterogeneous structures, were explored using a scaling model based on a two-phase system composed of the densely and sparsely cross-linked regions. Using in situ SAXS, the microscopic deformation of the tough and shrunk hydrogels was noted to follow the affine deformation, while a significantly non-affine deformation was observed in the swollen hydrogels, which might have led to the different mechanical performances of these materials.

Effect of Cybercrime in Real World

The Internet is a space that utilises the electronic and electromagnetic range to store, change, and exchange information through the organisation and system related to physical organisations. The Internet is an infinite space known as the Internet. PC exchanges, particularly exchanges between various PCs, can be seen as a space. Pictures and text on the Internet exist on the Internet. The term is used to describe computer-generated reality, naming the non-existent spot where a virtual item exists. There is a chance that a PC makes an image of a structure that permits the designer to "amble" and see the idea of a program. The system is supposed to be on the Internet. Cybercrime is a sequence of coordinated criminal attacks on the Internet and network safety. Cybercrime is like Hacking into the PC, can be through an organisational system and tapping on new connections interfacing with unnoticed Wi-Fi, downloading programming and documents to critical destinations, burning-through energy, electromagnetic radiation waves, and more. Network safety is a major issue and should be treated seriously as it has turned into a public concern. Most electronic gadgets like PCs, workstations and PDAs accompany worked in firewall security programming. PCs are not 100% safe and solid in securing our information.

Probing associations between interbrain synchronization and interpersonal action coordination during guitar playing

Playing music in an ensemble is a highly coordinated human action involving musicians' brain-body interactions at different levels of physical and cortical organization in time and space. It has been suggested that interbrain phase synchronization plays an essential role in musical interaction. In this study, we aimed to explore associations between interbrain synchronization and interpersonal action coordination, using electroencephalographic recordings of the brain activity of guitarists playing in a duet as well as the acoustic recordings of their music. By applying phase synchronization algorithms to the musicians' brain activities and the sounds produced during guitar playing, we show that synchronous brain activity is strongly related to instrument sounds and behavioral play-onset synchrony, as indicated by phase alignment in relation to the time differences in play onsets and an angular-linear correlation between phase and time differences across trials and guitarist pairs. Interestingly, this correlation was especially strong in the first part of the music piece, when the guitarists seem to adjust their coordinated play onsets and brain rhythms actively. This suggests that the methods capturing intra- and interbrain synchronization and its relations to coordinated playing provide crucial information about the underlying mechanisms of interpersonal action coordination.

The Filing Cabinet: A Vertical History of Information

The Filing Cabinet: A Vertical History of Information

Comparative genomics of two inbred lines of the potato cyst nematode Globodera rostochiensis reveals disparate effector family-specific diversification patterns

BackgroundPotato cyst nematodes belong to the most harmful pathogens in potato, and durable management of these parasites largely depends on host-plant resistances. These resistances are pathotype specific. The current Globodera rostochiensis pathotype scheme that defines five pathotypes (Ro1 - Ro5) is both fundamentally and practically of limited value. Hence, resistant potato varieties are used worldwide in a poorly informed manner.ResultsWe generated two novel reference genomes of G. rostochiensis inbred lines derived from a Ro1 and a Ro5 population. These genome sequences comprise 173 and 189 scaffolds respectively, marking a ≈ 24-fold reduction in fragmentation as compared to the current reference genome. We provide copy number variations for 19 effector families. Four dorsal gland effector families were investigated in more detail. SPRYSECs, known to be implicated in plant defence suppression, constitute by far the most diversified family studied herein with 60 and 99 variants in Ro1 and Ro5 distributed over 18 and 26 scaffolds. In contrast, CLEs, effectors involved in feeding site induction, show strong physical clustering. The 10 and 16 variants cluster on respectively 2 and 1 scaffolds. Given that pathotypes are defined by their effectoromes, we pinpoint the disparate nature of the contributing effector families in terms of sequence diversification and loss and gain of variants.ConclusionsTwo novel reference genomes allow for nearly complete inventories of effector diversification and physical organisation within and between pathotypes. Combined with insights we provide on effector family-specific diversification patterns, this constitutes a basis for an effectorome-based virulence scheme for this notorious pathogen.

