Deep Sclerectomy with Goniosynechiolysis Ab Interno for Chronic Glaucoma Associated with Peripheral Anterior Synechiae

Purpose. To report one-year results of phacoemulsification combined with deep sclerectomy and goniosynechiolysis ab interno for chronic glaucoma associated with peripheral anterior synechiae (PAS).Methods. We retrospectively analyzed medical charts of 16 patients (20 eyes) treated by one-site combined phacoemulsification and deep sclerectomy with goniosynechiolysis ab interno. PAS were transected by a spatula introduced into the anterior chamber through a paracentesis. To account for the correlation of right and left eyes a linear mixed model with unstructured covariance structure was calculated.Results. The mean preoperative intraocular pressure (IOP) was20.3±5.2 mmHg with2.4±1.0medications. One year postoperatively, the mean IOP was15.3±3.3 mmHg (P=0.004, pairedt-test) with0.6±1.0medications. A postoperative IOP of ≤21 mmHg without medication was achieved in 17 of 19 eyes (89.5%) and in 12/19 eyes (63.2%) at 3 and 12 months after surgery, respectively. In the remaining eyes (10.5% at 3 months and 36.8% at 12 months), additional medication led to an IOP ≤21 mmHg or the target pressure. No case required further glaucoma surgery. In one eye, conversion of the surgery to trabeculectomy was necessary due to Descemet’s window rupture.Conclusions. With goniosynechiolysis ab interno, effective and safe nonpenetrating glaucoma surgery is possible in presence of PAS.

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Comparison of Efficacy between 120° and 180° Schlemm’s Canal Incision Microhook Ab Interno Trabeculotomy

Journal of Clinical Medicine ◽

10.3390/jcm10143181 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3181

Author(s):

Naoki Okada ◽

Kazuyuki Hirooka ◽

Hiromitsu Onoe ◽

Yumiko Murakami ◽

Hideaki Okumichi ◽

...

Keyword(s):

Surgical Outcomes ◽

Open Angle Glaucoma ◽

Case Series ◽

Glaucoma Surgery ◽

Success Rates ◽

Schlemm’S Canal ◽

Schlemm's Canal ◽

Kaplan Meier ◽

The Mean ◽

Ab Interno

We compared surgical outcomes in patients with either primary open-angle glaucoma or exfoliation glaucoma after undergoing combined phacoemulsification with either a 120° or 180° incision during a Schlemm’s canal microhook ab interno trabeculotomy (μLOT-Phaco). This retrospective comparative case series examined 52 μLOT-Phaco eyes that underwent surgery between September 2017 and December 2020. Surgical qualified success was defined as an intraocular pressure (IOP) of ≤20 mmHg, ≥20% IOP reduction with IOP-lowering medications, and no additional glaucoma surgery. Success rates were evaluated by Kaplan-Meier survival analysis. The number of postoperative IOP-lowering medications and occurrence of complications were also assessed. Mean preoperative IOP in the 120° group was 16.9 ± 7.6 mmHg, which significantly decreased to 10.9 ± 2.7 mmHg (p < 0.01) and 11.1 ± 3.1 mmHg (p = 0.01) at 12 and 24 months, respectively. The mean number of preoperative IOP-lowering medications significantly decreased from 2.8 ± 1.4 to 1.4 ± 1.4 (p < 0.01) at 24 months. Mean preoperative IOP in the 180° group was 17.1 ± 7.0 mmHg, which significantly decreased to 12.1 ± 3.2 mmHg (p = 0.02) and 12.9 ± 1.4 mmHg (p = 0.01) at 12 and 24 months, respectively. The mean number of preoperative IOP-lowering medications significantly decreased from 2.9 ± 1.2 to 1.4 ± 1.5 (p < 0.01) at 24 months. The probability of qualified success at 24 months in the 120° and 180° groups was 50.4% and 54.6%, respectively (p = 0.58). There was no difference observed for hyphema formation or IOP spikes. Surgical outcomes were not significantly different between the 120° and 180° incisions in Schlemm’s canal.

