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This study investigates the impact of water resource restrictions on thermoelectric and hydroelectric stations, analyzing its influence on demand and electricity prices. It uses General Circulation Models (GCMs) and Soil and Water Assessment Tools (SWAT) to forecast future temperature trends and estimate river flow patterns. The research provides insights into climate change's potential effects on water resources and electricity potential. The study shows a significant decrease in river flow, indicating potential issues with hydroelectric and thermoelectric systems. The study also uses an optimized Echo State Network (ESN) for accurate electricity demand, using the Modified Snow Leopard Optimization (MSLO) algorithm as a new metaheuristic model. The simulation results show a consistent increase in electricity demand scenarios, which is expected to lead to higher supply prices due to decreased production capacity. This could have significant economic effects. The investigation provides a comprehensive understanding of water resource management challenges in power production, aiding in informed decisions in the future energy industry.

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Root exudation and its mediated nutrient cycling process driven by nitrogen (N) fertilizer can stimulate the plant availability of various soil nutrients, which is essential for microbial nutrient acquisition. However, the response of soil microbial resource limitations to long-term N fertilizer application rates in greenhouse vegetable systems has rarely been investigated. Therefore, we selected a 15-year greenhouse vegetable system, and investigated how N fertilizer application amount impacts on root carbon and nitrogen exudation rates, microbial resource limitations and microbial carbon use efficiency (CUEST). Four N treatments were determined: high (N3), medium (N2), low (N1), and a control without N fertilization (N0). Compared to the control (N0), the results showed that the root C exudation rates decreased significantly by 42.9 %, 57.3 % and 33.6 %, and the root N exudation rates decreased significantly by 29.7 %, 42.6 %, and 24.1 % under N1, N2, and N3 treatments, respectively. Interactions between fertilizer and plant roots altered microbial C, N, P limitations and CUEST; Microbial C and N/P limitations were positively correlated with root C and N exudation rates, negatively correlated with microbial CUEST. Random Forest analysis revealed that the root C and N exudation rates were key factors for soil microbial resource limitations and microbial CUEST. Through the structural equation model (SEM) analysis, soil NH4+ content had significant direct effects on the root exudation rates after long-term N fertilizer application. An increase in root exudation rates led to enhanced microbial resource limitations in the rhizosphere soils, potentially due to increased competition. This enhancement may reduce microbial carbon use efficiency (CUE), that is, microbial C turnover, thereby reducing soil C sequestration. Overall, this study highlights the critical role of root exudation rates in microbial resource limitations and CUE changes in plant-soil systems, and further improves our understanding of plant-microbial interactions.

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Natural or man-made medical disasters have repeatedly affected human communities. The impact on health care resources may vary depending on the magnitude of each crisis, catastrophe or pandemic, and the resources available. Medical triage protocols serve as invaluable tools to address clinical needs, particularly when resources, including supplies, equipment, and personnel, are limited. Although resources should be allocated to maximize the benefit, resource allocations need to be ethically sound. Existing triage protocols have inherent limitations.

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Microbial carbon (C) use efficiency (CUE) delineates the proportion of organic C used by microorganisms for anabolism and ultimately influences the amount of C sequestered in soils. However, the key factors controlling CUE remain enigmatic, leading to considerable uncertainty in understanding soil C retention and predicting its responses to global change factors. Here, we investigate the global patterns of CUE estimate by stoichiometric modeling in surface soils of natural ecosystems, and examine its associations with temperature, precipitation, plant-derived C and soil nutrient availability. We found that CUE is determined by the most limiting resource among these four basic environmental resources within specific climate zones (i.e., tropical, temperate, arid, and cold zones). Higher CUE is common in arid and cold zones and corresponds to limitations in temperature, water, and plant-derived C input, while lower CUE is observed in tropical and temperate zones with widespread limitation of nutrients (e.g., nitrogen or phosphorus) in soil. The contrasting resource limitations among climate zones led to an apparent increase in CUE with increasing latitude. The resource-specific dependence of CUE implies that soils in high latitudes with arid and cold environments may retain less organic C in the future, as warming and increased precipitation can reduce CUE. In contrast, oligotrophic soils in low latitudes may increase organic C retention, as CUE could be increased with concurrent anthropogenic nutrient inputs. The findings underscore the importance of resource limitations for CUE and suggest asymmetric responses of organic C retention in soils across latitudes to global change factors.

