Attitudes on Equal Health Care Access versus Efficient Clinical Decisions across a Not-for-Profit Health Care System

BACKGROUND

Professional roles within a hospital system may influence attitudes behind clinical decisions.

OBJECTIVE

To determine participants' preferences about clinical decisions that either value equal health care access or efficiency.

DESIGN

Deidentified survey asking participants to choose between offering a low-cost screening test to a whole population ("equal access") or a more sensitive, expensive test that could be given to only half of the population but resulting in 10% more avoided deaths ("efficient"). Data collection took place from August 18, 2021, to January 24, 2022. Study 1644 was determined to be exempt by Tufts Health Sciences Institutional Review Board (IRB).

SETTING

Tufts Medicine Healthcare System.

PARTICIPANTS

Approximately 15,000 hospital employees received an e-mail from the Tufts Medicine Senior Vice President of Academic Integration.

MEASUREMENTS

Analysis of survey responses with chi-square and 1-sample t tests to determine the proportion who chose each option. Logistic regression models fit to examine relationships between professional role and test choice.

RESULTS

A total of 1,346 participants completed the survey (∼9.0% response rate). Overall, approximately equal percentages of respondents chose the "equal access" (48%) and "efficient" option (52%). However, gender, professional role (categorical), and clinical role (dichotomous) were significantly associated with test choice. For example, among those in nonclinical roles, women were more likely than men to choose equal health care access. In multivariable analyses, having clinical roles was significantly associated with 1.73 times the likelihood of choosing equal access (95% confidence interval = 1.33-2.25).

LIMITATIONS

Generalizability concerns and survey question wording limit the study results.

CONCLUSION

Clinicians were more likely than nonclinicians to choose the equal health care access option, and health care administrators were more likely to choose efficiency. These differing attitudes can affect patient care and health care quality.

HIGHLIGHTS

Divergent preferences of valuing equal health care access and efficiency may be in conflict during clinical decision making.In this cross-sectional study that included 1,346 participants, approximately equal percentages of respondents chose the "equal access" (48%) and "efficient" option (52%), a nonsignificant difference. However, gender, professional role (categorical), and clinical role (dichotomous) were significantly associated with test choiceSince clinicians were more likely than nonclinicians to choose the equal health care access option and health care administrators were more likely to choose efficiency, these differing attitudes can affect patient care and health care quality.

Technical note: High-efficient and wireless transcranial ultrasound excitation based on electromagnetic acoustic transducer

BACKGROUND

The generation of transcranial ultrasound is usually based on the piezoelectric effect, so it is necessary to attach transducers around the skull. However, the skull will cause serious attenuation and scattering of ultrasound, which makes it particularly difficult for transcranial ultrasound imaging and modulation.

PURPOSE

In transcranial ultrasound imaging, there is significant attenuation and scattering of ultrasound waves by the skull bone. To mitigate this influence and enable precise imaging and high-efficient transcranial ultrasound for specific patients (such as stroke patients who already require craniotomy as part of their surgical care), this paper proposes to use EMAT to excite metal plates placed inside the skull based on the excellent penetration characteristics of EM waves into the skull, generating ultrasound signals, which can completely avoid the influence of skull on ultrasound transmission.

METHODS

Based on an efficient wireless transcranial ultrasound experimental platform, we first verified that the skull would not affect the propagation of electromagnetic waves generated by EMAT. In addition, the distribution of the transcranial sound field generated by EMAT was measured.

RESULTS

EMAT can generate 1.0 MHz ultrasound by wireless excitation of a 0.1 mm thick copper plate through an adult skull with a thickness of ∼1 cm, and the frequency and amplitude of the generated ultrasound are not affected by the skull. The results indicated that the electromagnetic waves successfully penetrated the skull, with a recorded strength of approximately 2 mV. We also found that the ultrasound signals generated by the EMAT probe through the skull remained unaffected, measuring around 2 mV. In addition, the measurement of the transcranial sound field distribution (80*50 mm2 ) generated by EMAT shows that compared with the traditional extracranial ultrasound generation method, the sound field distribution generated by the wireless excitation of the intracranial copper plate based on EAMT is no longer affected by the uneven and irregular skull.

CONCLUSION

Our experiments involved validating the penetration capabilities of electromagnetic waves utilizing the EMAT probe through a 7 (5+2) mm thick organic glass plate and a real human skull ranging from 8 to 15 mm in thickness. The efficient and wireless transcranial ultrasound excitation proposed in this paper may be possible for transcranial ultrasound imaging and therapy.

TLTC, a T5 exonuclease-mediated low-temperature DNA cloning method

Molecular cloning is used in a wide variety of biological and medical research. Here, we developed a rapid and efficient DNA-assembling method for routine laboratory work. We discovered that the cleavage speed of T5 exonuclease is approximately 3 nt/min at 0°C and hence developed a T5 exonuclease-mediated low-temperature sequence- and ligation-independent cloning method (TLTC). Two homologous regions of 15 bp-25 bp compatible with the ends of the vector backbones were introduced into the inserts through PCR. Approximately 120 fmol of inserts and linear vectors was mixed at a molar ratio of approximately 3:1 and treated with 0.5 U of T5 exonuclease at 0°C for 5 min. Then, the mixture was transformed into Escherichia coli to generate recombinant plasmids. Single segment and multi-segments can be assembled efficiently using TLTC. For single segment, the overall cloning efficiency is above 95%. Moreover, extra nucleotides in the vectors can be removed during TLTC. In conclusion, an extremely simple and fast DNA cloning/assembling method was established in the present study. This method facilitates routine DNA cloning and synthesis of DNA fragments.

Construction of Lanthanide Magnetic Bio-Based Porous Carbon Materials with Beam and Column Structure and Its Synergistic Adsorption Performance

Biochar porous carbon material (BPCM) has extraordinary adsorption properties and is being widely used in different fields around the world. The pore structure of BPCM is liable to collapse, and mechanical properties are inferior; hence, the focus is on developing a new ″powerful″ structure of functional BPCM. Rare earth elements with characteristic f orbitals are used as pore and wall strengthening units in this work. The new ″beam and column structure″ BPCM was synthesized by the aerothermal method, and then, the magnetic BPCM was prepared. The results showed that the designed synthesis route was reasonable, BPCM with a steady-state beam and column structure was attained, and the La element played a stabilizing role in maintaining the overall BPCM. The La hybridization exhibits the characteristic of ″the stronger column and weaker beam″, and the La group is the ″column″ to strengthen the BPCM as the ″beam″. The functionalized BPCM (lanthanum-loaded magnetic chitosan-based porous carbon materials, MCPCM@La₂O₂CO₃) obtained exhibited a transcendent efficient adsorption capacity with an average adsorption rate of 6.640 mg·g^-1·min^-1 and over 85% removal of different types of dye pollutants, which exceeded the adsorption performance of the materials of most other BPCMs. Ultrastructural analysis revealed that MCPCM@La₂O₂CO₃ has a huge specific surface area of 1458.513 m²·g^-1 and a magnetization value of 16.560 emu·g^-1 for MCPCM@La₂O₂CO₃. A new theoretical model for the adsorption of MCPCM@La₂O₂CO₃ (multiple adsorption coexistence equation) was established. The theoretical equations clarify that the mechanism of pollutant removal by MCPCM@La₂O₂CO₃ is different from the traditional adsorption model, presenting a mechanism of coexistence of multiple adsorption types, displaying a monolayer-multilayer adsorption mechanism, influenced by the synergistic effects of H bonding, electrostatic attraction, π-π conjugation, and ligand interaction. The rapid coordination of the d orbitals of La is an obvious factor in enhancing the adsorption efficiency.

