Personnel Costs Research Articles

The Emerging Industrial Revolution and the Future of the Accountant in Nigeria

The study was inspired by the concern for the next industrial revolution of artificial general intelligence with respect to the career of the accountant, given the continuous and increasing automation of the accounting process and systems in the current industrial revolution. Consequently, the study adopted an ex-post facto design to fathom the career fortune of the human accountant in the emerging industrial era of artificial general intelligence, using ten years personnel cost and net assets data, from the annual accounts and reports of the 7 deposits money banks in Nigeria that had international authorization, as at 31st December, 2022. Linear regression analysis results from SPSS 20.0 disclosed that the effect of the deployment of artificial intelligence on the career of the accountant in the current industrial era is statistically low and insignificant. Accordingly, the study predictively concludes that the technological agenda of the emerging industrial revolution will not impair the job fortune of the accountant. However, the study recommends that accounting practitioners should proactively develop themselves with relevant soft skills, and deep learning, python and big data programmes in readiness for effective machine collaboration and synthesis, in the emerging industrial era.

Inpatient cost comparison of total and unicompartmental knee arthroplasty in patients with medial compartmental osteoarthritis using time-driven activity-based costing.

Using time-driven activity-based costing (TDABC), we sought to compare the total facility costs, comprising supply and personnel costs during the episode of care for the index procedure, in patients with isolated medial compartmental knee osteoarthritis (OA) undergoing unicompartmental knee arthroplasty (UKA) versus total knee arthroplasty (TKA). We conducted a retrospective analysis of 100 UKAs and 100 TKAs from 2019 to 2022. From a larger sample of 4899 TKAs and 137 UKAs, patients with isolated medial OA (Kellgren-Lawrence Grade <2 in other compartments) were radiographically identified. Demographic data included age, sex and body mass index, with comorbidities controlled using the Charlson comorbidity index. Facility costs were calculated using TDABC and standardized in cost units (CUs), a metric for comparing costs across procedures. Multiple regression analysis was used to assess the independent effect of TKA versus UKA on facility costs. TKA patients had similar operative times (TKA vs. UKA: 1.01×, p = 0.783) and supply costs (1.00×, p = 0.866), where 'x' denotes the relative cost ratio. However, TKA was associated with higher personnel costs (260.0 vs. 222.5 CUs [1.17×], p < 0.001) and total facility costs, both including (706.3 vs. 667.5 CUs [1.06×], p = 0.007) and excluding implants (353.8 vs. 312.5 CUs [1.13×], p < 0.001). Adjusted for demographics and comorbidities, TKA had increased facility costs, including (32.2 CUs, 95% confidence interval [CI]: 2.9-61.5, p = 0.031) and excluding implants (37.8 CUs, 95% CI: 15.2-60.3, p = 0.001). TDABC analysis revealed higher total facility costs for the index procedure in TKA, suggesting UKA may be a cost-saving alternative for isolated medial compartment knee OA. Level III, retrospective comparative study.

Does Transforaminal Endoscopic Lumbar Discectomy Provide More Value than Microdiscectomy? An Application of the Operative Value Index

BACKGROUND AND OBJECTIVES: A few studies have compared the value (outcomes per dollar spent) provided by transforaminal endoscopic discectomy (TED) vs microdiscectomy (MD) for lumbar disc herniations. Here, we attempt to address this gap using a novel Operative Value Index (OVI), which combines a procedure-specific patient-reported outcome with intraoperative cost data based on time-driven activity-based costing. METHODS: MD (n = 95) and TED (n = 23) performed by neurosurgeons at our institution from 2017 to 2022 were retrospectively identified. Time-driven activity-based costing was applied to identify both direct and indirect costs for all cases. Individual costs were obtained by direct observation, electronic medical records, and through consulting multiple departments (including business operations, sterile processing, plant operations, and pharmacy). Oswestry Disability Index (ODI) scores were prospectively collected at baseline and 3 months after surgery. Our primary outcome of interest was the OVI, defined as the percent change in the ODI per $1000 spent intraoperatively. Generalized linear mixed model regression was performed to assess whether TED was associated with significantly different OVI as compared to MD. Similar analyses were also performed for operative times and length of stay. RESULTS: The average intraoperative cost of a TED was $3698, as compared to $3410 for an MD. For both procedures, this total cost was largely driven by the cost of supplies and personnel. Multivariable regression revealed that MD was associated with significantly higher OVI (β-coefficient: 7.2, P &lt; .05) and lower operative times (β-coefficient: - 34.6 minutes, P &lt; .01) compared with TED, with no significant differences in length of stay (P = .17). CONCLUSION: When performed by surgeons at our institution from 2017 to 2022, MD was associated with a 7% greater improvement in ODI per $1000 spent intraoperatively. Continual assessment of value over time (both for established procedures and new techniques) will become increasingly important with the emergence of value-based care.