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Resource limitation for soil microorganisms is the crucial factor in nutrient cycling and vegetation development, which are especially important in arid climate. Given that rock fragments strongly impact hydrologic and geochemical processes in arid areas, we hypothesized that microbial resource (C and N) limitation will increase along the rock fragment content (RFC) gradient. We conducted a field experiment in Minjiang river arid valleys with four RFC content (0 %, 25 %, 50 %, and 75 %, V V-1) and four vegetation types (Artemisia vestita, Bauhinia brachycarpa, Sophora davidii, and the soil without plants). Activities of C (ß-1,4-glucosidase, BG), N (ß-1,4-N-acetyl-glucosaminidase, NAG; L-leucine aminopeptidase, LAP), and P (acid phosphatase, ACP) acquiring enzymes were investigated to assess the limitations by C, N or P. In unplanted soil, the C acquiring enzyme activity decreased by 43 %, but N acquiring enzyme activity increased by 72 % in 75 % RFC than those in rock-free soils (0 % RFC). Increasing RFC reduced C:N and C:P enzymatic ratios, as well as vector length and vector angle (< 45°). Plants increased the activities of C and N acquiring enzymes in soils, as well as C:P and N:P enzyme activities, as well as vector length (by 5.6 %-25 %), but decreased vector angle (by 13 %-21 %). Enzyme stoichiometry was dependent on biotic and abiotic factors, such as soil water content, soil C:N, and total content of phospholipid fatty acids, reflecting microbial biomass content. Increased RFC shifted enzymatic stoichiometry toward lower C but stronger N limitation for microorganisms. Vegetation increased microbial C and N limitation, and impacted the enzymatic activities and stoichiometry depending on shrub functional groups. Consequently, the direct effects of vegetation, nutrient availability and microbial biomass content, as well as indirect effects of soil properties collectively increased microbial resource limitations along the RFC gradient.

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The bilateral erector spinae plane block (ESP) has been effectively used for abdominal surgery, and the placement of catheters is known to extend the benefits of the block while allowing for the adjustment of local anesthetic doses as necessary. Since fascial plane blocks require high volumes of local anesthetic and a prolonged duration of effect, typically, long-acting local anesthetics are preferred. However, lidocaine is not commonly chosen for these types of blocks due to the large volumes required and the associated risk of local anesthetic systemic toxicity. Nonetheless, we present a case report of a patient who underwent a partial hepatectomy under general anesthesia, with perioperative placement of a bilateral ESP block. Bilateral catheters were inserted, and 1% lidocaine was selected as the local anesthetic due to resource limitations. The surgery proceeded without complications, and the patient reported effective analgesia and a high level of satisfaction. Our report suggests that the utilization of lidocaine in a continuous ESP block can be a successful alternative for partial hepatectomies.