An easy method to generate recombinant pseudorabies virus expressing the capsid protein of Porcine circovirus type 2d

Introduction

Homologous recombination is an effective way to generate recombinant viruses for vaccine research such as pseudorabies virus (PRV) and adenovirus. Its efficiency can be affected by the integrity of viral genome and the linearization sites.

Methods

In the study, we described a simple approach to isolate the viral DNA with high genomic integrity for large DNA viruses and a time-saving method to generate recombinant PRVs. Several cleavage sites in the PRV genome were investigated by using the EGFP as a reporter gene for identification of PRV recombination.

Results

Our study showed that cleavage sites of XbaI and AvrII are ideal for PRV recombination which showed higher recombinant efficiency than others. The recombinant PRV-EGFP virus can be easily plaque purified in 1-2 weeks after the transfection. By using PRV-EGFP virus as the template and XbaI as the linearizing enzyme, we successfully constructed the PRV-PCV2d_ORF2 recombiant virus within a short period by simply transfecting the linearized PRV-EGFP genome and PCV2d_ORF2 donor vector into BHK-21 cells. This easy and efficient method for producing recombinant PRV might be adapted in other DNA viruses for the generation of recombinant viruses.

Efficient methods for multiple types of precise gene-editing in Chlamydomonas

Precise gene-editing using CRISPR/Cas9 technology remains a long-standing challenge, especially for genes with low expression and no selectable phenotypes in Chlamydomonas reinhardtii, a classic model for photosynthesis and cilia research. Here, we developed a multi-type and precise genetic manipulation method in which a DNA break was generated by Cas9 nuclease and the repair was mediated using a homologous DNA template. The efficacy of this method was demonstrated for several types of gene editing, including inactivation of two low-expression genes (CrTET1 and CrKU80), the introduction of a FLAG-HA epitope tag into VIPP1, IFT46, CrTET1 and CrKU80 genes, and placing a YFP tag into VIPP1 and IFT46 for live-cell imaging. We also successfully performed a single amino acid substitution for the FLA3, FLA10 and FTSY genes, and documented the attainment of the anticipated phenotypes. Lastly, we demonstrated that precise fragment deletion from the 3'-UTR of MAA7 and VIPP1 resulted in a stable knock-down effect. Overall, our study has established efficient methods for multiple types of precise gene editing in Chlamydomonas, enabling substitution, insertion and deletion at the base resolution, thus improving the potential of this alga in both basic research and industrial applications.

Corrigendum: QUaRTM: A Quadcopter with Unactuated Rotor Tilting Mechanism capable of faster, more agile, and more efficient flight

[This corrects the article DOI: 10.3389/frobt.2022.1033715.].

The Efficiency of Anganwadi Centers Located in Rural Field Practice Area of a Medical College in North India: Data Envelopment Analysis

Background

The Integrated Child Development Services (ICDS) scheme was launched in 1975 for the improvement in maternal and child health and nutrition. The services under ICDS are implemented through Anganwadi centers (AWCs) and are delivered by Anganwadi workers (AWWs) at grassroots level. To evaluate the efficiency of all AWCs located in the field practice area of the medical college in North India, using data envelopment analysis (DEA) technique.

Materials and Methods

A cross-sectional study was conducted in the catchment area of rural health training center. Each of the 15 AWCs was considered a decision-making unit (DMU), and physical structure and logistics were included as input variables; and percentage of beneficiaries receiving supplementary nutrition and health checkups were included as output variables. DEA technique was used to calculate the efficiency score for each DMU with the help of DEAOS free online software.

Results

DMU 14th was found to be most efficient (100%) and DMU second was the least efficient (45%). DMU 13 and 14 demonstrated a level of performance that is superior to all other DMUs. DMU 13th and 14th were, therefore, considered 100% efficient. DEA analysis showed that total output increases and/or input reductions were required for making the inefficient DMUs efficient.

Conclusion

Most of the AWCs were inefficient and an improvement in the infrastructure and logistics is likely to improve the efficiency of AWCs.

WSNEAP: An Efficient Authentication Protocol for IIoT-Oriented Wireless Sensor Networks

With the development of the Industrial Internet of Things (IIoT), industrial wireless sensors need to upload the collected private data to the cloud servers, resulting in a large amount of private data being exposed on the Internet. Private data are vulnerable to hacking. Many complex wireless-sensor-authentication protocols have been proposed. In this paper, we proposed an efficient authentication protocol for IIoT-oriented wireless sensor networks. The protocol introduces the PUF chip, and uses the Bloom filter to save and query the challenge-response pairs generated by the PUF chip. It ensures the security of the physical layer of the device and reduces the computing cost and communication cost of the wireless sensor side. The protocol introduces a pre-authentication mechanism to achieve continuous authentication between the gateway and the cloud server. The overall computational cost of the protocol is reduced. Formal security analysis and informal security analysis proved that our proposed protocol has more security features. We implemented various security primitives using the MIRACL cryptographic library and GMP large number library. Our proposed protocol was compared in-depth with related work. Detailed experiments show that our proposed protocol significantly reduces the computational cost and communication cost on the wireless sensor side and the overall computational cost of the protocol.

Dye Plants Derived Carbon Dots for Flexible Secure Printing

Carbon dots (C-dots) are fluorescent nanomaterials, exhibiting excellent structure-dependent optical properties for various types of optical and electrical applications. Although many precursors were used for C-dots production, it is still a challenge to produce high-quality C-dots using environmentally-friendly natural precursors. In this work, multiple-colored colloidal C-dots were synthesized via a heating reaction using natural plant dyes as precursors, for example, Indigo, Carcuma longa, and Sophora japonica L. The as-prepared C-dots have absorption in the UV range of 220 to 450 nm with the typical emission ranging from 350 to 600 nm. The as-obtained C-dots have a quantum yield as high as 3.8% in an aqueous solution. As a proof-of-concept, we used the as-prepared C-dots as fluorescence inks for textile secure printing. The printed patterns are almost invisible under daylight and have distinct and clear patterns under 365 and 395 nm light, proving the great potential in optical anti-counterfeiting. This work demonstrates the advanced strategy for high-performance C-dots production from natural dyes and their potential application in flexible secure printing systems.

