The remote Objective Structured Clinical Examination (OSCE) is a cornerstone of medical education, enabling structured and objective assessment of clinical skills, communication, and patient-centered care. However, its widespread adoption has introduced challenges related to cost-effectiveness and efficient use of rater resources. Traditional double scoring (DS) ensures reliability but is labor-intensive and costly, especially in large-scale assessments. To address these challenges, this study introduces Targeted Double Scoring (TDS), a novel methodology that selectively applies DS to specific score ranges, particularly those near the pass/fail threshold. The study was conducted using data from a pilot remote OSCE administered to 550 clinical medicine undergraduates in China. The OSCE consisted of three stations: Clinical Reasoning (CR), Physical Examination (PE), and Fundamental Skills (FS). Each station was scored remotely by two raters, with a cut-off score of 60 out of 100. The TDS methodology was modeled based on the OSCEs DS design and fitted with scoring data. A decision-theoretic approach identified optimal Critical Score Ranges (CSRs) for targeted double scoring, balancing reliability and cost-effectiveness. The findings show that TDS significantly reduces rater workload and costs while maintaining high reliability and fairness. For instance, TDS achieved up to 70% cost savings compared to traditional DS under certain configurations. The study also highlights the flexibility of TDS, which can be tailored to different OSCE designs and scoring rubrics. These results have broad implications for medical education, especially in resource-constrained settings where optimizing assessment efficiency is critical. This study provides a practical solution to the cost-related challenges of remote OSCEs and offers a framework for adopting TDS in assessments. By focusing raters on critical score ranges, TDS maintains rigorous and fair evaluations without overburdening faculty or exceeding budgets. Future research should explore TDS scalability and its integration with emerging technologies like artificial intelligence to enhance efficiency and reliability.
The Vibrio fischeri-Euprymna scolopes symbiosis has become a powerful animal-microbe model system to examine the genetic underpinnings of symbiont development and regulation. Although there has been a number of elegant bacterial genetic technologies developed to examine this symbiosis, there is still a need to develop more sophisticated methodologies to better understand complex regulatory pathways that lie within the association. Therefore, we have developed a suite of CRISPR interference (CRISPRi) vectors for inducible repression of specific V. fischeri genes associated with symbiotic competence. The suite utilizes both Tn7-integrating and shuttle vector plasmids that allow for inducible expression of CRISPRi dCas9 protein along with single-guide RNAs (sgRNA) modules. We validated this CRISPRi tool suite by targeting both exogenous (an introduced mRFP reporter) and endogenous genes (luxC in the bioluminescence producing lux operon, and flrA, the major regulatory gene controlling flagella production). The suite includes shuttle vectors expressing both single and multiple sgRNAs complementary to the non-template strand of multiple targeted genetic loci, which were effective in inducible gene repression, with significant reductions in targeted gene expression levels. V. fischeri cells harboring a version of this system targeting the luxC gene and suppressing the production of luminescence were used to experimentally validate the hypothesis that continuous luminescence must be produced by the symbiont in order to maintain the symbiosis at time points longer than the known 24-h limit. This robust new CRISPRi genetic toolset has broad utility and will enhance the study of V. fischeri genes, bypassing the need for gene disruptions by standard techniques of allelic knockout-complementation-exchange and the ability to visualize symbiotic regulation in vivo.
Cost reduction of cell components is a major issue in PEM water electrolysis. For the anode, titanium materials with noble metal coatings represent the state of the art. For the cathode, the use of carbon-based porous transport layers, also known as gas diffusion layers (GDLs), is gaining prominence due to their significantly lower costs compared to titanium-based materials. In PEM fuel cells, carbon-based GDLs are well-established, with advancements in contact and gas/water transport achieved through micro porous layers and hydrophobic treatments. In contrast, in PEM water electrolysis, topics like interfacial contact, compression behavior, and the use of additives for carbon-based GDLs have not been widely discussed in the literature yet. With this work, we present a fundamental performance investigation of these aspects. We investigate cell performance using voltage breakdown analysis and electrochemical impedance spectroscopy, combined with subsequent Distribution of Relaxation Time analysis. Our findings highlight the effect of GDL compression and underscore the necessity of coated flow fields at the cathode. PTFE additives were found to have minimal influence on cell behavior, regardless of the presence or absence of water flow at the cathode. However, the use of micro porous layers demonstrated positive effects, particularly for ultra-low cathode catalyst loadings.
In three longitudinal studies, we examined the relationship between worry about an outcome and information-management behavior-specifically seeking and avoiding information about that outcome-in the context of awaiting uncertain news. Study 1 examined a group of U.S. voters across the 4 weeks preceding the 2020 presidential election. Study 2 examined law graduates who completed the California bar exam during the 17 weeks between when they took the exam and when their results were posted online. Study 3 examined job candidates from a variety of academic fields from October to April as they searched for academic jobs. In all three studies, people who reported greater worry about the relevant outcome across the wait reported greater information seeking. Additionally, people were particularly likely to seek information at the times during the wait when they reported the most acute worry. Evidence for the relationship between worry and information avoidance during the wait was more mixed; we found only that people who worried more were more likely to avoid information generally (between-subjects effect) in Studies 1 and 2 and did not find evidence that people were more likely to avoid at times they were most worried (within-subjects effect). These findings suggest that information avoidance might not be the strategy of choice in response to worry during stressful waiting periods; instead, worry seems to be motivating the pursuit of (sometimes unhelpful) information. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
The tuning of the Fermi level in tin telluride, a topological crystalline insulator, is essential for accessing its unique surface states and optimizing its electronic properties for applications such as spintronics and quantum computing. In this study, we demonstrate that the Fermi level in tin telluride can be effectively modulated by controlling the tin concentration during chemical vapor deposition synthesis. By introducing tin-rich conditions, we observed a blue shift in the x-ray photoelectron spectroscopy core-level peaks of both tin and tellurium, indicating an upward shift in the Fermi level. This shift is corroborated by a decrease in work function values measured via ultraviolet photoelectron spectroscopy, confirming the suppression of Sn vacancies. Our findings provide a low-cost, scalable method to achieve tunable Fermi levels in tin telluride, offering a significant advancement in the development of materials with tailored electronic properties for next-generation technological applications.
Music traditions worldwide are subject to remarkable diversity but the origins of this variation are not well understood. Musical behaviour is the product of a multicomponent collection of abilities, some possibly evolved for music but most derived from traits serving nonmusical functions. Cultural evolution has stitched together these systems, generating variable normative practices across cultures and musical genres. Here, we describe the cultural evolution of musical distortion, a noisy manipulation of instrumental and vocal timbre that emulates nonlinear phenomena (NLP) present in the vocal signals of many animals. We suggest that listeners sensitivity to NLP has facilitated technological developments for altering musical instruments and singing with distortion, which continues to evolve culturally via the need for groups to both coordinate internally and differentiate themselves from other groups. To support this idea, we present an agent-based model of norm evolution illustrating possible dynamics of continuous traits such as timbral distortion in music, dependent on (i) a functional optimum, (ii) intra-group cohesion and inter-group differentiation and (iii) groupishness for assortment and social learning. This account illustrates how cultural transmission dynamics can lead to diversity in musical sounds and genres, and also provides a more general explanation for the emergence of subgroup-differentiating norms.This article is part of the theme issue Nonlinear phenomena in vertebrate vocalizations: mechanisms and communicative functions.