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One-year outcomes of microhook trabeculotomy versus suture trabeculotomy ab interno

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05333-7 ◽

2021 ◽

Author(s):

Hiroshi Yokoyama ◽

Masashi Takata ◽

Fumi Gomi

Keyword(s):

Survival Analysis ◽

Clinical Success ◽

Treatment Success ◽

Medication Use ◽

Glaucoma Surgery ◽

Success Rates ◽

Kaplan Meier ◽

One Year ◽

Ab Interno

Abstract Purpose To compare clinical success rates and reductions in intraocular pressure (IOP) and IOP-lowering medication use following suture trabeculotomy ab interno (S group) or microhook trabeculotomy (μ group). Methods This retrospective review collected data from S (n = 104, 122 eyes) and μ (n = 42, 47 eyes) groups who underwent treatment between June 1, 2016, and October 31, 2019, and had 12-month follow-up data including IOP, glaucoma medications, complications, and additional IOP-lowering procedures. The Kaplan–Meier survival analysis was used to evaluate treatment success rates defined as normal IOP (> 5 to ≤ 18 mm Hg), ≥ 20% reduction of IOP from baseline at two consecutive visits, and no further glaucoma surgery. Results Schlemm’s canal opening was longer in the S group than in the μ group (P < 0.0001). The Kaplan–Meier survival analysis of all eyes showed cumulative clinical success rates in S and µ groups were 71.1% and 61.7% (P = 0.230). The Kaplan–Meier survival analysis of eyes with preoperative IOP ≥ 21 mmHg showed cumulative clinical success rates in S and μ groups were 80.4% and 60.0% (P = 0.0192). There were no significant differences in postoperative IOP at 1, 3, and 6 months (S group, 14.9 ± 5.6, 14.6 ± 4.5, 14.6 ± 3.9 mmHg; μ group, 15.8 ± 5.9, 15.2 ± 4.4, 14.7 ± 3.7 mmHg; P = 0.364, 0.443, 0.823), but postoperative IOP was significantly lower in the S group at 12 months (S group, 14.1 ± 3.1 mmHg; μ group, 15.6 ± 4.1 mmHg; P = 0.0361). There were no significant differences in postoperative numbers of glaucoma medications at 1, 3, 6, and 12 months (S group, 1.8 ± 1.6, 1.8 ± 1.5, 2.0 ± 1.6, 1.8 ± 1.5; μ group, 2.0 ± 1.6, 2.0 ± 1.6, 2.1 ± 1.6, 2.2 ± 1.7; P = 0.699, 0.420, 0.737, 0.198). Conclusion S and µ group eyes achieved IOP reduction, but μ group eyes had lower clinical success rates among patients with high preoperative IOP at 12 months.

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Improved cephalic index following early cranial vault remodeling in patients with isolated nonsyndromic sagittal synostosis

Neurosurgical FOCUS ◽

10.3171/2021.1.focus201017 ◽

2021 ◽

Vol 50 (4) ◽

pp. E7

Author(s):

Arvid Frostell ◽

Maryam Haghighi ◽

Jiri Bartek ◽

Ulrika Sandvik ◽

Bengt Gustavsson ◽

...

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Cranial Vault ◽

Hospital Length Of Stay ◽

Cephalic Index ◽

Sagittal Synostosis ◽

The Mean ◽

Cranial Vault Remodeling

OBJECTIVE Isolated nonsyndromic sagittal synostosis (SS) is the most common form of craniosynostosis in children, accounting for approximately 60% of all craniosynostoses. The typical cranial measurement used to define and follow SS is the cephalic index (CI). Several surgical techniques have been suggested, but agreement on type and timing of surgery is lacking. This study aimed to evaluate the authors’ institutional experience of surgically treating SS using a modified subtotal cranial vault remodeling technique in a population-based cohort. Special attention was directed toward the effect of patient age at time of surgery on long-term CI outcome. METHODS A retrospective analysis was conducted on all patients with isolated nonsyndromic SS who were surgically treated from 2003 to 2011. Data from electronic medical records were gathered. Eighty-two patients with SS were identified, 77 fulfilled inclusion criteria, and 72 had sufficient follow-up data and were included. CI during follow-up after surgery was investigated with ANOVA and a linear mixed model. RESULTS In total, 72 patients were analyzed, consisting of 16 females (22%) and 56 males (78%). The mean ± SD age at surgery was 4.1 ± 3.1 months. Blood transfusions were received by 81% of patients (26% intraoperatively, 64% postoperatively, 9% both). The mean ± SD time in the pediatric ICU was 1.1 ± 0.25 days, and the mean ± SD total hospital length of stay was 4.6 ± 2.0 days. No patient required reoperation. The mean ± SD CI increased from 69 ± 3 to 87 ± 5 for patients who underwent surgery before 45 days of age. Surgery resulted in a larger increase in CI for patients who underwent surgery at a younger age compared with older patients (p < 0.05, Tukey’s HSD test). In the comparison of patients who underwent surgery before 45 days of age with patients who underwent surgery at 45–90, 90–180, and more than 180 days of age, the linear mixed model estimated a long-term loss of CI of 3.0, 5.5, and 7.4 points, respectively. CONCLUSIONS The modified subtotal cranial vault remodeling technique used in this study significantly improved CI in patients with SS. The best results were achieved when surgery was performed early in life.