Integration host factor bends and bridges DNA in a multiplicity of binding modes with varying specificity.

Nucleoid-associated proteins (NAPs) are crucial in organizing prokaryotic DNA and regulating genes. Vital to these activities are complex nucleoprotein structures, however, how these form remains unclear. Integration host factor (IHF) is an Escherichia coli NAP that creates very sharp bends in DNA at sequences relevant to several functions including transcription and recombination, and is also responsible for general DNA compaction when bound non-specifically. We show that IHF–DNA structural multimodality is more elaborate than previously thought, and provide insights into how this drives mechanical switching towards strongly bent DNA. Using single-molecule atomic force microscopy and atomic molecular dynamics simulations we find three binding modes in roughly equal proportions: ‘associated’ (73° of DNA bend), ‘half-wrapped’ (107°) and ‘fully-wrapped’ (147°), only the latter occurring with sequence specificity. We show IHF bridges two DNA double helices through non-specific recognition that gives IHF a stoichiometry greater than one and enables DNA mesh assembly. We observe that IHF-DNA structural multiplicity is driven through non-specific electrostatic interactions that we anticipate to be a general NAP feature for physical organization of chromosomes.

Training Characteristics, Academic Accomplishments, and Motivation of Current Chairs in Physical Medicine and Rehabilitation.

The aim of the study was to report the training characteristics, academic accomplishments, and motivation of current United States academic physical medicine and rehabilitation chairs. The authors developed a 23-question survey that was disseminated via e-mail to 86 current chairs who were members of the Chairs Council from the Association of Academic Physiatrists in May 2020. Follow-up e-mails were sent 2 and 4 wks after the initial distribution, and the survey closed after 6 wks in June 2020. The data collected were deidentified. Descriptive analysis was performed. Forty-nine chair responses were received, which had a response rate of 60%. A total of 69.4% of the chairs (32 of 49) were men and 30.6% (17 of 49) were women. A total of 75.5% (37 of 49) were White/Caucasian, 12.2% (6 of 49) Hispanic/Latinx, 10.2% (5 of 49) Asian, and 2% (1 of 49) were Black/African American. A total of 8.2% of the chairs (4 of 49) reported having a disability. Sixty-seven percent of the female chairs (10 of 15) reported experiencing gender discrimination in the workplace versus 3% of male chairs (1 of 34). Twenty-nine percent of the chairs were full professors in physical medicine and rehabilitation when first appointed, 57.1% associate professors, and 6% assistant professors. A total of 73.5% of the chairs had served as a reviewer for a peer-reviewed publication. Fifty-two percent of the chairs had a leadership role in a national physical medicine and rehabilitation organization. Fifty-eight percent of the chairs had at least 16 peer-reviewed publications when first appointed. This survey provides insight to the training characteristics, accomplishments, and motivation of current chairs for physiatrists aspiring to enter these ranks. It also highlights the underrepresentation of women and minorities among leadership positions in physical medicine and rehabilitation.

Commentary: Global Comparisons of Physician Associations.

The authors reflect on their own work in relation to the articles in this special section on physician organizations, and they make four observations. First, association-government power relations shift after countries introduce universal health insurance, but they are by no means diminished. In France, Germany, and Japan, physicians' economic interests are explicitly considered against broader health system goals, such as providing affordable universal insurance. In low- and middle-income countries (LMICs), physician organizations do not share power in the same way. Second, in higher-income countries, fragmentation may occur along specialty or generalist lines, and some physicians are unionized. Generally speaking, physician influence over reimbursement policy is reduced because of organizational fragmentation. Third, associations develop as legitimate voices for physicians, but their relationship to other professions differs in higher-income countries. Associations in LMICs form coalitions with other health professionals. Finally, although German state physician associations have a key implementation role, in most countries, state and federal policy roles seem relatively defined. Global comparison of the LMICs and other countries suggests power, unity, legitimacy, and federal roles are tied closely to the stage of health system development.