The Impact of Telemedicine on Physicians' After-hours Electronic Health Record "Work Outside Work" During the COVID-19 Pandemic: Retrospective Cohort Study

Background

Telemedicine as a mode of health care work has grown dramatically during the COVID-19 pandemic; the impact of this transition on clinicians’ after-hours electronic health record (EHR)–based clinical and administrative work is unclear.

Objective

This study assesses the impact of the transition to telemedicine during the COVID-19 pandemic on physicians’ EHR-based after-hours workload (ie, “work outside work”) at a large academic medical center in New York City.

Methods

We conducted an EHR-based retrospective cohort study of ambulatory care physicians providing telemedicine services before the pandemic, during the acute pandemic, and after the acute pandemic, relating EHR-based after-hours work to telemedicine intensity (ie, percentage of care provided via telemedicine) and clinical load (ie, patient load per provider).

Results

A total of 2129 physicians were included in this study. During the acute pandemic, the volume of care provided via telemedicine significantly increased for all physicians, whereas patient volume decreased. When normalized by clinical load (ie, average appointments per day by average clinical days per week), telemedicine intensity was positively associated with work outside work across time periods. This association was strongest after the acute pandemic.

Conclusions

Taking physicians’ clinical load into account, physicians who devoted a higher proportion of their clinical time to telemedicine throughout various stages of the pandemic engaged in higher levels of EHR-based after-hours work compared to those who used telemedicine less intensively. This suggests that telemedicine, as currently delivered, may be less efficient than in-person–based care and may increase the after-hours work burden of physicians.

Efficient method for whole-breast irradiation therapy using Halcyon linear accelerators

Background

The Halcyon is a linear accelerator‐based treatment machine designed for a high‐throughput simplified workflow. The machine features a compact jawless design, dual‐layer multileaf collimators, and a single 6‐MV flattening filter‐free (FFF) beam. However, the machine's 6‐MV FFF beam may restrict its applicability to conventional techniques, such as field‐in‐field (FiF) radiotherapy, for breast cancer treatment. This study developed a practical and efficient hybrid method for imaging, planning, and irradiation procedures for whole‐breast irradiation using Halcyon linear accelerators.

Materials and methods

The proposed method involves five major steps: (1) field arrangement, (2) planning target volume (PTV) generation and evaluation, (3) basal plan generation, (4) inverse planning intensity–modulated radiation therapy plan generation, and (5) plan evaluation and irradiation. The PTV is generated using isodose curves plotted on the basis of tangential fields, which are applied to create a basal plan. Subsequently, a basal‐dose‐compensation approach is applied to further optimize the treatment plan. This efficient workflow necessitates executing only one onboard cone‐beam computed tomography procedure. This study included 10 patients with early‐stage breast cancer who were treated at our center. The performance of the proposed method was evaluated by comparing its corresponding irradiation time and dose statistics with those derived for a dynamically flattened beam‐based FiF (DFB‐FiF) method.

Results

All plans were normalized to ensure that 98% of the prescribed dose covered 95% of the PTV. On average, the global maximum doses in the proposed and DFB‐FiF methods were lower than 106%. The homogeneity index for right‐sided (left‐sided) breast cancer was 0.053 (0.056) in the proposed method and 0.073 (0.076) in the DFB‐FiF method. The dose statistics of normal tissues, including the contralateral breast, heart, and lungs, were comparable between the methods. However, the irradiation time per monitor unit in the proposed method was approximately five times faster than that in the DFB‐FiF method, but the planning time and complexity were similar between the methods.

Conclusions

This study developed and evaluated an efficient and practical hybrid method for whole‐breast irradiation using the Halcyon. This method can significantly reduce the irradiation time, while providing comparable dose statistics to the DFB‐FiF method.

An efficient synthesis of furan-3(2H)-imine scaffold from alkynones

A novel efficient method to generate spiro furan-3(2H)-imine derivatives is established by the reaction between the α,β-unsaturated ketones and aniline derivatives. The reaction involves 1,4- addition of aniline followed by the subsequent intramolecular cyclization mediated by tertiary alcohol to produce the furan-3(2H)-imine. All the synthesized compounds are characterized using nuclear magnetic resonance and high-resolution mass spectrometry (HRMS).

Membrane-Based Electrolysis for Hydrogen Production: A Review

Hydrogen is a zero-carbon footprint energy source with high energy density that could be the basis of future energy systems. Membrane-based water electrolysis is one means by which to produce high-purity and sustainable hydrogen. It is important that the scientific community focus on developing electrolytic hydrogen systems which match available energy sources. In this review, various types of water splitting technologies, and membrane selection for electrolyzers, are discussed. We highlight the basic principles, recent studies, and achievements in membrane-based electrolysis for hydrogen production. Previously, the Nafion™ membrane was the gold standard for PEM electrolyzers, but today, cheaper and more effective membranes are favored. In this paper, CuCl–HCl electrolysis and its operating parameters are summarized. Additionally, a summary is presented of hydrogen production by water splitting, including a discussion of the advantages, disadvantages, and efficiencies of the relevant technologies. Nonetheless, the development of cost-effective and efficient hydrogen production technologies requires a significant amount of study, especially in terms of optimizing the operation parameters affecting the hydrogen output. Therefore, herein we address the challenges, prospects, and future trends in this field of research, and make critical suggestions regarding the implementation of comprehensive membrane-based electrolytic systems.

Electronic Video Consent to Power Precision Health Research: A Pilot Cohort Study

BACKGROUND

Developing innovative, efficient, and institutionally scalable biospecimen consent for remnant tissue that meets the National Institutes of Health consent guidelines for genomic and molecular analysis is essential for precision medicine efforts in cancer.

OBJECTIVE

This study aims to pilot-test an electronic video consent that individuals could complete largely on their own.

METHODS

The University of California, Los Angeles developed a video consenting approach designed to be comprehensive yet fast (around 5 minutes) for providing universal consent for remnant biospecimen collection for research. The approach was piloted in 175 patients who were coming in for routine services in laboratory medicine, radiology, oncology, and hospital admissions. The pilot yielded 164 completed postconsent surveys. The pilot assessed the usefulness, ease, and trustworthiness of the video consent. In addition, we explored drivers for opting in or opting out.