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The association of socio-demographic and environmental factors on childhood diarrhea in Cambodia

F1000Research ◽

10.12688/f1000research.23246.2 ◽

2020 ◽

Vol 9 ◽

pp. 303

Author(s):

Vong Pisey ◽

Pannee Banchonhattakit

Keyword(s):

Maternal Age ◽

Mixed Model ◽

Linear Mixed Model ◽

Secondary Data ◽

Cross Sectional Study ◽

Health Concern ◽

Childhood Diarrhea ◽

Public Health Concern ◽

Cross Sectional ◽

One Year

Background: Diarrhea is still the leading cause of childhood death worldwide, as well as a major cause for concern in developing countries. This study was conducted to investigate the factors related to childhood diarrhea in Cambodia. Methods: A cross-sectional study of the secondary data from the Cambodia Demographic and Health Survey 2014 was conducted using the combination of household data and children’s data. A generalized linear mixed model was used to analyze the determinant factors of childhood diarrhea. Results: The surveys included 2,828 children, aged 12 to 35 months. The prevalence of diarrhea in the last 2 weeks was 16.44% (95% CI: 14.72%-18.31%). Factors with statistically significant associations with childhood diarrhea in Cambodia were: maternal unemployment, compared with being in employment (AOR = 1.43; 95% CI: 1.14-1.78); the child being male (AOR = 1.25; 95%CI: 1.02-1.53); the presence of unimproved toilet facilities (AOR = 1.17; 95%CI: 1.05-1.31) compared with improved toilet facilities; and unhygienic disposal of children’s stools (AOR = 1.32; 95%CI: 1.06-1.64) compared with hygienic disposal of children’s stools when controlling for other covariates. Both maternal age (one year older; AOR = 0.85; 95%CI: 0.78– 0.93) and child age (one month older; AOR = 0.86; 95%CI: 0.78-0.94) had significant negative associations with the occurrence of childhood diarrhea. Conclusion: Childhood diarrhea remains a public health concern in Cambodia. The probability of diarrhea occurring is shown to be increased by maternal unemployment, the sex of the child being male, lack of provision of improved toilet facilities, and the unhygienic disposal of children’s stools; whereas increasing maternal age and child’s age were associated with a reduced chance of diarrhea occurring. On the basis of these results, we recommend provision of programs focusing on reducing diarrhea through the construction of improved toilet facilities and the promotion of behavior to improve hygiene, specifically targeting younger mothers.

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Impact of Physician Navigators on productivity indicators in the ED

Emergency Medicine Journal ◽

10.1136/emermed-2017-206809 ◽

2017 ◽

Vol 35 (1) ◽

pp. 5-11 ◽

Cited By ~ 5

Author(s):

Alexander K Leung ◽

Gaurav Puri ◽

Bingshu E Chen ◽

Zhenxian Gong ◽

Eddie Chan ◽

...

