Factors affecting outcome of acquired comitant esotropia with restricted use of digital devices: ACEDD Study 3.

OBJECTIVE: The objective of this study is to investigate factors associated with outcomes after 3 months of instructed usage of hand-held digital devices (DD) in patients with acquired comitant esotropia (ACE). METHODS AND ANALYSIS: This prospective multicentre observational study included patients with ACE, aged 5-35 years, who used DD within 1 year of onset and were followed up for clinical findings and instructed use of DD. The outcomes were classified into four groups: cured, improved, unchanged and worsened. After the analysis of group differences in the clinical and DD use-related factors by univariate analysis, we used ordinal logistic regression models to identify factors associated with favourable outcomes. RESULTS: Of 156 patients (mean age (SD): 16.4 (7.4) years), 10 (6%), 58 (37%), 67 (43%) and 21 (14%) were classified into the cured, improved, unchanged, and worsened, respectively. In the univariate analysis, consultation within 3 months of onset, small-angle strabismus at distance and good stereoacuity were associated with good outcomes. Ordinal logistic regression analysis on adjusting for age with stereoacuity or successful DD-use time halving showed that small-angle strabismus at distance (OR: 1.02, 95% CI 1.00 to 1.03, p=0.023), good stereoacuity (OR: 1.31; 95% CI 1.10 to 1.56; p=0.003) and successful halving of DD-use time (OR: 0.63; 95% CI 0.43 to 0.92; p=0.016) influenced favourable outcomes. CONCLUSION: Patients with small-angle esotropia, good stereoacuity on consultation and success in halving DD-use time had a higher chance of recovery through instructional DD usage. Further studies using objectively measurable systems are needed to ensure the accuracy of DD-use time.

Depth constancy and the absolute vergence anomaly.

Binocular disparity provides information about the depth structure of objects and surfaces in our environment. Since disparity depends on the distance to objects as well as the depth separation of points, information about distance is required to estimate depth from disparity. Our perception of size and shape is biased, such that far objects appear too small and flattened in depth, and near objects too big and stretched in depth. The current study assessed the extent to which the failure of depth constancy can be accounted for by the uncertainty of distance information provided by vergence. We measured individual differences in vergence noise using a nonius line task, and the degree of depth constancy using a task in which observers judged the magnitude of a depth interval relative to the vertical distance between two targets in the image plane. We found no correlation between the two measures, and show that depth constancy was much poorer than would be expected from vergence noise measured in this way. This limited ability to take account of vergence in the perception of depth is, however, consistent with our poor sensitivity to absolute disparity differences. This absolute disparity anomaly thus also applies to our poor ability to make use of vergence information for absolute distance judgements.

Margin-to-depth ratio as an independent prognostic factor in resected oral cavity squamous cell carcinoma: A nationwide cohort study.

BACKGROUND: The prognostic significance of margin-to-depth ratio (MDR) in oral cavity squamous cell carcinoma (OCSCC) remains unclear, particularly in comparison to traditional margin status. We aimed to examine the association between MDR and clinical outcomes in a large Taiwanese cohort. METHODS: A total of 18,324 patients with first primary OCSCC were categorized by margin status: positive (1013), <5 mm (8371), and ≥ 5 mm (8940). Disease-specific survival (DSS) and overall survival (OS) served as the main outcome measures. RESULTS: After excluding patients with positive margins (MDR = 0), the optimal MDR cutoff value for DSS and OS was 0.6. Patients with MDR > 0.6 showed significantly better 5-year DSS and OS rates (87 %, 81 %) compared to those with MDR ≤ 0.6 (71 %, 63 %) and MDR = 0 (53 %, 43 %). Multivariable analysis identified MDR ≤ 0.6 as independently associated with both DSS and OS in the entire cohort (hazard ratio [HR] = 1.34/1.32). This finding was consistent in the subgroups with surgical margins < 5 mm (HR = 1.39 for DSS and 1.38 for OS) and margins ≥ 5 mm (HR = 1.21 for both DSS and OS). In subgroups with surgical margins < 5 mm and ≥ 5 mm, an MDR > 0.6 was associated with better survival outcomes. CONCLUSIONS: An MDR (cutoff: 0.6) is independently associated with prognosis in OCSCC, offering improved risk stratification compared to margin status alone. While MDR may guide surgical margin modification, further research is needed to determine whether MDR could serve as a postoperative indicator for adjuvant therapy in patients with close or clear margins.