Abstract 4143262: Unlocking Value: Revealing the Hidden Cost of Outpatient Interstage Care

Background: Interstage programs decrease morbidity and mortality and are potentially resource intensive. The accurate cost of these programs is unknown. Understanding cost and outcomes of care is necessary to provide high-value care for this population. Time-driven activity-based costing(TDABC) provides an accurate way to understanding costs that occur at the level of the patient. Research Question: What is the outpatient cost of the interstage period to the health care system? Methods: Single-center study of outpatient interstage care. Direct observation (over 9 months) and retrospective review were utilized to develop process maps. Outpatient interstage and pediatric visits were timed by 5 observers. Cost of personnel was calculated in dollars per minute utilizing median national health system salary data. Results: Patients attended a median of 13 cardiology, 5 pediatric, 3 physical therapy(PT), 4 occupational therapy(OT), and 7 speech therapy(SLP) visits while interstage. Total cost of interstage visit personnel was $258.18[$208.59-$389.24] and equipment cost was $1457.79. Total cost of a pediatric visit was $123.55[$130.80-$167.12]. Total cost of outpatient PT, OT, and SLP was $70.58, $66.68 and $72.43, respectively. Total cost of the outpatient interstage period was $6417.38[$5808.94-$8338.96] per patient.(Table) In interstage clinic, patients spent 132[89-165] minutes with providers and 64[41-66] minutes waiting.(Figure) In pediatric clinic, patients spent 73[71-76] minutes with providers and 9[6-13] minutes waiting. Conclusion: This work demonstrates that while challenging, TDABC analysis can be applied to complex interstage care to understand costs and move to deliver high-value care for this population. While caring for a child during the interstage period is time and resource intensive, it carries a relatively low cost to the health care system with a total cost of $6417.38 per patient. Additional work is needed to understand costs of inpatient interstage care.

What is the True Cost of Motion Preservation? A Time-Driven Activity-Based Cost Analysis of Anterior Cervical Discectomy and Fusion versus Disc Replacement

Total disc replacement (TDR) has become a viable alternative to anterior cervical discectomy and fusion (ACDF) for select patients. Although most comparative studies have assessed outcomes, cost differences remain largely uninvestigated. This information is critical as we move towards value-based reimbursement. To address this knowledge gap, we used time-driven activity-based costing (TDABC) to compare total intraoperative costs between the two procedures. Total cost was divided into direct (personnel and supply cost) and indirect costs (administrative and overhead costs). Individual costs were determined through direct observation, electronic medical records, and through querying multiple departments (including business operations, sterile processing, plant operations, and pharmacy). Timestamps for all involved personnel and material resources were documented, in conjunction with process mapping of the intraoperative period. Total intraoperative costs were estimated for all ACDFs (n=810) and TDRs (n=54) from 2017 to 2022. Regression analyses were performed to identify factors associated with total cost. A total of 810 and 54 patients underwent one- and two-level ACDFs and TDRs, respectively. The average total intraoperative cost for an ACDF was $6,776 +/- $2,808, compared to $12,026 +/- $4,235 for TDR. Supply cost accounted for the majority of total cost for both procedures ($4,173 +/- $2,225 for ACDF and $9,532 +/- $4,010 for TDR). On multivariable linear regression analysis, TDR was associated with roughly $3,885 of additional cost compared to ACDF (p<0.001), as well as $4,072 in additional supply cost (p<0.001), most of which was driven by the higher cost of implants (p<0.001). TDABC is a highly useful methodology for estimating differences in true costs between procedures and determining cost drivers. TDRs were associated with an additional $3,885 of total intraoperative cost as compared to ACDFs, the majority of which was driven by the cost of implants.