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Patient Volume ◽

Autoregressive Modelling ◽

Volume Increase ◽

Left Without Being Seen ◽

Before And After ◽

Physician Time ◽

The Mean ◽

Productivity Indicators

ObjectivesWe created Physician Navigators in our ED to help improve emergency physician (EP) productivity. We aimed to quantify the effect of Physician Navigators on measures of EP productivity: patient seen per hour (Pt/hr), and turn-around time (TAT) to discharge. Secondary objectives included examining their impact on measures of ED throughput for non-resuscitative patients: ED length of stay (LOS), door-to-physician time and left-without-being-seen rates (LWBS).MethodsIn this retrospective study, 6845 clinical shifts worked by 20 EPs at a community ED in Newmarket, Canada from 1 January 2012 to 31 March 2015 were evaluated. Using a clustered design, we compared productivity measures between shifts with and without Physician Navigators, by physician. We used a linear mixed model to examine mean changes in Pt/hr and TAT to discharge for EPs who employed Physician Navigators. For secondary objectives, autoregressive modelling was performed to compare ED throughput metrics before and after the implementation of Physician Navigators for non-resuscitative patients.ResultsPatient volumes increased by 20 patients per day (p<0.001). Mean Pt/hr increased by 1.07 patients per hour (0.98 to 1.16, p<0.001). The mean TAT to discharge decreased by 10.6 min (−13.2 to −8.0, p<0.001). After implementation of the Physician Navigator programme, overall mean LOS for non-resuscitative patients decreased by 2.6 min (p=0.007), and mean door-to-physician time decreased by 7.4 min (p<0.001). LBWS rates decreased from 1.13% to 0.63% of daily patient volume (p<0.001).ConclusionDespite an ED volume increase, the use of a Physician Navigator was associated with significant improvements in EP productivity, and significant reductions in ED throughput times.

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Diurnal Rhythm rather than Dietary Iron Mediates Daily Hepcidin Variations

Clinical Chemistry ◽

10.1373/clinchem.2012.194977 ◽

2013 ◽

Vol 59 (3) ◽

pp. 527-535 ◽

Cited By ~ 40

Author(s):

Charlotte CM Schaap ◽

Jan CM Hendriks ◽

Guus AM Kortman ◽

Siem M Klaver ◽

Joyce JC Kroot ◽

...

Keyword(s):

Diurnal Rhythm ◽

Mixed Model ◽

Linear Mixed Model ◽

Transferrin Saturation ◽

Dietary Iron ◽

Deficient Diet ◽

Iron Deficient ◽

Sampling Protocols ◽

Baseline Values ◽

The Mean

BACKGROUND The iron-regulating hormone hepcidin is a promising biomarker in the diagnosis of iron disorders. Concentrations of hepcidin have been shown to increase during the day in individuals who are following a regular diet. It is currently unknown whether these increases are determined by an innate rhythm or by other factors. We aimed to assess the effect of dietary iron on hepcidin concentrations during the day. METHODS Within a 7-day interval, 32 volunteers received an iron-deficient diet on 1 day and the same diet supplemented with 65 mg ferrous fumarate at 0815 and 1145 on another day. Blood was drawn to assess ferritin, hepcidin-25, and transferrin saturation (TS) throughout both days at 4 time points between 0800 (fasted) and 1600. A linear mixed model for repeated data was used to analyze the effect of iron intake on TS and hepcidin concentrations. RESULTS Baseline values of hepcidin at 0800 correlated significantly with ferritin (r = 0.61). During the day of an iron-deficient diet the mean TS was similar both in men and in women, whereas hepcidin increased. During the day with iron supplementation the mean TS was significantly higher both in men and in women, and the mean hepcidin was moderately but significantly higher in women (1.0 nmol/L, 95% CI, 0.2–1.8) but not in men (0.0 nmol/L, 95% CI, −0.8 to 0.8). CONCLUSIONS Our data demonstrate that ferritin sets the basal hepcidin concentrations and suggest that innate diurnal rhythm rather than dietary iron mediates the daily hepcidin variations. These findings will be useful for optimizing sampling protocols and will facilitate the interpretation of hepcidin as an iron biomarker.

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Substance Use Among Patients Receiving Out- and Inpatient Dependence Care: a Prospective Norwegian Cohort Study From 2016 to 2020

10.21203/rs.3.rs-566225/v1 ◽

2021 ◽

Author(s):

Jørn Henrik Vold ◽

Fatemeh Chalabianloo ◽

Christer F. Aas ◽

Else-Marie Løberg ◽

Kjell Arne Johansson ◽

...