Unexplained Intraoperative Movement During a Complex Craniotomy for Recurrent Petrous Apex Cholesterol Granuloma: A Case Report.

Intraoperative patient movement under general anesthesia, even with multiple monitoring modalities and adequate anesthetic depth, is rare but can lead to serious complications. Such movements are particularly dangerous in neurosurgical procedures, where precision is crucial. Similar risks exist in ophthalmic, spinal, and cardiac surgeries, where patient immobilization is vital to prevent adverse outcomes. This report examines the case of a 37-year-old male diagnosed with recurrent cholesterol granuloma located at the petrous apex, which necessitated neurosurgical intervention. During the procedure, the patient was placed under deep general anesthesia, and multiple neuromonitoring techniques were used to track neural and motor activity. Despite maintaining stable hemodynamic parameters and unremarkable neuromonitoring results, the patient suddenly exhibited abrupt, forceful movements involving his head and upper arms. This unexpected event during a delicate neurosurgical procedure posed a significant challenge, prompting a deeper investigation into the possible underlying causes of the patient's sudden movements, which could include factors such as insufficient anesthetic depth, muscular or neural irritation, seizure activity, or mechanical factors related to surgical equipment or technique. This case highlights the critical role of comprehensive intraoperative monitoring in ensuring patient safety, particularly during complex neurosurgical procedures where precision is essential. The use of total intravenous anesthesia (TIVA), as was used in this case, presents unique challenges, as it requires a careful balance of maintaining adequate anesthetic depth without interfering with the neuromonitoring signals used during the procedure to ensure neural integrity.

Assessment of the elevation-dependent warming in the Qinling-Daba Mountains and its relationship with land surface albedo and aerosol optical depth from 2001 to 2021.

In this paper, we examined the elevation-dependent warming (EDW) patterns of MODIS LST across different seasons in the Qinling-Daba Mountains, further investigate the connections between the EDW patterns of Land surface temperature (LST) and land surface albedo (ALB) as well as aerosol optical depth (AOD). The key findings include: (1) Our study reveals a robust correlation between LST and air temperature in the Qinling-Daba Mountains, suggesting the feasibility of using MODIS LST to predict the temperature trends (2) During the period from 2001 to 2010, MODIS LST shows a significant EDW trend, primarily in the spring season. In contrast, a negative EDW is observed in the period during 2011-2021, which is contrary to the earlier decade, particularly during the autumn and winter seasons. (3) EDW of MODIS LST is affected by the combination of ALB and AOD. The former has a negative influence on the change of LST, particularly above 2500 m in elevation. However, the latter is negatively correlated with the trend of MODIS LST, primarily at lower and middle altitudes (0-2500 m). This study gives a comprehensive explanation for the EDW of the temporal variations of LST in the Qinling-Daba Mountains to improve our understanding of the complex interactions and potential future climate scenarios in the region.

Sizzling steaks and manly molds: Exploring the meanings of meat and masculinities in young men's lives.