Analysis of the Impact of Mileage, Service Costs, and Availability of Medical Personnel on Patient Satisfaction in Accessing Health Services in Disadvantaged Areas in Indonesia

This study examines the impact of distance travelled, cost of service, and availability of medical staff on patient satisfaction in accessing healthcare services in disadvantaged areas of Indonesia. Using a quantitative approach, data were collected from 50 respondents through a structured questionnaire, employing a Likert scale of 1-5. Multiple regression analysis was performed using SPSS version 26 to determine the relationships between the independent variables (distance travelled, cost of service, and availability of medical staff) and the dependent variable (patient satisfaction). The results indicate that distance travelled and cost of service have significant negative impacts on patient satisfaction, while the availability of medical staff positively influences satisfaction. These findings provide valuable insights for policymakers and healthcare providers in addressing the barriers to healthcare access in underserved regions of Indonesia and improving patient satisfaction.

How much does it cost to retain antiretroviral therapy (ART) clients in their first year? Routine financial costs of retention interventions at Lighthouse Trustin Lilongwe, Malawi.

Antiretroviral therapy (ART) improves the health of people living with HIV (PLHIV). However, a high loss to follow-up, particularly in the first year after ART initiation, is problematic. The financial expenses related to client retention in low- and middle-income countries (LMICs) in sub-Saharan Africa are not well understood. This study aimed to comprehensively assess and quantify the financial costs associated with routine ART retention services for clients in their first 12 months in care at Lighthouse Trust's (LT) Martin Preuss Centre (MPC), a large, public ART clinic in Lilongwe, Malawi. We performed activity-based microcosting using routine data to assess the expenses related to routine ART retention services at the MPC for 12 months, from January to December 2021. MPC provides an "ART Buddy" from ART initiation to 12 months. The MPC's Back-to-Care (B2C) program traces clients who miss ART visits by at least 14 days. Clients may be traced and return to care multiple times per year. We assessed client retention costs for the first 12 months of treatment with ART and conducted a sensitivity analysis. The total annual cost of ART retention interventions at MPC was $237,564. The proactive Buddy phase incurred $108,504; personnel costs contributed $97,764. In the reactive B2C phase, the total cost was $129,060, with personnel expenses remaining substantial at $73,778. The Buddy unit cost was $34 per client. The reactive B2C intervention was $17 per tracing event. On average, the unit cost for ART retention in the first year of ART averaged $22 per client. This study sheds light on the financial dimensions of ART retention during the first year on ART among clients in a routine public setting. ART retention is both costly and critical for helping clients adhere to visits and remain in care. Continued investment in the human resources needed for both proactive and reactive retention efforts is critical to engaging and retaining patients on lifetime ART.

Time-Driven, Activity-Based Cost Analysis of Pars Plana Vitrectomy in Rhegmatogenous Retinal Detachment at a Large Academic Center.

Purpose: To perform a time-driven, activity-based cost analysis of retinal detachment (RD) surgery and compare it with reimbursement rates. Methods: This economic analysis at a single academic institution used time-driven, activity-based costing methodology to determine the cost of rhegmatogenous RD repair with primary pars plana vitrectomy. A process flow map was created to highlight each surgical case's operative episodes, including clinical follow-ups. Time logs were obtained from the electronic health record for each operative phase and clinical follow-up. The overhead and anesthesia costs were collected from the institution's cost accounting system. The direct material and personnel costs were obtained from internal financial data. Results: Seventy-six cases that met the inclusion criteria were included in the cost analysis study. The time-driven, activity-based cost of RD was $6247.17, and the reimbursement was $5442.91. Therefore, each procedure had a net negative loss of $804.26. To break even, the average operation time would need to be reduced from the determined average of 90.49 minutes to 64.90 minutes. Conclusions: This study found that Medicare underestimates the true cost of RD surgery. Changes in referral patterns may be motivated by reimbursement rates lower than the cost of the procedure, which could ultimately affect patient access to care.