RESULTS

The pilot demonstrated that the electronic video consent was well received by patients, with high scores for usefulness, ease, and trustworthiness even among patients that opted out of participation. The revised more animated video pilot test in phase 2 was better received in terms of ease of use (P=.005) and the ability to understand the information (P<.001). There were significant differences between those who opted in and opted out in their beliefs concerning the usefulness of tissue, trusting researchers, the importance of contributing to science, and privacy risk (P<.001). The results showed that "I trust researchers to use leftover biological specimens to promote the public's health" and "Sharing a biological sample for research is safe because of the privacy protections in place" discriminated opt-in statuses were the strongest predictors (both areas under the curve were 0.88). Privacy concerns seemed universal in individuals who opted out.

CONCLUSIONS

Efforts to better educate the community may be needed to help overcome some of the barriers in engaging individuals to participate in precision health initiatives.

Smartphone adapter time trial analysis: A low-cost, time-efficient method to disseminate quality photomicrographs at the microscope

BACKGROUND

Within the field of pathology there is a need for a uniform low-cost option for securing high-quality photomicrographs. Advances in smartphone photography and 3D-printing technology allow for custom adapters to be designed for the purpose of photomicrograph capture.

METHODS

Photomicrograph acquisition was performed using four core modalities: a novel 3D-printed smartphone-to-microscope adapter, freehand smartphone-to-microscope technique, a commercial adaptor (LabCam Pro), and a microscope-mounted digital camera. Eight skin diagnoses were photographed using each of the modalities and time to image capture was measured. The photomicrographs were blindly reviewed by two academic dermatopathologists and one pathologist using a side-by-side comparison technique to determine the image quality. Cost assessments were evaluated by obtaining free pricing information on manufacturer websites.

RESULTS

The 3D-printed adapter was the most efficient method of capturing a high-quality photomicrograph in addition to being budget neutral. The microscope-mounted camera produced the highest quality photomicrographs followed by the 3D-printed adapter.

CONCLUSIONS

The 3D-printed smartphone-to-microscope adapter offers a low-cost, time-efficient method of capturing high-quality photomicrographs.

A Novel Spider-Inspired Rotary-Rolling Diaphragm Actuator with Linear Torque Characteristic and High Mechanical Efficiency

We present a novel, fluid-driven rotary-rolling diaphragm actuator with direct rotary output. Its working principle is inspired by the spider leg's hydraulically operated joints and the diaphragm design of rolling diaphragm actuators. The new actuator is fully sealed, shows minimal output torque losses, and minimum friction during operation. Stiction and Coulomb friction are avoided by design. Our proposed mechanism can be used as a compliant actuator in soft robots, or as a stiff transmission device, depending on the fluid and working pressure. The rotary-rolling diaphragm is the defining component of the actuator. The diaphragm is based on silicone rubber, reinforced by a fabric with anisotropic tensile strength characteristics. The diaphragm is custom-designed to follow the actuator's toroidal shape and to ensure the smooth unrolling behavior throughout the stroke. Our actuator outputs a constant torque throughout its stroke compared with monolithic, rotary soft robot actuators with a change in torque. Our design offers a high mechanical efficiency of 95%, compactness, a wide working range of 100°, and a low mechanical complexity from a single chamber.

A Simple Model to Determine the Efficient Duration of Exams

This study develops a theoretical model for the costs of an exam as a function of its duration. Two kind of costs are distinguished: (1) the costs of measurement errors and (2) the costs of the measurement. Both costs are expressed in time of the student. Based on a classical test theory model, enriched with assumptions on the context, the costs of the exam can be expressed as a function of various parameters, including the duration of the exam. It is shown that these costs can be minimized in time. Applied in a real example with reliability .80, the outcome is that the optimal exam time would be much shorter and would have reliability .675. The consequences of the model are investigated and discussed. One of the consequences is that optimal exam duration depends on the study load of the course, all other things being equal. It is argued that it is worthwhile to investigate empirically how much time students spend on preparing for resits. Six variants of the model are distinguished, which differ in their weights of the errors and in the way grades affect how much time students study for the resit.

Rapidly and highly efficient degradation of tetracycline hydrochloride in wastewater by 3D IO-TiO2-CdS nanocomposite under visible light

Tetracycline hydrochloride as an environmental pollutant is biologically toxic and highly difficult to degrade. To solve this problem, an efficient catalyst IO-TiO₂-CdS composite with honeycomb-like three-dimensional (3D) inverse opal TiO₂ (IO-TiO₂) and cadmium sulphide (CdS) was synthesized and applied in the degradation of tetracycline hydrochloride in this paper. More than 99% of the tetracycline hydrochloride (30 mg/L) can be degraded by IO-TiO₂-CdS (30 mg) within 20 min under visible light irradiation. Surprisingly, the naphthol rings can be opened and degraded to alkane with a minimum molecular weight of 60, which is the smallest fragment among all publications. The three-dimensional ordered macroporous (3DOM) structure of IO-TiO₂ improves the utilization of light via the slow photon effect. Meanwhile, the addition of CdS enhances the degradation efficiency of tetracycline by broadening the range of absorption spectrum and improving the separation of charge carrier on the catalyst. In addition to the degradation of tetracycline hydrochloride, IO-TiO₂-CdS also shows a good degradation efficiency of Rhodamine B (RhB). This work provides a promising approach to construct visible light response photocatalysts with non-noble metal for efficient degradation of wastewater pollutants.

Investigating efficient CNN architecture for multiple sclerosis lesion segmentation

Purpose: The automatic segmentation of multiple sclerosis lesions in magnetic resonance imaging has the potential to reduce radiologists' efforts on a daily time-consuming task and to bring more reproducibility. Almost all new segmentation techniques make use of convolutional neural networks with their own different architecture. Architectural choices are rarely explained. We aimed at presenting the relevance of a U-net-like architecture for our specific task and at building an efficient and simple model. Approach: An experimental study was performed by observing the impact of applying different mutations and deletions to a simple U-net-like architecture. Results: The power of the U-net architecture is explained by the joint benefits of using an encoder-decoder architecture and by linking them with long skip connections. Augmenting the number of convolutional layers and decreasing the number of feature maps allowed us to build an exceptionally light and competitive architecture, the minimally parameterized U-net (MPU-net), with only ∼ 30,000 parameters. Conclusion: The empirical study of the U-net has led to a better understanding of its architecture. It has guided the building of the MPU-net, a model far less parameterized than others (at least by a factor of seven). This neural network achieves a human-level segmentation of multiple sclerosis lesions on fluid-attenuated inversion recovery images only. It shows that this segmentation task does not necessitate overly complicated models to be achieved. This gives the opportunity to build more explainable models that can help such methods to be adopted in a clinical environment.