Eating (red) meat and masculinity are historically and culturally associated, leading to the stereotype "real men eat meat" in western society. Existing literature primarily examines men' motivations, justifications, and attitudes toward meat consumption; however, there is limited understanding of the themes that emerging adult men associate with their meat consumption and how these themes relate to their masculine identity. This study employed semi-structured interviews with thirty men aged 18 to 29, living in Flanders, Belgium. Through inductive analysis, we identified five meat themes (i.e. the topics men talk about when discussing their meat-eating behavior): "traditional cuisine", "doing meat", "fitness", "taste", and "meat ethics". Subsequently, these themes were deductively connected to the frameworks of Wong and Wang's (2022) model of masculinities and Piazza et al.'s (2015) 4N scale of meat justification to gain insight into the link between masculine identities and meat consumption. Finally, we formulated five "masculine meat identities": "normative", "performative", "embodied", "hedonistic" and "ethical" meat masculinities. Each identity reflects how men utilize meat, particularly red meat, for communicating and reinforcing their masculine identity, while also serving as a medium for expressing personal and social identities. This research contributes to a deeper understanding of how food, especially meat, operates as a means of communicating gender, bridging the disciplines of food and masculinities studies. Moreover, insights obtained from these masculine meat identities provide implications for public health, marketing, and policy. By tailoring strategies that resonate with diverse masculine identities, stakeholders can better align their initiatives with global health and sustainable objectives.

Multiresolution Analysis of HRRR Meteorological Parameters and GOES-R AOD for Hourly PM2.5 Prediction.

High-resolution, comprehensive exposure data are crucial for accurately estimating the human health impact of PM2.5. In recent years, satellite remote sensing data have been increasingly utilized in PM2.5 models to overcome the limited spatial coverage of ground monitoring stations. However, data gaps in satellite-retrieved parameters such as aerosol optical depth (AOD), the sparsity of regulatory air quality monitors for model training, and nonlinear relationships between PM2.5 and meteorological conditions can affect model performance and cause data gaps in most existing PM2.5 models. In this study, spatial gaps in AOD obtained from Geostationary Operational Environmental Satellite-16 are filled using Goddard Earth Observing System Composition Forecasting AOD estimations. Furthermore, to improve model performance, meteorological predictors such as temperature from the High-Resolution Rapid Refresh model are preprocessed using Daubechies wavelet to extract low and high frequency components. The spatially gap-filled AOD, along with meteorological data, are ingested into a machine learning model to predict hourly PM2.5 at a 1 km spatial resolution in California. The model evaluation metrics (OOB (out-of-bag) R2 = 0.86 and RMSE (root-mean-square error) = 9.27 µg/m3 and 10-fold spatial cross-validation R2 = 0.82 and RMSE = 9.82 µg/m3) demonstrate the model's reliability in predicting ambient PM2.5, especially for states like California that experience frequent episodes of wildfires.

The calculated voyage: benchmarking optimal strategies and consumptions in the Japanese eel's spawning migration.

Eels migrate along largely unknown routes to their spawning ground. By coupling Zermelo's navigation solution and data from the Japan Coastal Ocean Predictability Experiment 2 (JCOPE2M), we simulated a range of seasonal scenarios, swimming speeds, and swimming depths to predict paths that minimize migration duration and energy cost. Our simulations predict a trade-off between migration duration and energy cost. Given that eels do not refuel during their migration, our simulations suggest eels should travel at speeds of 0.4-0.6 body-length per second to retain enough energy reserves for reproduction. For real eels without full information of the ocean currents, they cannot optimize their migration in strong surface currents, thus when swimming at slow swimming speeds, they should swim at depths of 200 m or greater. Eels swimming near the surface are also influenced by seasonal factors, however, migrating at greater depths mitigates these effects. While greater depths present more favorable flow conditions, water temperature may become increasingly unfavorable, dropping near or below 5 °C. Our results serve as a benchmark, demonstrating the complex interplay between swimming speed, depth, seasonal factors, migration time, and energy consumption, to comprehend the migratory behaviors of Japanese eels and other migratory fish.

Exploring the Interplay of Wavelength, Quantum Yield, and Penetration Depth in In Vivo Fluorescence Imaging.