Keyword(s):

Substance Use ◽

Mixed Model ◽

Linear Mixed Model ◽

Severity Index ◽

Future Research ◽

Opioid Agonist ◽

Low Threshold ◽

The Mean ◽

The Impact ◽

Over Time

Abstract BackgroundContinuous use of amphetamines, alcohol, benzodiazepines, cannabis, cocaine, or opioids contributes to health impairments, increased morbidity, and overdose deaths among patients with substance use disorders (SUDs). This study evaluates the impact of inpatient detoxification, specialized opioid agonist therapy (OAT), and low-threshold municipality care on substance use over time. MethodsWe used data from a cohort of SUD patients in Norway through health assessments of self-reported substance use and sociodemographic and clinical factors. A total of 881 substance use measurements, including type and amount of substances, were assessed from 708 SUD patients in 2016-2020. Substance use for individual and total substances was calculated, creating a substance use severity index (SUSI) ranging from zero (no use) to one (daily use). We defined baseline as the first substance use measurement when the measurements were listed chronologically. Time was defined as years from baseline. We used a linear mixed model to analyze associations between the SUSI and inpatient detoxification, specialized OAT compared with low-threshold municipality care, as well as the factors like injecting substance use, gender, and age, presented with coefficients and 95% confidence intervals (CI).ResultsNeither inpatient detoxification (mean SUSI change: 0.01, -0.03;0.04) nor specialized OAT (0.03, -0.09;0.14) compared with low-threshold municipality care were associated with changes in substance use over time. Patients who were over 60 years of age (mean SUSI difference: -0.06, -0.13;0.00) had a lower SUSI than those under 30 years of age, while patients who injected substances had a higher SUSI than those who did not inject substances (0.18, 0.15;0.20) at baseline. The mean SUSI for the individual substances were 0.50 (standard deviation (SD): 0.38) for cannabis, 0.40 (0.37) for benzodiazepines, 0.33 (0.34) for amphetamines and cocaine, 0.31 (0.29) for alcohol, and 0.22 (0.31) for opioids at baseline. The mean SUSI of all substances was 0.35 (0.20). Conclusion The present study demonstrates that neither inpatient detoxification nor specialized OAT compared to low-threshold municipality care were associated with changes in substance use over time. Future research needs to evaluate the impact on substance use and healthy survival of multiple health care interventions to this patient group.

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PSVIII-10 Effects of enzyme supplementation in corn distiller’s dried grains with solubles (DDGS) diets on growth performance in broilers: a meta-analysis

Journal of Animal Science ◽

10.1093/jas/skaa054.365 ◽

2020 ◽

Vol 98 (Supplement_3) ◽

pp. 211-211

Author(s):

Jae-Cheol Jang ◽

Zhikai Zeng ◽

Pedro E Urriola ◽

Gerald C Shurson

Keyword(s):

Growth Performance ◽

Fixed Effects ◽

Mixed Model ◽

Linear Mixed Model ◽

Meta Analysis ◽

Growth Responses ◽

Exogenous Enzymes ◽

The Mean ◽

Enzyme Supplementation ◽

Mean Differences

Abstract The objective of this study was to conduct a meta-analysis to quantitatively summarize the growth responses of broilers fed cDDGS and the efficacy of various types of dietary enzyme supplementation. A total of 12 publications with 69 observations were included in the database. Individual observations were analyzed using a multivariable linear mixed model. The mean differences (MD) of BWG, FI, and gain efficiency (G/F) were calculated by subtracting either the enzyme response in corn-soybean meal (CSB) or CSB+cDDGS based diets to the control, and was expressed as a percentage (MD = (enzyme – control)/control ×100%). A type of exogenous enzymes (xylanase; protease; carbohydrases; cocktail = proteases + carbohydrases), and feeding phase (starter = d 0 to d 21; finisher = d 21 to d 42 or 49; overall = d 0 to d 42 or more) were included as fixed effects. Dietary enzyme inclusion showed significant improvement on BWG (3.19%, P < 0.01) and G/F (5.69%, P < 0.01) in broilers fed cDDGS diet. However, no significant enzyme responses were observed in broilers fed CSB diet on growth performance. Broilers fed cDDGS diet had increased (P < 0.01) BWG with the addition of protease (3.32 %) and cocktail (3.27 %), whereas addition of xylanased improved (P < 0.01) G/F by (3.56 %) and carbohydrases (1.90 %). Broilers fed cDDGS diet with enzyme supplementation showed greater improvement in BWG (3.71 %, P < 0.01) and G/F (3.78 %, P < 0.01) at finisher phase compared with starter phase. Likewise, Broilers fed CSB diet with enzyme supplementation increased BWG (9.40 %, P < 0.01) and G/F (3.11 %, P < 0.01) at finisher phase. In conclusion, supplementation of xylanase and carbohydrases in cDDGS diet improved G/F, and the enzyme response can be maximized when fed during the finisher phase diet compared with the starter phase diet.