Cost-effectiveness of Dual Hypothermic Oxygenated Machine Perfusion Versus Static Cold Storage in DCD Liver Transplantation.

Ex situ machine perfusion of the donor liver, such as dual hypothermic oxygenated machine perfusion (DHOPE), is increasingly used in liver transplantation. Although DHOPE reduces ischemia/reperfusion-related complications after liver transplantation, data on cost-effectiveness are lacking. Our objective was to evaluate the cost-effectiveness of DHOPE in donation after circulatory death (DCD) liver transplantation. We performed an economic evaluation of DHOPE versus static cold storage (SCS) based on a multicenter randomized controlled trial in DCD liver transplantation (DHOPE-DCD trial; ClinicalTrials.gov number, NCT02584283). All patients enrolled in the 3 participating centers in the Netherlands were included. Costs related to the transplant procedure, hospital stay, readmissions, and outpatients treatments up to 1 y posttransplant were calculated. The cost for machine perfusion was calculated using 3 scenarios: (1) costs for machine perfusion, (2) machine perfusion costs plus costs for personnel, and (3) scenario 2 plus depreciation expenses for a dedicated organ perfusion room. Of 119 patients, 60 received a liver after DHOPE and 59 received a liver after SCS alone. The mean total cost per patient up to 1 y posttransplant was €126 221 for the SCS group and €110 794 for the DHOPE group. The most significant reduction occurred in intensive care costs (28.4%), followed by nonsurgical interventions (24.3%). In cost scenario 1, DHOPE was cost-effective after 1 procedure. In scenarios 2 and 3, cost-effectiveness was achieved after 25 and 30 procedures per year, respectively. Compared with conventional SCS, machine perfusion using DHOPE is cost-effective in DCD liver transplantation, reducing the total medical costs up to 1 y posttransplant.

АНАЛІТИКА ДІЯЛЬНОСТІ ПІДПРИЄМСТВ УКРАЇНИ З ВИРОБНИЦТВА ЦЕМЕНТУ В УМОВАХ СИСТЕМНИХ ВИКЛИКІВ

The article examines the activity of Ukrainian cement production enterprises in conditions of systemic challenges. The steady growth of the cement market in Ukraine in 2021 relative to 2020 has been determined. However, the full-scale war in Ukraine significantly affected the activities of cement manufacturing enterprises. The hostilities on the territory of the country have led to a decrease in the demand for cement due to the suspension of construction projects and infrastructure works, as well as due to instability and economic uncertainty. This was reflected in the decrease in business activity in the cement market in Ukraine. In 2022, the number of active cement production entities decreased by 22.2% compared to 2021. The decrease in the number of business entities in the cement industry of Ukraine led to a decrease in the number of employees, particularly, the number of employees decreased by 21.8% in 2022 compared to 2021. Such trends continued in the reduction of personnel costs of cement production enterprises by 25.1% over the last year under review. It has been proven that the most noticeable negative impact of the war on the development of the cement industry in Ukraine can be traced in the dynamics of the volumes of products sold (goods, services) of enterprises in 2022 compared to 2021: the value of this indicator decreased by UAH 7,499,298.9 thousand. or more than a third. As a result, the financial results of cement production enterprises in 2022 significantly worsened compared to 2021. In general, the level of profitability of the operational activities of cement production enterprises in 2022 significantly decreased compared to the previous three years. The most significant decrease was in profitability of operational activity resulting in a reduction of this indicator to the level of -25.6% in 2022. In general, the system challenges for the development of the cement market in Ukraine derived from war require adequate strategic decisions to support this exceptionally important activity for the post-war recovery of Ukraine. The further research of business responses for the current challenges is a perspective of the further studies in the field.

The impact of minimum wage on automotive companies' performance

This paper aims to verify the relationship between minimum wage growth and the financial indicators of automotive companies. As a hi-tech sector, the automotive industry is usually not expected to be affected by minimum wage policies. The introduction of the minimum wage in Germany and the dynamic development of the minimum wage in Eastern European countries make it possible to assess this relationship. German, Czech, Polish, and Slovak automotive company data was obtained from the Orbis database. Panel regression models were applied to test for dependencies. The paper detects the association between the growth of the minimum wage and the increase in personnel cost, which is next to the associations with several financial indicators at the company level. The identified impact is specific to small and medium-sized companies.