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Cortisol is a glucocorticoid hormone produced during activation of the hypothalamic-pituitary-adrenal axis (HPA) in response to psychological or physiological demands. High amounts of circulating cortisol can be found in individuals experiencing energetically demanding physiological events, such as pregnancy, lactation, injury, or starvation, but, also, in individuals who may have less obvious HPA activation from social situations. The feral horse population on Sable Island (Nova Scotia, Canada) provides an opportunity to look at hair cortisol concentration (HCC) as a proxy for circulating cortisol concentration to better understand physiological correlates. The horse's complex social structure also allows us to look at how the population and group structure may influence HPA activation. Hair samples (n = 282) were analyzed from 113 females and 135 males. Females with dependent offspring (foals) had higher HCC than those females without dependent offspring (p = 0.005). Horses in poor body condition were also more likely to have higher HCC (females: p < 0.001, males: p = 0.028); females had greater variation in the body condition index (BCI), which also correlated with foal production. In general, the top-ranked models describing female cortisol levels included age, BCI, presence of a foal, as well as social measures such as harem size and the number of bachelors in the vicinity. The top model describing male cortisol levels included age, BCI, and year of collection only, and the number of bachelors in the home range appeared in subsequent, though still high-ranked, models. Among the variables not of direct interest, we found some significant results relating to hair color and hair texture. Differences in HCC patterns between feral and domestically kept horses (e.g., age and sex) are likely linked to periods of resource limitations, particularly for individuals experiencing energetically demanding processes such as reproduction, illness/parasitism, or related to experiencing the full range of social and reproductive behaviors.

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Microbial communities in soils are generally considered to be limited by carbon (C), which could be a crucial control for basic soil functions and responses of microbial heterotrophic metabolism to climate change. However, global soil microbial C limitation (MCL) has rarely been estimated and is poorly understood. Here, we predicted MCL, defined as limited availability of substrate C relative to nitrogen and/or phosphorus to meet microbial metabolic requirements, based on the thresholds of extracellular enzyme activity across 847 sites (2476 observations) representing global natural ecosystems. Results showed that only about 22% of global sites in terrestrial surface soils show relative C limitation in microbial community. This finding challenges the conventional hypothesis of ubiquitous C limitation for soil microbial metabolism. The limited geographic extent of C limitation in our study was mainly attributed to plant litter, rather than soil organic matter that has been processed by microbes, serving as the dominant C source for microbial acquisition. We also identified a significant latitudinal pattern of predicted MCL with larger C limitation at mid- to high latitudes, whereas this limitation was generally absent in the tropics. Moreover, MCL significantly constrained the rates of soil heterotrophic respiration, suggesting a potentially larger relative increase in respiration at mid- to high latitudes than low latitudes, if climate change increases primary productivity that alleviates MCL at higher latitudes. Our study provides the first global estimates of MCL, advancing our understanding of terrestrial C cycling and microbial metabolic feedback under global climate change.

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Decision making within the context of resource limitations requires balancing the short-term benefits of obtaining a resource and the long-term consequences of depleting those resources. The present manuscript focuses on four types of tasks that share this tradeoff to develop a taxonomy that will encourage a deeper understanding of the psychological processes at play. The four types considered are foraging, common pool traps, deterioration traps, and a novel designation referred to as resource cliffs. All four will be shown to include two opposite processes - depletion of the resource and its replenishment over time. By considering the unique and shared features of these tasks, a taxonomy of features emerges that can be combined to not only create novel tasks but also to shift the research focus to task features rather than specific tasks. The paper closes with a consideration of current theoretical frameworks previously applied to one or more of these resource-limitation tasks as well as the promise of reinforcement learning as a unifying theory.

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BACKGROUND: At the onset of the coronavirus pandemic, concerns were raised about sufficiency of available intensive care resources. In many places, routine interventions were postponed and criteria for the allocation of scarce resources were formulated. In Germany, some hospitals were at times seriously burdened during the course of the pandemic. Intensive care units in particular experienced a shortage of resources, which may have led to a restriction of services and a stricter indication setting for resource-intensive measures such as extracorporeal membrane oxygenation (ECMO). The aim of this work is to provide an overview of how these pressures were managed at large ECMO centers in Germany. METHODS: One representative of each major ECMO referral center in Germany was invited to participate in an online survey in spring 2021. RESULTS: Of 34 invitations that were sent out, the survey was answered by 23 participants. In all centers, routine procedures were postponed during the pandemic. Half of the centers increased the number of beds on which ECMO procedures could be offered. Nevertheless, in one-third of the centers, the start of at least one ECMO support was delayed because of a feared resource shortage. In 17% of centers, at least one patient was denied ECMO that he or she would have most likely received under prepandemic conditions. CONCLUSION: The results of this online survey indicate that the experienced pressures and resource constraints led some centers to be cautious about ECMO indications.