An efficient acute stress response in Chinese individuals with high interdependent self-construal

BACKGROUND AND OBJECTIVE

An efficient stress response comprises both quick reactivity and rapid recovery. Studies have found an enhanced stress response in Chinese people with high interdependent self-construal (ISC). ISC is a personality trait that is well-matched with Chinese collectivistic culture, and whether they exhibit an efficient stress response has not been exclusively examined.

DESIGN

We conducted a novel experiment to examine the stress response change rate in Chinese participants with varying levels of ISC，then performed a validation analysis against previous data to examine the reliability of current results.

METHODS

In our experiment, 84 healthy (42 high-ISC and 42 low-ISC), young, native Chinese were randomly assigned to either the Trier Social Stress Test (TSST), or the control condition. In the published study, 46 native Chinese participants (23 high-ISC and 23 low-ISC) had undergone the TSST. Data were collected throughout the two experiments.

RESULTS

Compared to low-ISC participants, cortisol and subjective stress levels in high-ISC participants peaked sooner and declined rapidly, suggesting quick stress reactivity and rapid recovery. This finding was supported by the previous study.

CONCLUSIONS

High-ISC individuals display an efficient stress response pattern, manifested by fast reactivity and rapid recovery, which may be adaptive in Chinese collectivistic culture.

Adaptive platform trials using multi-arm, multi-stage protocols: getting fast answers in pandemic settings

Global health pandemics, such as coronavirus disease 2019 (COVID-19), require efficient and well-conducted trials to determine effective interventions, such as treatments and vaccinations. Early work focused on rapid sequencing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), subsequent in-vitro and in-silico work, along with greater understanding of the different clinical phases of the infection, have helped identify a catalogue of potential therapeutic agents requiring assessment. In a pandemic, there is a need to quickly identify efficacious treatments, and reject those that are non-beneficial or even harmful, using randomised clinical trials. Whilst each potential treatment could be investigated across multiple, separate, competing two-arm trials, this is a very inefficient process. Despite the very large numbers of interventional trials for COVID-19, the vast majority have not used efficient trial designs. Well conducted, adaptive platform trials utilising a multi-arm multi-stage (MAMS) approach provide a solution to overcome limitations of traditional designs. The multi-arm element allows multiple different treatments to be investigated simultaneously against a shared, standard-of-care control arm. The multi-stage element uses interim analyses to assess accumulating data from the trial and ensure that only treatments showing promise continue to recruitment during the next stage of the trial. The ability to test many treatments at once and drop insufficiently active interventions significantly speeds up the rate at which answers can be achieved. This article provides an overview of the benefits of MAMS designs and successes of trials, which have used this approach to COVID-19. We also discuss international collaboration between trial teams, including prospective agreement to synthesise trial results, and identify the most effective interventions. We believe that international collaboration will help provide faster answers for patients, clinicians, and health care systems around the world, including for future waves of COVID-19, and enable preparedness for future global health pandemics.

Adaptive platform trials using multi-arm, multi-stage protocols: getting fast answers in pandemic settings

Global health pandemics, such as coronavirus disease 2019 (COVID-19), require efficient and well-conducted trials to determine effective interventions, such as treatments and vaccinations. Early work focused on rapid sequencing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), subsequent in-vitro and in-silico work, along with greater understanding of the different clinical phases of the infection, have helped identify a catalogue of potential therapeutic agents requiring assessment. In a pandemic, there is a need to quickly identify efficacious treatments, and reject those that are non-beneficial or even harmful, using randomised clinical trials. Whilst each potential treatment could be investigated across multiple, separate, competing two-arm trials, this is a very inefficient process. Despite the very large numbers of interventional trials for COVID-19, the vast majority have not used efficient trial designs. Well conducted, adaptive platform trials utilising a multi-arm multi-stage (MAMS) approach provide a solution to overcome limitations of traditional designs. The multi-arm element allows multiple different treatments to be investigated simultaneously against a shared, standard-of-care control arm. The multi-stage element uses interim analyses to assess accumulating data from the trial and ensure that only treatments showing promise continue to recruitment during the next stage of the trial. The ability to test many treatments at once and drop insufficiently active interventions significantly speeds up the rate at which answers can be achieved. This article provides an overview of the benefits of MAMS designs and successes of trials, which have used this approach to COVID-19. We also discuss international collaboration between trial teams, including prospective agreement to synthesise trial results, and identify the most effective interventions. We believe that international collaboration will help provide faster answers for patients, clinicians, and health care systems around the world, including for each further wave of COVID-19, and enable preparedness for future global health pandemics.

Development and Validation of a Computationally Efficient Finite Element Model of the Human Lumbar Spine: Application to Disc Degeneration

INTRODUCTION

This study develops and validates an accurate, computationally efficient, 3-dimensional finite element model (FEM) of the human lumbar spine. Advantages of this simplified model are shown by its application to a disc degeneration study that we demonstrate is completed in one-sixth the time required when using more complicated computed tomography (CT) scan-based models.

METHODS

An osseoligamentous FEM of the L1-L5 spine is developed using simple shapes based on average anatomical dimensions of key features of the spine rather than CT scan images. Pure moments of 7.5 Nm and a compressive follower load of 1000 N are individually applied to the L1 vertebra. Validation is achieved by comparing rotations and intradiscal pressures to other widely accepted FEMs and in vitro studies. Then degenerative disc properties are modeled and rotations calculated. Required computation times are compared between the model presented in this paper and other models developed using CT scans.

RESULTS

For the validation study, parameter values for a healthy spine were used with the loading conditions described above. Total L1-L5 rotations for flexion, extension, lateral bending, and axial rotation under pure moment loading were calculated as 20.3°, 10.7°, 19.7°, and 10.3°, respectively, and under a compressive follower load, maximum intradiscal pressures were calculated as 0.68 MPa. These values compare favorably with the data used for validation. When studying the effects of disc degeneration, the affected segment is shown to experience decreases in rotations during flexion, extension, and lateral bending (24%-56%), while rotations are shown to increase during axial rotation (14%-40%). Adjacent levels realize relatively minor changes in rotation (1%-6%). This parametric study required 17.5 hours of computation time compared to more than 4 days required if utilizing typical published CT scan-based models, illustrating one of the primary advantages of the model presented in this article.

CONCLUSIONS

The FEM presented in this article produces a biomechanical response comparable to widely accepted, complex, CT scan-based models and in vitro studies while requiring much shorter computation times. This makes the model ideal for conducting parametric studies of spinal pathologies and spinal correction techniques.

