Saint Louis University

The shift toward virtual interviews in physician assistant/associate (PA) admissions accelerated during the COVID-19 pandemic, yet little is known about applicants' modality preferences. This study aimed to determine whether personal characteristics were associated with applicants' choice of interview format and to assess whether interview type was associated with admission outcomes and first-semester academic performance. This multicenter retrospective study included 405 interviewees to 3 private PA programs during the 2023 to 2024 admission cycle. Applicants chose either in-person or virtual interviews. Data were extracted from Centralized Application Service for Physician Assistants and institutional records and included demographics, academic metrics, and interview outcomes. Bivariable analyses and logistic regression were used to explore associations between interview type, admission status, matriculation, and grade point average (GPA). Of 405 interviewees, 270 chose in-person and 135 virtually. Those who chose virtual interviews were older, more likely to be male, lived farther from campus, had more patient care experience, and were more likely to identify as underrepresented in medicine (URiM). Among matriculants, those who interviewed virtually were more likely to report economic and environmental disadvantage. The proportion of interviewees offered admission and the proportion that matriculated were higher for those who chose in-person interviews than for those who chose to interview virtually. Interview type was not associated with first-semester GPA. Logistic regression identified URiM status and geographic distance as significant predictors of virtual interview choice. Offering virtual interviews may promote greater access and diversity without compromising academic outcomes. Applicants with URiM backgrounds or greater geographic/economic constraints were more likely to choose virtual formats. These findings support continued offering of virtual interviews as a strategy to reduce barriers in PA admissions.

This paper applies the Temporal Fusion Transformer (TFT) model to learn dynamic time-series patterns in mutual fund performance and to assess whether these patterns predict future alpha. I summarize the model’s cross-sectional ranking power using diagnostic portfolio spreads: a top-minus-bottom decile exhibits an annualized Carhart four-factor alpha spread of 2.8%, with dispersion persisting for up to four years. In panel regressions controlling for standard predictors and fund and time fixed effects, TFT forecasts improve explanatory power by more than 25% in adjusted R 2 . Leveraging TFT’s interpretable outputs, I show that historical fund returns receive the largest weight (about 29%), their importance displays earnings-cycle seasonality, and attention to past observations rises by 46% during crisis periods. Using fund-by-month variable-importance weights, I define fund-specific informativeness states and construct conditional skill measures that predict and persist precisely when the same signal becomes informative again, beyond coarse macro conditioning. Together, these results provide an alternative explanation for why unconditional performance persistence appears weak: skill is episodic and becomes visible when a manager’s key signals regain relevance. • TFT deep learning model predicts mutual fund alpha from time-series patterns. • Top-minus-bottom decile spread yields 2.8% annualized four-factor alpha. • Model attention to past observations rises 46% during crisis periods. • Conditional skill measures persist when key signals regain informativeness. • Episodic skill explains why unconditional persistence appears weak.

Anti-Inflammatory Reliever (AIR) therapy-the use of inhaled corticosteroids (ICS)/formoterol or ICS with short-acting beta-agonists as reliever therapy is guideline-recommended for mild asthma. However, its uptake remains low in community settings. To improve AIR adoption, we developed an AIR Asthma Plan (AIR-AP) and implementation strategies to support its adoption, which we then pilot-tested to assess feasibility and acceptability. Using an exploratory sequential design, we collaborated with stakeholders and pilot site providers to: (1) assess provider needs, (2) co-develop multicomponent provider support tools, (3) tailor workflows, and (4) conduct a 3-5-month pilot test of the tools and implementation strategies in three diverse community practices (pediatrics, family medicine, and allergy). We evaluated usability, acceptability, and feasibility of our implementation strategy using validated questionnaires and provider interviews. Asthma patients were asked to evaluate the usability of the AIR-AP and instructional videos. We co-developed multi-component provider support tools for adoption of AIR, including: (1) AIR-AP (patient-level), (2) instructional videos (patient-level), (3) patient selection tool (provider-level),(4) AIR implementation guide (provider-level), and (5) practice training materials (slide deck). Seven providers from three pilot sites participated. AIR provider support tools were generally feasible and acceptable; however, ongoing barriers to AIR adoption persisted, including limited visit time, unfamiliarity and communication challenges, patients' health literacy and hesitancy to change, and inadequate institutional dissemination. Based on pilot testing, co-developed tools for AIR adoption were feasible and acceptable in community settings. Future efforts should focus on evaluating the effectiveness and other implementation outcomes of these tools.

BackgroundMisalignment between actual and perceived balance ability provides relevant information to understand functional deficits and fall risk. However, few studies have provided a continuous quantification of misalignment in neurological populations such as people with Parkinson's disease (PD).ObjectiveDetermine whether a continuous quantification of misalignment between actual and perceived balance ability, discordance, relates to functional outcomes such as quality of life and cognition.MethodsActual (gait velocity), and perceived (Activities of Balance Confidence) balance, cognition (measured via a computer-based cognitive assessment), and mobility-related quality of life were captured in a clinical sample of 95 people with PD. Primary outcomes were quality of life and cognitive domains frequently altered in people with PD (global cognition & executive function). Secondary cognitive domains assessed were attention, memory, visuo-spatial, verbal function, and information processing. Linear and non-linear models assessed the relationship between discordance, quality of life, and cognition.ResultsDiscordance related to mobility-related quality of life, such that under-confidence was related to poorer quality of life. Non-linear (quadratic) models were shown to fit the discordance-Global cognition (p = 0.02) data better than linear models such that over- and under-confidence related to poorer cognition. Secondary cognitive domains were not robustly related to discordance.ConclusionsIn a clinical sample of people with PD, discordance was related to mobility-related quality of life and global cognition. Global cognition further exhibited a possible non-linear relationship to discordance indicating that over- or under-confidence may relate to poorer cognition. This work underscores the functional relevance of misalignment of actual and balance abilities.

Mechanical circulatory support (MCS) devices can be helpful to maintain hemodynamic stability during high-risk percutaneous coronary intervention (PCI). Iliofemoral arterial disease limits the use of transfemoral MCS devices. Impella 5.5, a surgical transaxillary MCS device, represents a viable option for MCS-protected PCI. We report a 74-year-old man with prior endovascular aneurysm repair (EVAR), severe peripheral artery disease (PAD), and newly diagnosed NSTEMI was found to have three-vessel and left main coronary disease with an ejection fraction (EF) of 13%. Due to aortoiliac occlusion, transfemoral MCS was not feasible. Instead, an Impella 5.5 was implanted via a right axillary artery graft, enabling successful orbital atherectomy and bifurcation PCI. In summary, axillary Impella 5.5 insertion is a viable option in anatomically complex patients where femoral access is contraindicated. This approach allows full left ventricular hemodynamic support for revascularization in otherwise inoperable patients.