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Behavior has short-term (proximal) and long-term (distal) consequences, and these consequences often involve different commodities. In particular, a commonly encountered distal consequence involves running out of resources - energy to respond, available food, ammunition, or money in the bank - that must be replenished before continuing a rewarding task. The current project examines proximal behavioral consequences in a video game (the amount of damage done to a clicked-on target as a function of waiting) and distal behavioral consequences (running out of the resources that allow the player to click on a target). When depleted, the resource replenished after a fixed amount of time. Thus, participants sometimes faced a tradeoff between behaviors that maximized their short-term reward rate and those that maximized their long-term reward rate. When the proximal contingency did not affect the short-term reward rate, the mere presence of limitations resulted in the slower use of resources, but the slowdown did not evidence strong sensitivity to the size of the resource pool nor the delay to its replenishment (Experiment 1). However, when the proximal contingency rewarded faster use of resources, participants did show sensitivity to the duration of the replenishment delay and the size of the resource pool (Experiment 2).

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Extracorporeal membrane oxygenation (ECMO) is increasingly being used for patients with severe respiratory failure and has received particular attention during the coronavirus disease 2019 (COVID-19) pandemic. Evidence from two key randomized controlled trials, a subsequent post hoc Bayesian analysis, and meta-analyses support the interpretation of a benefit of ECMO in combination with ultra-lung-protective ventilation for select patients with very severe forms of acute respiratory distress syndrome (ARDS). During the pandemic, new evidence has emerged helping to better define the role of ECMO for patients with COVID-19. Results from large cohorts suggest outcomes during the first wave of the pandemic were similar to those in non-COVID-19 cohorts. As the pandemic continued, mortality of patients supported with ECMO has increased. However, the precise reasons for this observation are unclear. Known risk factors for mortality in COVID-19 and non-COVID-19 patients are higher patient age, concomitant extra-pulmonary organ failures or malignancies, prolonged mechanical ventilation before ECMO, less experienced treatment teams and lower ECMO caseloads in the treating center. ECMO is a high resource-dependent support option; therefore, it should be used judiciously, and its availability may need to be constrained when resources are scarce. More evidence from high-quality research is required to better define the role and limitations of ECMO in patients with severe COVID-19.

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BACKGROUND: We used a quality improvement framework to transform two-day and in-person advanced communication training (ACT) course into a remote ACT (Re-ACT) format to help clinicians improve serious illness conversation (SIC) skills. MEASURES: We assessed the reach, impact, and costs of Re-ACT and compared these measures to in-person ACT courses. INTERVENTIONS: About 45-60 minutes of synchronous, remote sessions consisting of a didactic introduction to SIC skills, tailored to the SARS-Cov-2 (COVID-19) crisis, and a live demonstration of SICs with patient-actors. OUTCOMES: The transition to Re-ACT sessions resulted in reaching a greater number of clinicians in less time, although depth of content and opportunities for skill practice decreased. Although both formats were well received, Re-ACT respondents felt less prepared than ACT respondents to use SIC skills. The costs of Re-ACT were significantly less than in-person ACT courses. CONCLUSIONS/LESSONS LEARNED: We provided effective and well-received SIC training during a time of crisis. Future work should further define the optimal mix of in-person and remote experiences to teach SIC skills.