Pruning strategies for efficient online globally consistent mosaicking in fetoscopy

Twin-to-twin transfusion syndrome is a condition in which identical twins share a certain pattern of vascular connections in the placenta. This leads to an imbalance in the blood flow that, if not treated, may result in a fatal outcome for both twins. To treat this condition, a surgeon explores the placenta with a fetoscope to find and photocoagulate all intertwin vascular connections. However, the reduced field of view of the fetoscope complicates their localization and general overview. A much more effective exploration could be achieved with an online mosaic created at exploration time. Currently, accurate, globally consistent algorithms such as bundle adjustment cannot be used due to their offline nature, while online algorithms lack sufficient accuracy. We introduce two pruning strategies facilitating the use of bundle adjustment in a sequential fashion: (1) a technique that efficiently exploits the potential of using an electromagnetic tracking system to avoid unnecessary matching attempts between spatially inconsistent image pairs, and (2) an aggregated representation of images, which we refer to as superframes, that allows decreasing the computational complexity of a globally consistent approach. Quantitative and qualitative results on synthetic and phantom-based datasets demonstrate a better trade-off between efficiency and accuracy.

IDSSR: An Efficient Pipeline for Identifying Polymorphic Microsatellites from a Single Genome Sequence

Simple sequence repeats (SSRs) are known as microsatellites, and consist of tandem 1–6-base motifs. They have become one of the most popular molecular markers, and are widely used in molecular ecology, conservation biology, molecular breeding, and many other fields. Previously reported methods identify monomorphic and polymorphic SSRs and determine the polymorphic SSRs via experimental validation, which is potentially time-consuming and costly. Herein, we present a new strategy named insertion/deletion (INDEL) SSR (IDSSR) to identify polymorphic SSRs by integrating SSRs with nucleotide insertions/deletions (INDEL) solely based on a single genome sequence and the sequenced pair-end reads. These INDEL indexes and polymorphic SSRs were identified, as well as the number of repeats, repeat motifs, chromosome location, annealing temperature, and primer sequences, enabling future experimental approaches to determine the correctness and polymorphism. Experimental validation with the giant panda demonstrated that our method has high reliability and stability. The efficient SSR pipeline would help researchers obtain high-quality genetic markers for plants and animals of interest, save labor, and reduce costly marker-screening experiments. IDSSR is freely available at https://github.com/Allsummerking/IDSSR.

Secure and Efficient Skyline Queries on Encrypted Data

Outsourcing data and computation to cloud server provides a cost-effective way to support large scale data storage and query processing. However, due to security and privacy concerns, sensitive data (e.g., medical records) need to be protected from the cloud server and other unauthorized users. One approach is to outsource encrypted data to the cloud server and have the cloud server perform query processing on the encrypted data only. It remains a challenging task to support various queries over encrypted data in a secure and efficient way such that the cloud server does not gain any knowledge about the data, query, and query result. In this paper, we study the problem of secure skyline queries over encrypted data. The skyline query is particularly important for multi-criteria decision making but also presents significant challenges due to its complex computations. We propose a fully secure skyline query protocol on data encrypted using semantically-secure encryption. As a key subroutine, we present a new secure dominance protocol, which can be also used as a building block for other queries. Furthermore, we demonstrate two optimizations, data partitioning and lazy merging, to further reduce the computation load. Finally, we provide both serial and parallelized implementations and empirically study the protocols in terms of efficiency and scalability under different parameter settings, verifying the feasibility of our proposed solutions.

Q-Learning Based Fair and Efficient Coexistence of LTE in Unlicensed Band

The increased demand for spectrum resources for multimedia communications and a limited licensed spectrum have led to widespread concern regarding the operation of long term evolution (LTE) in the unlicensed (LTE-U) band for internet of things (IoT) systems. Because Wi-Fi and LTE are diverse with dissimilar physical and link layer configurations, several solutions to achieve an efficient and fair coexistence have been proposed. Most of the proposed solutions facilitate a fair coexistence through a discontinuous transmission using a duty cycling or contention mechanism and an efficient coexistence through a clean channel selection. However, they are constrained only by fairness or efficient coexistence but not both. Herein, we propose joint adaptive duty cycling (ADC) and dynamic channel switch (DCS) mechanisms. The ADC mechanism supports a fair channel access opportunity by muting certain numbers of subframes for Wi-Fi users whereas the DCS mechanism offers more access opportunities for LTE-U and Wi-Fi users by preventing LTE-U users from occupying a crowded channel for a longer time. To support these mechanisms in a dynamic environment, LTE-U for IoT applications is enhanced using Q-learning techniques for an automatic selection of the appropriate combination of muting period and channel. Simulation results show the fair and efficient coexistence achieved from using the proposed mechanism.

An Efficient Method to Calculate Genomic Prediction Accuracy for New Individuals

Diagonal elements of the coefficient matrix are necessary to calculate the genomic prediction accuracy. Here an improved methodology is described, to update the inverse of the coefficient matrix (C) for new individuals with a genotype, with and without phenotypes. Computational performance is significantly improved by re-using parts of the coefficient matrix inverse calculations that do not change from one animal to another, in combination with updated calculations for those that do change. This method expedites calculation of accuracy for new individuals with genotypes, without re-doing the whole population, by using the previously calculated matrices.

The Role of Lanthanum in a Nickel Oxide-Based Inverted Perovskite Solar Cell for Efficiency and Stability Improvement

A high-performing inverted perovskite solar cell (PSC) always relies on the hole transporting layer (HTL) quality and its interfaces. This work investigates the impact of La incorporation within the NiO_x matrix for defects passivation, thus leading to high charge extraction ability and stability without compromising its power conversion efficiency. In the presence of La, the La-NiO_x quality is clearly improved; without the formation of pinholes. In addition, the inclusion of La alters the energy band alignment; consequently, enhancing the hole transportation and widening the V_oc (>1 V), as compared to the pristine NiO_x . The beneficial effect of La was further revealed through the photoluminescence measurement and density of states (DOS) analysis, in which trap states are passivated by La. More importantly, the perovskite solar cell, with La-NiO_x as the HTL, exhibits 21 % enhancement in efficiency and a remarkable stability that is greater than that of pristine NiO_x . This also unlocks an opportunity for commercialization.