The intricate interplay between the irradiation wavelength, the fluorophore quantum yield (QY) and penetration depth profoundly influences the efficacy of in vivo fluorescence imaging in various applications. Understanding the complex behavior of fluorescence in vivo, specifically how variations in wavelength affect the QY of commonly used dyes and the depth of imaging is crucial for optimizing fluorescence imaging techniques, as it directly impacts the accuracy and efficiency of imaging in biological tissues. In our study, we explore these dynamics through Monte Carlo simulations conducted under conditions reflective of wide-field fluorescence imaging, examining how variations in wavelength impact the dye's QY and depth of imaging, and consequently, the fluorescence behavior. A transition in the exponential decay of the emission depth exponent is observed around the 500-600 nm range, indicating varying degrees of influence of depth on the fluorescence emission. The analysis of the fluorophore's QY reveals wavelength-dependent variations, with the most significant impact observed in the 600-700 nm range. Moreover, we continued our investigation to explore multiplexing, unveiling insights into the spacing between identical spots in multiplexing images across various depths and wavelengths.

Direct visualization of microwires in hybrid depth electrodes using high-resolution photon-counting CT.

Hybrid depth electrodes are increasingly being used for epilepsy monitoring and human neurophysiology research. Microwires extending from the tip of the Behnke-Fried (BF) electrode into (sub)cortical areas allow to isolate single neurons and perform microstimulation. Conventional CT or MRI visualize the entire microwire bundle as an artifact extending from the BF electrode tip with low resolution, without proper identification of individual microwires. We illustrate the first direct visualization method of individual microwires using high-resolution photon-counting CT (PCCT). Coregistration of the PCCT scan with a preoperative MRI can visualize individual wires directly in cortex, which is an advantage as it provides feedback on the accuracy of the implantation method and can guide future implantations. This PCCT technique allows for accurately depicting individual microwires which could be relevant for neuroscientific research through improved visualization and implantation of specific cortical and subcortical brain areas. PLAIN LANGUAGE SUMMARY: Researchers are using hybrid depth electrodes to study epilepsy and brain activity. These electrodes, called Behnke-Fried (BF) electrodes, have microwires at the tip that can record single neurons and stimulate brain areas. Regular CT or MRI scans do not show the individual microwires clearly. The authors use a new high-resolution photon-counting CT (PCCT) technique, which can show each individual microwire in the brain. By combining PCCT with MRI, the authors can precisely see where the microwires are located. This could improve future implantation surgeries and brain research.

Impact of cochlear detailed morphology on insertion results and intracochlear trauma of a slim pre-curved electrode array: a micro-CT study.

OBJECTIVE: This study aimed to evaluate the impact of detailed cochlear dimensions, assessed using micro-CT (µCT) imaging, on insertion outcomes and associated trauma with a new slim, precurved electrode array. MATERIALS AND METHODS: Eleven temporal bone specimens underwent implantation of a 22-electrode slim precurved array via the round window. High-resolution µCT scans post-implantation enabled visualization of cochlear structures and electrode positioning. Combination with subsequent scans taken after electrodes removal, we analyzed angular insertion depth (AID), insertion length, number of electrodes inserted, cochlear dimensions (specifically cochlear duct length (CDL), basal turn diameter, scala tympani dimension), and intracochlear trauma of fine structures. Statistical analyses were performed to correlate cochlear detailed dimensions and morphology with insertion outcomes and trauma. RESULTS: The mean AID was 351.82°, and the mean insertion length was 21.07 mm. CDL showed positive correlations with AID and insertion length. Basal turn diameter (value B) positively correlated with AID and insertion length, unlike value A. Middle-basal turn (M/B) relationships (angle and height) significantly influenced insertion depth. The cochleae with smaller M/B heights and specific angles were more susceptible to insertion trauma. Larger basal turn diameters correlated with increased trauma and electrode translocation into the scala vestibuli. CONCLUSION: This study highlights the importance of precise cochlear measurements in predicting and optimizing cochlear implant outcomes. Specific cochlear dimensions and anatomical shapes were identified as critical factors affecting insertion depth, trauma risk, and electrode positioning. Utilizing micro-CT provided detailed insights into cochlear anatomy and insertion outcomes, offering valuable data for advancing cochlear implant technology and surgical practices.