Financial performance of new circular economy companies in rural settings

AbstractThis study examines how rural conditions affect the establishment and performance of new circular economy (CE) companies—those that reduce, reuse, recycle, and recover materials in their processes—focusing on their longevity, financial performance, and distribution of economic value to stakeholders. We hypothesize that while rural conditions generally lead to fewer business establishments, the liability of rurality is less severe for CE companies than for others. We also anticipate that new CE companies will grow more slowly but achieve better performance, resulting in higher survival rates compared to those in other sectors. Our empirical analysis includes all CE companies established in Spain over the past decade. The results indicate that rural CE companies have higher survival rates than their urban counterparts, even after controlling for factors like subsidies and personnel costs. Although rural CE companies exhibit slower growth, they achieve greater profitability. Thus, the CE sector in rural areas demonstrates sustainability not only through its circular practices but also in financial terms, offering significant implications for investors seeking sustainable ventures.

Assessing the Efficacy of Budget in Detecting Fraudulent Personnel Cost Figure in Borno State Civil Service, Nigeria

Assessing the Efficacy of Budget in Detecting Fraudulent Personnel Cost Figure in Borno State Civil Service, Nigeria

CURRENT CHALLENGES AND OPPORTUNITIES OF PERSONNEL MANAGEMENT

In modern conditions, human capital is the most significant asset of any organization, because it is employees, both at the individual level and in the team, who contribute to achieving common goals. Effective management of human resources contributes to maintaining the competitive position of the organization in the market, successful activities in the face of fierce competition and provides opportunities for strategic development. In today’s business environment, HR management is becoming extremely important, because it is aimed at optimizing personnel costs and achieving high results of the organization. The article "Modern Challenges and Opportunities of HR Management" examines the main trends and problems faced by HR managers in the conditions of modern business. The author analyzes the influence of digitalization, remote work and changes in corporate culture on the function of personnel management. The issues of maintaining the well-being of employees, introducing innovative technologies and developing talents as key factors of successful HR management are separately covered. The article also focuses on new opportunities for HR managers to create effective strategies for managing human capital in response to modern challenges

HRM and Its Effect on Employee, Organizational, and Financial Outcomes in Organizations

Object: To study the impact of Human Resource Management (HRM) on employee outcomes, organizational, and financial performance. Methods: Both quantitative and qualitative data analysis methods were used. The sample included 500 employees from 100 organizations from various sectors such as manufacturing, healthcare, services and education. Data were collected through surveys and semi-structured interviews with managers and employees. Statistical methods, including regression and correlation analysis were applied using SPSS software. Results: The implementation of HRM practices improved labor productivity by 15 %, job satisfaction by 20 %, and reduced employee turnover by 10 %. There was strong correlation between HRM practices and job satisfaction (correlation coefficient of 0.70) and a negative correlation with employee turnover (-0.50). Company profits increased by 15 %, and personnel costs decreased by 10 %. Conclusions: Effective HRM practices such as employee recognition, motivation programs and continuous development contribute to increased productivity and strengthened organizational culture, leading to improved financial performance and lower turnover.

The Cost of Lipoedema Treatment Exceeds the DRG Revenues - Evaluation of the Surgical Treatment Costs of Lipoedema (Stage III) at a German University Clinic