Carbon Nanotube Bridging Method for Hole Transport Layer-Free Paintable Carbon-Based Perovskite Solar Cells

The incredible stability of carbon-based perovskite solar cells (C-PSCs) has aroused enormous interest. However, for the paintable C-PSCs, the fill factor (FF) and power conversion efficiency (PCE) remain low, which is because of the insufficient contact at the interface between the perovskite and the electrode and the low conductivity of the electrode. In this work, a carbon nanotube (CNT) bridging method is introduced into the devices by adding single-walled CNTs (SWCNTs) in both perovskite and carbon layers to form a high-quality perovskite/carbon interface. The CNT bridges penetrating into both the CH₃NH₃PbI₃ layer and the carbon cathode not only facilitate charge extraction and transport between the two layers but also promote the electrical conductivity of the carbon electrode. The hole transport layer-free C-PSC with a structure of fluorine-doped tin oxide/compact TiO₂/mesoporous TiO₂/CH₃NH₃PbI₃-SWCNT/SWCNT-C gained a remarkable PCE of 15.73% with an FF of 0.72, accompanied by an outstanding stability of 90 days in the dark under high-humidity [65 ± 5% relative humidity (RH), 25 ± 5 °C] and high-temperature (75 ± 5 °C, 25 ± 5% RH) conditions. The low-cost fabrication process makes highly stable and efficient C-PSCs promising candidates for future applications.

An efficient and accurate method for robust inter-dataset brain extraction and comparisons with 9 other methods

Brain extraction is an important first step in many magnetic resonance neuroimaging studies. Due to variability in brain morphology and in the appearance of the brain due to differences in scanner acquisition parameters, the development of a generally applicable brain extraction algorithm has proven challenging. Learning-based brain extraction algorithms in particular perform well when the target and training images are sufficiently similar, but often perform worse when this condition is not met. In this study, we propose a new patch-based multi-atlas segmentation method for brain extraction which is specifically developed for accurate and robust processing across datasets. Using a diverse collection of labeled images from 5 different datasets, extensive comparisons were made with 9 other commonly used brain extraction methods, both before and after applying error correction (a machine learning method for automatically correcting segmentation errors) to each method. The proposed method performed equal to or better than the other methods in each of two segmentation scenarios: a challenging inter-dataset segmentation scenario in which no dataset-specific atlases were used (mean Dice coefficient 98.57%, volumetric correlation 0.994 across datasets following error correction), and an intra-dataset segmentation scenario in which only dataset-specific atlases were used (mean Dice coefficient 99.02%, volumetric correlation 0.998 across datasets following error correction). Furthermore, combined with error correction, the proposed method runs in less than one-tenth of the time required by the other top-performing methods in the challenging inter-dataset comparisons. Validation on an independent multi-centre dataset also confirmed the excellent performance of the proposed method.

The introduction of electromagnetic navigation bronchoscopy for the diagnosis of small pulmonary peripheral lesions in an Asian population

Background

Electromagnetic navigation bronchoscopy (ENB) is emerging as a useful new technique for diagnosing small pulmonary peripheral lesions (SPPLs). However, the accuracy and efficiency of ENB have not been investigated in Asian populations where the differential diagnoses for SPPLs may be different. To analyze this question, this study included patients who received diagnostic ENB followed by surgery for the excision of SPPLs.

Methods

Consecutive patients referred to the Department of Thoracic Surgery, Shanghai Pulmonary Hospital (Tongji University), between May 2014 and April 2015 were recruited. ENB was used to obtain biopsy tissue and make a diagnosis, which was then confirmed by histopathological examination.

Results

The ENB was performed on 84 SPPLs of 78 patients in the study, with four patients having more than one SPPL. It successfully reached and biopsied 81 lesions. The average ENB navigation time was 10.8 minutes (range, 0.5-52 minutes). No mortality occurred, with only two complications (one bleeding and one pneumothorax). The mean diameter of the biopsied SPPLs was 19.0 mm (range, 5.0-30.0 mm). The distance from the sensor probe to the focus was 8.0 mm (range, 1-16 mm). ENB diagnosis had identical results with histopathology examination in 81 lesions (37 lung cancer and 41 non-lung cancer). The sensitivity of ENB was 92.9% (78 out of 84 lesions) in this study.

Conclusions

These data suggested that ENB was an accurate and efficient procedure to sample and diagnose SPPLs in the Asian population. It appeared that ENB had a high percentage of successful results in both navigating and aiding in the diagnosis of SPPLs in the Asian population.

Dual tumor-targeted poly(lactic-co-glycolic acid)-polyethylene glycol-folic acid nanoparticles: a novel biodegradable nanocarrier for secure and efficient antitumor drug delivery

Further specific target-ability development of biodegradable nanocarriers is extremely important to promote their security and efficiency in antitumor drug-delivery applications. In this study, a facilely prepared poly(lactic-co-glycolic acid) (PLGA)-polyethylene glycol (PEG)-folic acid (FA) copolymer was able to self-assemble into nanoparticles with favorable hydrodynamic diameters of around 100 nm and negative surface charge in aqueous solution, which was expected to enhance intracellular antitumor drug delivery by advanced dual tumor-target effects, ie, enhanced permeability and retention induced the passive target, and FA mediated the positive target. Fluorescence-activated cell-sorting and confocal laser-scanning microscopy results confirmed that doxorubicin (model drug) loaded into PLGA-PEG-FA nanoparticles was able to be delivered efficiently into tumor cells and accumulated at nuclei. In addition, all hemolysis, 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, and zebrafish-development experiments demonstrated that PLGA-PEG-FA nanoparticles were biocompatible and secure for biomedical applications, even at high polymer concentration (0.1 mg/mL), both in vitro and in vivo. Therefore, PLGA-PEG-FA nanoparticles provide a feasible controlled-release platform for secure and efficient antitumor drug delivery.

Bacterial magnetic particles improve testes-mediated transgene efficiency in mice

Nano-scaled materials have been proved to be ideal DNA carriers for transgene. Bacterial magnetic particles (BMPs) help to reduce the toxicity of polyethylenimine (PEI), an efficient gene-transferring agent, and assist tissue transgene ex vivo. Here, the effectiveness of the BMP-PEI complex-conjugated foreign DNAs (BPDs) in promoting testes-mediated gene transfer (TMGT) in mouse was compared with that of liposome-conjugated foreign DNAs. The results proved that through testes injection, the clusters of BPDs successfully reached the cytoplasm and the nuclear of spermatogenesis cell, and expressed in testes of transgene founder mice. Additionally, the ratio of founder mice obtained from BPDs (88%) is about 3 times higher than the control (25%) (p < 0.05). Interestingly, the motility of sperms recovered from epididymis of the founder mice from BPD group were significantly improved, as compared with the control (p < 0.01). Based on classic breeding, the ratio of transgene mice within the first filial was significantly higher in BPDs compared with the control (73.8% versus 11.6%, p < 0.05). TMGT in this study did not produce visible histological changes in the testis. In conclusion, nano-scaled BPDs could be an alternative strategy for efficiently producing transgene mice in vivo.