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Tensor P-Spline Smoothing for Spatial Analysis of Plant Breeding Trials

10.1101/2021.05.10.443463 ◽

2021 ◽

Author(s):

Hans-Peter Piepho ◽

Martin Boer ◽

Emlyn R. Williams

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Null Space ◽

Spatial Interaction ◽

Natural Extension ◽

Covariance Structure ◽

Spatial Modelling ◽

Field Trials ◽

Agricultural Field ◽

Randomized Field Trials

Large agricultural field trials may display irregular spatial trends that cannot be fully captured by a purely randomization-based analysis. For this reason, paralleling the development of analysis-of-variance procedures for randomized field trials, there is a long history of spatial modelling for field trials, starting with the early work of Papadakis on nearest neighbour analysis, which can be cast in terms of first or second differences among neighbouring plot values. This kind of spatial modelling is amenable to a natural extension using P-splines, as has been demonstrated in recent publications in the field. Here, we consider the P-spline framework, focussing on model options that are easy to implement in linear mixed model packages. Two examples serve to illustrate and evaluate the methods. A key conclusion is that first differences are rather competitive with second differences. A further key observation is that second differences require special attention regarding the representation of the null space of the smooth terms for spatial interaction, and that an unstructured variance-covariance structure is required to ensure invariance to translation and rotation of eigenvectors associated with that null space. We develop a strategy that permits fitting this model with ease, but the approach is more demanding than that needed for fitting models using first differences. Hence, even though in other areas second differences are very commonly used in the application of P-splines, our main conclusion is that with field trials first differences have advantages for routine use.

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Bayesian Linear Mixed Models for Motif Activity Analysis

10.1101/782615 ◽

2019 ◽

Author(s):

Simone Lederer ◽

Tom Heskes ◽

Simon J. van Heeringen ◽

Cornelis A. Albers

Keyword(s):

Gene Expression ◽

Dna Sequences ◽

Ridge Regression ◽

Mixed Model ◽

Target Genes ◽

Linear Mixed Model ◽

Covariance Structure ◽

Regulatory Elements ◽

Mathematical Explanation ◽

Experimental Conditions

AbstractMotivationCellular identity and behavior is controlled by complex gene regulatory networks. Transcription factors (TFs) bind to specific DNA sequences to regulate the transcription of their target genes. On the basis of these TF motifs in cis-regulatory elements we can model the influence of TFs on gene expression. In such models of TF motif activity the data is usually modeled assuming a linear relationship between the motif activity and the gene expression level. A commonly used method to model motif influence is based on Ridge Regression. One important assumption of linear regression is the independence between samples. However, if samples are generated from the same cell line, tissue, or other biological source, this assumption may be invalid. This same assumption of independence is also applied to different, yet similar, experimental conditions, which may also be inappropriate. In theory, the independence assumption between samples could lead to loss in signal detection. Here we investigate whether a Bayesian model that allows for correlations results in more accurate inference of motif activities.ResultsWe extend the Ridge Regression to a Bayesian Linear Mixed Model, which allows us to model dependence between different samples. In a simulation study, we in-vestigate the differences between the two model assumptions. We show that our Bayesian Linear Mixed Model implementation outperforms Ridge Regression in a simulation scenario where the noise, the signal that can not be explained by TF motifs, is uncorrelated. However, we demonstrate that there is no such gain in performance if the noise has a similar covariance structure over samples as the signal that can be explained by motifs. We give a mathematical explanation to why this is the case. Using two representative real data sets we show that at most ∼ 40% of the signal is explained by motifs using the linear model. With these data there is no advantage to using the Bayesian Linear Mixed Model, due to the similarity of the covariance structure.Availability & ImplementationThe project implementation is available at https://github.com/Sim19/SimGEXPwMotifs.

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