Deep learning-based normative database of anterior chamber dimensions for angle closure assessment: the Singapore Chinese Eye Study.

BACKGROUND/ AIMS: The lack of context for anterior segment optical coherence tomography (ASOCT) measurements impedes its clinical utility. We established the normative distribution of anterior chamber depth (ACD), area (ACA) and width (ACW) and lens vault (LV), and applied percentile cut-offs to detect primary angle closure disease (PACD; ≥180° posterior trabecular meshwork occluded). METHODS: We included subjects from the Singapore Chinese Eye Study with ASOCT scans. Eyes with ocular surgery or laser procedures, and ocular trauma were excluded. A deep-learning algorithm was used to obtain Visante ASOCT (Carl Zeiss Meditec, USA) measurements. Normative distribution was established using 80% of eyes with open angles. Multivariable logistic regression was performed on 80% open and 80% angle closure eyes. Diagnostic performance was evaluated using 20% open and 20% angle closure eyes. RESULTS: We included 2157 eyes (1853 open angles; 304 angle closure) for analysis. ACD, ACA and ACW decreased with age and were smaller in females, and vice versa for LV (all p<0.022). ACD 20th percentile and LV 85th percentile had a balanced accuracy of 84.4% and 84.2% in detecting PACD, respectively. When combined, ACD 20th and LV 85th percentile had 88.68% sensitivity and 88.85% specificity in detecting PACD as compared with a multivariable regression model (ACA, angle opening distance, LV, iris area) with 88.33% sensitivity and 83.75% specificity. CONCLUSION: Anterior chamber parameters varied with age and gender. The ACD 20th and LV 85th percentile values may be used in silos or in combination to detect PACD in the absence of more sophisticated classification algorithms.

Fundamental effects of array density and modulation frequency on image quality of diffuse optical tomography.

BACKGROUND: Diffuse optical tomography (DOT) provides three-dimensional image reconstruction of chromophore perturbations within a turbid volume. Two leading strategies to optimize DOT image quality include, (i) arrays of regular, interlacing, high-density (HD) grids of sources and detectors with closest spacing less than 15 mm, or (ii) source modulated light of order ∼100 MHz. PURPOSE: However, the general principles for how these crucial design parameters of array density and modulation frequency may interact to provide an optimal system design have yet to be elucidated. METHODS: Herein, we systematically evaluated how these design parameters effect image quality via multiple key metrics. Specifically, we simulated 32 system designs with realistic measurement noise and quantified localization error, spatial resolution, signal-to-noise, and localization depth of field for each of ∼85 000 point spread functions in each model. RESULTS: We found that array density had a far stronger effect on image quality metrics than modulation frequency. Additionally, model fits for image quality metrics revealed that potential improvements diminish with regular arrays denser than 9 mm closest spacing. Further, for a given array density, 300 MHz source modulation provided the deepest reliable imaging compared to other frequencies. CONCLUSIONS: Our results indicate that both array density and modulation frequency affect the spatial sampling of tissue, which asymptotically saturates due to photon diffusivity within a turbid volume. In summary, our results provide comprehensive perspectives for optimizing future DOT system designs in applications from wearable functional brain imaging to breast tumor detection.

Ocular manifestations for misdiagnosing acute angle closure secondary to lens subluxation.