Cost-Effective Encryption-Based Autonomous Routing Protocol for Efficient and Secure Wireless Sensor Networks

The deployment of intelligent remote surveillance systems depends on wireless sensor networks (WSNs) composed of various miniature resource-constrained wireless sensor nodes. The development of routing protocols for WSNs is a major challenge because of their severe resource constraints, ad hoc topology and dynamic nature. Among those proposed routing protocols, the biology-inspired self-organized secure autonomous routing protocol (BIOSARP) involves an artificial immune system (AIS) that requires a certain amount of time to build up knowledge of neighboring nodes. The AIS algorithm uses this knowledge to distinguish between self and non-self neighboring nodes. The knowledge-building phase is a critical period in the WSN lifespan and requires active security measures. This paper proposes an enhanced BIOSARP (E-BIOSARP) that incorporates a random key encryption mechanism in a cost-effective manner to provide active security measures in WSNs. A detailed description of E-BIOSARP is presented, followed by an extensive security and performance analysis to demonstrate its efficiency. A scenario with E-BIOSARP is implemented in network simulator 2 (ns-2) and is populated with malicious nodes for analysis. Furthermore, E-BIOSARP is compared with state-of-the-art secure routing protocols in terms of processing time, delivery ratio, energy consumption, and packet overhead. The findings show that the proposed mechanism can efficiently protect WSNs from selective forwarding, brute-force or exhaustive key search, spoofing, eavesdropping, replaying or altering of routing information, cloning, acknowledgment spoofing, HELLO flood attacks, and Sybil attacks.

An Efficient Chemical Synthesis of Scutellarein: An in Vivo Metabolite of Scutellarin

Scutellarein (2), which is an important in vivo metabolite of scutellarin (1), was synthesized from 3,4,5-trimethoxyphenol (3) in high yield in four steps. This strategy relies on acetylation, aldolization, cyclization and hydrolysis reactions, respectively.

Conventional Laparoscopic vs Robotic Training: Which is Better for Naive Users? A Randomized Prospective Crossover Study

OBJECTIVE

Robotic training (RT) using the da Vinci skills simulator and conventional training (CT) using a laparoscopic "training box" are both used to augment operative skills in minimally invasive surgery. The current study tests the hypothesis that skill acquisition is more rapid using RT than using CT among naive learners.

DESIGN AND PARTICIPANTS

A total of 40 subjects without laparoscopic or robotic surgical experience were enrolled and randomized to begin with either RT or CT. Then, 2 specific RT tasks were reproduced for CT and repeated 5 times each with RT and CT. Time and quality indicators were measured quantitatively. A crossover technique was used to control for in-study experience bias.

RESULTS

The tasks "pick and place jacks" (PP) and "thread the rings" (TR) were achieved faster with RT than with CT despite crossover (p < 0.0001). An RT-favoring difference was observed in speed for both tasks when changing modality. Percentage improvement with increasing trials was similar for RT and CT: RT completion time averaged 39 seconds and 211 seconds (PP and TR, respectively), compared with 65 seconds and 362 seconds when using CT (p < 0.0001); final improvement averaged 26% and 46% for RT (PP and TR, respectively) vs 31% and 47% for CT (p was 0.76 for PP and 0.20 for TR). Within the PP task, RT times averaged 41 seconds without previous CT experience vs 35 seconds with previous CT experience (p = 0.20); CT times averaged 61 seconds without and 69 seconds with previous RT experience (p = 0.48). Comparable times for the TR task were 212 seconds vs 216 seconds (p = 0.66) and 388 seconds vs 334 seconds (p = 0.17). Both instrument collisions and excessive force occurred more commonly for RT than for CT within the TR task (p < 0.0001).

CONCLUSIONS

Speeds were faster overall with RT than with CT, but the percentage of speed improvement with trials was similar, suggesting similar learning curves, with minimal transfer effect appreciated.

An efficient Agrobacterium-mediated transformation system for poplar

Poplar is a model system for the regeneration and genetic transformation of woody plants. To shorten the time required for studies of transgenic poplar, efforts have been made to optimize transformation methods that use Agrobacterium tumefaciens. In this study, an Agrobacterium infective suspension was treated at 4 °C for at least 10 h before infecting explants. By transforming the Populus hybrid clone "Nanlin895" (Populus deltoides×P. euramericana) with Agrobacterium harboring the PBI121:CarNAC6 binary vector, we showed that the transformation efficiency was improved significantly by multiple independent factors, including an Agrobacterium infective suspension with an OD600 of 0.7, an Agrobacterium infection for 120 min, an Agrobacterium infective suspension at a pH of 5.0, an acetosyringone concentration of 200 µM, a cocultivation at 28 °C, a cocultivation for 72 h and a sucrose concentration of 30 g/L in the cocultivation medium. We also showed that preculture of wounded leaf explants for two days increased the regeneration rate. The integration of the desired gene into transgenic poplars was detected using selective medium containing kanamycin, followed by southern blot analysis. The expression of the transgene in the transgenic lines was confirmed by northern blot analysis.

A standard for test reliability in group research

Many authors adhere to the rule that test reliabilities should be at least .70 or .80 in group research. This article introduces a new standard according to which reliabilities can be evaluated. This standard is based on the costs or time of the experiment and of administering the test. For example, if test administration costs are 7 % of the total experimental costs, the efficient value of the reliability is .93. If the actual reliability of a test is equal to this efficient reliability, the test size maximizes the statistical power of the experiment, given the costs. As a standard in experimental research, it is proposed that the reliability of the dependent variable be close to the efficient reliability. Adhering to this standard will enhance the statistical power and reduce the costs of experiments.

Automaticity in anxiety disorders and major depressive disorder

In this paper we examine the nature of automatic cognitive processing in anxiety disorders and Major Depressive Disorder (MDD). Rather than viewing automaticity as a unitary construct, we follow a social cognition perspective (Bargh, 1994) that argues for four theoretically independent features of automaticity: unconscious (processing of emotional stimuli occurs outside awareness), efficient (processing emotional meaning uses minimal attentional resources), unintentional (no goal is needed to engage in processing emotional meaning), and uncontrollable (limited ability to avoid, alter or terminate processing emotional stimuli). Our review of the literature suggests that most anxiety disorders are characterized by uncontrollable, and likely also unconscious and unintentional, biased processing of threat-relevant information. In contrast, MDD is most clearly typified by uncontrollable, but not unconscious or unintentional, processing of negative information. For the anxiety disorders and for MDD, there is no sufficient evidence to draw firm conclusions about efficiency of processing, though early indications are that neither anxiety disorders nor MDD are characterized by this feature. Clinical and theoretical implications of these findings are discussed and directions for future research are offered. In particular, it is clear that paradigms that more directly delineate the different features of automaticity are required to gain a more comprehensive and systematic understanding of the importance of automatic processing in emotion dysregulation.