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Undergraduate microbiology curriculum should be amenable to periodic changes to incorporate new developments and ideas. The curriculum should be used not merely as a way to disseminate facts but also as a way to allow students to experience the process of science. In the context of undergraduate microbiology education in Osmania University (Hyderabad, India), existing curriculum does not explicitly allow students to engage in deeper understanding of concepts and understanding of the process of science, both in lecture and laboratory courses. The assessment methods that are currently used are limited in scope as they only test factual recall and superficial understanding of the subject and very minimally assess critical thinking skills. Another factor hampering innovation in the broader context of undergraduate education is the unavailability and inaccessibility to adequate resources. To address the issue of resource-limitations in implementing activities that expose undergraduate students to real-world microbiology experiences, a collaboration between a research institute and two teaching colleges was formed. This collaboration involved teacher and student workshops on exploring microbial diversity using 16S rRNA analysis with a view of blending novel research questions with technical skills in the undergraduate microbiology lab. This effort is an example of educators providing students with authentic experiences and, helping them gain critical knowledge and research skills in microbiology even under resource constraints, and students demonstrating motivation to participate in similar activities in the future. The collaborative effort described here can be a broadly sustainable model to improve overall undergraduate education in relatively resource-limited environments.

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Human decisions are based on finite information, which makes them inherently imprecise. But what determines the degree of such imprecision? Here, we develop an efficient coding framework for higher-level cognitive processes in which information is represented by a finite number of discrete samples. We characterize the sampling process that maximizes perceptual accuracy or fitness under the often-adopted assumption that full adaptation to an environmental distribution is possible, and show how the optimal process differs when detailed information about the current contextual distribution is costly. We tested this theory on a numerosity discrimination task, and found that humans efficiently adapt to contextual distributions, but in the way predicted by the model in which people must economize on environmental information. Thus, understanding decision behavior requires that we account for biological restrictions on information coding, challenging the often-adopted assumption of precise prior knowledge in higher-level decision systems.

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Real causal systems are complicated. Despite this, causal learning research has traditionally emphasized how causal relations can be induced on the basis of idealized events, i.e., those that have been mapped to binary variables and abstracted from time. For example, participants may be asked to assess the efficacy of a headache-relief pill on the basis of multiple patients who take the pill (or not) and find their headache relieved (or not). In contrast, the current study examines learning via interactions with continuous dynamic systems, systems that include continuous variables that interact over time (and that can be continuously observed in real time by the learner). To explore such systems, we develop a new framework that represents a causal system as a network of stationary Gauss-Markov ("Ornstein-Uhlenbeck") processes and show how such OU networks can express complex dynamic phenomena, such as feedback loops and oscillations. To assess adult's abilities to learn such systems, we conducted an experiment in which participants were asked to identify the causal relationships of a number of OU networks, potentially carrying out multiple, temporally-extended interventions. We compared their judgments to a normative model for learning OU networks as well as a range of alternative and heuristic learning models from the literature. We found that, although participants exhibited substantial learning of such systems, they committed certain systematic errors. These successes and failures were best accounted for by a model that describes people as focusing on pairs of variables, rather than evaluating the evidence with respect to the full space of possible structural models. We argue that our approach provides both a principled framework for exploring the space of dynamic learning environments as well as new algorithmic insights into how people interact successfully with a continuous causal world.

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BACKGROUND: India's Mental Healthcare Act, 2017 (MHCA) greatly restricts the use of electroconvulsive therapy (ECT) in minors and bans unmodified ECT. Indian psychiatrists have raised concerns that these measures may deprive certain patients of life-saving treatment. This study describes the perspectives of Indian psychiatrists on how ECT is dealt with in the legislation. METHODS: We conducted nine focus groups in three Indian states. We explored the positive and negative implications of the MHCA and discussed its implementation, especially in relation to ECT. RESULTS: Many of the themes and concerns commonly discussed in relation to ECT in other jurisdictions are readily apparent among Indian psychiatrists, although perspectives on specific issues remain heterogeneous. The one area of near-universal agreement is Indian psychiatrists' affirmation of the effectiveness of ECT. We identified three main areas of current concern: the MHCA's ban on unmodified ECT, ECT in minors, and ECT in the acute phase. Two broad additional themes also emerged: resource limitations and the impact of nonmedical models of mental health. We identified a need for greater education about the MHCA among all stakeholders. CONCLUSION: Core concerns about ECT in India's new legislation relate, in part, to medical decisions apparently being taken out of the hands of psychiatrists and change being driven by theoretical perspectives that do not reflect "ground realities." Although the MHCA offers significant opportunities, failure to resource its ambitious changes will greatly limit the use of ECT in India.