Introduction: The objective of this study was to assess the clinical characteristics and biometric parameters, as measured by the IOLMaster, of patients suffering from acute secondary angle closure due to zonular dialysis (ASAC-ZD) who were misdiagnosed with acute primary angle closure (APAC). Methods: In this retrospective study, 34 ASAC-ZD and 39 APAC eyes were examined. Sex, age, best-corrected visual acuity, axial length (AL), anterior chamber depth (ACD), anterior chamber depth standard deviation (ACDSD), lens thickness (LT), and lens thickness standard deviation (LTSD) were measured using the IOLMaster and compared between the two groups. In addition, the difference in ACD (ACD difference) between the affected eye and the contralateral eye was analyzed. Logistic regression analysis was performed to determine the predictive factors of lens subluxation. To determine the appropriate cutoff values for biometric parameters, ROC curves were constructed to distinguish between ASAC-ZD, APAC, and cataracts. Results: Compared to the APAC group, the ASAC-ZD group was younger (69.92 ± 9.345, 63.74 ± 6.947), had longer AL (22.39 ± 0.7852, 23.23 ± 1.168), shallower ACD (2.120 ± 0.2986, 1.889 ± 0.5167), higher ACDSD (7.605 ± 5.425, 9.941 ± 6.120), higher LTSD (28.00 ± 19.52, 39.79 ± 22.74), and larger ACD differences (-0.1249 ± 0.2349, -0.7306 ± 0.5332) in the affected eye. Younger age, longer AL, lower ACD, higher LTSD, and higher ACD differences were associated with lens subluxation in the univariate logistic regression analysis. ACD difference (p = 0.0003), age (p = 0.0024), and ACD (p = 0.0491) were significantly associated with lens subluxation in the multivariable logistic regression analysis. Furthermore, the ROC curve analysis showed that the cutoff values for lens subluxation were a difference in ACD of 0.225 mm and 1.930 mm. Conclusion: Asymmetric ACD in both eyes with normal AL and increasing ACDSD and LTSD may support the clinical diagnosis of lens subluxation.

Comparison of Clinical and Radiographic Outcomes Between Single Symphyseal and Parasymphyseal Implants Versus Two Implant-Assisted Complete Mandibular Overdentures.

PURPOSE: This study aimed to compare the efficacy of single implants in the symphyseal and parasymphyseal regions with that of two implants in complete mandibular overdentures. PATIENTS AND METHODS: Fifteen completely edentulous male patients (50-65 years) were chosen and randomly grouped into three equal groups (five patients in each) according to the position and number of the received implants to assist mandibular complete overdentures: group I: single median implant; group II: single parasymphyseal implant; and group III: two implants were inserted in the canine area bilaterally. After three months of osseointegration, the lower denture was transformed into an implant-assisted complete mandibular overdenture. Clinical observations were documented on the day of loading, and three, six, and nine months later for each implant. Follow-up cone beam computed tomography scans were performed to assess marginal bone loss on the day of loading, and six and twelve months later. The masticatory efficiency evaluation was conducted one and three months after loading. RESULTS: The obtained results demonstrated insignificant differences between the three groups concerning marginal bone loss, plaque index, pocket depth, and bleeding index. Regarding the masticatory efficiency, the results revealed a significantly higher masticatory efficiency in group III than in groups I and II. CONCLUSION: Using two implants to retain mandibular overdentures is the first choice due to their higher masticatory efficiency than a single implant. However, a single implant may be a viable treatment alternative, especially in cases where there are any limitations that restrict the use of additional implants.

Temporal and spatial use of a freshwater lake by upstream and downstream migrating adult Atlantic salmon Salmo salar.

Atlantic salmon Salmo salar typically enter fresh water several months prior to spawning and just as pools can provide areas of refuge in river systems, lakes may also provide important refuge habitat during the spawning migration. Using acoustic telemetry we examined the spatial and temporal movements of wild and a ranched strain of Atlantic salmon in a freshwater lake where the main spawning areas were located upstream of the lake. Over the study period (2011-2014), returning adult wild salmon spent an average of 228 days in fresh water and 90% of that time in the lake. On entering the lake, most wild salmon moved quickly to the northern part of the lake, close to the main inflow, spending an average 76% of the time in this location. The average number of days wild fish were absent from the lake during the main spawning period varied between years, ranging from 10 to 26 days for females and 32 to 35 days for males. Seventy four per cent (17/23) of salmon spawners returned to the lake and two salmon subsequently died in the lake post-spawning. Atypically, two salmon were resident in the lake for the whole period in 2013/14. During the study, wild salmon were detected at depths within the top 5 m for 73% of the time. Median depths post-spawning were greater than in the pre-spawning period, when salmon were found to spend extensive periods at depths in excess of 10 m. In July 2013, when the lake was stratified, thermal regulation behaviour was observed in wild salmon, whereby salmon moved to cooler deeper water when water temperatures at 1 m exceeded 20°C. In contrast to wild salmon, the majority of ranch salmon returned to the traps downstream of the lake prior to the spawning period, which would be expected as they were released as smolts below the freshwater lake. Ranch fish spent an average 80% of the time in the vicinity of receivers in the south of the lake and an average 98% of the time within the top 5 m. However, two ranch females were resident in the lake until the following spring and one ranch female moved upstream into the river during the spawning period. Clearly, in this catchment the lake provides an important habitat for migrating adult salmon. In the context of climate change, where thermal and hydrological regimes in rivers are expected to change in response to changes in air temperature and precipitation patterns, the availability of deep lakes that stratify in the summer and cool water refuges in river systems is likely to play a key role in the sustenance and conservation of salmonid species. Information about the migration patterns of Atlantic salmon in undisturbed freshwater systems may also assist in resolving issues associated with fish passage in impacted rivers and inform management decisions.