Liposuction for stage III lipoedema is a guideline-based but also time-consuming treatment, which can be carried out under specific conditions at the expense of the German statutory health insurance companies (SHI) based on a decision made by the German Federal Joint Committee ("Gemeinsamer Bundesausschuss", G-BA), the highest decision-making body in the German healthcare system, in 09/2019. We postulate that the treatment is not reflected in a cost-covering manner in the university cost system. This monocentric, retrospective study examined the economic aspects of 92 cases in 48 lipoedema patients treated during the period from 09/2019 to 08/2023 at the expense of the SHI. These cases were filtered out using DRG coding and the Operation and Procedure Classification system ("Operationen- und Prozedurenschlüssel", OPS), and the costs and revenues per patient were calculated using the data from our internal service accounting. After an inpatient stay of 2.64±1.33 days, the total revenue was € 4,726.79±680.98. This included € 1,532.92±856.99 inpatient costs, € 2,686.02±1,174.70 in operating costs, € 940.76±189.18 in anaesthesia costs and € 63.19±125.38 in other costs that had to be paid within the clinic. On average across all treatments, this resulted in a loss of -€ 875.22 /case. In 54 cases (59%), the costs exceeded the revenue. In total, the calculation of all cases resulted in a loss of € -80,520.63. If medical personnel costs are included, this amount rises to over € 100,000. The results show that the surgical treatment of lipoedema in the German DRG and university cost systems is not cost-covering. This could be relevant in the final economic assessment of the G-BA, which may result in an adjustment of the DRG revenue.

Direct Variable Cost Comparison of Monitored Anesthesia Care Versus Wide Awake Local Anesthesia No Tournique Carpal Tunnel Release: A Time-Driven Activity-Based Costing Analysis

Time-driven activity-based costing (TDABC) provides a more accurate and granular estimation of direct variable costs compared with traditional accounting methods. This study used TDABC to quantitatively compare the same-day facility costs of open carpal tunnel release (CTR) performed under monitored anesthesia care (MAC) versus wide awake local anesthesia no tourniquet (WALANT). We retrospectively identified 474 unilateral CTR (182 MAC and 292 WALANT) performed at an orthopedic specialty hospital between 2015 and 2021. Itemized facility costs were calculated using a TDABC algorithm. Patient demographics, surgical characteristics, and itemized costs were compared between those treated under MAC (MAC-CTR) and WALANT (WALANT-CTR). Multivariable regression was performed to determine the independent effect of MAC on true facility costs. Total facility costs were $170 higher in MAC-CTR compared with WALANT-CTR ($652 vs $482). Monitored anesthesia care-CTR cases had higher personnel costs ($537 vs $394), likely because of higher surgery personnel ($303 vs $185) and postanesthesia care unit personnel costs ($117 vs $95). Monitored anesthesia care-CTR cases also had higher supply costs ($119 vs $81). When controlling for demographics and comorbidities, MAC-CTR was independently associated with an increase in personnel costs by $150.65 (95% CI, $131.09-$170.21), supply costs by $24.99 (95% CI, $9.40-$40.58), and total facility costs by $175.66 (95% CI, $150.18-$201.09) per case. Using TDABC, MAC-CTR was found to be 35% more costly to the facility compared with WALANT-CTR. Notably, WALANT-CTR facility costs presented here do not include additional cost savings from anesthesiologist service fees or preoperative laboratory clearance required for MAC-CTR surgeries. To reduce costs related to CTR surgery, greater efforts should be made to reduce the number of intraoperative personnel and maximize the use of WALANT-CTR in an outpatient setting. Economic and Decision Analysis II.

A new decision-support tool in a multi-center randomized trial for personalized, optimized, and simplified fertility treatment in non-PCOS patients.