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OBJECTIVE: The benefits of internal whistleblowing or speaking-up in the healthcare sector are significant. The a priori assumption that employee whistleblowing is always beneficial is, however, rarely examined. While recent research has begun to consider how the complex nature of healthcare institutions impact speaking-up rates, few have investigated the institutional processes and factors that facilitate or retard the benefits of speaking up. Here we consider how the efficacy of formal inquiries within organisations in response to employees' speaking up about their concerns affects the utility of internal whistleblowing. DESIGN: Using computational models, we consider how best to improve patient care through internal whistleblowing when resource and practical limitations constrain healthcare operation. We analyse the ramifications of varying organisational responses to employee concerns, given organisational and practical limitations. SETTING: Drawing on evidence from international research, we test the utility of whistleblowing policies in a variety of organisational settings. This includes institutions where whistleblowing inquiries are handled with varying rates of efficiency and accuracy. RESULTS: We find organisational inefficiencies can negatively impact the benefits of speaking up about bad patient care. We find that, given resource limitations and review inefficiencies, it can actually improve patient care if whistleblowing rates are limited. However, we demonstrate that including softer mechanisms for internal adjustment of healthcare practice (eg, peer to peer conversation) alongside whistleblowing policy can overcome these organisational limitations. CONCLUSION: Healthcare organisations internationally have a variable record of responding to employees who speak up about their workplace concerns. Where organisations get this wrong, the consequences can be serious for patient care and staff well-being. The results of this study, therefore, have implications for researchers, policy makers and healthcare organisations internationally. We conclude with a call for further research on a more holistic understanding of the interplay between organisational structure and the benefits of whistleblowing to patient care.

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Blokpoel reminds us of the importance of consistency of function across Marr's levels, but we argue that the approach to ensuring consistency that he advocates-a strict relation through exact implementation of the higher level function at the lower level-is unnecessarily restrictive. We show that it forces overcomplication of the computational level (by requiring it to incorporate concerns from lower levels) and results in the sacrifice of the distinct responsibilities associated with each level. We propose an alternative, no less rigorous, potential characterization of the relation between levels.

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We examined physical condition, niche dimensions, and survival of New England cottontails (Sylvilagus transitionalis) that occupied 21 habitat patches of different sizes during winter. Rabbits on small patches (≤2.5 ha) were predominantly males, and both sexes had lower body mass than individuals on large patches (≥5.0 ha). Niche indices (ß, where ß ranges from 0 to 1. and values approaching 1 indicate generalized resource use) of habitat use revealed that rabbits on small patches used a greater variety of microhabitats (based on understory stem density: ßs, and proximity to cover: ßc) than rabbits occupying large patches (ßs=0.65, ßc=0.66). Rabbits on small patches also consumed low quality forage more often and fed at sites farther from escape cover than rabbits on large patches. There were no significant correlations between rabbit densities and niche dimensions. Niche expansion was not a result of compertitive release or relaxation of predator pressure. Rabbits on small patches apparently modified their niche dimensions in response to resource limitations. This response included occupying sites with limited understory cover that apparently resulted in rabbits on small patches having a lower survival rate (0.35) than rabbits on large patches (0.69) during a 10-week monitoring period. Skewed sex ratios and low survival rates among rabbits on small patches suggest that these habitats act as sinks to dispersing, juveniles from large (source) patches. As a result, local populations of New England cottontails may become vulnerable to extinction if larte patches of habitat are not maintained.