Advancing microbial diagnostics: a universal phylogeny guided computational algorithm to find unique sequences for precise microorganism detection.

Sequences derived from organisms sharing common evolutionary origins exhibit similarity, while unique sequences, absent in related organisms, act as good diagnostic marker candidates. However, the approach focused on identifying dissimilar regions among closely-related organisms poses challenges as it requires complex multiple sequence alignments, making computation and parsing difficult. To address this, we have developed a biologically inspired universal NAUniSeq algorithm to find the unique sequences for microorganism diagnosis by traveling through the phylogeny of life. Mapping through a phylogenetic tree ensures a low number of cross-contamination and false positives. We have downloaded complete taxonomy data from Taxadb database and sequence data from National Center for Biotechnology Information Reference Sequence Database (NCBI-Refseq) and, with the help of NetworkX, created a phylogenetic tree. Sequences were assigned over the graph nodes, k-mers were created for target and non-target nodes and search was performed over the graph using the depth first search algorithm. In a memory efficient alternative NoSQL approach, we created a collection of Refseq sequences in MongoDB database using tax-id and path of FASTA files. We queried the MongoDB collection for the target and non-target sequences. In both the approaches, we used an alignment free sliding window k-mer-based procedure that quickly compares k-mers of target and non-target sequences and returns unique sequences that are not present in the non-target. We have validated our algorithm with target nodes Mycobacterium tuberculosis, Neisseria gonorrhoeae, and Monkeypox and generated unique sequences. This universal algorithm is a powerful tool for generating diagnostic sequences, enabling the accurate identification of microbial strains with high phylogenetic precision.

Hydraulic traits exert greater limitations on tree-level maximum sap flux density than photosynthetic ability: Global evidence.

Transpiration is a key process that couples the land-atmosphere exchange of water and carbon, and its maximum water transport ability affects plant productivity. Functional traits significantly influence the maximum transpiration rate; however, which factor plays the dominant role remains unknown. SAPFLUXNET dataset, which includes sap flux density of diverse species worldwide, provides fundamental data to test the importance of photosynthetic and hydraulic traits on maximum tree-level sap flux density (Js_max). Here, we investigated variations in Js_max of 2194 trees across 129 species using data from the SAPFLUXNET dataset, and analysed the relationship of Js_max with photosynthetic and hydraulic traits. Our results indicated that Js_max was positively correlated with photosynthetic traits at both leaf and tree level. Regarding hydraulic traits, Js_max was positively related to xylem hydraulic conductivity (Ks), leaf-specific hydraulic conductivity (Kl), xylem pressure inducing 50 % loss of hydraulic conductivity (P50), xylem vessel diameter (Vdia), and leaf-to-sapwood area ratio (AlAs). Random forest model showed that 87 % of the variability in Js_max can be explained by functional traits, and hydraulic traits (e.g., P50 and sapwood area, As) exerted larger effects on Js_max than photosynthetic traits. Moreover, trees with a lower sapwood area or depth could increase their sap flux density to compensate for the reduced whole-tree transpiration. Js_max of the angiosperms was significantly higher than that of the gymnosperms. Mean annual total precipitation (MAP) were positively related to Js_max with a weak correlation coefficient. Furthermore, Js_max showed a significant phylogenetic signal with Blomberg's K below 0.2. Overall, tree species with acquisitive resource economics or more efficient hydraulic systems show higher water transport capacity, and the efficiency of xylem hydraulic system rather than the demand for carbon uptake predominantly determines water transport capacity.