This study aimed to evaluate the effectiveness of a clinical decision support tool, Opt-IVF, in achieving the following outcomes: reducing the total cumulative dosage of Gonadotropins (Gns) used during controlled ovarian stimulation cycles and reducing the repeated ultrasonograms (USG) for monitoring follicular growth without compromising the number of good quality blastocysts obtained. The study design employed a multi-center randomized trial. The study enrolled 115 women aged 25-45 years undergoing IVF. Among the participants, 55 were randomly assigned to the intervention group (Opt-IVF), and 60 were randomly assigned to the control group. The intervention involved using a clinical decision support tool, Opt-IVF, to guide Gn dosing and trigger dates. The participants in the intervention group required significantly lower cumulative Gn dosage. The intervention group had higher numbers of oocytes retrieved and M2 retrieved than the control group. The number of good-quality blastocysts, the good-quality blastocyst rate, the ovarian sensitivity index (OSI), and the pregnancy rate in the intervention group were significantly higher than in the control group. The utilization of the clinical decision support tool led to several positive outcomes, including eliminating the need for ultrasound exams after day 5, reducing the dosage of Gn required, and yielding significantly higher numbers of high-quality blastocysts and higher pregnancy rates. Thus, Opt-IVF can successfully provide a personalized, optimized, and simplified approach to superovulation. Opt-IVF consistently outperformed the clinical teams in most of the outcomes. Clinical trials registration: ClinicalTrials.gov (ID - NCT05811065). Date of Registration: 15 March 2023. Date of enrollment of the first subject: 20 March 2023. The high cost of IVF is a result of costly drugs, fixed prices for infrastructure, extensive testing required, and labor costs for physicians and other healthcare personnel. Superovulation, which involves the drug-induced release of multiple eggs needed for IVF, accounts for a significant share of these costs. Current approaches to superovulation involve almost daily monitoring of follicle development using ultrasound and/or blood tests. The daily dosage of stimulatory hormones is then prescribed by physicians based on empirical data and clinical experience. However, the dose is not optimized for each patient, and overstimulation complications can occur. The cost of testing and drugs makes this stage very expensive. To overcome the shortcomings of this system, we have developed a decision support tool (Opt-IVF) that can provide a personalized model-optimized dosage profile for each patient. The clinical results show that Opt-IVF optimizes and personalizes dosage, reduces testing, and provides better outcomes for patients.

A fast and genotype-independent in planta Agrobacterium-mediated transformation method for soybean

Efficient genotype-independent transformation and genome editing are highly desirable for plant biotechnology research and product development efforts. We have developed a novel approach to enable fast, high-throughput, and genotype-flexible Agrobacterium-mediated transformation using the important crop soybean as a test system. This new method is called GiFT (genotype-independent fast transformation) and involves only a few simple steps. The method uses germinated seeds as explants, and DNA delivery is achieved through Agrobacterium infection of wounded explants as in conventional in vitro-based methods. Following infection, the wounded explants are incubated in liquid medium with a sublethal level of selection and then transplanted directly into soil. The transplanted seedlings are then selected with herbicide spray for 3 weeks. The time required from initiation to fully established healthy T0 transgenic events is about 35 days. The GiFT method requires minimal in vitro manipulation or use of tissue culture media. Because the regeneration occurs in planta, the GiFT method is highly flexible with respect to genotype, which we demonstrate via successful transformation of elite germplasms from diverse genetic backgrounds. We also show that the soybean GiFT method can be applied to both conventional binary vectors and CRISPR-Cas12a vectors for genome editing applications. Analyses of T1 progeny demonstrate that the events have a high inheritance rate and can be used for genome engineering applications. By minimizing the need for tissue culture, the novel approach described here significantly improves operational efficiency while greatly reducing personnel and supply costs. It is the first industry-scale transformation method to utilize in planta selection in a major field crop.

Pilot Assessment of Piezoelectric Transducers as a Cost-Effective Alternative to EndoPAT

Introduction: Current microvascular assessments may not be practical or accessible requiring experienced personnel and/or ongoing equipment costs. Piezoelectric transducers can reliably obtain finger blood pressure waves, similar to peripheral arterial tonometry devices; thus, they could be used to estimate microvascular function. We aimed to validate piezoelectric transducers as an alternative measure of microvascular function compared to EndoPAT. Methods: Twenty-five adults (aged 20–64 years) completed reactive hyperemia (5 min forearm circulatory occlusion and 3 min recovery) with piezoelectric transducers on the middle fingers and EndoPAT probes on the index fingers. Average area under the curve (AUC) of the pulse wave signal for the occluded and control arms was determined at baseline, every 30 s post-occlusion, and 10 s around the peak response. Microvascular function index (MFI) was calculated as the ratio of AUC post-occlusion to AUC baseline in the test arm, then normalized to the same ratio in the control arm. MFI at each time point was correlated with the reactive hyperemia index (RHI) from the EndoPAT. Results: The greatest significance was found between RHI and MFI at 10 s around the peak response (Spearman’s r = 0.67, p = 0.0002; Pearson’s r = 0.76, p = 0.00001). Conclusion: MFI is a reusable and user-friendly microvascular function assessment that could provide better access to vascular health screening.