Implementation and development of hospital-based health technology assessment in Poland from the perspective of hospital representatives: qualitative research.

Introduction: The analysis of health technologies in Poland has so far mainly concerned drugs assessed by the Agency for Health Technology Assessment and Tariffication, which was established for this purpose. Due to the implementation of various forms of investment (hardware, diagnostic, and organizational) in hospitals, and the growing need to properly assess the costs of implemented solutions, Hospital-Based Health Technology Assessment (HB-HTA) began to develop. In order to implement HB-HTA in the Polish healthcare system, in 2019-2022 a project was carried out, the consortium members of which were: the National Health Fund (NHF), the National Institute of Cardiology in Warsaw (NIKARD), and Lazarski University (UL). Purpose of the study: Analyzing the possibilities of developing HB-HTA in Polish hospitals based on the experiences of the study participants. Presenting benefits and barriers for HB-HTA units implementation to Polish hospitals. Methods: Qualitative analysis of in-depth interviews with the representatives of hospitals that participated in the HB-HTA project using the Nvivo12 program. A specially prepared questionnaire with questions regarding the pre-project, design, and post-project phases was presented to respondents from five of the seven hospitals participating in the pilot phase of the project, during which HB-HTA reports were prepared for selected medical technologies. The remaining two facilities that were invited refused to participate in the study. The Ethics Committee of the Jagiellonian University Medical College gave consent to conduct the study. Results: Hospital representatives indicate that the HB-HTA methodology allows for the assessment of investments in facilities based on appropriate data. Thanks to the project, employees of hospital units gained new skills, such as becoming familiar with literature reviews in medical bibliographic databases. However, HB-HTA in Poland has not been fully implemented because facilities do not obtain adequate benefits from the implementation of HB-HTA at the organizational and financial level. According to the study participants, the methodology itself should be modified to take into account the needs of the facility. Conclusion: The hospitals participating in the HB-HTA project are developing the field of analyzing how innovative solutions are implemented in their facilities, but not to the extent that was intended in the project design.

Bill Length of Non-breeding Shorebirds Influences the Water Depth Preferences for Foraging in the West Coast of India.

Body size, bill length and shape determine foraging techniques, habitat selection and diet among shorebirds. In this study, water depth preferences of different shorebirds with different bill sizes in various habitats including mudflats, mangroves at Kadalundi-Vallikkunnu Community Reserve (KVCR) (19 shorebird species) and adjacent agroecosystems at Vazhakkad (12 species) were studied between 2017 and 2020. The bill length of the shorebirds was significantly and positively associated with the average water depth, where shorebirds were observed to forage. Shorebirds with shorter bill lengths preferred shallow waters and those with longer bills preferred deep waters for their foraging activities. Habitat type also had a significant effect on the shorebird occurrence. Eurasian Curlews in both mangroves and mudflats were observed in areas with a higher water depth compared to other species. This is due to the fact that shorebirds tend to specialise in feeding habitats or in prey items to reduce intraspecific competition and distribute themselves in space and time in accordance with the availability of their resources. The occurrence of some species in agroecosystems is attributed to the reduced food availability, habitat quality and other disturbances for shorebirds on tidal flats, which are critical for sustaining migratory phenology. The differences in bill morphology are crucial in determining diet, water depth, niche preferences and segregation. Morphological characters and hydrological rhythms determine specialisation in diet and habitat preference in shorebirds.